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Int J Infect Dis. 2015 Mar;32:30-1. doi: 10.1016/j.ijid.2014.11.017.

Host-directed therapies for tuberculous pericarditis.

Author information

1
Center for Clinical Microbiology, Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre at UCL Hospital, London, United Kingdom. Electronic address: a.zumla@ucl.ac.uk.
2
Department of Laboratory Medicine, Karolinska Institute and CAST (Center for allogeneic stem cell transplantation), Karolinska Hospital, Stockholm, Sweden. Electronic address: Markus.Maeurer@ki.se.
3
Department of Laboratory Medicine, Karolinska Institute and CAST (Center for allogeneic stem cell transplantation), Karolinska Hospital, Stockholm, Sweden. Electronic address: guido.moll@ki.se.
4
The Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. Electronic address: Bongani.Mayosi@uct.ac.za.

Abstract

TB Pericarditis is associated with significant inflammatory and immune responses which can paradoxically cause injury to the pericardium and myocardium. Management with anti-TB therapy alone does not prevent complications or reduce mortality. Thus the prevailing view is that adjunct host-directed therapies such as use of glucocorticoid treatment could attenuate destructive inflammatory responses and improve morbidity and mortality rates. A recent trial showed no advantage of using adjunct corticosteroid treatment on the combined endpoint of death, cardiac tamponade or constriction. The current lack of effective medical treatment for reducing the significant morbidity and mortality associated with TB pericarditis, highlights the urgent need for newer approaches to treating the disease. Newer treatment options for pericarditis using adjunct host-directed therapies, including autologous bone-marrow-derived Mesenchymal Stromal Cells (MSCs) therapy, now require evaluation in randomized placebo-controlled controlled trials.

KEYWORDS:

Bone marrow; Host-directed; Infection; Pericarditis; Stromal cells; Treatment; Tuberculosis

PMID:
25809752
DOI:
10.1016/j.ijid.2014.11.017
[Indexed for MEDLINE]
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