Molecular mechanisms of drug resistance in Mycobacterium tuberculosis: Role of nanoparticles against multi-drug-resistant tuberculosis (MDR-TB)

Abstract

Tuberculosis (TB) is a leading chronic bacterial infection caused by Mycobacterium tuberculosis (M. tuberculosis) and an increasing public health threat. The current therapeutic management of M. tuberculosis is insufficient due to the prolonged course of treatment, side effects of drugs, and unorganized therapy, and these aspects can lead to therapeutic failure and development of drug-resistant tuberculosis. The multi-drug-resistant (MDR), extensively drug-resistant (XDR), and total drug-resistant (TDR) tuberculosis pose significant challenges to the diagnosis, lengthy course of treatment, higher side effect, cost, and control of tuberculosis worldwide. Drug resistance to the anti-TB drugs has existed since the commencement of the antibiotic era. The understanding of the entire mechanisms of drug resistance helps in the development of newer rapid diagnostic tools and newer drug with novel targets for drug-resistant TB. The newer diagnostics and drug target tools help to improve the existing treatment, management, and prevent emergence of TB. The recent advances in the new-generation sequencing (NGS) help to unravel the novel gene mutations to understand the mechanism of drug resistance. The physiognomies of the nanoparticle in the treatment of MDR-TB and XDR-TB are discussed. The targeted nanoparticle-based treatment may further increase the efficacy with less dosage and reduced toxic side effects of drugs. This chapter summarises the molecular mechanism of drug resistance and novel drug delivery systems for treatment of the drug-resistant and susceptible TB.