Nine years on from the World Health Organisation’s #EndTB strategy the death rate has only marginally improved, however a number of developments over the last 12 months do give a glimpse of a hope.
At PBD Biotech we are working to develop Actiphage TB, a new diagnostic that aims to meet the WHO Target Product Profile. This blood-based biomarker identifies active mycobacterium tuberculosis and will be a game-changer in the fight against TB for a number of reasons.
New biomarkers with high accuracy will support two objectives of the WHO End TB strategy:
- Early diagnosis and treatment of TB disease to break the cycle of infection
- Disease prevention through screening for asymptomatic TB infection
As new insights have shown, a persistent cough is not a reliable indicator of disease status
A study led by Frank Cobelens, Professor of Global Health at Amsterdam UMC, has found that 80 percent of people with TB do not have a persistent cough – the entry point for diagnosis – and yet are still infective. The researchers says that this reservoir of asymptomatic disease could be the reason why the TB burden is not falling and that a “rethink is needed on how we identify people with TB.”
New research has shown that TB bacteria in the blood is a biomarker for TB disease
Dr Pranabashis Haldar, clinician and Principal Investigator of the Leicester NIHR Biomedical Research Centre, UK, says: “We have been able to demonstrate that Mtb is detectable in the blood of people with active or latent TB in the absence of immunodeficiency. Historically, culture-based methods only detected Mtb in the blood of those with very severe illness. The detection of live mycobacteria circulating in the blood provides an early indication of TB disease progression.”
This correlates to the inflammatory changes observed with PET-CT
Dr Haldar continues: “Using Actiphage, we found a significant association between Mtb DNA in the blood and progressive infection. This was consistent with the trajectory of inflammatory changes observed with PET-CT, visible before any abnormalities were detected at clinical screening.”
A test of cure that can distinguish live infection could accelerate development of new drugs
Phage – a natural enemy of the bacteria – could provide another tool in the armoury against anti-microbial resistance, according to Dr Ben Swift, lecturer in AMR at the Royal Veterinary College and pioneer in phage-based diagnostics.
In a supplement published in the International Journal of Infectious Disease to commemorate World Tuberculosis Day 2024, he writes:
“By targeting the pathogen, phage-based diagnostics could also be developed to detect major genetic mutations associated with drug resistance.”
Yes! We can End TB
Together these findings are reasons to be optimistic that Yes! We can End TB, according to Joely Irlam, Chief Technical Officer for PBD Biotech:
“Ending tuberculosis requires global solidarity and concerted action.
“The team at PBD are actively engaged in translating the renewed commitments made at high-level meetings into tangible actions.
“Among our initiatives is the development of Actiphage, a phage-based molecular test for the accurate detection of TB disease. This novel innovative approach promises rapid screening of vulnerable populations and facilitates a test of cure for shorter treatment protocols, accelerating our progress toward combatting tuberculosis and saving countless lives.
“Our goal is to support the #EndTb strategy, realising a world free from the burden of tuberculosis infection and deaths.”