Editorial [ Infectious Diseases: What is in our future? ]

Current Drug Targets-Infectious Disorders (CDT-ID) was launched in May of 2001 and is now starting its seventh year with the March 2007 issue, although under a new name: Infectious Disorder - Drug Targets. Special Topics issues, organized by a Guest Editor, are published twice a year and have been well received since their inception in 2001. Two Special Topics issues are scheduled for 2007: 1) Drs. Robert Goldman and Barbara Laughon (Complications and Coinfections Research Branch, National Institutes of Health, Bethesda, MD) will be the Guest Editors of our June 2007 Special Topics issue on Tuberculosis Targets and Drug Discovery and Development; and 2) Dr. Christopher F. Basler (Mount Sinai School of Medicine) will be the Guest Editor of our December 2007 Special Topics issue on Influenza Virus Epidemics and Drug Targets. Someone dies of tuberculosis (TB) every 15 seconds, and in spite of global control and treatment efforts some regions of the world are experiencing a crisis that will likely spread. The discovery of streptomycin in the 1943 by the Nobel Laureate Selman Waksman's group at Rutgers University and subsequent demonstration of its efficacy against TB proved that effective chemotherapy could be administered. However, in only a few years of clinical use the specter of resistance arose and became a major concern. Today we have to deal with multidrug resistant TB (MDR-TB) and extensively drug resistant TB (XDR-TB) strains. MDR-TB strains are defined as those resistant to both isoniazid and rifampicin, two of the most effective first-line drugs. XDR-TB was initially defined as MDR-TB with further resistance to three or more of the six main classes of second-line antitubercular drugs (aminoglycosides, polypeptides, fluoroquinolones, thioamides, cycloserine and para-aminosalicylic acid). This definition was changed to resistance to isoniazid and rifampicin plus resistance to any fluoroquinolone and at least one of three injectable second-line drugs (amikacin, kanamycin, or capreomycin). Regardless of semantic definitions, multiple drug resistance in TB has led to a developing global health-care crisis over the past decade, one that was brought to the forefront when a deadly outbreak of XDR-TB occurred in a rural area in KwaZulu Natal, South Africa. The initial report described infection in 53 persons (44 know to be HIV positive) that lead to death in 52 of 53 patients with a median survival of 16 days from time of diagnosis (Neel R Gandhi, Anthony Moll, A Willem Sturm, Robert Pawinski, Thiloshini Govender, Umesh Lalloo, Kimberly Zeller, Jason Andrews, Gerald Friedland, The Lancet Vol. 368, November 4, 2006, page 1575). Since then the outbreak has increased to over 500 known cases. A more detailed review of XDR-TB will appear in the June 2007 Special Topics issue. The March 2007 issue of Infectious Disorders - Drug Targets presents a range of topics covering many exciting developments in infectious disease research. Targeting Bacterial Secretion Systems: Benefits of Disarmament in the Microcosm (C. Baron and B. Coombes): Bacterial pathogens use specialized secretion systems to deliver virulence factors temporally and spatially in the infected host. The assembly and function of type II, type III and type IV secretion systems in Gram-negative bacteria are reviewed in the context of structure and function, as well as strategies for identifying potential inhibitors. Novel Targets for the Development of Anti-herpes Compounds (A. Greco, J-J Diaz, D. Thouvenot and F. Morfin): Herpes simplex (HSV) viruses represent a major infectious disease problem for millions of people, especially those who are immunocompromised. Reliance on a single agent, acyclovir, as the major therapy has led to resistance selection. Viral and cellular targets involved in HSV replication and infection are reviewed along with progress in discovering new inhibitory agents. Antibiotic Resistance during Therapy: Mechanisms and Means of Control (J. C. Rodríguez, E. Pastor, M. Ruiz, E. Flores, and G. Royo): The continued evolution and dissemination of drug resistant bacteria is a major health care burden. The complex microbiological factors involved in the selection of resistance during antibiotic therapy are reviewed, along with approaches to minimize selection of resistance in the future.......