Perspectives for systems biology in the management of tuberculosis

Irina Kontsevaya, Christoph Lange, Patricia Comella-Del-barrio, Cristian Coarfa, Andrew R. Dinardo, Stephen H. Gillespie, Matthias Hauptmann, Christoph Leschczyk, Anna M. Mandalakas, Antal Martinecz, Matthias Merker, Stefan Niemann, Maja Reimann, Olena Rzhepishevska, Ulrich E. Schaible, Katrin M. Scheu, Erwin Schurr, Pia Abel Zur Wiesch, Jan Heyckendorf

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations


Standardised management of tuberculosis may soon be replaced by individualised, precision medicine-guided therapies informed with knowledge provided by the field of systems biology. Systems biology is a rapidly expanding field of computational and mathematical analysis and modelling of complex biological systems that can provide insights into mechanisms underlying tuberculosis, identify novel biomarkers, and help to optimise prevention, diagnosis and treatment of disease. These advances are critically important in the context of the evolving epidemic of drug-resistant tuberculosis. Here, we review the available evidence on the role of systems biology approaches – human and mycobacterial genomics and transcriptomics, proteomics, lipidomics/metabolomics, immunophenotyping, systems pharmacology and gut microbiomes – in the management of tuberculosis including prediction of risk for disease progression, severity of mycobacterial virulence and drug resistance, adverse events, comorbidities, response to therapy and treatment outcomes. Application of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach demonstrated that at present most of the studies provide “very low” certainty of evidence for answering clinically relevant questions. Further studies in large prospective cohorts of patients, including randomised clinical trials, are necessary to assess the applicability of the findings in tuberculosis prevention and more efficient clinical management of patients.

Original languageEnglish (US)
Article number200377
JournalEuropean Respiratory Review
Issue number160
StatePublished - Jun 30 2021

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine


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