Drug resistance in tuberculosis (TB) is a matter of great concern

Drug resistance in tuberculosis (TB) is a matter of great concern for TB control programs since these strains could spread in the community, stressing the need for early detection of drug resistance and subsequently initiation Nutlin-3a nmr of adjusted therapy. Conventional diagnosis of drug-resistance in MTB strains relies heavily upon mycobacterial culture and drug susceptibility testing in liquid or solid media. Usually, results are only obtained

after weeks to months of incubation and many developing countries lack the resources to establish the stringent laboratory conditions needed for these growth-based methods. From a clinical perspective, the existing growth-based diagnostics are too slow as patients undergoing treatment with drugs to which they are resistant, remain contagious, and those with XDR-TB and HIV often die before they are even diagnosed [6]. Major advances in molecular biology and the availability of new information generated after deciphering

the complete genome sequence of M. tuberculosis[7], Ibrutinib cell line have led to the development of new tools for rapid detection of drug resistance [8, 9]. Molecular methods are based on assigning the presence or absence of certain mutations in specific positions or genetic locations which are known to be associated with resistance [10]. About 95% of rifampicin (RIF) -resistant strains have mutations in the 81-bp core region of the rpoB gene encoding the β-subunit of the RNA polymerase, named RIF-Resistance Determining Region (RRDR) Silibinin [11]. In contrast to RIF, the situation for isoniazid (INH) is much more complex. Resistance mutations have been reported in at least 4 different genes including katG, inhA, ahpC and oxyR[10]. Meanwhile, resistance

against streptomycin (SM) has been reported to be associated with mutations in rrs gene, which codes for 16S ribosomal RNA, and rpsL coding for the ribosomal protein S12 [12] and these mutations are found in a limited proportion of clinically isolated SM-resistant M. tuberculosis strains. Recently, Okamoto et al. [13] found that mutations within the gidB gene which encodes a conserved 7-methylguanosine (m7G) methyltransferase specific for the 16S rRNA, is associated with low-level SM-resistance and are an important cause of resistance found in 33% of resistant M. tuberculosis isolates. Resistance to ethambutol (EMB) is primarily mediated by mutations in the embB gene, coding for an arabinosyltransferase participating in mycobacterial cell wall synthesis, with codon 306 being most frequently affected [14]. Furthermore, mutations in the embA[15, 16] and upstream of embC[16, 17] are also involved in EMB -resistance.

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