Tuberculosis - World TB Day 2011


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Centenary Institute TB researcher Dr Bernadette Saunders talks about tuberculosis and her team's research into genetic susceptibility

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Tuberculosis - World TB Day 2011

  1. 1. Unraveling the Mysteries of Tuberculosis Bernadette Saunders Host Response to Tuberculosis Mycobacterial Research
  2. 2. TB- Consumption <ul><li>Many famous artists died of TB </li></ul><ul><ul><li>DH Lawrence, </li></ul></ul><ul><ul><li>Robert Louis Stevenson, George Orwell, </li></ul></ul><ul><ul><li>Emily & Charlotte Bronte, Chopin, Gauguin, Chekov, Keats, </li></ul></ul><ul><ul><li>Florence Nightingale, </li></ul></ul><ul><ul><li>Numerous Kings of France/England </li></ul></ul>
  3. 3. TB an ancient disease <ul><li>Studies have identified TB in mummies from Peru and Egypt 3000-5000yrs old. </li></ul>Dr Granvilles mummy on display at the British Museum in London Died 2600 yrs ago from TB
  4. 4. TB The Global Disease <ul><li>World Health Organisation estimates that 1/3 of the world (over 2 billion people) are infected with TB </li></ul><ul><li>9-10 million new cases of clinical TB every year </li></ul><ul><li>1.8 million deaths annually </li></ul><ul><li>TB is the number one killer of HIV/AIDS patients </li></ul>
  5. 5. TB – The Global Challenges <ul><li>We NEED A BETTER VACCINE- </li></ul><ul><ul><li>The current vaccine, known as BCG fails to provide life-long immunity in developing countries </li></ul></ul><ul><li>We NEED NEW ANTIBIOTICS to treat and cure TB , </li></ul><ul><ul><li>treatment requires 6-12 months of continuous, multiple (usually 4) antibiotic treatment </li></ul></ul><ul><ul><li>Multi-drug resistant strains of TB are increasing </li></ul></ul><ul><ul><li>Much harder to treat and may require long periods of quarantine </li></ul></ul><ul><ul><li>450,000 MDR cases of TB in 2009. </li></ul></ul>
  6. 6. TB Disease <ul><li>90% of people infected with TB bacteria, never develop TB disease (never get sick) </li></ul><ul><li>But 10% of 2 billion is a lot of people at risk </li></ul><ul><li>WE NEED A WAY TO DETERMINE WHO IS MOST AT RISK of getting sick- </li></ul>
  7. 7. TB – The BIG Questions <ul><li>Why do 10% people develop TB disease? </li></ul><ul><li>How do we predict those people who are most at risk of developing TB disease? </li></ul>
  8. 8. TB- The Risk Factors Host Genetic Mycobacterium Virulence Dose Other mycobacterial exposure Environment Poverty, crowding, social disorder Nutrition Infections – HIV
  9. 9. P2X7 Receptor and Control of TB P2X7 Receptor Highly expressed on White blood Cells that eat TB (macophages) Activation of this receptor is one mechanism of killing TB. Identified a single amino acid change in this receptor A1513  C Reduced killing of TB
  10. 10. Study to determine if the SNP in P2X7 increases susceptibility to TB Refugees from Southwest Sydney screened for LTBI upon arrival 24652 Latent TB 8609 Subjects with TB in NSW 119 13.6 year median follow up Enrolled in Liverpool genotyping study >200 active disease free subjects
  11. 11. 1513 C allele is associated with increased risk of developing TB AA (Normal) AC/CC (mutant) % with C Odds Ratio p Control 105 62 37 - - Extrapulmonary TB 9 21 70 4.0 .001
  12. 12. Vietnam-Australia TB Partnership Collect DNA from1500 TB patients and 1500 controls to screen for SNPs that may be associated with increased risk of developing TB. National Lung Hospital Hanoi
  13. 13. Tuberculosis Research Program <ul><li>National Lung Hospital </li></ul><ul><li>Hanoi Vietnam </li></ul><ul><li>A/Professor Dinh Ngoc Sy </li></ul><ul><li>Dr Nguyen Viet Nhung </li></ul><ul><li>Nguyen Van Hung </li></ul><ul><li>Phan Minh Tuan, </li></ul><ul><li>Nguyen Kim Cuong </li></ul><ul><li>Dr Phuong </li></ul><ul><li>Dr Ngoc </li></ul><ul><li>Purinergic Research Group, </li></ul><ul><li>Nepean Hospital </li></ul><ul><li>Jim Wiley </li></ul><ul><li>Ronald Sluyter </li></ul><ul><li>Kristen Skarratt </li></ul><ul><li>Woolcock Institute </li></ul><ul><li>Guy Marks </li></ul><ul><li>Kitty Ng </li></ul>Group Photo
  14. 14. You Can Help!