An International Publications House

Albert Science International Organization

Connecting People With Pioneering Thought

Albert Science International Organization (ASIO) is international , peer-reviewed , open access , cum print version & online journals.
JOURNALS || ASIO Journal of Experimental Pharmacology & Clinical Research (ASIO-JEPCR) [ISSN: 2455-7080]

Author Names : Nidhi Singh
Page No. : 01-07  volume 1 issue 1
Article Overview


Nidhi SinghAn Overview of Tuberculosis Management: Mechanism and Therapeutic Applications, ASIO Journal of Experimental Pharmacology & Clinical Research (ASIO-JEPCR), 2016, 1(1): 01-07.


dids no.: 03.2016-35559215,

dids Link:


Tuberculosis infections have exceptional virulence factors compared to other pathogens and they infect host cell and persist inside phagosomes. First symptoms of active pulmonary TB can include weight loss, night sweats, fever, and loss of appetite etc. The infection can either go into remission or become more serious with onset of chest pain and coughing up bloody sputum. The exact symptoms of extra-pulmonary TB vary according to the site of infection in the body. The Mantoux tuberculin skin test, also called as the PPD (purified protein derivative) test, is primarily used to identify TB infection. According to their clinical utility the anti-TB drugs can be divided into, two categories; one is first line, these drugs have high anti-tubercular efficiency as well as low toxicity; are used routinely, as for examples- Rifampin (R), Isoniazid (H), Streptomycin (S), Pyrazinamide (Z), Ethambutol (E) and another is second line, these drugs have either low anti-tubercular efficacy or high toxicity or both; are used in special circumstances only. There are six classes of second-line drugs likes amino glycosides, fluoro quinolones, polypeptides, thioamides, cycloserine, p-amino salicylic acid. Another group of scientists found that a newly identified protein with carboxy-esterase activity is required for the virulence of Mycobacterium tuberculosis. Preliminary treatment for tuberculosis involved eats nourishing food and have plenty of fresh air.

Keywords: TB, Mantoux, symptoms, anti-TB drugs, Mechanism of Actions.


[1] National institute of Allergy and Infectious diseases (2009), Tuberculosis(TB)

[2]  Nahid P, Pai M and Hopewell PC. Advances in the diagnosis and treatment of tuberculosis, Proc Amer Thoracic Soc., 2006, 3:103-110.

[3]  World Health Organization, 2009, Tuberculosis (TB)

[4]  Goodman A and Lpman M. Tuberculosis, Clinical Med., 2008, 8:531-534.

[5]  KaraKousis PC, Bishai WR. Mycobacterium tuberculosis cell envelope lipids and the host immune response, Cell Microbiol., 2004, 6(2):105-116.

[6]  Kochi A, Vareldzis B. Multidrug-resistant tuberculosis and its control, Res Microbial., 1993, 144(2):104-110.

[7]  Dessen A, Quemard A. Crystal structure and function of isoniazid target of M. tuberculosis, Science, 1995, 267(5204):1638-1641.

[8]  Basso L, Zheng AR. Mechanisms of isoniazid resistance in Mycobacterium tuberculosis: enzymatic characterization of enoyl reductase mutants identified in isoniazid-resistant clinical isolates, Journal of infectious Disease, 1998, 178(3):769-775.

[9]  Miesel L, Wiesbrod TR. NADH dehdrogenase defects confer isoniazid resistance and conditional lethality in mycobacterium smegmatis, J Bacteriol., 1998, 180(9):2459-2467.

[10] Telenti A, Imboden P. Detection of refampicin-resistance mutations in Mycobacterium tuberculosis, Lancet, 1993, 341(8846):647-650.

[11] Raynaud C, Laneelle MA. Mechanisms of pyrazinamide resistance in mycobacteria:importance of lack of uptake in addition to lack of pyrazinamydase activity, Microbiology, 1999, 145:1359-1367.

[12] Zhang Y, Scorpio A. Role of acid pH and deficient efflux of pyrazinoic acid in unique susceptibility of Mycobacterium tuberculosis to pyrazinamide, Journalof Bacteriology, 1999, 181(7):2044-2049.

[13] Belanger AE, Besra GS. The embAB genes of M.avium encode an arabinosyl transferase involved in cell wall arabinan biosynthesis that is the target for the antimycobacterial drug ethambutol, Proc Natl Acad Sci U S A, 1996, 93(21):11919-11924. 

[14] Drlica K And Malik M. Fluoroquinolones:action and resistance, Curr Top Med Chem., 2003, 3(3):249-282.

[15] Ginsburg AS, Grosset JH. Fluoroquinolones, tuberculosis and resistance, Lancet infactious disease, 2003, 3(7):432-442.

[16] Baulard AR, Betts JC. Activation of the prodrug ethionamide is regulated in mycobacteria, J Biol Chem., 2000, 275(36):28326-28331.

[17] Morlock GP, Metchock B. rthA, inhA and katG loci of ethionamide-resistant clinical mycobacterium tuberculosis isolates, Antimicrob agents Chemother, 2003, 47(12):3799-3805.

[18] Vilcheze C, Av-Gay Y. Mycothiol biosynthesis is essential for ethionamide susceptibility in Mycobacterium tuberculosis, Mol Microbiol., 2008, 69(5):1316-1329.

[19] Wade MM and Zhang Y. Mechanisms of drug resistance in Mycobacterium tuberculosis, Front Biosci., 2004, 9:975-994.

[20] Rengarajan J, Sassetti CM. The folate pathway is a target for resistance to the drug para-aminosalicylic acid(PAS) in mycobacteria, Mol Microbiol., 2004, 53(1):275-282.

[21] Feng Z and Barletta RG. Roles of Mycobaterium smegmatis D-alanine:D-alanine  ligase and D-alanin racemase in the mechanism of action of and resistance to the peptidoglycan inhibitor D-cycloserine, Antimicrob Agents chemother, 2003, 47(1):283-291.

[22] Ouellet H. Mycobacterium tuberculosis CYP125A1, a steroid C27 monooxygenase that detoxifies intracellularly generated cholest-4-en-3-one, Mol. Microbiol., 2010, 77, 730.

[23] Ouellet H, Johnston JB, De Montellano PRO. Cholesterol catabolism as a therapeutic target in Mycobacterium tuberculosis, Trends Microbiol., 2011, 19, 530.

[24] Yam KC. Studies of a ring-cleaving dioxygenase illuminate the role of cholesterol metabolism in the pathogenesis of Mycobacterium tuberculosis, PLoS pathogens, 2009, 5, e1000344.

[25] Schweigert N, Zehnder AJ, Eggen RI. Chemical properties of catechols and their molecular modes of toxic action in cells,from microorganisms to mammals, Environ.Microbiol., 2001, 3, 81.

[26] Harries AD, Dye C.Tuberculosis, Ann Trop Med Parasitology, 2006, 100:415-431.

[27] William W.The actinobacterial mce4 Locus encodes transporter, J. Biol. Chem., 2008, 283, 35368-35374.

[28] Tulloch M. Tubarculosis. Blue Ridge Sanatorium,

[29] Condrau F. Who is the Captain of all these Men of Death’: The Social Structure of a Tuberculosis Sanatorium in Postwar Germany, J Interdisc Hist, 2001, 32:243-263.

[30] Hurt R. Tuberculosis sanatorium regimen in the 1940s: a patient’s personal diary, J Royal Soc Med., 2004, 97:350-353.

[31] Munoz-Elias EJ, Mckinney JD. Mycobacterium tuberculosis isocitrate lyases 1 and 2 are jointly required for in vivo growth and virulence, Nat Med., 2005, 11 :638-644.

[32] Bishai WR, Lun S. Characterization of a novel cell wall-anchored protein with carboxyesterase activity required fir virulence in Mycobacterium tuberculosis. The Journal of Biological Chemistry, 2007, 1-22.