Tuberculosis is a serious infectious disease caused by the bacterium Mycobacterium tuberculosis, also known as Koch's bacillus. It is one of the leading causes of death worldwide, with more than one million deaths and 10 million new cases each year. It is estimated that a quarter of the world's population is infected with the pathogen. Resistance to treatments is also a major problem. As such, the fight against tuberculosis is one of the global Sustainable Development Goals adopted by the United Nations in 2015.

Tuberculosis: a disease of global importance

Tuberculosis is a contagious disease transmitted through the air. It most often affects the lungs, but can also affect any other organ or part of the body, such as the kidneys, lymph nodes, bones, or central nervous system. In the latter case, morbidity and mortality rates are particularly high.
While the infection can remain silent, without clinical manifestations, throughout the lives of the vast majority of people, it will progress to disease in 5 to 10% of carriersThis symptomatic development is favored by weakened or deficient immune defenses. These conditions can be found in malnourished individuals, those suffering from AIDS or diabetes, or those undergoing immunosuppressive treatment, for example, to combat transplant rejection or chronic inflammatory conditions such as Crohn's disease or multiple sclerosis.

What are the symptoms of tuberculosis?

Common symptoms of pulmonary tuberculosis include:

In 1: Persistent cough A cough that lasts more than three weeks is one of the most common symptoms. It can be dry or productive (with phlegm).
In 2: Coughing up blood : In some cases, sputum may contain blood (hemoptysis).
In 3: Chest pain Chest pain may occur, especially when breathing or coughing.
In 4: Tiredness  : A feeling of fatigue or general weakness is common.
In 5: Weight loss Unexplained and unintentional weight loss is common.
In 6: Fever A mild but persistent fever may be present.
In 7: Night sweats Excessive night sweats are another typical symptom.
In 8: Loss of appetite A lack of appetite can also be a symptom of tuberculosis

While the infection can remain silent, without clinical manifestations, throughout the lives of the vast majority of people, it will progress to disease in 5 to 10% of carriersThis symptomatic development is favored by weakened or deficient immune defenses. These conditions can be found in malnourished individuals, those suffering from AIDS or diabetes, or those undergoing immunosuppressive treatment, for example, to combat transplant rejection or chronic inflammatory conditions such as Crohn's disease or multiple sclerosis.

What are the causes of tuberculosis?

La TB is a contagious disease that is transmitted through the airIt most often affects the lungs, but can also affect all other organs or parts of the body, such as the kidneys, lymph nodes, bones, or the central nervous system. In the latter case, morbidity and mortality rates are particularly high.

It can also be transmitted for the following reasons:

Advances and the fight against tuberculosis at the Pasteur Institute of Lille

The standard treatment for tuberculosis requires daily doses of four antibiotics for an initial two-month induction phase, followed by four months of maintenance therapy with two antibiotics. In cases of resistance to rifampicin, the primary drug in this regimen, second-line treatments are required, involving a minimum of three other antibiotics—and up to seven in some cases—for durations of 6 to 20 months or more. These combination therapies can cause significant side effects. Furthermore, these treatments are seriously threatened by the emergence and spread of multidrug-resistant and extensively drug-resistant strains, including those resistant to some of the latest available anti-tuberculosis drugs.

Therefore, research and development of new, shorter, and well-tolerated treatments, and new rapid diagnostic tests capable of extensively identifying sensitivities or resistances to antituberculosis drugs in order to ensure their effectiveness, are global priorities. International efforts are also focused on developing a vaccine more effective than the BCG (the Calmette and Guérin bile vaccine). The latter, developed by Albert Calmette et Camille Guerin at the Pasteur Institute of Lille in 1921To this day, it remains the only available vaccine against the disease. It effectively prevents extrapulmonary forms in children and is still widely used around the world. However, it provides insufficient protection against the contagious pulmonary forms of tuberculosis.

Teams from the Pasteur Institute of Lille, comprising more than 40 peopleThey conduct internationally recognized, cutting-edge research across all three of these areas. They develop innovative antibiotic therapeutic molecules, next-generation molecular diagnostics, and promising vaccine approaches. They also seek to identify the factors involved in the emergence and unparalleled evolutionary success of the pathogen. Some of this work has already led to a novel treatment strategy, currently undergoing clinical trials, as well as the development of the most comprehensive rapid antibiotic resistance detection tool to date, approved by theWorld Health Organization in 2023. The combination of these fundamental and applied research areas within the same institute is unparalleled in Europe.

The Pasteur Institute of Lille, a key player in the fight against tuberculosis

Historically, the fight against tuberculosis is closely linked to the Pasteur Institute of Lille. Drawing on its expertise in the field of infectious diseases and true to its commitment to longevity, researchers remain dedicated to combating this disease to this day.

A legacy of Calmette and Guérin

It is worth remembering that these were two researchers from the institute, Albert Calmette et Camille Guerinwho, at the beginning of the 20th century, developed the first effective vaccine against tuberculosis (BCG). Dr. Alain Baulard, research director at Inserm at the Pasteur Institute of Lille, may be on the verge of winning another victory against this scourge, and more generally against infectious diseases.

His team and that of the Professor Nicolas Willand are currently developing a novel strategy to boost the effectiveness of available antibiotic treatments. The project is currently in the preclinical development phase with the Pasteur Institute of Lille and other partners. It is so promising that the Dr. Baulard has already received the Pasteur-SINF (Industrial Society of Northern France) prize to recognize the work already undertaken on this topic.

Birthplace of the tuberculosis vaccine

In 1895, Albert Calmette takes over responsibility for the Pasteur Institute of Lille. He is joined by the veterinarian Camille Guerin in 1897 and together they began their research on tuberculosis from 1900. This research would last about twenty years and would lead, in Lille, to the discovery of an effective vaccine which bears their name: BCG (Bacillus Calmette and Guérin).

This vaccine was first tested on newborns in 1921, with success. The first vaccination campaigns began in 1924, and were widely rolled out around the world from 1928 onwards.

Today, researchers at the Pasteur Institute of Lille, such as Camille Locht and his team, continue to work on this disease, particularly to prolong the effectiveness of BCG and make Koch's bacillus more sensitive to antibiotics.

The original strains of BCG are on display at the Pasteur Institute Museum in Lille, open to the public on Fridays and Saturdays. More information about the museum.