TB archive could be the start of Google-ized medical science
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4/3/2008 - 4/1/08
A new weapon could soon emerge at the forefront of the global battle against tuberculosis, but it isn't a vaccine or a cure.
It's a really good search engine — and while it might not sound like it, such a tool could be critical to finding new, creative ways to stop the disease and its growing number of antibiotic-resistant forms from spreading, said Damian Gessler, a researcher at the National Center for Genome Resources in Santa Fe, who's leading the charge to build it at The University of New Mexico.
"We have 100 years of data on TB in the U.S., lots of repositories and lots of databases," Gessler said. "But they're not connected. Nobody has combined them all for TB or any other disease in an organized, bar-coded way."
Right now, if a researcher wants to investigate a strain of tuberculosis, they have to call people in several states to try to track its origins, get samples and look at DNA strains, which slows down the scientific community's ability to fight the disease, he said.
And with a global community connected by airplanes — outbreaks of some of the more deadly forms of tuberculosis are potentially only a day or so away from getting to the United States, said Marcos Burgos, a doctor and researcher focused on tuberculosis at UNM.
"This is a disease I think everybody has to worry about," Burgos said. "We have a world economy. People move from places around the globe, and tuberculosis doesn't need a passport. There's no real way to prevent that from occurring, but to protect ourselves we should make sure the U.S. is at the forefront of tuberculosis control."
The search engine, attached to an archive of all genetic samples of the disease that have been collected in the U.S. over several decades, will help doctors like Burgos rapidly track the origins of new strains and take action before they spread far, he said.
"Transmission of tuberculosis is a problem, but if you can stop that, you can basically eradicate the disease," Burgos said. "We know we can't stop it 100 percent, but even if we could reduce it 50 percent, it would be a big benefit."
Tuberculosis is a huge problem in the developing world. In Africa, especially, it is prevalent in AIDS patients and often kills them.
New drug-resistant strains are even harder to fight. MDR — which stands for multidrug-resistant TB — can cost upward of $250,000 per case to treat. And a new variety, called XDR — for extreme-drug-resistant TB — is pretty much impossible to treat and is often a death sentence, Burgos said.
And if you think it's far from home, think again. There are two MDR cases connected to New Mexico right now, he said, while emphasizing that overall our state has a relatively low number of tuberculosis cases.
One of our two MDR cases came here from another state and is in treatment, and the other appeared here and is being treated on New Mexico's dime in another state that has better in-patient facilities, Burgos said.
The searchable database, with genetic information from tuberculosis strains, could help keep cases under control. It would function as a map or genealogy tree that tells scientists where the disease has been and where it's moving, and that's critical information when you want to fight it, he said.
"With all this data in one place, it will let us really understand how transmission occurs and what factors are making some people more at risk for transmitting the disease to others," Burgos said.
It would be a truly modern tool to fight tuberculosis, Gessler added.
"We'd like to bring this all into the 21st century and build an integrated resource," he said.
The database, called the National Tuberculosis Archive, would cost about $15 million. And Gessler, Burgos and others organizing it are still trying to get federal or state funding for it, he said.
But there's a very good reason it should be located in New Mexico. UNM is uniquely qualified to operate the facility and already has worked on something similar, Gessler said.
"UNM has a lot of history and experience in archiving things like this," he said. "They have the space, the experience, the computer skills, and they know how to build redundant backup systems. Going to UNM is basically going to the pros when it comes to this kind of archiving."
Much of UNM's experience comes from the hantavirus outbreak in the early 1990s.
When that disease appeared, nobody knew what it was or where it came from, Gessler said.
"They had no idea if it had always been here, if it was new, if it was cooked up in a bioweapons lab," he said. "They estimated it would take 10 years to find out."
But UNM researcher Terry Yates, who later became vice president for research and economic development at the school, took his own stab at the disease.
He'd been archiving tissue samples from rodents. And after going through that archive, he was able to determine what hantavirus was and where it came from, Gessler said.
"In 19 days, they were able to determine that not only was this virus endemic, but they found the virus had been here for maybe 10 million years in the rodents themselves," Gessler said.
Yates died of cancer late last year, but the resources he built at UNM continue to be some of the best in the world, Gessler said.
Another reason to build the archive in New Mexico is the state has more than a 100-year history in working with the disease, considering it used to be a hot spot for sanatoria, hospitals specifically aimed at TB patients in the early 1900s, Burgos said.
"We've had some of the most well-known experts on tuberculosis here," he said. "We have a long history and knowledge of how to treat it."
Tissue samples for the archive would fit in deep freezers small enough to occupy a single room at UNM. And information about genetics, history, various methods tried and success rates in treating each strain would all be held in a computer system, Gessler said.
NCGR would help analyze some of the strains, as would scientists from Los Alamos National Laboratory. And New Mexico Tech would work on cyber security to make sure none of the information was hacked by people outside of the medical community, Gessler said.
The database wouldn't hold any personal information about sources of the samples, he added.
And once the TB archive is set up, there's no reason the basic idea couldn't expand to other diseases, perhaps speeding up treatments and cures for them as well, Gessler said.
"Once you establish this model for TB, not only could you do it for other infectious diseases, but you could also do it for chronic diseases like diabetes or cancer," he said. "I think the sky's the limit for this in New Mexico, once we get it started."
Contact Sue Vorenberg at 986-3072 or svorenberg@sfnewmexican.com.
