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乙酰半胱氨酸作为一线和二线抗结核药物增效剂的前景与局限性

The promises and limitations of acetylcysteine as a potentiator of first-line and second-line tuberculosis drugs.

作者信息

Vilchèze Catherine, Jacobs William R

机构信息

Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA.

Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA

出版信息

Antimicrob Agents Chemother. 2023 May 1;65(5). doi: 10.1128/AAC.01703-20. Epub 2021 Feb 22.

Abstract

acetylcysteine (NAC) is most commonly used for the treatment of acetaminophen overdose and acetaminophen-induced liver injury. In patients infected with , the causative agent of tuberculosis (TB), NAC is given to treat hepatotoxicity induced by TB drugs. We had previously shown that cysteine, a derivative of NAC, potentiated the activity of isoniazid, a first-line TB drug, by preventing the emergence of INH resistance and persistence in in vitro. Herein, we demonstrate that in vitro, NAC has the same boosting activity with various combinations of first- and second-line TB drugs against drug-susceptible and multidrug-resistant strains. Similar to cysteine, NAC increased respiration. However, in -infected mice, the addition of NAC did not augment the activity of first- or second-line TB drugs. A comparison of the activity of NAC combined with TB drugs in murine and human macrophage cell lines revealed that studies in mice might not be recapitulated during host infection in vivo.

摘要

乙酰半胱氨酸(NAC)最常用于治疗对乙酰氨基酚过量及对乙酰氨基酚引起的肝损伤。在感染结核分枝杆菌(结核病的病原体)的患者中,给予NAC以治疗由抗结核药物引起的肝毒性。我们之前已经表明,NAC的衍生物半胱氨酸通过防止结核分枝杆菌体外对异烟肼(一种一线抗结核药物)产生耐药性和持续性,增强了异烟肼的活性。在此,我们证明在体外,NAC与一线和二线抗结核药物的各种组合对药物敏感和耐多药结核分枝杆菌菌株具有相同的增强活性。与半胱氨酸类似,NAC增加了结核分枝杆菌的呼吸作用。然而,在结核分枝杆菌感染的小鼠中,添加NAC并未增强一线或二线抗结核药物的活性。对NAC与抗结核药物在小鼠和人巨噬细胞系中的活性比较表明,在小鼠中的研究可能无法在体内宿主感染期间得到重现。

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