Case Western Reserve University Tuberculosis Research Unit
  Integrating research to combat the global TB epidemic




Tuberculosis Research Support Increases
In the United States and most other parts of the developed world, both tuberculosis cases and tuberculosis research abated markedly after the introduction of multi-drug therapy during the late 1950s. Then, after decades of decline, tuberculosis made a dramatic comeback. The number of cases in the U.S. increased 14% from 1985 to 1993. The increase is attributed to the association of tuberculosis with the HIV epidemic, immigration from countries with high endemic rates of disease, transmission in congregate settings, and a decline of the health care infrastructure. More challenging for health officials were outbreaks of multidrug-resistant forms of tuberculosis. These events pointed to an urgent need for improved prevention, diagnostic, and treatment interventions to control the disease. In fact, the disease had never left. The increase in cases reported in the U.S. and elsewhere in the developed world reflected a worldwide increase in tuberculosis. The World Health Organization responded and declared tuberculosis a global emergency in 1993. In 1994 the U.S. National Institute of Allergy and Infectious Disease (NIAID) responded and dramatically increased support for tuberculosis research.  Support for tuberculosis research continues to be a priority for NIAID and other agencies worldwide.

Overview of TBRU
An NIAID contract that established the Tuberculosis Research Unit (TBRU) was awarded to Case Western Reserve University in September 1994. This first contract continued through 1999, led by Jerrold Ellner, M.D. as Director with Kathleen Eisenach, Ph.D. of the University of Arkansas for Medical Sciences as Co-Director.  This first contract created a multidisciplinary, international team, to translate basic research findings into useful tools to improve the treatment and control of tuberculosis. During the first five years, partners included researchers in the US, India, Uganda, and Brazil.  The NIAID contract was re-competed for two additional cycles (2000-2015) under the direction of W. Henry Boom, M.D., continuing the interdisciplinary research teams with new, additional scientific leaders and expanding a Data and Administrative Coordinating Center and Specimen Repository based at CWRU in Cleveland. Partners expanded to the Philippines and South Africa for clinical studies. The last cycle (2007-2015) evolved to address changing TB research needs and specifically built on human TB immunology, human genetics and vaccine evaluation and with U.S., European, Ugandan, and South African partners.

During TBRU’s NIAID contract cycles, the scientific leaders at CWRU with their well-established Coordinating Center secured additional research awards for TB and related areas of international research.  These new opportunities were possible due to CWRU’s long-standing Collaboration with Makerere University in Uganda, namely the Uganda-CWRU Research Collaboration.

The Evolving TBRU at CWRU
The TBRU at CWRU continues to lead worldwide efforts conducting vital clinical studies for TB and addressing critical gaps in TB translational research.  Our U.S. and international partners continue to evolve and grow.  Our Coordinating Center continues to evolve beyond our TB research, supporting CWRU researchers from all disciplines as well as supporting operations of the Uganda-CWRU Research Collaboration.  The TBRU at CWRU continues to tackle all challenges of our international research agenda.