The use of transcriptomics to predict drug efficacy and treatment outcome in tuberculosis

Several new drugs have recently been developed for the treatment of tuberculosis (TB) and, together with a number of repurposed drugs, are currently in clinical trials. The challenge remains to determine which of these novel compounds to prioritize, and to identify which drug combinations will be most effective. The task of testing each novel drug in combination with both new and existing antitubercular compounds using conventional methodologies is an expensive and daunting prospect. There is a need therefore for new assays to characterize drug efficacy, which are both robust and rapid, and which predict a superior regimen in combination drug therapy. In this chapter we discuss the use of gene expression profiling as a tool in the tuberculosis drug discovery pipeline, and the application of RNA-based assays for monitoring treatment success.