Controlling strategy of dormant Mycobacterium tuberculosis

Area of Science:

• Microbiology
• Infectious Diseases
• Pharmacology

Background:

• Latent tuberculosis infection (LTBI) poses a significant challenge due to the dormant state of Mycobacterium tuberculosis.
• Current chemotherapy for TB is often prolonged, necessitating strategies to overcome bacterial dormancy.

Purpose of the Study:

• To review existing literature on the control of latent tuberculosis infection.
• To propose novel strategies for shortening the duration of TB chemotherapy.

Main Methods:

• A literature review was conducted using PubMed.
• Search terms included "therapy of tuberculosis," "therapy of latent TB infection," and "vaccine of TB."
• Selected articles on TB treatment and vaccines were reviewed.

Main Results:

• Dormant Mycobacterium tuberculosis is the primary reason for prolonged TB chemotherapy.
• No current drugs effectively kill dormant M. tuberculosis.
• Potential control methods include direct killing, vaccine-mediated prevention of resuscitation, and resuscitation followed by killing.

Conclusions:

• Drugs targeting dormant cells are in clinical trials, with TMC207 showing promise.
• Vaccines offer a promising approach due to fewer side effects and long action periods.
• A strategy involving short-term chemotherapy to eliminate active bacteria followed by targeted treatment of remaining dormant bacilli could significantly shorten TB treatment.