Rehabilitation, optimized nutritional care, and boosting host internal milieu to improve long-term treatment outcomes in tuberculosis patients.
Disease-related malnutrition
Immune response
Pulmonary rehabilitation
Tuberculosis
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
08
01
2020
revised:
16
01
2020
accepted:
16
01
2020
pubmed:
27
1
2020
medline:
11
6
2020
entrez:
27
1
2020
Statut:
ppublish
Résumé
The holistic management of tuberculosis (TB) patients can improve life expectancy and lost organ function. Chronic sequelae are very common among patients who survive TB, which can lead to a further decline in lung function. There is still no guidance for 'cured' patients with impaired lung function who need pulmonary rehabilitation. Additional tests for evaluation should be given after the end of treatment, as recent studies have shown the good effect of pulmonary rehabilitation for TB patients. Malnutrition is very common among TB patients and is related to malabsorption. The latter can cause lower drug exposure, which may result in treatment failure, increasing the risk of death, and can lead to acquired drug resistance. Malnutrition should be assessed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and the diagnosis should lead to an individualized treatment plan, including sufficient proteins and preferably in combination with adequate training. Under normal circumstances, most immune cells use a glucose-based mechanism to generate energy. Therefore the patient's nutritional status is a key factor in shaping immune responses. Disease-related malnutrition leads to proteolysis and lipolysis. In the end, the identification of individuals who will benefit from immune-modulatory strategies may lead to clinically relevant markers.
Sections du résumé
BACKGROUND
BACKGROUND
The holistic management of tuberculosis (TB) patients can improve life expectancy and lost organ function.
REHABILITATION
RESULTS
Chronic sequelae are very common among patients who survive TB, which can lead to a further decline in lung function. There is still no guidance for 'cured' patients with impaired lung function who need pulmonary rehabilitation. Additional tests for evaluation should be given after the end of treatment, as recent studies have shown the good effect of pulmonary rehabilitation for TB patients.
OPTIMIZED NUTRITIONAL CARE
UNASSIGNED
Malnutrition is very common among TB patients and is related to malabsorption. The latter can cause lower drug exposure, which may result in treatment failure, increasing the risk of death, and can lead to acquired drug resistance. Malnutrition should be assessed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and the diagnosis should lead to an individualized treatment plan, including sufficient proteins and preferably in combination with adequate training.
PROTECTIVE IMMUNE RESPONSES
UNASSIGNED
Under normal circumstances, most immune cells use a glucose-based mechanism to generate energy. Therefore the patient's nutritional status is a key factor in shaping immune responses. Disease-related malnutrition leads to proteolysis and lipolysis. In the end, the identification of individuals who will benefit from immune-modulatory strategies may lead to clinically relevant markers.
Identifiants
pubmed: 31982628
pii: S1201-9712(20)30031-X
doi: 10.1016/j.ijid.2020.01.029
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
S10-S14Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.