Persisting positron emission tomography lesion activity and Mycobacterium tuberculosis mRNA after tuberculosis cure

Malherbe, Stephanus T., Shenai, Shubhada, Ronacher, Katharina, Loxton, Andre G., Dolganov, Gregory, Kriel, Magdalena, Van, Tran, Chen, Ray Y., Warwick, James, Via, Laura E., Song, Taeksun, Lee, Myungsun, Schoolnik, Gary, Tromp, Gerard, Alland, David, Barry, Clifton E, Winter, Jill, Walzl, Gerhard, Catalysis TB–Biomarker Consortium, Lucas, L., Spuy, G.V.D., Stanley, K., Theart, L., Smith, B., Burger, N., Beltran, C.G.G., Maasdorp, E., Ellmann, A., Choi, H., Joh, J., Dodd, L.E., Allwood, B., Kogelenberg, C., Vorster, M. and Griffith-Richards, S. (2016) Persisting positron emission tomography lesion activity and Mycobacterium tuberculosis mRNA after tuberculosis cure. Nature Medicine, 22 10: 1094-1100. doi:10.1038/nm.4177


Author Malherbe, Stephanus T.
Shenai, Shubhada
Ronacher, Katharina
Loxton, Andre G.
Dolganov, Gregory
Kriel, Magdalena
Van, Tran
Chen, Ray Y.
Warwick, James
Via, Laura E.
Song, Taeksun
Lee, Myungsun
Schoolnik, Gary
Tromp, Gerard
Alland, David
Barry, Clifton E
Winter, Jill
Walzl, Gerhard
Catalysis TB–Biomarker Consortium
Lucas, L.
Spuy, G.V.D.
Stanley, K.
Theart, L.
Smith, B.
Burger, N.
Beltran, C.G.G.
Maasdorp, E.
Ellmann, A.
Choi, H.
Joh, J.
Dodd, L.E.
Allwood, B.
Kogelenberg, C.
Vorster, M.
Griffith-Richards, S.
Title Persisting positron emission tomography lesion activity and Mycobacterium tuberculosis mRNA after tuberculosis cure
Journal name Nature Medicine   Check publisher's open access policy
ISSN 1546-170X
1078-8956
Publication date 2016-10-01
Year available 2016
Sub-type Article (original research)
DOI 10.1038/nm.4177
Open Access Status Not Open Access
Volume 22
Issue 10
Start page 1094
End page 1100
Total pages 7
Place of publication New York, NY, United States
Publisher Nature Publishing Group
Language eng
Formatted abstract
The absence of a gold standard to determine when antibiotics induce a sterilizing cure has confounded the development of new approaches to treat pulmonary tuberculosis (PTB). We detected positron emission tomography and computerized tomography (PET-CT) imaging response patterns consistent with active disease, along with the presence of Mycobacterium tuberculosis (MTB) mRNA in sputum and bronchoalveolar lavage samples, in a substantial proportion of adult, HIV-negative patients with PTB after a standard 6-month treatment plus 1 year follow-up, including patients with a durable cure and others who later developed recurrent disease. The presence of MTB mRNA in the context of nonresolving and intensifying lesions on PET-CT images might indicate ongoing transcription, suggesting that even apparently curative treatment for PTB may not eradicate all of the MTB bacteria in most patients. This suggests an important complementary role for the immune response in maintaining a disease-free state. Sterilizing drugs or host-directed therapies, and better treatment response markers, are probably needed for the successful development of improved and shortened PTB-treatment strategies.
Keyword Biochemistry & Molecular Biology
Cell Biology
Medicine, Research & Experimental
Biochemistry & Molecular Biology
Cell Biology
Research & Experimental Medicine
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
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