Berlin

For the first time in over a century, researchers are to use live human lung tissue in a systematic study of tuberculosis.

On the rise: tuberculosis bacilli (green), shown here inside an immune cell, are on the rampage across many parts of the world. Credit: S.H.E. KAUFMANN & R. GOLECKI, MAX-PLANCK INSTITUTE

A collaboration between German and Russian scientists hopes to gain a better understanding of the biology behind the multidrug-resistant (MDR) strain of Mycobacterium tuberculosis, the microorganism that causes the disease.

The tissue samples will come from infected patients in Russia, and the ready availability of the material reflects the rampant spread of MDR tuberculosis among the country's poor. For the first time in decades, many patients there are resorting to surgery to remove infected tissue, because they cannot afford the sophisticated drug treatments needed to tackle MDR disease.

Under an agreement worked out last December, the Russian Academy of Medical Sciences' Central Research Institute of Tuberculosis in Moscow will acquire some of the removed tissue, subject to the patients' consent. The samples will be sent to the Max Planck Institute for Infection Biology in Berlin for analysis.

More than 50 million people worldwide are infected with MDR tuberculosis. In some places, as many as one in seven new cases of tuberculosis are caused by MDR strains of M. tuberculosis. In Russia, MDR tuberculosis is particularly concentrated in overcrowded prisons.

“The new source of tissue gives us a unique research tool,” says Timo Ulrichs, of the Berlin institute, one of the collaboration's coordinators. “Little is known about the immune reactions that go on in the lungs during human infection,” he says.

The researchers will study the expression of genes and proteins in the tissue in an attempt to improve understanding of what happens during infection, in both the host and the pathogen. They also hope to work out why some patients are more susceptible than others — 95% of those infected with M. tuberculosis do not develop the disease. Lung tumour tissue taken from cancer patients will be used as a control.

Optimistic: Stefan Kaufmann hopes that a German–Russian collaboration will lead to new therapies or vaccines for tuberculosis.

But the collaborators have not yet decided how to transport the infected material from Russia to the Berlin laboratory. They have permission to import the infected tissue into Germany, but they are still trying to persuade the Russian foreign ministry to grant export permission. They are also trying to find a carrier that is willing and able to transport the material frozen in dry ice — moving dangerous biological tissues has become more difficult, they say, since the anthrax attacks in the United States last autumn.

The tissue is “a very precious reagent” for the study of the disease, says Bill Jacobs, a tuberculosis molecular geneticist at the Albert Einstein College of Medicine in New York. Tuberculosis researchers have generally been restricted to working with animal models and blood samples from patients.

Some of the biochemistry and immunology planned under the collaboration is already under way in Moscow, and George Kosmiadi, a senior scientist there and Russian coordinator of the project, says he hopes that work on live tissue will start in the next few months. “The transport problem is entirely solvable,” he says.

Stefan Kaufmann, a co-director of the Berlin institute, who initiated and now coordinates the collaboration, is also optimistic about the prospects for the work. “The approach could generate new targets for therapy or vaccination,” he says.