Do we need a new Fleming époque: The nightmare of drug-resistant tuberculosis

Quercetin: A Potential Polydynamic Drug

The study of natural products as potential drug leads has gained tremendous research interest. Quercetin is one of those natural products. It belongs to the family of flavonoids and, more specifically, flavonols. This review summarizes the beneficial pharmaceutical effects of quercetin, such as its anti-cancer, anti-inflammatory, and antimicrobial properties, which are some of the quercetin effects described in this review. Nevertheless, quercetin shows poor bioavailability and low solubility. For this reason, its encapsulation in macromolecules increases its bioavailability and therefore pharmaceutical efficiency. In this review, a brief description of the different forms of encapsulation of quercetin are described, and new ones are proposed. The beneficial effects of applying new pharmaceutical forms of nanotechnology are outlined.

Silencing miR-125b-5p attenuates inflammatory response and apoptosis inhibition in mycobacterium tuberculosis-infected human macrophages by targeting DNA damage-regulated autophagy modulator 2 (DRAM2)

Tuberculosis is one of the most important infectious diseases worldwide and macrophage apoptosis is the major host defense mechanism against TB. We attempted to characterize the role of miRNA (miR)-125b-5p on mycobacterium tuberculosis (Mtb) infection and macrophages behaviors in vitro. According to fluorescence-activated cell separation (FACS), primary monocytes (CD14⁺) in TB patients were accumulated, and apoptotic monocytes were decreased. Peripheral blood mononuclear cells (PBMCs)-derived macrophages (MDMs) and monocytic cells THP-1-derived macrophage-like cells (TDMs) in vitro were used to be infected with H37Rv. After infection, colony-forming units assay revealed the increase of bacterial activity, FACS demonstrated the decrease of apoptosis rate of MDMs and TDMs, as well as promoted levels of IL-6, TNF-α, Bax, and Bim and suppressed levels of IL-10 and Bcl-2, examined by enzyme-linked immunosorbent assay (ELISA) and western blot assay. Expression of miR-125b-5p and DNA damage-regulated autophagy modulator 2 (DRAM2) was examined, and real-time PCR and western blot assay showed that miR-125b-5p was upregulated, whereas DRAM2 was downregulated in primary monocytes and H37Rv-infected macrophages (MDMs and TDMs). Moreover, blocking miR-125b-5p could attenuated H37Rv-induced bacterial activity and inflammatory response of MDMs and TDMs, accompanied with apoptosis inhibition. Whereas these effects of miR-125b-5p knockdown were abolished by downregulating DRAM2. In mechanism, DRAM2 was a downstream target of miR-125b-5p, as evidenced by dual-luciferase reporter assay. Collectively, silencing miR-125b-5p could protect human macrophages against Mtb infection through promoting apoptosis and inhibiting inflammatory response via targeting DRAM2, suggesting a novel target for Mtb eliminating. Abbreviations: TB: tuberculosis; PBMCs: peripheral blood mononuclear cells; Mtb: mycobacterium tuberculosis; AFB: acid fast bacilli; FITC: fluorescein isothiocyanate; MDMs: monocytes-derived macrophages; TDMs: THP-1-derived macrophage-like cells; ERFP: Mtb-enhanced red fluorescent protein; CFU: colony-forming units; ELISA: enzyme-linked immunosorbent assay; FACS: fluorescence-activated cell separation; PI: propidium iodide; DRAM2: DNA damage-regulated autophagy modulator 2; Real-time PCR: real-time polymerase chain reaction; in-miR-125b-5p: miR-125b-5p inhibitor; si-DRAM2: siRNA against DRAM2.

Natural cinnamic acids, synthetic derivatives and hybrids with antimicrobial activity

Antimicrobial natural preparations involving cinnamon, storax and propolis have been long used topically for treating infections. Cinnamic acids and related molecules are partly responsible for the therapeutic effects observed in these preparations. Most of the cinnamic acids, their esters, amides, aldehydes and alcohols, show significant growth inhibition against one or several bacterial and fungal species. Of particular interest is the potent antitubercular activity observed for some of these cinnamic derivatives, which may be amenable as future drugs for treating tuberculosis. This review intends to summarize the literature data on the antimicrobial activity of the natural cinnamic acids and related derivatives. In addition, selected hybrids between cinnamic acids and biologically active scaffolds with antimicrobial activity were also included. A comprehensive literature search was performed collating the minimum inhibitory concentration (MIC) of each cinnamic acid or derivative against the reported microorganisms. The MIC data allows the relative comparison between series of molecules and the derivation of structure-activity relationships.

Isolation and characterization of antimicrobial compounds from Terminalia phanerophlebia Engl. & Diels leaf extracts

ETHNOPHARMACOLOGICAL RELEVANCE

The emergence of drug resistant-tuberculosis and other pathogenic diseases over the past decades, constitutes a serious threat to human health worldwide. According to a 2012 report by the World Health Organization (WHO), South Africa, China, India and Russia are the countries with the highest prevalence of Multi-Drug Resistant tuberculosis (MDR-tuberculosis) as they represented 60% of the total. Several reports have documented antimycobacterial properties of Terminalia species but only a few species from this genus have been explored for their antimycobacterial constituents. The crude extracts of Terminalia phanerophlebia showed good antimicrobial activities in our previous study against two Mycobacterium as well as two other bacterial strains responsible for opportunistic infections related to respiratory ailments. This paper studies the isolation of compounds responsible for such activities and to isolate compounds responsible for antimicrobial activities from the crude extracts of Terminalia phanerophlebia leaves.

MATERIALS AND METHODS

Terminalia phanerophlebia crude extracts obtained from 80% methanol was successively extracted with hexane, dichloromethane (DCM), ethyl acetate (EtOAc) and n-butanol. The fractions obtained and isolated compounds were tested for their antibacterial activities against Mycobacterium aurum, Mycobacterium tuberculosis, Staphylococcus aureus and Klebsiella pneumoniae. Bioguided fractionation of the EtOAc fraction afforded two bioactive compounds. Structure elucidation was carried out using NMR (1D and 2D) spectroscopic methods.

RESULTS

EtOAc fraction exhibited highest antimicrobial activities and its fractionation afforded methyl gallate (methyl-3,4,5-trihydroxybenzoate) (1) and a phenylpropanoid glucoside, 1,6-di-O-coumaroyl glucopyranoside (2) These compounds are reported from Terminalia phanerophlebia for the first time. Both compounds showed good antimicrobial activity against all bacterial strains tested with minimum inhibitory concentration (MIC) values ranging from 63 to 250 µg/mL. Inhibition of Mycobacterium tuberculosis by 1,6-di-O-coumaroyl glucopyranoside (2) at a MIC value of 63 µg/mL was noteworthy, as this bacterial strain is reported to be the leading cause of tuberculosis worldwide.

CONCLUSIONS

Good antimicrobial activities exhibited by the compounds isolated from Terminalia phanerophlebia authenticate the traditional use of this plant in treating tuberculosis and its related symptoms. Compound (2), 1,6-di-O-coumaroyl glucopyranoside could serve as a lead compound for tuberculosis drug discovery.

MUBII-TB-DB: a database of mutations associated with antibiotic resistance in Mycobacterium tuberculosis

Background

Tuberculosis is an infectious bacterial disease caused by Mycobacterium tuberculosis. It remains a major health threat, killing over one million people every year worldwide. An early antibiotic therapy is the basis of the treatment, and the emergence and spread of multidrug and extensively drug-resistant mutant strains raise significant challenges. As these bacteria grow very slowly, drug resistance mutations are currently detected using molecular biology techniques. Resistance mutations are identified by sequencing the resistance-linked genes followed by a comparison with the literature data. The only online database is the TB Drug Resistance Mutation database (TBDReaM database); however, it requires mutation detection before use, and its interrogation is complex due to its loose syntax and grammar.

Description

The MUBII-TB-DB database is a simple, highly structured text-based database that contains a set of Mycobacterium tuberculosis mutations (DNA and proteins) occurring at seven loci: rpoB, pncA, katG; mabA(fabG1)-inhA, gyrA, gyrB, and rrs. Resistance mutation data were extracted after the systematic review of MEDLINE referenced publications before March 2013. MUBII analyzes the query sequence obtained by PCR-sequencing using two parallel strategies: i) a BLAST search against a set of previously reconstructed mutated sequences and ii) the alignment of the query sequences (DNA and its protein translation) with the wild-type sequences. The post-treatment includes the extraction of the aligned sequences together with their descriptors (position and nature of mutations). The whole procedure is performed using the internet. The results are graphs (alignments) and text (description of the mutation, therapeutic significance). The system is quick and easy to use, even for technicians without bioinformatics training.

Conclusion

MUBII-TB-DB is a structured database of the mutations occurring at seven loci of major therapeutic value in tuberculosis management. Moreover, the system provides interpretation of the mutations in biological and therapeutic terms and can evolve by the addition of newly described mutations. Its goal is to provide easy and comprehensive access through a client–server model over the Web to an up-to-date database of mutations that lead to the resistance of M. tuberculosis to antibiotics.

A retrospective analysis of isoniazid-monoresistant tuberculosis: among Iranian pulmonary tuberculosis patients

Background and objectives:

Isoniazid (INH) is one of the most potent anti-tuberculosis (TB) drugs. The spread and transmission of INH- resistant bacilli are likely to pose a significant problem for National TB control Program (NTP). In this study, we aimed to determine the trend of INH-monoresistant TB in Iran.

Methods:

The susceptibility patterns of Mycobacterium tuberculosis (MTB) strains that were isolated from clinical samples were retrospectively analyzed (January 2003-December 2011). Identification and drug susceptibility testing (DST) were performed using both conventional and molecular methods. The associated risk factors were assessed using the Chi-square test.

Results:

Out of 4825 culture-positive isolates, 6.1% were resistant to INH, with an increasing trend over the study period. The INH-monoresistance from 4.4 in 2003 reached to 9.4% in 2011. Among the studied risk factors, age was significantly associated with INH-monoresistance (p < 0.05).

Conclusions:

The increased trend in INH-monoresistance underlines the need for greater enforcement of national TB control programs. In this regard, better management of TB cases, establishing advanced diagnostic facilities and use of standard treatment regimens are recommended to avoid further emergence of INH resistant cases.