24 Mar Through collaborative research, the Amsterdam TB Centre envisions a Tuberculosis Free World

“There is a lot of Tuberculosis (TB) research going on in Amsterdam with close links to research in the rest of the world. After the merger of the two major universities in Amsterdam to become the Amsterdam UMC, I realized it was time for greater collaboration in TB research in Amsterdam,” says Prof. Frank Cobelens.

Using the world-famous McGill International TB Centre as a blueprint, Prof. Frank Cobelens and pediatrician Prof. Marceline Tutu-van Furth founded the Amsterdam Tuberculosis Center (TBC) in 2018 with a mission to join forces in TB Research between the Vrije Universiteit (VU) and the Universiteit van Amsterdam (UvA). Today, the center brings together over 40 researchers from both universities and fosters collaborative multidisciplinary TB research.

Collaboration in TB research is needed globally, as the infectious disease continues to take its toll, especially in low- and middle-income countries. Scientific contributions to improve TB diagnostics and treatment are needed now more than ever in order to meet the WHO’s ‘End TB’ strategy. To fulfill their vision of eliminating TB worldwide, the Amsterdam TB Center focuses on collaboration, networking, and education. It is primarily meant for scientists that are affiliated with Amsterdam UMC, including PhD students who are based outside of the Netherlands.

Prof. Wilbert Bitter has been a member of the Amsterdam TBC from the start. Wilbert ventured into TB research in 2001 when he set-up his own lab that investigated the conditions of Mycobacterium tuberculosis’ (the bacterium causing TB) survival in the host. Today, Wilbert’s research team is one of the largest TB research groups in Amsterdam with over 80 publications in his name. Wilbert and his team discovered a unique animal model that allows them to investigate TB.

“It is impossible to understand disease development without an organism to observe it in. TB experiments on animals are expensive, time-consuming and above all, ethically problematic. Rarely, research on TB is carried out on rabbits and apes. We realized that this type of research on animals was not going to be possible financially and timewise, so we investigated alternative models. This brought us to the zebrafish.”

Wilbert explains that TB develops very similarly in fish as it does in humans. His group has made some interesting findings using this unique model. “There have been criticisms about the usage of a fish model to describe TB in humans. In fact, there is a probability that what we see in these fish will not work in humans. But if you find something in this fish model it’s much easier to translate it to another TB model.” The zebrafish have the unique feature of being transparent, which makes it very easy to see interactions within the organism through fluorescence. Furthermore, zebrafish embryos do not pose the same ethical issues as mice or monkeys.

As of 2015, Wilbert and his team have been testing antibiotics for TB on these fish. First, the team showed that the current antibiotics used to treat TB work effectively on the zebrafish. Then, his team started operating on a larger scale by testing new antibiotic components. “We are now going to test three promising antibiotic compounds in mice together with the Erasmus Medical Center in Rotterdam. After that step is fulfilled, we will pursue clinical trials.” As Wilbert explains, the zebrafish model is an effective, low-cost alternative to test potential new antibiotics to treat TB before researching on mice. The Amsterdam TBC was an important platform for collaboration in this groundbreaking work, Wilbert says. His team received funding from the TBC to write a software that automatically reads detailed photographs of the zebrafish.

“Scientists can be very focused on their area of expertise. Amsterdam TBC shows that there are other ways to look at the disease. The biggest added value of the TBC is that it combines multiple disciplines that are working towards a common goal and it pushes researchers out of their comfort zones.” Wilbert highlights that there is a lot of relevant TB research going on in the Netherlands, and in Amsterdam. All of this research complements each other, and it is crucial to have a center like the TBC to aggregate the research and see the full picture.

The center holds quarterly research meetings that each hosts a keynote lecture on a topic relevant to TB, ranging from fundamental research to epidemiology. “In fact, Covid-19 has helped us expand our reach,” says Frank Cobelens. “As it forced us to hold our meetings online we now have lectures by renowned experts from all over the world, with an audience that includes many of our collaborators in Africa and Asia”. The Amsterdam TBC receives an annual subsidy from the Meester Willem Bakhuys Roozeboom foundation, a civil society organization for TB control in Amsterdam, founded when TB was still among the major causes of death in the city and is being spent primarily on post-doctoral research grants.

In addition to its educational and research collaboration components, the Amsterdam TBC provides a large network of national and international stakeholders that operate all along the TB Research and Development chain. These include clinicians in the Amsterdam UMC, the Amsterdam Municipal Health Service (GGD) and collaborating research institutes abroad. In addition, the founders of TBC share ties with institutions involved in global TB control such as KNCV Tuberculosis Foundation and the WHO, which can be helpful in translating research findings into policy and practice and provide networking opportunities for members.

The center is free and inclusive; membership to the Amsterdam TBC is open to anyone who is involved in TB research or has TB-related research interests; and is a PhD student, postdoc, junior or senior researcher; and is affiliated with the Amsterdam University Medical Centers, the University of Amsterdam or VU University, or otherwise works in the Amsterdam area.

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