Tuberculosis Research in Korea

Abstract

Korea has been listed as an example of countries demonstrating how successful tuberculosis (TB) control programs could reduce the prevalence and mortality of TB. With tremendous efforts led by the Korea Institute of Tuberculosis, the prevalence of TB reduced from over 5% in 1965 to 1% in 1995, and now about 0.3% in 2010. All these remarkable achievements could not be made without endless efforts for operational research activity including the nationwide TB prevalence surveys which were carried out every five years from 1965 to 1995. During the same period, there were also numerous research activities on drug trials, new diagnostic tests, and BCG vaccine whose results were then translated into the better TB control programs. As the prevalence of TB decreased to less than 1%, however, interests in the TB control programs and research among scientists and clinicians were also reduced markedly leaving basic and clinical research idle. Coincidently, there has been no significant decrease since late 1990s leaving TB control community a little bit nervous about the situation. Without the nationwide survey, it has been difficult to know or estimate the TB burden in the country. Emergence of HIV infection and a steady increase in multi-drug resistance (MDR)-TB in Korea and oversea countries have made a big alarm to scientists and clinicians around the country last several years. With a recent boost in biomedical research funds led by the Ministry of Health and Welfare, research grants and contracts had been also available to TB research. Even though there was only a handful of basic and clinical researchers, their research topics include: (i) molecular diagnosis for detection of DNA or mRNA of Mycobacterium tuberculosis, species identification, and detection of mutations in the genes which are associated with drug resistance, whose results have been translated to several diagnostic kits in the market. (ii) new drug development against M. tuberculosis infection. A couple of drug candidates were licensed out and several more on the preclinical development stages. (iii) new vaccine development including identifying vaccine candidate antigens and adjuvant inducing cell-mediated immune responses toward development of subunit or DNA vaccines. (iv) clinical trials with new drug candidates against MDR-TB and XDR-TB as an effort to identify life-saving drugs. (iv) basic research for understanding host-parasite interaction between M. tuberculosis and human whose results can be translated into new diagnostics, drugs, and vaccines. In addition, there were also a group of scientists working on non-tuberculous mycobacterial infection which covers 7-10% of mycobacterial diseases in Korea. Hopefully, all these research activity in both basic and clinical settings can be extended and boosted markedly in the foreseeable future.