Trends in the discovery of new drugs for Mycobacterium tuberculosis therapy with a glance at resistance

Tuberculosis (Edinb). 2018 Mar:109:17-27. doi: 10.1016/j.tube.2017.12.002. Epub 2017 Dec 9.

Abstract

Despite the low expensive and effective four-drug treatment regimen (isoniazid, rifampicin, pyrazinamide and ethambutol) was introduced 40 years ago, TB continues to cause considerable morbidity and mortality worldwide. In 2015, the WHO estimated a total of 10.4 million new tuberculosis (TB) cases worldwide. Currently, the increased number of multidrug-resistant (MDR-TB), extensively-drug resistant (XDR-TB) and in some recent reports, totally drug-resistant TB (TDR-TB) cases raises concerns about this disease. MDR-TB and XDR-TB have lower cure rates and higher mortality levels due to treatment problems. Novel drugs and regimens for all forms of TB have emerged in recent years. Moreover, scientific interest has recently increased in the field of host-directed therapies (HDTs) in order to identify new treatments for MDR-TB. In this review, we offer an update on the discovery of new drugs for TB therapy with a glance at molecular mechanisms leading to drug resistance in Mycobacterium tuberculosis.

Keywords: Drug resistance; HDTs; MDR; Mechanisms; Mycobacterium tuberculosis; New drugs; TDR; XDR.

Publication types

  • Review

MeSH terms

  • Animals
  • Antitubercular Agents / adverse effects
  • Antitubercular Agents / therapeutic use*
  • Drug Discovery / trends*
  • Drug Resistance, Multiple, Bacterial* / genetics
  • Drug Therapy, Combination
  • Extensively Drug-Resistant Tuberculosis / diagnosis
  • Extensively Drug-Resistant Tuberculosis / drug therapy*
  • Extensively Drug-Resistant Tuberculosis / microbiology
  • Extensively Drug-Resistant Tuberculosis / mortality
  • Humans
  • Mycobacterium tuberculosis / drug effects*
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / pathogenicity
  • Tuberculosis, Multidrug-Resistant / diagnosis
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / microbiology
  • Tuberculosis, Multidrug-Resistant / mortality

Substances

  • Antitubercular Agents