Advancing tuberculosis management: the role of predictive, preventive, and personalized medicine

Abstract

Tuberculosis is a major global health issue, with approximately 10 million people falling ill and 1.4 million dying yearly. One of the most significant challenges to public health is the emergence of drug-resistant tuberculosis. For the last half-century, treating tuberculosis has adhered to a uniform management strategy in most patients. However, treatment ineffectiveness in some individuals with pulmonary tuberculosis presents a major challenge to the global tuberculosis control initiative. Unfavorable outcomes of tuberculosis treatment (including mortality, treatment failure, loss of follow-up, and unevaluated cases) may result in increased transmission of tuberculosis and the emergence of drug-resistant strains. Treatment failure may occur due to drug-resistant strains, non-adherence to medication, inadequate absorption of drugs, or low-quality healthcare. Identifying the underlying cause and adjusting the treatment accordingly to address treatment failure is important. This is where approaches such as artificial intelligence, genetic screening, and whole genome sequencing can play a critical role. In this review, we suggest a set of particular clinical applications of these approaches, which might have the potential to influence decisions regarding the clinical management of tuberculosis patients.

The Next Frontier in Tuberculosis Investigation: Automated Whole Genome Sequencing for Mycobacterium tuberculosis Analysis

“…The WHO has emphasized that accurate diagnosis and characterization of TB is the key strategy for successful treatment and eradication of complicated TB cases [3]. Rapid genotypic-based diagnostic tools, such as GeneXpert, have been widely adopted as they are faster and cheaper than traditional culture-based diagnostic susceptibility testing.…”

“…Failure to detect novel AMR genotypes and mutations within the MTB genome can lead to inaccurate prescription of patient treatment 2 regimes, posing a risk of treatment failure. [3]. Whole genome sequencing (WGS) is an agnostic approach to screen the entire pathogen genome for the detection of specific single nucleotide polymorphisms (SNPs) to discriminate known MTB complex (MTBC) (sub)lineages.…”

“…DNA was extracted by Clear Labs, Inc. using proprietary inhouse-developed extraction protocol 2. Genomic DNA obtained from the culture collections (ATCC or BEI Resources) 3. DNA was extracted by Nevada State Public Health Laboratory (NSPHL) using Promega Maxwell RSC Cultured Cell Kit 4.…”