Mechanisms, Biomarkers and Pulmonary Rehabilitation in Post-TB Lung Disease

Tuberculosis (TB) affects millions of people worldwide, and many individuals continue to experience long-term health problems even after completing TB treatment. One of the most important of these complications is post-tuberculosis lung disease (PTLD), which can cause persistent breathing problems, reduced physical capacity, and poor quality of life. Despite its high burden, PTLD is still poorly understood, and effective strategies for prevention, early detection, and long-term management are limited.

The AFTER-TB study aims to address these gaps by combining long-term follow-up of people with TB with the evaluation of pulmonary rehabilitation (PR) strategies for those who develop PTLD. The study includes three groups: people with active TB who are followed over time, people with established PTLD, and healthy individuals without TB to provide basal values. By following people from the start of TB treatment, the study will identify who develops PTLD and which clinical, biological, and imaging factors contribute to lung damage or recovery. In addition, the study will collect detailed information on symptoms, lung function, imaging, and biological samples over time. Advanced laboratory techniques will be used to identify biomarkers linked to disease progression or protection, as well as bacterial genetic factors that may influence long-term lung outcomes. This information will help improve early diagnosis and risk stratification. AFTER-TB study will also implement a comprehensive pulmonary rehabilitation programme that includes exercise training, respiratory physiotherapy, education for healthy habits, and psychosocial support. The impact of rehabilitation on physical capacity, lung function, and quality of life will be assessed over time. Overall, the AFTER-TB study combines clinical follow-up, biological research, and pulmonary rehabilitation to generate new knowledge that can improve the prevention and management of PTLD, ultimately supporting better long-term health and quality of life for TB survivors.