20 October 2016

Antitubercular aerosol

Nanotechnology has reached consumption

Angelina Deryabina, "Soviet Siberia"

The Federal Research Institute of Tuberculosis, which is also the center of the World Health Organization for Tuberculosis, is a closed institution located in the forest, in the suburbs of Novosibirsk.

Outsiders are not allowed to come here. In itself, the fact that a journalist's foot has set foot on the territory of a medical institution is almost a sensation.

And here's another reason: scientists and doctors shared the results of ten years of joint work – they created an innovative form of obtaining and delivering medicines to the body of tuberculosis patients.

Acquaintance with the Research Institute began with a biobacteriological laboratory equipped according to the latest international standards in terms of infectious safety for employees and the environment, the ability to apply modern diagnostic techniques.

– 50-60 studies are performed daily in our laboratory. This is our routine work, – conducts through deserted premises (work here is over for today) Andrey Cherednichenko, Head of the bacteriological laboratory. – We have formed a biological collection of cultures of Mycobacterium tuberculosis, they are stored for research of the epidemiological component and many other important areas of our scientific and practical work.

Conventional drugs can not overcome

The laboratory diagnoses tuberculosis of patients from the most disadvantaged regions in this sense, and such in Russia – 66 percent of the territory. Employees conduct tests for drug sensitivity, determining which drug to treat each individual patient. According to Andrey Cherednichenko, the usual testing methods are quite long: the time to get a result is two to three months. But the Tuberculosis Research Institute has a laboratory of molecular genetic research methods, where in just two hours, a maximum of two days, they receive the necessary information - whether this pathogen of infection is susceptible to the effects of a particular drug.

– Over the last decade, the number of patients infected with mycobacteria with broad drug resistance has been increasing, that is, to almost all anti–tuberculosis drugs, - explained Andrey Cherednichenko. – For our region, this is one percent of patients. They are the most difficult to treat.

An employee of the Research Institute adds: the level of drug resistance to certain drugs is even higher. Among the newly identified patients, half already emit Mycobacterium tuberculosis into the environment, and 33 percent of them are not sensitive to treatment with anti-tuberculosis drugs. Why is the level of multidrug resistance increasing? There is an unfavorable tuberculosis background in our regions, 75 percent of people are infected. It is unknown which strain will get to us. A drug–sensitive mycobacterium can get in, which has never met with medical drugs. And it may happen the other way around. The distributors of treatment–resistant bacteria are patients who quit treatment halfway through, chronicles.

It smells like a big breakthrough

In November, the Tuberculosis Research Institute will begin preclinical trials of a new method of combating a dangerous disease. Doctors believe that the technology developed jointly with scientists from various institutes of the Siberian Branch of the Russian Academy of Sciences and drug manufacturers will be a breakthrough in phthisiology.

– In fact, we have done two basic things that have no analogues in the world yet, – said Oleg Abdiev, Deputy Coordinating Council for Innovation of the SB RAS, who oversees the new development. – Firstly, it is the production of nanoaerosols with a high concentration of the drug; secondly, aerosol spectrometers capable of measuring in real time the dose of the drug that remains in the patient's lungs, as well as monitoring, monitoring the intake of drugs by patients.

We are talking about an innovative method of delivering drugs to the foci of infection – not by pills or injections, but by inhaling nanoparticles only from 10 to 100 nanometers in size. This will allow the drugs to reach the alveoli, enter the bloodstream and stay in the blood several times longer – up to a day. Thanks to nanoaerosols, the amount of injected medication can be reduced several times and thus avoid the extremely severe toxic effects of anti-tuberculosis drugs on the body, which often causes patients to refuse the necessary long-term treatment.

The device for inhaling nanoparticles of drugs resembles an electronic cigarette

– Nanoaerosols can also be obtained from other medicines that have strong side effects, therefore, various diseases can be treated with their help, – Oleg Abdiev explained. – Experiments with more than 40 medicinal substances, including six anti-tuberculosis drugs, have shown results worthy of use in clinical practice.

In November, the reconstruction of the laboratory will be completed at the Tuberculosis Research Institute, where preclinical tests of the method on mice will begin. According to optimistic forecasts, in eight months a new form of treatment will be tried on tuberculosis patients. According to the institute, there are always more people willing to participate in research than required.

The regional Ministry of Health spends 200 million a year on medicines for tuberculosis patients.

Siberia and the Far East have the worst epidemic situation for tuberculosis in the country. In the Novosibirsk region, the incidence exceeds the all-Russian level by 1.8 times: in 2015, it was 105.8 cases per 100 thousand inhabitants (2.9 thousand patients with active tuberculosis were registered), despite the fact that the national average for the same period was 57.7.
At the same time, in our region over the past ten years, the incidence has decreased by 25 percent: in 2004 there were 142.3 cases per 100 thousand inhabitants. Mortality from tuberculosis decreased by 10 percent compared to 2014. The number of cases of tuberculosis cure exceeds the average Russian level. The coverage of preventive examinations for tuberculosis is also higher than the all–Russian indicator - 75.5 percent versus 66.6.

Portal "Eternal youth" http://vechnayamolodost.ru  20.10.2016

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