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DBT support brings hope for TB

Rapid Fire

  • Diagnostic kit ‘Crystal TB Confirm’ supported by DBT adopted as confirmatory test under RNTCP programme
  • DBT focusing on diagnostics, vaccine development, immunomodulation, basic biology & drug-development
  • With ICMR & DHR, DBT will validate local diagnostic technologies to replace imported kits with these
  • DBT is planning to set-up an India TB Research Forum
  • DBT sponsoring brain storming symposium on challenges in tuberculosis diagnosis & management on world TB day

Crystal TB Confirm, a diagnostic kit supported by DBT has been adopted as a confirmatory test under Government.-run Revised National Tuberculosis Control Programme (RNTCP) programme.

It is a visual test for early detection of the disease; easy to carry out, requires no training and produces results in 20 minutes. Developed by Delhi University for detection of TB antigen in early cultures, it was evaluated in a multi-centric trial. TB Confirm is an ELISA- based test-format for confirming Mycobacterium tuberculosis (Mtb) complex for treatment decision.

This is only one of the several technologies that DBT’s funding and administration of tuberculosis research has rolled out.

DBT has been funding research on Tuberculosis for the past two decades with a focus on: diagnostics, vaccine development, immuno-modulation, basic biology; and early & late stage drug-development. While many other Government agencies such as DHR, ICMR and Ministry of Health & Family Welfare also support research, their focus is more on operation research.

In order to convert several other scientific leads into products, DBT has signed an MoU with ICMR/ DHR to validate indigenously developed technologies for diagnosis of pulmonary tuberculosis and multi-drug resistant tuberculosis with an aim to replace imported kits with locally developed technologies.

Four major institutions and two Indian companies are involved in a tightly governed exercise. The institutes include All India Institute of Medical Sciences, New Delhi; National Institute of Tuberculosis and Respiratory Diseases (NITRD/LRS), New Delhi; National JALMA Institute of Leprosy and other Mycobacterial Diseases, Agra & National Institute for Research in Tuberculosis (NIRT), Chennai. Start-up companies i.e. Bigtec & XCyton, both Bengaluru- based have put-in their young R & D team behind for this national cause. It is planned to offer them to the RNTCP, if found cost-effective and scientifically matching.

Among the autonomous institutes under the DBT, the National Institute of Immunology, the National Centre for Cell Sciences and the Central Drug Research Institute are doing major work on Tuberculosis Research. NII is working on deciphering the signaling pathways in Mycobacterium tuberculosis and their role in survival of the pathogen in the host, the molecular mechanisms underlying the action of membrane proteases from Mycobacterium tuberculosis (Mtb) and tuberculosis vaccine development.

The National Centre for Cell sciences is investigating the role of ‘Hypothetical Proteins’ of Mycobacterium tuberculosis among other significant work on the disease. The Central Drug Research Institute (CDRI) is simplifying and shortening treatment for drug-sensitive tuberculosis and searching for new treatments for multi drug resistant-TB, and for new drugs on tuberculosis.

DBT is also collaborating with several international organisations to support tuberculosis research. DBT along with UK’s Medical Research Council will jointly set up a Chennai-based National Institute for Research in Tuberculosis which will develop new diagnostic tools and new treatments to address the sharp rise in cases of multi-drug resistant tuberculosis (MTB).

Earlier the National Institute of Allergy and Infectious Diseases (NIAID), the Indian Department of Biotechnology, the Indian Council of Medical Research (ICMR) and the NIH Office of AIDS research (OAR), announced funding opportunities for joint teams of U.S. and Indian scientists working on tuberculosis research.

DBT is planning to set-up an India TB Research Forum jointly with DBT, ICMR, Central TB Division and Ministry of Health and Family Welfare with a purpose to undertake activities pertaining to diagnostics, treatment and prevention of TB and Multi Drug Resistant -TB on a long term basis.

Placed under an “Expert Committee”, the forum would be a collective Indian voice on tuberculosis in all national & global meetings and fora. It would review the achievements under TB research and identify strengths and gaps; convene joint meetings/ consultations to formulate India-specific guidelines for the programme; formulate guidelines for multi-disciplinary research contributing to TB elimination and pool the resources and promote funding in Innovative Research.

DBT believes regular brainstorming of issues on biotechnology. For the world TB day DBT is sponsoring a brainstorming symposium on challenges in tuberculosis diagnosis and management. Professor Sarman Singh, In-charge, Lab Medicine, AIIMS will be organising the event which is expected to bring together approximately 200 delegates including scientists, general practitioners, mycobacteriologists, clinical microbiologists, TB and chest specialists, paediatricians specialized in TB, researcher scholars as well as laboratory technicians, nurses, caregivers, programme managers, representatives from funding agencies and diagnostic kit manufacturers. We are also expecting some social scientists and national and international students to participate.

The symposium will deliberate on a range of topics spanning from markers and methods for early diagnosis, prognosis and outcome (cure or treatment failure), alternative clinical samples for pulmonary and extra-pulmonary tuberculosis (eg urine, blood, saliva, buccal swabs, etc.) specially in HIV-TB coinfected patients, biomarkers of treatment compliance/non-compliance, developing Novel and highly specific test methods to rule out tuberculosis and whether dosage and duration of treatment should be modified according to the mycobacterial burden on the host.

Every year, both national & international communities get together and take a pledge to do something tangible for the deadly disease which afflicts about one-third of the world’s population in latent form which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease. They have all the chances to become clinical cases once their immune system is compromised.

Tuberculosis (TB) continues to be a curse in resource-limited countries and regions. Asia and Africa currently face the highest burden of the disease. Among the Asian countries India and China are the worst affected and together accounts for almost forty percent of the world’s TB cases. In 2011, WHO reported that India had largest number of incident cases with an estimate of 2.0-2.5 million. The major problem in containing the unabated epidemic is difficulties in early detection of index cases and management of drug resistance cases.