Drug development for tuberculosis: the missing ingredient.
Drug development for tuberculosis: the missing ingredient.
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结核病药物开发：缺失的成分。
DOI：
10.1016/s0140-6736(05)71341-6
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Fanning,A
中科院分区：
文献类型：
--
作者：
Reichman,LB;Fanning,A
主席先生——多重耐药结核病（MDRTB）本质上是人为造成的。事实上，所有耐药性都是由单步突变引起的，这种突变是由不适当的药物治疗（单一疗法）或不适当的药物摄入（治疗依从性）在大量细菌群体中引起的。 1 任何耐药或多重耐药的患者都没有得到适当的治疗，没有正确地服药，或者被没有正确治疗或没有正确服药的人感染。耐多药结核病已成为一个巨大的全球性问题，反映出全球结核病治疗习惯和政策的不当。越来越多的证据表明病毒已蔓延到较发达的世界。 2 解决耐多药结核病增加难题的一种可能的解决方案是开发结核病治疗新药。这一行动将是一项适当的措施，因为自 1966 年以来没有推出新一类结核病药物，而且新抗结核药物开发方面的不作为已有充分记录。 3 为了应对耐多药结核病危机，人们终于对开发新的抗结核药物产生了极大的兴趣和支持。最著名的支持者之一是全球结核病药物开发联盟，由洛克菲勒基金会和比尔及梅琳达·盖茨基金会支持。这个组织严密的组织，由利益相关者、顾问、享有盛誉的董事会和高效的员工组成，在制定了经济分析和商业计划后，开始筹集资金并资助一些选定的私营部门研究和开发项目。他们的使命是加速此类药物的发现和开发，并在 10 年内以欠发达国家可以承受的价格将其推向市场。如果成功，该计划可能会解决可用于耐药病例的有效结核病药物数量不断减少的问题。困难在于，这一行动无法解决几乎所有耐药性的根本原因——患者和医生不遵守推荐的治疗方案。 4 因此，任何结核病药物开发工作都应该
Sir—Multiple-drug-resistant tuberculosis(MDRTB) is essentially manmade. Virtually all drug resistance occurs by a single-step mutation, induced in a large bacterial population by inappropriate drug treatment (monotherapy) or inappropriate drug ingestion (treatment adherence). 1 Any patient with drug resistance or multiple-drug resistance invariably has not been treated properly, did not take his or her medication properly, or was infected by someone who had not been treated properly or did not take their medication properly. MDRTB has become a huge global issue that indicates these improper global tuberculosis treatment habits and policies. There is increasing evidence of spread to the moredeveloped world. 2 One possible solution to the difficulty of increasing MDRTB is the development of new drugs for tuberculosis treatment. This action would be an appropriate measure since there has been no new class of tuberculosis drug introduced since 1966, and inaction in new antituberculosis drug development has been well documented. 3 In response to the MDRTB crisis, there had finally been tremendous interest and support for developing new antituberculosis drugs. One of the most prominent backers is the Global Alliance for Tuberculosis Drug Development, supported by the Rockefeller Foundation and the Bill and Melinda Gates Foundation. This highly organised group, with stakeholders, advisors, prestigious boards, and effective staff, after drawing up an economic analysis and business plan, is beginning to raise funds and finance a selected number of private-sector research and development projects. Their mission is to accelerate the discovery and development of such drugs and have them on the market within 10 years at prices affordable in less-developed countries.If successful, the initiative might address the issue of the dwindling number of effective tuberculosis medications available for resistant cases. The difficulty is that this action will not address the main underlying cause of almost all drug resistance—non-adherence of patients and doctors to recommended regimens. 4 Therefore, any tuberculosis drug development effort should be