Priority Research Area Infections
Clinical Infectious Diseases
Mission Projects Funding Techniques Publications Staff
Tuberculosis has an enormous global impact and ranges on the 7th position of all causes of deaths globally.
At the Research Center Borstel we have a special interest in tuberculosis and we belong to the leading biomedical research institutes in this field worldwide.
A diagnostic approach to a patient with possible tuberculosis includes a detailed medical history and clinical examination as well as radiological, microbiological, immunological, molecular-biological and histological investigations, where available. Recently, important advances have been achieved that have lead to substantial improvements in the accuracy and the timing of the diagnosis of tuberculosis. Novel methods allow for a better identification of latently infected individuals with Mycobacterium tuberculosis, the bacteria causing tuberculosis, which are at risk of developing active disease. They also offer the possibility for a rapid diagnosis of active tuberculosis in patients with negative sputum smears for acid-fast bacilli and enable prompt identification of drug-resistant strains of M. tuberculosis directly from respiratory specimen with a high accuracy. In addition, promising methods that will further optimize the diagnosis of tuberculosis are under development. In the future, therapeutic interventions based on the results of novel diagnostic procedures can be made earlier leading to improvements in patient care.
Currently, the standard short-course chemotherapy for tuberculosis comprises a six-month regimen, with a 4-drug intensive phase and a 2-drug continuation phase. Alternative chemotherapy using more costly and toxic drugs, often for prolonged durations generally more than 18 months, is required for multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis. Directly observed treatment, as part of a holistic care program, is a cost-effective strategy to ensure high treatment success and curtail development of drug resistance in tuberculosis. New antituberculosis drugs are urgently needed to improve the present standard short-course chemotherapy and alternative chemotherapy, by shortening administration durations and increasing cure rates, through the greater potency of these agents.
Coinfection with the human immunodeficiency virus (HIV) has become a major factor for the dissemination of tuberculosis in Africa.
The focus of the Division of Clinical Infectious Diseases at the Research Center Borstel is aimed to improve tuberculosis care and to understand the pathogenesis of tuberculosis, especially in HIV-confection. There are various cellular and molecular biological methods available to investigate immunoregulatory mechanisms in the defense to an infection with mycobacteria. An intensive co-operation between the hospital and the basic research laboratory guarantees an immediate processing of the cell material obtained from the peripheral blood and/or bronchoalveolar lavages of patients. In addition to the research in molecular biology, translational studies are accomplished for the validation of new diagnostic and therapeutic procedures. In 2006 the Tuberculosis Network European Trials group (TBNET) of research-oriented physicians, microbiologists, mycobiologists and epidemiologists has been founded with participation of the Division of Clinical Infectious Diseases. TBNET offers an appropriate platform for organization, coordination and analysis of translational clinical studies. The research of the Division of Clinical Infectious Diseases is now mainly focused to the international collaborations within the TBNET. The international TBNET coordinating office is localized inBorstel.
The activities of the Division of Clinical Infectious Diseases include:
- Development and validation of immunological biomarkers for the susceptibility and resistance against M. tuberculosis in TB contacts (collaboration with Prof. Dr. Steffen Stenger, Ulm, and Prof. Dr. Stefan H. E. Kaufmann, Berlin)
- Establishment of a bio- and databank for patients with tuberculosis in Germany (collaboration with Prof. Dr. Tom Schaberg, Rotenburg, and Popgen, Kiel)
- Validation of new methods for diagnosis of latent TB and the risk to develop active TB in a European cohort (collaboration with PD Dr. Roland Diel, Hamburg, and Dr. Jean Pierre Zellweger, Lausanne)
- Establishment of a European database for patients with MDR/XDR-TB (collaboration with TBNET)
- Systematic reviews on tuberculosis diagnosis and investigations on the standards of MDR-tuberculosis treatment (collaboration with TBNET)
- Development and validation of new methods for the diagnosis of pulmonary and extra pulmonary TB (collaboration with TBNET)
- Immunoregulation of the HIV/M. tuberculosis co-infection
- The role of antimicrobial peptides in COPD (collaboration with PD Dr. rer. nat. Holger Heine)
- Novel biomarker in inflammatory processes at interfaces (collaboration with PD. Dr. rer. nat. N. Reiling)