TY - JOUR
T1 - Cavitary tuberculosis
T2 - the gateway of disease transmission
AU - Urbanowski, Michael E.
AU - Ordonez, Alvaro A.
AU - Ruiz-Bedoya, Camilo A.
AU - Jain, Sanjay K.
AU - Bishai, William R.
N1 - Funding Information:
We thank Eric Nuermberger and Elizabeth Ihms for discussions and insight into the pathogenesis of cavitary tuberculosis. We also acknowledge Marjorie Winslow Kehoe and the archival team at The Alan Mason Chesney Medical Archives of The Johns Hopkins Medical Institutions. SKJ and AAO received support from the National Institutes of Health (NIH) (Director's Transformative Research Award R01-EB020539, R01-HL131829, R01-EB025985, R56-AI145435, and R21-AI149760). WRB received support from NIH (R21-AI127311, R01-AI37856, and R01-HL133190). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Funding Information:
We thank Eric Nuermberger and Elizabeth Ihms for discussions and insight into the pathogenesis of cavitary tuberculosis. We also acknowledge Marjorie Winslow Kehoe and the archival team at The Alan Mason Chesney Medical Archives of The Johns Hopkins Medical Institutions. SKJ and AAO received support from the National Institutes of Health (NIH) (Director's Transformative Research Award R01-EB020539, R01-HL131829, R01-EB025985, R56-AI145435, and R21-AI149760). WRB received support from NIH (R21-AI127311, R01-AI37856, and R01-HL133190). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/6
Y1 - 2020/6
N2 - Tuberculosis continues to be a major threat to global health. Cavitation is a dangerous consequence of pulmonary tuberculosis associated with poor outcomes, treatment relapse, higher transmission rates, and development of drug resistance. However, in the antibiotic era, cavities are often identified as the most extreme outcome of treatment failure and are one of the least-studied aspects of tuberculosis. We review the epidemiology, clinical features, and concurrent standards of care for individuals with cavitary tuberculosis. We also discuss developments in the understanding of tuberculosis cavities as dynamic physical and biochemical structures that interface the host response with a unique mycobacterial niche to drive tuberculosis-associated morbidity and transmission. Advances in preclinical models and non-invasive imaging can provide valuable insights into the drivers of cavitation. These insights will guide the development of specific pharmacological interventions to prevent cavitation and improve lung function for individuals with tuberculosis.
AB - Tuberculosis continues to be a major threat to global health. Cavitation is a dangerous consequence of pulmonary tuberculosis associated with poor outcomes, treatment relapse, higher transmission rates, and development of drug resistance. However, in the antibiotic era, cavities are often identified as the most extreme outcome of treatment failure and are one of the least-studied aspects of tuberculosis. We review the epidemiology, clinical features, and concurrent standards of care for individuals with cavitary tuberculosis. We also discuss developments in the understanding of tuberculosis cavities as dynamic physical and biochemical structures that interface the host response with a unique mycobacterial niche to drive tuberculosis-associated morbidity and transmission. Advances in preclinical models and non-invasive imaging can provide valuable insights into the drivers of cavitation. These insights will guide the development of specific pharmacological interventions to prevent cavitation and improve lung function for individuals with tuberculosis.
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U2 - 10.1016/S1473-3099(20)30148-1
DO - 10.1016/S1473-3099(20)30148-1
M3 - Review article
C2 - 32482293
AN - SCOPUS:85085014416
SN - 1473-3099
VL - 20
SP - e117-e128
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 6
ER -