Research At Baylor Scott & White Could Have Global Impact on Tuberculosis

Dr. Tawanda Gumbo has dedicated his life to researching tuberculosis, and discoveries made in his East Dallas laboratory may change how other infectious diseases are treated around the globe.

Gumbo is—and bear with me, this is a long title—the director of the Center for Infectious Diseases Research and Experimental Therapeutics at the Baylor Scott & White Research Institute. He has led a research initiative that spans continents, seeking a way to test the medicines given to people infected with tuberculosis to determine their effectiveness ahead of time. The disease is nearly an afterthought in America, something that drums headlines every once in a while but largely is overlooked. But in other parts of the world, particularly so in India and China and South Africa, the disease is present in as much as 3 percent of some country’s populations. There were more than 10 million new cases last year, and about 1.8 million deaths, worldwide, according to the World Health Organization.

And last week, The Clinical Infections Diseases journal published his research, which included details on a model for testing medicines on pediatric TB patients.

“It became very clear over the years that we needed to come up with a good lab model that would approximate what happens in patients so that we could develop more optimal treatments, more optimal drugs,” Gumbo said. “This laboratory tool mimics a lot of the conditions in human beings who have TB and how they handle drugs.”

The genus for the research dates back to Gumbo’s medical training in Zimbabwe, where he noticed that what he was reading in the books about the effectiveness of tuberculosis treatments weren’t mimicked among the people he studied. Something was off. The books, he noticed, had been written decades prior, and the disease had morphed, he later learned. Some strains were susceptible to antibiotics. Others were resistant. Meanwhile, the disease was spreading.

“For an old disease, we knew very little,” Tumbo said. “The idea at the time was if we did our programs and patients took their medications, then you would have higher cure rates and the infection would disappear. But even when patients were taking their medicine, there were worse outcomes.”

Regional differences like environment and diet shifted the genetic makeup of people in different regions. What worked was no longer keeping pace with how the disease was progressing. They researched patients in Cape Town with patients in other regions from South Africa, finding “radically different” results from the drugs. They later delved into India, a country that had more than 2 million incidences last year alone. They found the doses of the drugs that had typically been given had only fueled resistance. They gradually increased the doses of standard drugs to compensate, exacerbating the issue.

Gumbo says he knew that something in a lab would have to be established to pursue new treatments. Clinical trials require a lot of time, money, and a large population. Using tests in the laboratory, mimicking the effects of drugs on the virus in a human being, would reduce the legwork and the resources necessary to test a drug on people where they live.

And so he came stateside to pursue furthering that research, first landing at the Cleveland Clinic and then moving to New York for about six years. He was recruited to Dallas to UT Southwestern, but went to the Baylor Scott & White Research Institute, which specializes in immunology and offered him, he says, more lab space.

“They have invested very heavily by giving us support to elevate tuberculosis research to the next level,” Gumbo says. “Hopefully, that will allow us to have an impact on the global tuberculosis.”

In a glass tube, the researchers place tuberculosis organisms and feed them nutrients to keep them alive. They then test it with various combinations of drugs at various times and various doses, to see what’s most effective. Using artificial intelligence algorithms, the researchers also use data to analyze how medicine interacts with the disease and with the patient. They can even watch how it changes patient RNA, to judge toxicity. In the future, Baylor Scott & White Research Institute Director Dr. Michael Ramsay says Gumbo’s analytical model will be able to apply to the treatment of other infectious diseases. It doesn’t have to be tuberculosis—the data can be harnessed to show how drugs will interact with any disease.

“We want the research that we do to be clinically relevant. It’s got to translate over to helping patients in the population,” Ramsay says. “We will support research that we can see an immediate or very short-term future benefit coming to the patient. …with Tawanda’s device, we can now look at every drug resistant disease and see how we can maybe make organisms susceptible to these drugs by giving them different timings, different amounts. This model was for TB, which is something he was interested in, but this can be applied in many other cases.”

Posted in News, Research.