Center Assistant Professor Returns from Two Month Visit to India Setting Up New Lab to Evaluate his New Treatment Monitoring TB Diagnostic

Dr. Kayvan Zainabadi, Center Assistant Professor of Molecular Microbiology in Medicine, recently spent 2 months in Pune, India launching a new project to evaluate a new TB diagnostic he and Weill Cornell Medicine colleagues developed for predicting treatment outcomes in TB patients. 

This project for the new diagnostic tool is in collaboration with investigators at RePORT India (Regional Prospective Observational Research in Tuberculosis) and funded by RePORT International. 

The goal of the study is to determine whether their new RNA-based approach is able to accurately distinguish TB patients who experience poor clinical outcomes (treatment failure or disease relapse) from those who have successful outcomes (ie cure). This is important because, unlike many other infectious diseases, TB currently does not have a diagnostic test that can assess when patients have achieved cure during therapy. This deficiency necessitates all patients to adhere to a strict 6 month treatment regimen, even though 5-10% of patients will fail therapy with such an approach, which predisposes them to drug resistance and bad clinical outcomes, including death. Further, the majority of TB patients are known to achieve cure earlier than 6 months, meaning that most TB patients take months of unnecessary and potentially toxic drugs.

A diagnostic test that could accurately distinguish between these two groups would be a transformative tool for TB care and management. First and foremost, it would prevent the negative clinical outcomes currently experienced by 5-10% of TB patients. Second, it would also allow clinicians to tailor treatment regimens, enabling the majority of TB patients who achieve cure earlier than 6 months to safely discontinue therapy early. 

As part of the project, Dr. Zainabadi spent two months at the Indian Institute of Science Education and Research (IISER) in Pune, India helping to build the necessary research infrastructure to carry out these studies. This is not Dr. Zainabadi's first time in India — following completion of his PhD, he spent 1 year as a Visiting Scientist at the Indian Institute of Science (IISc) in Bangalore, India in 2011-2012. Dr. Zainabadi has also performed similar research capacity building  projecs in other countries, including in Haiti at the GHESKIO Centers and in Myanmar at the Ministry of Health. Based on his experiences, Dr. Zainabadi recently published a best-practices guide for developing molecular surveillance capacity in resource-limited settings. 

Dr. Zainabadi is joined on this project by his RePORT India co-PIs, Neeta Pradhan and Dr. Mandar Paradkar, as well as Center Associate Professor, Dr. Myung Hee Lee, who serves as lead biostatistician and co-investigator. Dr. Zainabadi plans to return to India in the new year for another two months to follow-up on initial findings and for further training. The ultimate goal of the team is to develop a TB treatment monitoring diagnostic that improves clinical outcomes for patients with TB.