a Department of Biochemistry , National JALMA Institute for Leprosy and Other Mycobacterial Diseases (ICMR) , Agra , India.
b Department of Immunology , National JALMA Institute for Leprosy and Other Mycobacterial Diseases (ICMR) , Agra , India.
Infect Dis (Lond). 2018 Feb;50(2):81-94. doi: 10.1080/23744235.2017.1377346. Epub 2017 Sep 21.
Targeting M. tuberculosis (Mtb) in latent form of infection is a major obstacle and big challenge in tuberculosis (TB) eradication by current chemotherapy. A better understanding of the physiology of Mtb and of the metabolic state of the bacillus during the dormancy, is a primary need in finding drug targets against non replicating persistent (NRP) form of the Mtb. Identification of potential drug targets against dormant state of Mtb is critically important to achieve the goal of complete eradication for shortening of anti-TB therapy. The metabolic processes functioning in dormant Mtb in providing cell viability and protecting Mtb from sterilization by the hostile environment can be explored as drug targets. This review discusses about the potential drug targets in dormant tubercle bacilli, anti-dormancy inhibitors and the strategies which can be pursued for maximizing success if these targets are exploited for killing the dormant bacilli. This has important implications as the currently available arsenal of drugs suffers from the demerit of achieving sterilizing killing of mycobacteria. This lacuna can be overcome if the proposed strategies for eliminating dormant bacteria are combined along with the existing treatment modalities for the extirpation of bacilli.
针对潜伏性感染的结核分枝杆菌（Mtb）是当前化学疗法根除结核病（TB）的主要障碍和巨大挑战。更好地了解 Mtb 的生理学以及休眠期间杆菌的代谢状态，是寻找针对非复制性持续（NRP）形式的 Mtb 的药物靶点的首要需求。鉴定针对休眠状态的 Mtb 的潜在药物靶点对于实现完全根除的目标，缩短抗结核治疗至关重要。可以探索休眠 Mtb 中发挥作用的代谢过程，为细胞活力提供支持，并防止 Mtb 被恶劣环境灭菌，以此作为药物靶点。本文综述了休眠结核杆菌中的潜在药物靶点、抗休眠抑制剂以及如果利用这些靶点杀死休眠杆菌可以采取的策略，以最大程度地提高成功率。这具有重要意义，因为目前可用的药物库存在实现杀菌杀灭分枝杆菌方面存在缺陷。如果将消除休眠细菌的拟议策略与现有的治疗方式相结合，以根除杆菌，就可以克服这一空白。
