Catching Breath: The Making and Unmaking of Tuberculosis

by Kathryn Lougheed

Overview

With more than a million victims every year—more than any other disease, including malaria—and antibiotic resistance now found in every country worldwide, tuberculosis is once again proving itself to be one of the smartest killers that humanity has ever faced. But it's hardly surprising considering how long it's had to hone its skills. Forty-thousand years ago, our ancestors set off from the cradle of civilization on their journey towards populating the planet. Tuberculosis hitched a lift and came with us, and it's been there ever since; waiting, watching, and learning.

The organism responsible, Mycobacterium tuberculosis, has had plenty of time to adapt to its chosen habitat—human lungs—and has learned through natural selection to be an almost perfect pathogen. Using our own immune cells as a Trojan Horse to aid its spread, it's come up with clever ways to avoid being killed by antibiotics. But patience has been its biggest lesson—it can enter into a latent state when times are tough, only to come back to life when a host's immune system is compromised. Today, more than one million people die of the disease every year and around one-third of the world's population are believed to be infected. That's more than two billion people. Throw in the compounding problems of drug resistance, the HIV epidemic, and poverty, and it's clear that tuberculosis remains one of the most serious problems in world medicine.

Catching Breath follows the history of TB through the ages, from its time as an infection of hunter-gatherers to the first human villages, which set it up with everything it needed to become the monstrous disease it is today, through to the perils of industrialization and urbanization. It goes on to look at the latest research in fighting the disease, with stories of modern scientific research, interviews with doctors on the TB frontline, and the personal experiences of those affected by the disease.

Product Details

ISBN-13:	9781472930330
Publisher:	Bloomsbury USA
Publication date:	09/05/2017
Pages:	272
Product dimensions:	5.30(w) x 8.50(h) x 1.10(d)

About the Author

Kathryn Lougheed worked in tuberculosis research for more than ten years, focusing on the biological mechanisms of latent tuberculosis. She completed her Ph.D. at Imperial College London, and worked at the National Institute for Medical Research where she collaborated with industrial partners to develop inhibitors targeted against Mycobacterium tuberculosis. Lougheed has published dozens of peer-reviewed papers and was an active member of the tuberculosis research community. This is her first book and she lives in London, England.

Table of Contents

Introduction: I Caught TB from My Pet Cat 7

Chapter 1 Bringing the Dead Back to Life 13

Chapter 2 From Moo to Man and Back Again 29

Chapter 3 Didn't We Already Cure It? 49

Chapter 4 All That Glitters 65

Chapter 5 Thanks for the Memories 83

Chapter 6 The Human Universe 101

Chapter 7 Huber the Tuber's 20-Tuberculear Sleep 121

Chapter 8 Growing Fat on the Atkins Diet 141

Chapter 9 Killing the Unkillable 159

Chapter 10 The Drugs Don't Work 177

Chapter 11 A Barometer of Inequality 197

Chapter 12 Ratting Out the Missing 3 Million 217

Chapter 13 New Drugs for Bad Bugs 239

Epilogue: TB Continued 259

Acknowledgements 265

Index 267

Editorial Reviews

Lougheed offers an impressive survey of current attempts to diagnose and treat the disease, from the experimental use of cancer drugs that modify the immune system to statins, which are typically prescribed to lower cholesterol…Without underplaying the challenges, especially of TB's multidrug-resistant and extensively drug-resistant strains, she presents a league of smart scientists whose ingenuity and commitment offer at least some sense of hope.

The New York Times Book Review - Amanda Schaffer

06/26/2017
British medical researcher Lougheed creditably covers the long, painful history of tuberculosis, the world’s leading infectious killer, and the impressive recent advances in combatting it. The slow-growing and tough TB bacterium has infected humans since prehistory, but our immune system largely kept it under control up until the industrial revolution, when humans packed into cities and their health and immune systems declined. Improvements in public health after 1900 reduced infections, and it was widely believed that anti-TB antibiotics—which were developed after just after WWII—would eliminate the threat. But resistance appeared; widespread poverty in the developing world, combined with other diseases attacking the immune system such as HIV, has produced a worldwide epidemiological crisis. Lougheed delivers an expert account of this history, although her efforts to enliven a dismal subject with cheerful anecdotes and jokes do not always succeed. She is at her best when describing the research done in the late 20th and early 21st centuries. Dazzling technical advances, new drugs, the development of genomics, insights into the bacterium’s metabolism, and massive but halting political efforts may eventually turn the tide, but as Lougheed writes, TB is “very much a disease of the present and, sadly, the future.” (Sept.)

Publishers Weekly

"With humor and clarity, she skillfully distills the complex science surrounding mycobacterium TB into a comprehensible narrative . . . sure to be appreciated by scientists as well as lay people interested in learning more about this persistent disease." - Library Journal

". . . an expert account . . ." - Publishers Weekly

"Not just a medical history but a call to action." - Kirkus

"Lougheed sets out the statistics calmly but returns to their enormity as she delivers on her aim to raise the profile of this prolific killer . . . Through her passion, many others may find inspiration." - Valerie Thompson, Science

From the Publisher

06/01/2017
Causing 1.8 million deaths a year, a count that surpasses that of either malaria or HIV/AIDS, tuberculosis (TB) clocks in as the deadliest infectious disease. TB researcher Lougheed takes a closer look at this ancient yet potentially curable illness that continues to ravage humans around the world, particularly in areas with high poverty and limited access to health care. She has crafted a biography of TB, exploring its historical evolution and humans' response to it. Beginning with the work of molecular archaeologists to diagnose TB in ancient remains, Lougheed moves through history covering a variety of topics such as the migration of TB to all corners of the globe. According to the author, if we ever hope to overcome the disease, a comprehensive, collaborative approach combining science and efforts to combat poverty and improve access to health care will be necessary. With humor and clarity, she skillfully distills the complex science surrounding mycobacterium TB into a comprehensible narrative. VERDICT Sure to be appreciated by scientists as well as lay people interested in learning about this persistent disease. Make no mistake, however—this is serious science.—Ragan O'Malley, Saint Ann's Sch., Brooklyn

Library Journal

2017-05-31
An exegesis on tuberculosis, a scourge that continues to threaten humanity: in 2015, there were 10.4 million new cases and 1.4 million deaths.London-based microbiologist Lougheed left the TB field after years of drug research that yielded few results. Indeed, her text makes clear that Mycobacterium tuberculosis is a bug that has co-evolved with humans since the birth of our species, acquiring extraordinary survival strategies. When the bugs land in a lung, the immune system sends macrophages to engulf and eat them, but they convert the macrophages to squats and live on various immune cell lipids. In turn, these infested macrophages group into granulomas that cluster in the lung, each with its own ecology. Further complicating the problem of combatting the disease is the fact that M. tuberculosis has an especially thick cell wall. Antibiotics only work against actively growing cells, so if the TB bug is sleeping, it can persist and then become the source of reactivation of a latent infection. Then there are the bugs with mutations that have resulted in multiply drug-resistant TB. Lougheed examines all these microbe-immune system interactions by dissecting current research papers as though readers were part of a weekly session of post-doctoral candidates keeping up-to-date. (The book could have used further editing for a general audience.) The author also explains the need for daily treatment regimens of multiple pills or injections that can last for years. As Lougheed notes, as well, TB flourishes in the presence of poverty, malnutrition, crowded living conditions, and co-infections. Unfortunately, this makes certain areas particularly vulnerable to the disease, including migrant and refugee camps. Not just a medical history, but a call to action. TB is not some quaint 19th-century romantic tragedy but rather a very real and present danger that requires investments in diagnostics and new drugs and greater attention to social and racial inequities.

Kirkus Reviews

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