Evidence map›Paper›PMID 40460906›Full record

ArticleJournal of theoretical biology2025

Rankings of tuberculosis antibiotic treatment regimens are sensitive to spatial scale, detection limit, and initial host bacterial burden.

Christian T Michael, Maral Budak, Pauline Maiello, Kara Kracinovsky, Mark Rodgers, Jaime Tomko, Philana Ling Lin, JoAnne Flynn, Jennifer J Linderman, Denise Kirschner

Abstract read
In one paragraph

Article in Journal of theoretical biology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. GEODE: anFrontiers in pharmacology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Christian T MichaelDepartment of Microbiology & Immunology, University of Michigan Medical School, Ann Arbor, MI, USA.
Maral BudakDepartment of Microbiology & Immunology, University of Michigan Medical School, Ann Arbor, MI, USA.
Pauline MaielloMicrobiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Kara KracinovskyMicrobiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Mark RodgersMicrobiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Jaime TomkoMicrobiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Philana Ling LinDepartment of Pediatrics, Children's Hospital of the University of Pittsburgh of UPMC, Pittsburgh, PA, USA.
JoAnne FlynnMicrobiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Jennifer J LindermanDepartment of Chemical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA.
Denise KirschnerDepartment of Microbiology & Immunology, University of Michigan Medical School, Ann Arbor, MI, USA. Electronic address: kirschne@umich.edu.

Funding

Molecular Mechanisms of Microbial Pathogenesis Training ProgramT32AI007528 · NIAID · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CARRUTHERS, VERNON BRUCE · 1998 to 2024
$6.8M
Lesion-centric optimization of multidrug therapies for tuberculosisR01AI150684 · NIAID · TUFTS UNIVERSITY BOSTON · PI ALDRIDGE, BREE BEARDSLEY, KIRSCHNER, DENISE E · 2020 to 2024
$4.2M
NIAID NIH HHS R01 AI150684NIAID NIH HHS T32 AI007528
6 · The paper itself

Abstract

Pulmonary infection after inhalation of Mycobacterium tuberculosis (Mtb) causes tuberculosis (TB). TB presents with lung granulomas - complex spheroidal structures composed of immune cells and bacteria. Granulomas often have centralized caseum (necrotic tissue) where mycobacteria are quarantined, complicating and prolonging multi-antibiotic regimens. Determining which antibiotic regimens are optimal for reducing treatment time and toxicity is a goal of recent TB eradication campaigns. Clinical trials are expensive and challenging, making it difficult to untangle which host-pathogen interactions drive heterogeneous infection and treatment outcomes observed both within and between hosts. To determine responses to antibiotic regimens, we simulate treatments in HostSim, our whole-host mechanistic, multi-scale computational model of Mtb-infection. HostSim tracks dynamics of pulmonary Mtb-infection over molecular, cellular, tissue, organ, and whole-host scales. We create a heterogenous virtual cohort, comprising distinct hosts, for virtual clinical trials. We represent drug treatments by newly-integrating pharmacokinetics / pharmacodynamics into HostSim, simulating treatment with commonly-prescribed TB antibiotic regimens (e.g., HRZE or BPaL). Our approach allows us to identify both (1) which hosts/granulomas improve with treatment, and (2) which mechanisms influence outcome heterogeneity. By tracking experimental and clinical measurements, we virtually recreate several drug rankings from literature. We find that many methods of ranking treatment efficacy are strongly influenced by the 'definition of improvement' used and, in some cases, the detection threshold of CFU. Our work suggests that a study's reported optimal treatment may depend on its experimental design, including initial disease state and bacterial burden measures, possibly explaining seemingly-contradictory findings from prior studies.

Indexed as

Anti-Bacterial AgentsAntitubercular AgentsBacterial LoadModels, BiologicalMycobacterium tuberculosisTuberculosisTuberculosis, PulmonaryComputer SimulationHost-Pathogen InteractionsHumansAnti-Bacterial AgentsAntitubercular AgentsDigital partnerGranulomaMechanistic modelingQuantitative systems pharmacologyVirtual clinical trialVirtual cohort

Identifiers

PMID40460906
PMCPMC12364387

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.