New TB treatments tackle the disease without wrecking your microbiome

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Researchers in a study published in The Lancet Microbe examined how various tuberculosis treatment regimens affect the respiratory microbiome. They found that certain treatments control tuberculosis effectively while minimally impacting the diversity and health of the respiratory microbiome.

By Dr. Chinta SidharthanOct 15 2023Reviewed by Sophia Coveney In a recent study published in the journal The Lancet Microbe, researchers examined the impact of six experimental treatment regimens and the standard-of-case treatment for tuberculosis on the respiratory microbiome obtained from sputum samples.

With the aim of reducing the duration of antibiotic exposure to the respiratory microbiome, new and shorter treatment regimens for tuberculosis are being investigated. The PanACEA MAMS-TB clinical trial investigated the efficacy of four experimental treatments, which included varying combinations and dosages of isoniazid, pyrazinamide, rifampicin, and ethambutol. The HIGHRIF2 study evaluated the bacteriological response, tolerability, and pharmacokinetics of varying doses of rifampicin.

The obtained sequences were analyzed for total bacteria and separately for photosynthetic cyanobacteria. A range of diversity and evenness indices, such as alpha diversity metrics, Shannon diversity index, Pielou’s evenness index, and Faith’s phylogenetic diversity index, were calculated for the obtained data.

The microbiome analyses revealed that the pre-treatment sputum microbiomes were dominated by Firmicutes at the phylum level and Streptococcus at the genus level. Furthermore, while most of the microbiome taxa levels recovered during the follow-up, the Mycobacterium levels did not recover, indicating that M. tuberculosis was especially susceptible to these antibiotics.

 

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