Tüberküloz tedavisinde kullanılan antitüberküloz ilaçlar

Öz

Tüberküloz (TB), Mycobacterium tuberculosis (M. tuberculosis)’in sebep olduğu değişik klinik görünümlere sahip kronik, granülomatöz karakterde bakteriyel bir hastalıktır. TB günümüzde halen önemini koruyan bir halk sağlığı sorunu olmaya devam etmektedir. Son yıllarda HIV/AIDS ile ko-enfeksiyon olması ve çok ilaca dirençli (ÇİD) vakalar göz önüne alındığında TB hastalığında tedavi en az altı ay süre ile çoklu anti-TB ilaçlarla birlikte mevcut tedaviyi oluşturmaktadır. TB için mevcut birinci kuşak (primer) tedaviler, ilk iki ay boyunca izoniazid (INH), rifampisin (RIF), pirazinamid (PZA) ve etambutol (EMB) kombinasyonunun uygulanmasına ve ardından dört ila yedi aydan daha uzun süreli INH ve RIF tedavisine dayanmaktadır. TB tedavisinde, anti-TB ilaçların uzun süre kullanılması ile M. tuberculosis’in ÇİD ve yaygın ilaca dirençli (YİD) suşlarının ortaya çıkması ve yayılması TB’nin tedavisinde zorlukları beraberinde getirmektedir. Bu derlemede TB tedavisinde kullanılan birinci ve ikinci kuşak anti-TB ilaçların genel özelliklerinden bahsedilmesi amaçlanmıştır.

Anahtar Kelimeler

• Tüberküloz
• Tedavi
• Anti-tüberküloz ilaçlar

Antituberculosis drugs used in the treatment of tuberculosis

Öz

Tuberculosis (TB) is a chronic, granulomatous bacterial disease with different clinical manifestations caused by Mycobacterium tuberculosis (M. tuberculosis). TB continues to be a public health problem that still maintains its importance today. Given the recent years of co-infection with HIV/AIDS and multidrug-resistant (MDR) cases, treatment for TB disease is available in combination with multiple anti-TB drugs for at least six months. Current first-line (primary) treatments for TB, administration of a combination of isoniazid (INH), rifampicin (RIF), pyrazinamide(PZA), and ethambutol(EMB) during the first two months and then based on INH and RIF treatment for a duration of more than four to seven months. In the treatment of TB, with prolonged use of anti-TB drugs, the emergence and spread of MDR and extensive drug-resistant (XDR) M. tuberculosis strains present challenges in treating TB. In this review, it was aimed to mention the general properties of first and second-line anti-TB drugs used in the treatment of TB.

Anahtar Kelimeler

• Tuberculosis
• treatment
• anti-tuberculosis drugs

Kaynakça

1. Knechel NA. Tuberculosis: pathophysiology, clinical features, and diagnosis. Critical care nurse. 2009;29(2):34-43. https://doi.org/10.4037/ccn2009968
2. Sia JK, Rengarajan J. Immunology of Mycobacterium tuberculosis infections. Microbiology spectrum. 2019;7(4):7-4. https://doi.org/10.1128/microbiolspec.GPP3-0022-2018
3. Bañuls AL, Sanou A, Nguyen TVA, Godreul S. Mycobacterium tuberculosis: Ecology and Evolution of a Human Bacterium. Journal of Medical Microbiology. 2015;64(11):1261-1269. https://doi.org/10.1099/jmm.0.000171
4. World Health Organization (WHO). Global Tuberculosis Report 2021. Geneva: World Health Organization; 2021. https://www.who.int/publications/i/item/9789240037021. 10 Ekim 2022 de erişildi.
5. T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Türkiye’de Verem Savaşı 2020 Raporu Ankara. https://hsgm.saglik.gov.tr/depo/kurumsal/yayinlarimiz/Raporlar/Turkiyede_Verem_Savasi_2020_Raporu.pdf. 15 Kasım 2022’de erişildi.
6. Jhun BW, Koh WJ. Treatment of isoniazid-resistant pulmonary tuberculosis. Tuberculosis and Respiratory Diseases, 2020;83(1):20-30. https://doi.org/10.4046/trd.2019.0065
7. Prasad R, Gupta N, Banka A. Multidrug-resistant tuberculosis/rifampicin-resistant tuberculosis: Principles of management. Lung India: official organ of Indian chest society. 2018;35(1): 78-81. https://doi.org/10.4103/lungindia.lungindia_98_17
8. An Q, Li C, Chen Y, Deng Y, Yang T, Luo Y. Repurposed drug candidates for antituberculosis therapy. European journal of medicinal chemistry. 2020;192:112175. https://doi.org/10.1016/j.ejmech.2020.112175

9. Almedia da Silva P, Aínsa JA. Drug and drug interactions. İçinde: Palomino JC, Leão SC, Ritacco V, ed. Tuberculosis 2007 From basic science to patient care. 1st Ed. Bourcillier Kamps, 2007:593-611.
10. Hopewell PC. Treatment of Tuberculosis. İçinde: Raviglione MC, Ed. Tuberculosis: the Essentials (Vol. 237). 4.Baskı. Informa Healthcare USA, Inc;2016:113-122.
11. Mitchison DA. The action of antituberculosis drugs in shortcourse therapy. Tubercle 1985;66:219-25.
12. Otkun M. Tüberküloz tedavisinde Temel ilkeler ve direnç sorunu. Klimik dergisi. 2001;14(2):71-82.
13. Janin YL. Antituberculosis drugs: ten years of research. Bioorganic & medicinal chemistry. 2007;15(7):2479-2513.
14. Blumberg HM, Burman WJ, Chaisson RE, Daley CL. American thoracic society/centers for disease control and prevention/infectious diseases society of America: treatment of tuberculosis. American journal of respiratory and critical care medicine. 2003; 167(4):603.
15. Hoagland DT, Liu J, Lee RB, Lee RE. New agents for the treatment of drug-resistant Mycobacterium tuberculosis. Advanced drug delivery reviews. 2016;102:55-72. https://doi.org/10.1016/j.addr.2016.04.026
16. T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Tüberküloz Tanı ve Tedavi Rehberi. 2 Baskı. 2019. https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/haberler/Tuberkuloz_Tani_Ve_Tedavi_Rehberi_/Tuberkuloz_Tani_ve_Tedavi_Rehberi.pdf 1 Mart 2023’de erişildi.
17. Zhang Y, Amzel L. Tuberculosis drug targets. Curr Drug Targets. 2002;3(2):131-154.
18. Bansal R, Sharma D, Singh R. Tuberculosis and its treatment: an overview. Mini Reviews in Medicinal Chemistry. 2018;18(1):58-71. https://doi.org/10.2174/1389557516666160823160010
19. Cheng S, Hide M, Pheng SH, et al. Resistance to second-line anti-TB drugs in cambodia: a phenotypic and genetic study. Infection and Drug Resistance. 2021;1089-1104. doi: 10.2147/IDR.S289907
20. Brausch LM, Bass JB Jr. The treatment of tuberculosis. Medical Clinic of North America. 1993;77:1277-88.
21. Kocabaş A, Kuleci S. Antimikobakteriyel ajanlar. İçinde: Sarıca Y, İnal TC, Canataroğlu A, Güvenç B, Horoz M, Sağlıker Özkaynak P, ed. Harrison İç Hastalıklar Prensibleri. 1.Cilt. Nobel Tıp Kitabevleri, İstanbul; 2004: 1017-23.
22. Özkara Ş. Tüberküloz kliniği, tanı ve tedavisine genel bakış. İçinde: Şimşek H, Gülhan M, İlhan Tarhan A, ed. Her Yönüyle Tüberküloz. 1.Baskı. Hipokrat Kitabevi, Ankara; 2019: 93-105.
23. Vilchèze C, Jacobs Jr WR. The isoniazid paradigm of killing, resistance, and persistence in Mycobacterium tuberculosis. Journal of molecular biology. 2019;431(18):3450-61. https://doi.org/10.1016/j.jmb.2019.02.016
24. Unissa AN, Subbian S, Hanna LE, Selvakumar N. Overview on mechanisms of isoniazid action and resistance in Mycobacterium tuberculosis. Infection, Genetics Evolution. 2016;45:474-492. doi: 10.1016/j.meegid.2016.09.004
25. Miotto P, Zhang Y, Cirillo DM, Yam WC. Drug resistance mechanisms and drug susceptibility testing for tuberculosis. Respirology. 2018;23(12):1098-1113. https://doi.org/10.1111/resp.13393
26. Grobbelaar M, Louw GE, Sampson SL, van Helden PD, Donald PR, Warren RM. Evolution of rifampicin treatment for tuberculosis. Infection, Genetics and Evolution. 2019;74:103937. https://doi.org/10.1016/j.meegid.2019.103937
27. Zaw MT, Emran NA, Lin Z. Mutations inside rifampicin-resistance determining region of rpoB gene associated with rifampicin-resistance in Mycobacterium tuberculosis. Journal of infection and public health. 2018;11(5):605-10. https://doi.org/10.1016/j.jiph.2018.04.005
28. Palomino JC, Martin A. Drug resistance mechanisms in Mycobacterium tuberculosis. Antibiotics. 2014;3(3):317-40. https://doi.org/10.3390/antibiotics3030317
29. Goldstein BP. Resistance to rifampicin: a review. The Journal of antibiotics. 2014;67(9):625-30.
30. Waters M, Tadi P. Streptomycin. In:StatPearls. StatPearls Publishing, Treasure Island (FL). 2022. PMID: 32310346.
31. Sreevatsan S, Pan X, Stockbauer KE, Williams DL, Kreiswirth BN, Musser JM. Characterization of rpsL and rrs mutations in streptomycin-resistant Mycobacterium tuberculosis isolates from diverse geographic localities. Antimicrobial agents and chemotherapy. 1996;40(4):1024-26.
32. Smittipat N, Juthayothin T, Billamas P, et al. Mutations in rrs, rpsL and gidB in streptomycin-resistant Mycobacterium tuberculosis isolates from Thailand. Journal of global antimicrobial resistance. 2016; 4:5-10. https://doi.org/10.1016/j.jgar.2015.11.009
33. Sharma D, Bisht D. Secretory proteome analysis of streptomycin-resistant Mycobacterium tuberculosis clinical isolates. SLAS DISCOVERY:Advancing Life Sciences R&D. 2017; 22(10):1229-38. https://doi.org/10.1177/2472555217698428
34. Lee N, Nguyen H. Ethambutol. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2022. PMID: 32644476.
35. Mohammadi B, Ramazanzadeh R, Nouri B, Rouhi S. Frequency of codon 306 mutations in embB gene of Mycobacterium tuberculosis resistant to ethambutol: a systematic review and meta-analysis. International Journal of Preventive Medicine. 2020;11:112. https://doi.org/10.4103/ijpvm.IJPVM_114_19
36. Zhang N, Savic RM, Boeree MJ. Optimising pyrazinamide for the treatment of tuberculosis. European Respiratory Journal. 2021;58(1):2002013. doi: 10.1183/13993003.02013-2020.
37. Zhang Y, Mitchison D. The curious characteristics of pyrazinamide: a review. The international journal of tuberculosis and lung disease. 2003;7(1):6-21.
38. De Jong BC, Onipede A, Pym AS, Gagneux S, Aga RS, DeRiemer K, Small PM. Does resistance to pyrazinamide accurately indicate the presence of Mycobacterium bovis?. Journal of clinical microbiology. 2005; 43(7):3530-32.
39. Njire M, Tan Y, Mugwer, J, et al. Pyrazinamide resistance in Mycobacterium tuberculosis: Review and update. Advances in Medical Sciences. 2016;61(1): 63-71. https://doi.org/10.1016/j.advms.2015.09.007
40. Chen J, Zhang S, Cui P, Shi W, Zhang W, Zhang Y. Identification of novel mutations associated with cycloserine resistance in Mycobacterium tuberculosis. J Antimicrob Chemother.2017;72(12):3272-76. doi: 10.1093/jac/dkx316.
41. Ushtanit A, Kulagina E, Mikhailova Y, Makarova M, Safonova S, Zimenkov D. Molecular determinants of Ethionamide resistance in clinical isolates of mycobacterium tuberculosis. Antibiotics. 2022;11(2):133. https://doi.org/10.3390/antibiotics11020133
42. Vilchèze C, Jacobs Jr WR. Resistance to isoniazid and ethionamide in Mycobacterium tuberculosis:genes, mutations, and causalities. Microbiology spectrum. 2014;2(4):2-4. https://doi.org/10.1128/microbiolspec.MGM2-0014-2013
43. Bashir KM, Cho MG. The Effect of Kanamycin and Tetracycline on Growth and Photosynthetic Activity of Two Chlorophyte Algae. Biomed Res Int. 2016;2016:5656304. doi: 10.1155/2016/5656304.
44. Hotta K, Kondo S. Kanamycin and its derivative, arbekacin: significance and impact. J Antibiot (Tokyo). 2018;71(4):417-24. doi: 10.1038/s41429-017-0017-8.
45. Ramirez MS, Tolmasky ME. Amikacin: Uses, Resistance, and Prospects for Inhibition. Molecules. 2017;22(12):2267. doi: 10.3390/molecules22122267.
46. Cheng AF, Yew WW, Chan EW, Chin ML, Hui MM, Chan RC. Multiplex PCR amplimer conformation analysis for rapid detection of gyrA mutations in fluoroquinolone-resistant Mycobacterium tuberculosis clinical isolates. Antimicrobial Agents and Chemotherapy. 2004; 48(2):596-601. https://doi.org/10.1128/AAC.48.2.596-601.2004
47. Chakraborty S, Gruber T, Barry CE 3rd, Boshoff HI, Rhee KY. Para-aminosalicylic acid acts as an alternative substrate of folate metabolism in Mycobacterium tuberculosis. Science. 2013;339(6115):88-91. doi: 10.1126/science.1228980.
48. Minato Y, Thiede JM, Kordus SL, McKlveen EJ, Turman BJ, Baughn AD. Mycobacterium tuberculosis folate metabolism and the mechanistic basis for para-aminosalicylic acid susceptibility and resistance. Antimicrob Agents Chemother. 2015;59(9):5097-106. doi: 10.1128/AAC.00647-15.
49. O'Brien RJ, Spigelman M. New drugs for tuberculosis: current status and future prospects. Clinics in chest medicine. 2005;26(2): 327-40. https://doi.org/10.1016/j.ccm.2005.02.013
50. Peng YUE, Wen-jing CAO, Xin XU, et al. Research progress on new anti-tuberculosis drug pretomanid. China Tropical Medicine. 2021; 21(4):370-6.
51. Torfs E, Piller T, Cos P, Cappoen D. Opportunities for Overcoming Mycobacterium tuberculosis Drug Resistance: Emerging Mycobacterial Targets and Host-Directed Therapy. İnternational Journal of Molecular Sciences.2019;20(12):2868. https://doi.org/10.3390/ijms20122868
52. Manjunatha U, Boshoff Im H, Barry CE. The mechanism of action of PA-824: Novel insights from transcriptional profiling. 2009;(3):215-8. https://doi.org/10.4161/cib.2.3.7926
53. Ginsberg AM, Laurenzi MW, Rouse DJ, Whitney KD, Spigelman MK. Safety, tolerability, and pharmacokinetics of PA-824 in healthy subjects. Antimicrob Agents Chemother. 2009;53(9):3720-5. doi: 10.1128/AAC.00106-09.
54. Dawson R, Diacon A. PA-824 , moxifloxacin and pyrazinamide combination therapy for tuberculosis. Expert Opin Investig Drugs. 2013;22(7):927-32. doi: 10.1517/13543784.2013.801958.
55. Bahuguna A, Rawat DS. An overview of new antitubercular drugs, drug candidates, and their targets. Med Res Rev. 2020;40(1):263-292. doi: 10.1002/med.21602.
56. Matsumoto M, Hashizume H, Tomishige T, et al. OPC-67683, a nitro-dihydro-imidazooxazole derivative with promising action against tuberculosis in vitro and in mice. PLoS medicine. 2006;3(11):e466. https://doi.org/10.1371/journal.pmed.0030466
57. Peloquin CA, Davies GR. The Treatment of Tuberculosis. Clin Pharmacol Ther. 2021;110(6):1455-1466. doi: 10.1002/cpt.2261.
58. Mirsaeidi M. After 40 years, new medicine for combating TB. International journal of mycobacteriology. 2013;2(1):1-2. https://doi.org/10.1016/j.ijmyco.2013.01.004
59. D'Ambrosio L, Centis R, Sotgiu G, Pontali E, Spanevello A. Migliori GB. New anti-tuberculosis drugs and regimens: 2015 update. ERJ Open Research. 2015;1(1):00010. doi: 10.1183/23120541.00010-2015.
60. Hashemian SMR, Farhadi T, Ganjparvar M. Linezolid: a review of its properties, function, and use in critical care. Drug design, development and therapy. 2018;12, 1759–1767.
61. Cholo MC, Steel HC, Fourie PB, Germishuizen WA, Anderson R. Clofazimine: current status and future prospects. Journal of antimicrobial chemotherapy. 2012;67(2): 290-298. https://doi.org/10.1093/jac/dkr444 https://doi.org/10.2147/DDDT.S164515
62. Lessem E. The tuberculosis treatment pipeline. HIV Treatment Bulletin. Related: Special reports http://i-base.info/htb/17111. 21 Kasım 2022’de erişildi.
63. Scarim CB, Pavan FR. Thiazole, triazole, thio-and semicarbazone derivatives-Promising moieties for drug development for the treatment of tuberculosis. European Journal of Medicinal Chemistry Reports. 2021;1:100002. https://doi.org/10.1016/j.ejmcr.2021.100002
64. Padmapriyadarsini C, Vohra V, Bhatnagar A, et al. Bedaquiline, Delamanid, Linezolid, and Clofazimine for Treatment of Pre-extensively Drug-Resistant Tuberculosis. Clinical Infectious Diseases. 2022;ciac528. https://doi.org/10.1093/cid/ciac528