La Organización Mundial de la Salud (OMS) ubica a la tuberculosis (TB) como uno de los problemas de salud más preocupantes en la actualidad, y señala que se requieren de acciones novedosas para controlar su expansión y, de esta manera, alcanzar una de las metas establecidas en los Objetivos de Desarrollo Sostenible: reducir para 2030 la morbilidad e incidencia de TB. Para lograr este objetivo, está claro que las herramientas empleadas actualmente para su diagnóstico y tratamiento ya no son las adecuadas. En este sentido, es necesario desarrollar nuevos medicamentos y vacunas, así como novedosos procedimientos de administración de fármacos que generen una mejor respuesta, disminuyan el tiempo y optimicen los tratamientos. La nanotecnología ha incorporado en los últimos años un gran número de nuevas herramientas que incrementan considerablemente, la diversidad de mecanismos para la administración de tratamientos antituberculosos. Dicho esto, la presente revisión describe brevemente el estado actual de la farmacorresistencia en TB, así como las características generales de las nanopartículas que están evaluándose como herramientas para transportar antibióticos antituberculosos.
Background
Mexico is on the top five countries with the highest number of TB cases in America continent, nevertheless, information about genotypes circulating is practically unknown. Considering the above this study aims to characterize the genetic diversity of TB in the city of Veracruz, México.
Methods
A cross-sectional study was conducted among positive smear samples from patients living in Veracruz City, samples were cultured, and first-line drug profiles determined. Genotyping was made by spoligotyping and MIRU-VNTR 24 loci. Associations of lineages, clusters, and variables were also analyzed.
Results
Among the 202 isolates analyzed resistance to at least one drug was observed in 60 (30%) isolates and 41(20%) were multidrug-resistant. Three major lineages were identified: L4/Euro-American (88%), L1/Indo-Oceanic (9%), and L2/East Asian (3%). The Euro-American lineage included more than six sublineages, the most abundant were: H (32%), T (23%), LAM (18%), and X (12%). 140 isolates (70%) were placed in 42 SITs patterns.
Conclusions
These results provide the first baseline data on the genetic structure of TB in the city of Veracruz. Sublineages H, X and LAM were predominant; however, it was founded an important diversity of genotypes that could contribute to the dispersion of TB and explain the high prevalence. This information might be useful for the development of further interventions to reduce impact of TB.
Genes related to DNA damage repair in Mycobacterium tuberculosis are critical for survival and genomic diversification. The aim of this study is to compare the presence of SNPs in genes related to DNA damage repair in sensitive and drug-resistant M. tuberculosis genomes isolated from patients with and without type 2 diabetes mellitus (T2DM). We collected 399 M. tuberculosis L4 genomes from several public repositories; 224 genomes belonging to hosts without T2DM, of which 123 (54.9%) had drug sensitive tuberculosis (TB) and 101 (45.1%) had drug resistance (DR)-TB; and 175 genomes from individuals with T2DM, of which 100 (57.1%) had drug sensitive TB and 75 (42.9%) had DR-TB. The presence of SNPs in the coding regions of 65 genes related to DNA damage repair was analyzed and compared with the resistance profile and the presence/absence of T2DM in the host. The results show the phylogenetic relationships of some SNPS and L4 sub-lineages, as well as differences in the distribution of SNPs present in DNA damage repair-related genes related to the resistance profile of the infecting strain and the presence of T2DM in the host. Given these differences, it was possible to generate two discriminant functions to distinguish between drug sensitive and drug resistant genomes, as well as patients with or without T2DM.
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