结核分枝杆菌异烟肼和丙硫异烟胺耐药及其交叉耐药相关机制研究进展

结核病是一种严重危害人类健康的呼吸道传染病。据世界卫生组织估算,2018年全球耐多药结核病患者数为48.4万。异烟肼是重要的一线抗结核药物,但其目前耐药情况比较严重。丙硫异烟胺,作为异烟肼耐药患者的替代治疗药物,与异烟肼存在部分的交叉耐药性。本文综述了异烟肼和丙硫异烟胺交叉耐药的相关机制,为异烟肼耐药及耐多药结核病患者的治疗提供科学依据。

Progress on the molecular mechanism of independent resistance and cross-resistance to isoniazid and prothionamide in Mycobacterium tuberculosis

Tuberculosis is a respiratory infectious disease that threat to public health worldwide.According to the statistics of World Health Organization,the amount of multi-drug resistance tuberculosis patients was about 484000 in the world during 2018.Isoniazid is an important first line anti-tuberculosis drug with seriously drug resistance at present.Prothionamide is an important second-line anti-tuberculosis drug,which can be used as replacement drug for isoniazid resistant patients.However,prothionamideis partially cross resistance to isoniazid,which will weaken the replaceable role of prothionamide.This paper reviewed the independent resistance and cross-resistance related genes of Mycobacterium tuberculosis to isoniazid and prothionamide,with an emphasis on cross-resistant related genes.At present,the gene mutation involved in isoniazid and prothionamide cross-resistance are mainly inhA,ndh and fabG1-inhA,with two of them(ndh and fabG1-inhA)are still controversial.The aim of this review is to provide reference for the treatment of isoniazid resistance and multi-drug resistance tuberculosis patients.