Adjunctive corticosteroids in TBM treatment seem beneficial in some patients but ineffective or even harmful in others, maybe as a result of the highly variable inflammation and immunopathology in TBM.
Clinical trials have only proven the benefit of adjunctive corticosteroids on survival rate in HIV-negative patients, with no apparent reduction in long-term neurological disability and uncertain effect in HIV-infected patients. Therefore, there is a clear need to optimise host-directed therapy in TBM.
Omics are new technologies used to explore large amounts of data representing an entire set of genes or molecules, such as proteins, lipids, or metabolites, in a cell or patient. We propose to use omics studies (i.e., genomics, transcriptomics, metabolomics and proteomics) to investigate pathogenesis and treatment responses in TBM patients.
This study integrates data and specimens from large studies in Vietnam and Indonesia with state-of-the-art omics technology and systems biology in the Netherlands and USA, including: