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Meningitis is the most deadly manifestation of tuberculosis. Following a series of smaller trials that showed a benefit of high-dose rifampicin for tuberculous meningitis, Reinout van Crevel (Dept of Internal Medicine) and Rob Aarnoutse, Lindsey te Brake and Elin Svensson (Dept of Pharmacy/Pharmacology), theme Infectious diseases and global health, have received funding (4 million British Pounds) from the MRC Wellcome Trust global health trials scheme for a phase 3 randomized clinical trial evaluating high-dose rifampicin in 500 tuberculous meningitis patients in Indonesia, Uganda and South Africa.
Besides intensified antibiotic treatment, targeting damaging inflammation might also improve survival of tuberculous meningitis patients. Following the discovery of a critical role for cerebral tryptophan metabolism (Van Laarhoven et al, Lancet Inf Dis 2018), Van Crevel and colleagues Arjan van Laarhoven, Vinod Kumar and Mihai Netea from the department of Internal Medicine, theme Infectious diseases and global health, have also received 5-year funding (4 million Euro) from the National Institute of Health (NIH, Washington) to apply a ‘multi-omics’ approach in >2000 tuberculous meningitis patients from Vietnam and Indonesia, aiming to find more effective host-directed therapy with collaborators from Boston, Vietnam and Indonesia.
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