Kaur Kirtipal, Gupta Anuj, Narang R K, Murthy R S R
Nanomedicine Research Centre, Department of Pharmaceutics, I.S.F. College of Pharmacy, Moga, Punjab, India.
J Adv Pharm Technol Res. 2010 Apr;1(2):145-63.
Tuberculosis has claimed its victims throughout much of known human history and is currently the most devastating human bacterial disease. The ability to infect human population on a global scale, combined with the widespread emergence of multi-drug resistant strains, has led to the placement of Mycobacterium tuberculosis on the National Institute of Allergy and Infectious Diseases (NIAID) list of Biodefence and Emerging Infectious Disease Threats Agents. The resurgence of interest in tuberculosis (TB) has stemmed because of increased evidences from developed countries. Contrary to expectations, no country has reached the phase of elimination and in no subsection of society TB has been completely eliminated. A deeper understanding of the process will assist in the identification of the host and mycobacterial efforts involved and provide targets for therapeutic strategies against tuberculosis. The article presents a view on pathogenesis of tuberculosis and its diverse manifestations, host defense evasion, mechanisms of microbial persistence, emergence of Multiple Drug Resistance and Extensive Drug Resistance, conventional therapy used and the possible novel systems which are under extensive investigation as drug carriers for improving the cytosolic concentration of the anti-tubercular agents.
在已知的人类历史大部分时间里,结核病都在夺取人们的生命,目前它仍是最具毁灭性的人类细菌性疾病。结核分枝杆菌能够在全球范围内感染人群,再加上多重耐药菌株的广泛出现,使其被列入美国国立过敏与传染病研究所(NIAID)的生物防御和新发传染病威胁病原体名单。对结核病(TB)兴趣的再度兴起源于发达国家越来越多的证据。与预期相反,没有一个国家达到消除阶段,社会的任何一个群体中结核病都未被完全消除。对这一过程的更深入理解将有助于确定所涉及的宿主和分枝杆菌的作用,并为抗结核治疗策略提供靶点。本文阐述了结核病的发病机制及其多样表现、宿主防御逃避、微生物持续存在机制、多重耐药和广泛耐药的出现、使用的传统疗法以及作为药物载体正在进行广泛研究的可能新型系统,这些系统旨在提高抗结核药物的胞质浓度。