Decoding drug resistance in Mycobacterium tuberculosis complex: genetic insights and future challenges.

IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Expert Review of Anti-infective Therapy Pub Date : 2024-07-01 Epub Date: 2024-09-04 DOI:10.1080/14787210.2024.2400536
Amey Deshpande, Rupali Likhar, Tabassum Khan, Abdelwahab Omri
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Abstract

Introduction: Tuberculosis (TB), particularly its drug-resistant forms (MDR-TB and XDR-TB), continues to pose a significant global health challenge. Despite advances in treatment and diagnosis, the evolving nature of drug resistance in Mycobacterium tuberculosis (MTB) complicates TB eradication efforts. This review delves into the complexities of anti-TB drug resistance, its mechanisms, and implications on healthcare strategies globally.

Areas covered: We explore the genetic underpinnings of resistance to both first-line and second-line anti-TB drugs, highlighting the role of mutations in key genes. The discussion extends to advanced diagnostic techniques, such as Whole-Genome Sequencing (WGS), CRISPR-based diagnostics and their impact on identifying and managing drug-resistant TB. Additionally, we discuss artificial intelligence applications, current treatment strategies, challenges in managing MDR-TB and XDR-TB, and the global disparities in TB treatment and control, translating to different therapeutic outcomes and have the potential to revolutionize our understanding and management of drug-resistant tuberculosis.

Expert opinion: The current landscape of anti-TB drug resistance demands an integrated approach combining advanced diagnostics, novel therapeutic strategies, and global collaborative efforts. Future research should focus on understanding polygenic resistance and developing personalized medicine approaches. Policymakers must prioritize equitable access to diagnosis and treatment, enhancing TB control strategies, and support ongoing research and augmented government funding to address this critical public health issue effectively.

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解码结核分枝杆菌复合体的耐药性:基因见解与未来挑战。
导言:结核病(TB),尤其是其耐药性形式(MDR-TB 和 XDR-TB),继续对全球健康构成重大挑战。尽管在治疗和诊断方面取得了进步,但结核分枝杆菌(MTB)不断演变的耐药性使根除结核病的工作变得更加复杂。本综述深入探讨了抗结核耐药性的复杂性、其机制以及对全球医疗战略的影响:我们探讨了一线和二线抗结核药物耐药性的基因基础,强调了关键基因突变的作用。讨论延伸到先进的诊断技术,如全基因组测序(WGS)、基于 CRISPR 的诊断及其对耐药性结核病的识别和管理的影响。此外,我们还讨论了人工智能的应用、当前的治疗策略、管理 MDR-TB 和 XDR-TB 所面临的挑战,以及结核病治疗和控制方面的全球差异,这些都会转化为不同的治疗结果,并有可能彻底改变我们对耐药结核病的理解和管理:抗结核耐药性的现状要求我们采取综合方法,将先进的诊断方法、新颖的治疗策略和全球合作努力结合起来。未来的研究重点应放在了解多基因耐药性和开发个性化医疗方法上。政策制定者必须优先考虑公平获得诊断和治疗,加强结核病控制策略,支持正在进行的研究并增加政府资金,以有效解决这一关键的公共卫生问题。
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来源期刊
CiteScore
11.20
自引率
0.00%
发文量
66
审稿时长
4-8 weeks
期刊介绍: Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.
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