Tuberculosis

Tuberculosis is one of the major causes of death from many infectious diseases (3). Out of 9 million people who are infected with mycobacteria, about 2 million deaths occur from tuberculosis every year (3). Unfortunately, the prevalence of tuberculosis is in a continuous increase due to increased number of Human immunodeificnecy virus (HIV) patients, bacterial resistance to anti-tuberculous drugs, and growing number of recreational drug users (3). The pathogen responsible for bacterial infection, potentially causing tuberculosis, is mycobacterium tuberculosis (MTB) (2). Persons with adequate immune system can control the bacterial infection so mycobacteria remain dormant for a long time (11). In a typical tuberculous granuloma, mature macrophages accumulate around a caseous lesion to prevent mycobacteria from leaking into the extracellular matrix (11). Therefore, only those with less effective immune systems will progress to primary progressive tuberculosis (2). When a patient progresses to active tuberculosis, early signs and symptoms include extreme fatigue, weight loss, and fever (7). The inflammatory and immune responses cause wasting that involves a period of rapid fat loss and muscle loss (7). Patients eventually develop cough, blood-streaked sputum from lung abscess, as well as pleuritic chest pain from the inflamed parenchyma (7). To fight against this grave and fatal disease, number of anti-tuberculous drugs was invented in hope of finding a cure. Although some first-line drugs (Isoniazid and Rifampicin) first appeared to be effective in treating tuberculosis, these anti-tuberculous drugs have failed to eradicate all cases of tuberculosis. Instead, anti-tuberculous drugs introduced more challenges in tuberculosis treatmen...

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...different conformation than the wild-type DNA. Therefore, MTB drug resistance can be determined by measuring different electrophoresis mobility on a gel (9). Further research on drug resistance mechanisms and associated mutations can be used for diagnosis and clinical care of individual patients with tuberculosis, as well as potentially combating resistant tuberculosis.

Over many years of biomedical research, there were great advances in understanding of the epidemiology and pathogenesis of tuberculosis. However, the prevalence of tuberculosis is still remains high, mainly due to acquired or developed drug resistance in Mycobacterium tuberculosis. The increase in incidences of multidrug-resistant tuberculosis (MDR-TB) urgently suggests the development of more effective drugs, which specifically targets biochemical pathway and a stage of pathogen’s life cycle.