Name: Professor Amy Barczak (MD)

Institution: Ragon Institute of MGH, MIT and Harvard

Location: Boston, United States

Website: http://ragoninstitute.org/portfolio-item/barczak/

Tell me a bit about how you came to be interested in TB and what your work entails.

How did I get interested in TB? When I was a first year medical student, I simultaneously took two very different classes that led me to TB research. The first was microbiology- I found myself completely fascinated by bacteria. I had done bench research before, but hadn't found anything that engaged me enough to see myself as a scientist for the long haul. In that micro class, I found that bacteria were a subject I could be happy studying forever. At the same time, I was taking a social medicine class called "Culture, Poverty, and Infectious Disease" taught by Drs. Paul Farmer and Jim Kim (both of Partners in Health at that point). For me, that course led to an acute awareness of the global burden of morbidity and mortality caused by TB, particularly among economically and socially vulnerable populations. In spite of the high global burden of disease, the global resources devoted to solving the problem of TB both clinically and scientifically seemed woefully inadequate to the task. So TB felt like an important enough problem to devote a career to trying to help solve at the same time that it seemed intellectually interesting. Since taking those classes, I've been lucky enough to learn from several scientific and clinical mentors with expertise in everything from very basic aspects of pathogenesis to clinical management of complex cases, and I now have my own lab studying TB.

What does my work entail? My lab is broadly interested in trying to identify new approaches to treating TB. We have three areas of focus: 1) We're interested in identifying and characterizing the bacterial factors that allow TB to be such a successful pathogen in the host setting; we're particularly interested in the role of virulence lipids in infection. 2) We're interested in translating our growing understanding of what TB needs to survive in the human host into screenable assays for new TB drugs. 3) We apply mycobacterial genetic tools to understand the host response to TB infection, particularly on the individual macrophage level.

What is the most interesting thing about working with/treating TB?

Scientifically and clinically, it's fascinating that the same disease can present and progress so differently in two different individuals who on the surface might look quite similar.

What do you think is the biggest challenge today for successfully eradicating TB?

I think that gaps in our fundamental knowledge about the disease- unknowns like biological correlates of protective immunity that would facilitate vaccine testing or key bacterial vulnerabilities that would allow us to develop more effective and shorter treatments- limit what we're able to develop as new prevention and treatment strategies.

What would you like the public (and general microbiological audience) to appreciate about TB?

Because biological and logistical constraints mean that basic TB research is very slow, focusing on translational research and implementation strategies can seem like the most effective way to concretely improve morbidity and mortality from TB in the short term. But simultaneously investing time and resources in basic research is critical to filling those fundamental knowledge gaps that stand in the way of the transformative changes in how we approach TB that would make eradication a possibility.