Abstract:
Introduction
We urgently need novel treatments for multidrug-resistant tuberculosis (MDR-TB). Autologous mesenchymal stromal cell (MSC) infusion is one such possibility due to its potential to repair damaged lung tissue and boost immune responses. We aimed to assess the effectiveness of MSC to improve outcomes among MDR-TB patients.
Keywords
Mesenchymal stromal cells; Extensively drug resistant; Outcomes; Treatment
Methods
We analyzed outcomes for 108 Belarussian MDR-TB patients receiving chemotherapy. Thirty-six patients (“cases”) also had MSCs extracted, cultured and re-infused (average time from chemotherapy start to infusion was 49 days); another 36 patients were “study controls”. We identified another control group: 36 patients from the Belarussian surveillance database (“surveillance controls”) 1:1 matched to cases.
Results
Of the cases, 81% had successful outcomes versus 42% of surveillance controls and 39% of study controls. Successful outcome odds were 6.5 (95% Confidence Interval: 1.2–36.2, p = 0.032) times greater for cases than surveillance controls (age-adjusted). Radiological improvement was more likely in cases than study controls. Culture analysis prior to infusion demonstrated a poorer initial prognosis in cases, yet despite this they had better outcomes than the control groups.
Citation: Aliaksandr Skrahin, Helen E. Jenkins, Henadz Hurevich, Varvara Solodovnikova, Yanina Isaikina, Dzmitri Klimuk, Zoya Rohava, Alena Skrahina Effectiveness Of A Novel Cellular Therapy To Treat Multidrug-resistant Tuberculosis http://dx.doi.org/10.1016/j.jctube.2016.05.003
Received: 7 January 2016, Revised: 27 April 2016, Accepted: 3 May 2016, Available online: 14 May 2016
Copyright: © 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Conclusion
MSC treatment could vastly improve outcomes for MDR-TB patients. Our findings could revolutionize therapy options and have strong implications for future directions of MDR-TB therapy research.
Acknowledgments
This work was funded by the State Committee on Science and Technology of the Republic of Belarus (State Scientific and Technical Program “Infection Diseases and Microbiological Biotechnologies”, grant no. 03.14/09). This work was also supported by a National Institutes of Health award to HEJ (Award no. K01AI102944 from the National Institute of Allergy and Infectious Diseases). The funders had no role in study design or conduct; in collection, management, analysis, or interpretation of the data; or in preparation, review, approval, or submission of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Allergy and Infectious Diseases or the National Institutes of Health.
The authors would like to thank Carole Mitnick (Harvard Medical School), Marcello Pagano (Harvard School of Public Health) and Bill Hanage (Harvard School of Public Health) for useful discussions.
