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EN
The capacities of differentiation of Mycobacterium bovis BCG from other members of M. tuberculosis complex species using PCR-RFLP, multiplex PCR, and PCR-based genomic deletion analysis approaches were compared. In the study, mycobacteria isolated from patients suspected of adverse events following vaccination with BCG, primarily classified according presence of RD1 marker as virulent and avirulent mycobacteria, were used. The PCR-based genomic deletion analysis was found the best option for mycobacteria diagnostics improvement, as it was capable precisely differentiate virulent and avirulent mycobacteria or virulent species of M. tuberculosis complex. The routine confirmation of mycobacteria species in the cases of adverse events following BCG vaccination is highly expected, especially in clinical practice of patients with primary immunodeficiency.
Kosmos
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2017
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tom 66
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nr 1
41-58
PL
Gruźlica pozostaje nadal jednym z największych zagrożeń zdrowotnych dla populacji ludzkiej. Każdego roku notuje się około 9 mln nowych zachorowań na gruźlicę i blisko 2 mln zgonów z powodu tej choroby. Wśród najważniejszych czynników, które negatywnie wpływają na sytuację epidemiologiczną gruźlicy w świecie jest lekooporność wywołujących ją prątków Mycobacterium tuberculosis. Szczególne znaczenie ma oporność typu MDR (ang. multidrug resistance), definiowana jako oporność prątków na co najmniej izoniazyd (INH) irifampicynę (RMP), dwa kluczowe leki stosowane w terapii gruźlicy. Główną rolę w kształtowaniu oporności na leki przeciwprątkowe odgrywają spontaniczne mutacje w genach kodujących białka lub RNA będące często, choć nie zawsze, celami molekularnymi tych leków. W szczepach M. tuberculosis mutacje występują z różną częstością i w różny sposób kształtują ich fenotyp lekooporności, co wyraża się odmiennym mianem oporności szczepu na dany lek przeciwprątkowy. Niniejsza praca omawia najważniejsze zagadnienia związane z lekoopornością w gruźlicy, w tym epidemiologię, diagnostykę i leczenie gruźlicy lekoopornej. Najwięcej miejsca w pracy zajmuje charakterystyka leków stosowanych obecnie w leczeniu gruźlicy, ze szczególnym uwzględnieniem mechanizmów ich działania i oporności na nie prątków.
EN
Tuberculosis (TB) still persists as a significant health problem for the entire human population. Every year, about 9 million people develop TB, and nearly 2 million die from the disease. Among major factors that influence current TB epidemiology is drug resistance of its causative agent - Mycobacterium tuberculosis. Of particular importance is multidrug resistance, defined as resistance of tubercle bacilli to at least isoniazid (INH) and rifampicin (RMP), the two most potent anti-TB drugs. The pivotal role in the development of drug resistance in tubercle bacilli is attributed to spontaneous mutations in genes coding for proteins or RNAs that often, yet not always, serve as molecular targets for anti-TB therapeutics. These mutations occur at different frequencies in M. tuberculosis strains and differently impact the level of resistance to a specific drug. This review addresses the most important issues related to drug-resistance in TB, including epidemiology, diagnostics, and treatment strategies for drug-resistant TB. A substantial part of the article is devoted to anti-TB drug’s profiles, with particular emphasis on their modes of action and mechanisms of resistance.
EN
Tuberculosis (ТВ) is the main bacterial pathogen that causes more deaths than AIDS, malaria and all infectious diseases. The unusual long doubling time (about 24h), highly hydrophobic cell envelope resistant to chemical lysis was the reason to delay the molecular study of this bacteria. Fifteen years ago, we did not have any molecular tools and methods for genetic manipulation or isolation and analysis of intracellular protein and nucleic acids. Today we have many useful shuttle or integration vectors for basic study of mycobacteria. The full sequence of M. tuberculosis genome is already known. At the present time the diagnosis of tuberculosis is supported with fast-culture system BACTEC and molecular techniques based on PCR and DNA hybridization. The mechanisms of resistance to antituberculosis drugs were described, and first identification of resistance profile is available by using PCR and sequencing or real time PCR methods. In our group in the Center for Microbiology and Virology Polish Academy of Sciences and in the Dept, of Genetics of Microorganisms, University Łódź we have characterized new insertion sequences from M. tuberculosis complex- 18990 and IS1607. In diagnostic studies we have proposed the DIG-PCR ELISA assay as a reliable, specific and sensitive test to identify M. tuberculosis directly in clinical samples. We have performed wide epidemiological studies of M. tuberculosis strains isolated from Polish ТВ patients including drug - and multidrug - resistant strains. Finally we identified the most frequently present mutations responsible for drug resistance of polish clinical isolates of M. tuberculosis.
EN
Mycobacterium tuberculosis (Mtb), the etiological agent of tuberculosis (TB), is the leading bacterial cause of infectious disease mortality. The current WHOapproved treatment for TB involves a three- or four-drug regimen comprising isoniazid, rifampin, pyrazinamide, and/or ethambutol for a minimum of 6 months. While these first-line agents remain useful in treating susceptible Mycobacterium tuberculosis strains, the emergence of multidrug resistant tuberculosis demands the development of new drugs [1]. Iron acquisition is an essential process for M. tuberculosis as well as almost all other microorganisms. However, this essential micronutrient is highly sequestered in a mammalian host. In response to iron starvation, Mtb produces small-molecule iron chelators, a pair of related peptidic siderophores known as mycobactin and carboxymycobactins that vary by the appended lipid residue termed siderophores [4, 5, 7, 8]. Because mycobactins are critical for growth and virulence of M. tuberculosis, they have emerged as attractive targets for the development of anti-TB agents [4]. Biosynthesis of mycobactin is initiated by the aryl acid adenylation enzyme MbtA which activates salicylic acid forming an acyladenylate intermediate (Sal- AMP). MbtA is also responsible for loading the acyladenylate intermediate onto the thiolation domain of MbtB-SH – the enzyme taking part in the next step of biosynthesis process [10]. Given the documented importance of many siderophores for virulence and lack of human aryl acid adenylation enzymes homologues, several analogues possessing stable linkers as bioisosteres of the labile acyl phosphate function have been synthesized as the potent enzyme inhibitors [13]. The initial lead compound 5’-O-[N- (salicyl)sulfamoyl]adenosine (Sal-AMS) has emerged as a promising inhibitor of MbtA and was shown to possess promising whole-cell activity toward M. tuberculosis.
EN
The current “gold standard” in molecular epidemiological studies of Mycobacterium tuberculosis is IS6110 RFLP based on IS6110 polymorphism. However PCR-based methods are becoming increasingly important. Recently, fast ligation-mediated PCR (FLiP), based on IS6110 polymorphism was proposed. In this study, the discriminatory power of FLiP, spoligotyping and MIRU-VNTR typing, in differentiation of M. tuberculosis isolates was compared. The discriminatory index (HGI) of spoligotyping, MIRU-VNTR analysis, and FLiP was 0.653, 0.837, and 0.917, respectively. This indicates that FLiP allows a high level of differentiation among M. tuberculosis strains and it might be a valuable alternative to the other typing methods.
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tom 62
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nr 1
EN
Tuberculosis (TB), affecting one-third of the global population, kills an estimated two to three million people every year. The development of drug resistance is becoming a serious threat to any attempt to control this disease, which underscores the need for new agents targeting Mycobacterium tuberculosis (M. tuberculosis). Osthole (7-methoxy-8-isopentenoxycoumarin) is a coumarin derivative present in many medicinal plants. Previous studies have shown that osthole possesses antimycobacterial effects, however, the action mechanism of osthole is unclear. In the study, we used a commercial oligonucleotide microarray to determine the overall transcriptional response of M.tuberculosis H37Rv triggered by exposure to osthole. Analysis of the microarray data revealed that a total of 478 genes were differentially regulated by osthole. Of these, 241 genes were upregulated, and 237 genes were downregulated. Some of the important genes that were significantly regulated are related to different pathways such as fumarate reductase, class I peroxidase, cell wall, nitrate respiration, and protein synthesis. Real-time quantitative RT-PCR was performed for chosen genes to validate the microarray results. To our knowledge, this genome-wide transcriptomics approach has produced the first insights into the response of M. tuberculosis when exposed to osthole.
EN
Tuberculosis (TB), a serious public health infection that mainly affects the lungs, is caused by bacteria (Mycobacterium tuberculosis, TB). This research is designed and analyzed using a compartmental modelling approach to study the transmission dynamics of TB with different stages of infection. Qualitative analysis of the proposed model reveals that the model exhibits two equilibrium points: the disease-free equilibrium point (DFE) and the endemic equilibrium (EE). The basic reproduction number (R0 ) is determined using the next generation matrix technique, and stability analysis is carried out to show whether the disease can persist or die out in population. Further analysis of the model shows that the EE is globally asymptotically stable (GAS) when R0 > 1. With the aid of the forward sensitivity index method, we determine the most sensitive parameters of the model to control the spread of TB infection effectively. Our analysis shows that treatment (medication) and campaign awareness coupled with other key control measures, could help maintain the spread of MTB infection in human geographical boundaries.
EN
In the article the authors presented the epidemiological data referring to tuberculosis in some countries and in Poland. Tuberculosis continues to be a priority challenge for public health. The present chemotherapy for tuberculosis is very efficacious but has the disadvantages of being lengthy and complex. The serious problems remain drug-resistant strains of Mycobacterium tuberculosis, especially multi-drug MDR-TB and extensively-drug resistant XRD-TB as well as the prevalence of HIV co-infection among tuberculosis cases. In October, 2011 the European Union Standards for Tuberculosis Care (ESTC) were finalized. This document is consistent with WHO definitions and recommendations. ESTC consists of four sections – diagnosis, treatment, HIV and comorbidities and public health, which correspond to the International Standards for Tuberculosis Care (ISTC) from 2009. In 2013, the Polish recommendations for tuberculosis were published. The authors of this paper comment on all recommendations referring to tuberculosis. Clinical symptoms of tuberculosis and some problems connected with latent tuberculosis are presented. All sputum specimens and other samples should be submitted for microscopic, culture and drug susceptibility tests. WHO recommends rapid molecular assay, which should be performed on the day of microbiological diagnosis of tuberculosis. All patients, including those with HIV infection, who have not been previously treated and without any risk factors for drug resistance, should receive isoniazid, rifampicin, pyrazinamide and ethambutol for two months and isoniazid and rifampicin for four months. Some standards are devoted to children tuberculosis. Infection evoked by Mycobacterium tuberculosis should be elicited using tuberculin skin test and/or interferon gamma release assay (IGRA test). Children under 5 years of age and patients with HIV infection should be treated for latent tuberculosis infection with isoniazid when they do not have active tuberculosis.
PL
Autorzy przedstawiają dane epidemiologiczne odnoszące się do gruźlicy w niektórych krajach, w tym w Polsce. Gruźlica ciągle pozostaje priorytetowym wyzwaniem dla zdrowia publicznego. Obecnie stosowana chemioterapia jest skuteczna, ale długotrwała i kompleksowa. Poważny problem stanowią szczepy Mycobacterium tuberculosis oporne na leki przeciwprątkowe, szczególnie szczepy oporne na wiele leków (MDR-TB) i te o rozszerzonej oporności (XDR-TB), oraz zakażenia HIV wśród chorych na gruźlicę. W październiku 2011 roku zostały sfinalizowane standardy dotyczące gruźlicy dla krajów Unii Europejskiej (European Union Standards for Tuberculosis Care, ESTC). Dokument ten pozostaje w zgodzie z definicjami i rekomendacjami WHO. ESTC składają się z czterech sekcji: diagnozowanie, leczenie, HIV i choroby współistniejące, zdrowie publiczne, które korespondują z Międzynarodowymi Standardami Opieki nad Chorymi na Gruźlicę (ISTC) z 2009 roku. W 2013 roku zostały opublikowane polskie rekomendacje. Autorzy komentują wszystkie odnoszące się do gruźlicy rekomendacje. Przedstawiono objawy kliniczne gruźlicy i wybrane problemy gruźlicy utajonej (latent tuberculosis). Próbki wydzieliny oskrzelowej powinny być poddane badaniu mikroskopowemu, hodowli i testom lekowraźliwości. WHO rekomenduje szybki test molekularny, który należy wykonać w dniu bakteriologicznej diagnozy gruźlicy. Wszyscy chorzy (w tym osoby zakażone HIV), którzy nie byli wcześniej leczeni i u których nie występują czynniki ryzyka oporności na leki, powinni otrzymywać przez 2 miesiące izoniazyd, ryfampicynę, pirazynamid i etambutol, a przez 4 miesiące izoniazyd i ryfampicynę. Niektóre standardy odnoszą się do gruźlicy dziecięcej. Infekcja wywołana przez Mycobacterium tuberculosis powinna zostać wykryta za pomocą testu tuberkulinowego lub testu uwalniania interferonu gamma (IGRA). Dzieci poniżej 5. roku życia i osoby zakażone HIV, u których stwierdzono gruźlicę utajoną, należy leczyć izoniazydem, jeśli nie stwierdza się u nich aktywnej gruźlicy.
EN
VPS33B, a human Vacuolar Protein Sorting (VPS) protein which mediates the phagolysosomal fusion in macrophage of the eukaryotic organisms. This protein has a great role during the mycobacterial infections, which binds with the Mycobacterium protein tyrosine phosphatase A (PtpA). A single functional domain of PtpA has been identified using SMART domain databases, followed by finding the antigenicity of PtpA using CLC main workbench tool. The protein-protein interaction network predicts the interface of biological functions of proteins, built by using Cytoscape 2.8.3 version tool for manual literature survey of protein sets. According to the literature the specific interactivity of PtpA with VPS33B of human lead to pathogenesis, and provided a good platform to find the structure of VPS33B as it lacks the 3 dimensional structure in PDB. Homology Modelling of VPS33B provides a significant properties to design a specific drug through screening the drug databases (eDrug3D). The modelled protein has been validated through SAVES server maintained by NIH and UCLA with the standard Ramachandran plot with accuracy of 90.7 %. From our findings the interface residues are very crucial points which has been found through docking the modelled protein and Mycobacterium protein and interface residues were selected manually using PyMol software.
EN
In this study, 62 Mycobacterium tuberculosis strains were characterized by fast ligation-mediated PCR (FLiP) and, previously performed, IS6110 restriction fragment length polymorphism (RFLP). FLiP proved a reproducible and specific method for differentiation between M. tuberculosis strains. The discriminatory power of FLiP was close to that of the reference IS6110 RFLP suggesting its usefulness in studying the genetic diversity of M. tuberculosis strains.
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