Boldrin Francesca, Provvedi Roberta, Cioetto Mazzabò Laura, Segafreddo Greta, Manganelli Riccardo
Department of Molecular Medicine, University of Padova, Padova, Italy.
Department of Biology, University of Padova, Padova, Italy.
Front Microbiol. 2020 Aug 26;11:1924. doi: 10.3389/fmicb.2020.01924. eCollection 2020.
The treatment of tuberculosis is extremely long. One of the reasons why elimination from the organism takes so long is that in particular environmental conditions it can become tolerant to drugs and/or develop persisters able to survive killing even from very high drug concentrations. Tolerance develops in response to a harsh environment exposure encountered by bacteria during infection, mainly due to the action of the immune system, whereas persistence results from the presence of heterogeneous bacterial populations with different degrees of drug sensitivity, and can be induced by exposure to stress conditions. Here, we review the actual knowledge on the stress response mechanisms enacted by during infection, which leads to increased drug tolerance or development of a highly drug-resistant subpopulation.
结核病的治疗周期极长。病原体从机体中清除所需时间如此之长的原因之一是,在特定环境条件下,它会对药物产生耐受性和/或产生即使在极高药物浓度下也能存活的持留菌。耐受性的产生是对细菌在感染过程中遇到的恶劣环境暴露的反应,主要是由于免疫系统的作用,而持留性则源于存在不同程度药物敏感性的异质性细菌群体,并且可以通过暴露于应激条件而诱导产生。在此,我们综述了关于感染期间结核杆菌所启动的应激反应机制的现有知识,这些机制会导致药物耐受性增加或产生高度耐药亚群。