The Collaborative Ocular Tuberculosis Study (COTS) calculator—a consensus-based decision tool for initiating antitubercular therapy in ocular tuberculosis

Agrawal, Rupesh; Ludi, Zhang; Betzler, Bjorn Kaijun; Testi, Ilaria; Mahajan, Sarakshi; Rousselot, Andrés; Kempen, John H.; Smith, Justine R.; McCluskey, Peter; Nguyen, Quan Dong; Pavésio, Carlos; Gupta, Vishali

doi:10.1038/s41433-022-02147-7

Cited by 6 publications

(4 citation statements)

References 46 publications

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“…Another avenue is ophthalmic drug delivery for the treatment of ocular TB, in which eyes and orbital tissues are affected, leading to ocular morbidity and visual loss [98,302]. Even though it is a comparatively rare extrapulmonary manifestation, ocular TB may be the first presentation of TB in initially asymptomatic patients, especially since 92% of patients with ocular TB present without evidence of concomitant pulmonary TB [303][304][305]. A RIF-loaded cationic nanoemulsion with specific surface modification employing chitosan and polymyxin B was found to be promising to overcome the hurdle of the blood-retinal barrier of the eye that hinders the availability of ATD delivered by the systemic route [30,98].…”

Section: Extrapulmonary Tb Therapymentioning

confidence: 99%

Advanced drug delivery and therapeutic strategies for tuberculosis treatment

Nair,

Greeny,

Nandan

et al. 2023

J Nanobiotechnol

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Tuberculosis (TB) remains a significant global health challenge, necessitating innovative approaches for effective treatment. Conventional TB therapy encounters several limitations, including extended treatment duration, drug resistance, patient noncompliance, poor bioavailability, and suboptimal targeting. Advanced drug delivery strategies have emerged as a promising approach to address these challenges. They have the potential to enhance therapeutic outcomes and improve TB patient compliance by providing benefits such as multiple drug encapsulation, sustained release, targeted delivery, reduced dosing frequency, and minimal side effects. This review examines the current landscape of drug delivery strategies for effective TB management, specifically highlighting lipid nanoparticles, polymer nanoparticles, inorganic nanoparticles, emulsion-based systems, carbon nanotubes, graphene, and hydrogels as promising approaches. Furthermore, emerging therapeutic strategies like targeted therapy, long-acting therapeutics, extrapulmonary therapy, phototherapy, and immunotherapy are emphasized. The review also discusses the future trajectory and challenges of developing drug delivery systems for TB. In conclusion, nanomedicine has made substantial progress in addressing the challenges posed by conventional TB drugs. Moreover, by harnessing the unique targeting abilities, extended duration of action, and specificity of advanced therapeutics, innovative solutions are offered that have the potential to revolutionize TB therapy, thereby enhancing treatment outcomes and patient compliance. Graphical Abstract

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Section: Extrapulmonary Tb Therapymentioning

confidence: 99%

Advanced drug delivery and therapeutic strategies for tuberculosis treatment

Nair,

Greeny,

Nandan

et al. 2023

J Nanobiotechnol

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“…The key diagnostic criteria for OTB as defined by the Standardization of Uveitis Nomenclature (SUN) Working Group is a compatible uveitic syndrome, including: 1) anterior uveitis with iris nodules, 2) serpiginous-like tubercular choroiditis, 3) choroidal nodule (tuberculoma), 4) occlusive retinal vasculitis, and 5) in hosts with evidence of active systemic TB, multifocal choroiditis; including: 1) histologically- or microbiologically-confirmed infection, 2) positive IGRA test, or 3) positive TST 26 . Putting all these together, the COTS group published an online, cost-effective, web-based clinical scoring system known as the COTS Calculator ( https://www.oculartb.net/cots-calc ) to guide the crucial decision of initiating ATT in clinically suspected OTB cases 27 .…”

Section: Background Of the Clinical Problems 11 Epidemiology Of Tuber...mentioning

confidence: 99%

Diagnosis and biomarkers for ocular tuberculosis: From the present into the future

Ludi¹,

Sule²,

Samy³

et al. 2023

Theranostics

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Tuberculosis is an airborne disease caused by Mycobacterium tuberculosis (Mtb) and can manifest both pulmonary and extrapulmonary disease, including ocular tuberculosis (OTB). Accurate diagnosis and swift optimal treatment initiation for OTB is faced by many challenges combined with the lack of standardized treatment regimens this results in uncertain OTB outcomes. The purpose of this study is to summarize existing diagnostic approaches and recently discovered biomarkers that may contribute to establishing OTB diagnosis, choice of anti-tubercular therapy (ATT) regimen, and treatment monitoring. The keywords ocular tuberculosis, tuberculosis, Mycobacterium, biomarkers, molecular diagnosis, multi-omics, proteomics, genomics, transcriptomics, metabolomics, T-lymphocytes profiling were searched on PubMed and MEDLINE databases. Articles and books published with at least one of the keywords were included and screened for relevance. There was no time limit for study inclusion. More emphasis was placed on recent publications that contributed new information about the pathogenesis, diagnosis, or treatment of OTB. We excluded abstracts and articles that were not written in the English language. References cited within the identified articles were used to further supplement the search. We found 10 studies evaluating the sensitivity and specificity of interferon-gamma release assay (IGRA), and 6 studies evaluating that of tuberculin skin test (TST) in OTB patients. IGRA (Sp = 71-100%, Se = 36-100%) achieves overall better sensitivity and specificity than TST (Sp = 51.1-85.7%; Se = 70.9-98.5%). For nuclear acid amplification tests (NAAT), we found 7 studies on uniplex polymerase chain reaction (PCR) with different Mtb targets, 7 studies on DNA-based multiplex PCR, 1 study on mRNA-based multiplex PCR, 4 studies on loop-mediated isothermal amplification (LAMP) assay with different Mtb targets, 3 studies on GeneXpert assay, 1 study on GeneXpert Ultra assay and 1 study for MTBDRplus assay for OTB. Specificity is overall improved but sensitivity is highly variable for NAATs (excluding Ivyspring

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“…Multifocal/unifocal choroiditis, recurrent rubercular anterior uveitis, intermediate uveitis, panuveitis, and active retinal vasculitis: ATT is indicated if one or both of TST/IGRA are positive and radiological studies demonstrate the presence of active or healed TB infection [24,25]. The COTS-CON group has created a calculator to generate a score of 1 to 5 to assist clinicians with determining what clinical scenarios warrant ATT initiation [26 ▪ ].…”

Section: Ocular Tuberculosis Treatmentmentioning

confidence: 99%

Ophthalmic manifestations of tuberculosis

Bates,

Crowell

2023

Current Opinion in Ophthalmology

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Purpose of review To evaluate the epidemiology, microbiology, and pathology of Mycobacterium Tuberculosis (MTB). Utilizing these basic science concepts, the reader will discover how MTB can cause disease in any part of ophthalmic system. This article will aid clinicians in establishing the difficult diagnosis and management strategies for ophthalmic tuberculosis (OTB). Recent findings Recently, expert panels have reached a consensus on naming conventions and treatment strategies for the variety of ocular tuberculosis (TB). This consensus helps individual clinicians decide when to recommend full anti-TB treatment. Summary Globally, TB is nearly ubiquitous in the human population. It is most recognized for its pulmonary disease, but pathology of nearly every structure of the ophthalmic system has been identified. This heterogeneity makes establishing a diagnosis difficult, but recent improvements in expert panel naming consensus and nucleic acid amplification tests are improving diagnostic abilities. Clinicians are now feeling more confident with prescribing anti-TB regimens, but ongoing questions regarding the use of oral steroids and risk of medication-induced ocular toxicity remain.

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The Collaborative Ocular Tuberculosis Study (COTS) calculator—a consensus-based decision tool for initiating antitubercular therapy in ocular tuberculosis

Cited by 6 publications

References 46 publications

Advanced drug delivery and therapeutic strategies for tuberculosis treatment

Advanced drug delivery and therapeutic strategies for tuberculosis treatment

Diagnosis and biomarkers for ocular tuberculosis: From the present into the future

Ophthalmic manifestations of tuberculosis

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