We are far away from the days when tuberculosis (TB) accounted for 1 in 4 deaths during the 19th century. However, Mycobacterium tuberculosis complex (MTBC) strains are still the leading cause of morbidity and mortality by a single infectious disease, with 9.6 million cases and 1.5 million deaths reported. One-third of the world's population is estimated by the WHO to be infected with latent TB. During the last decade, several studies have aimed to define the characteristics of dormant bacteria in these latent infections. General features of the shift to a dormant state encompass several phenotypic changes that reduce metabolic activity. This low metabolic state is thought to increase the resistance of MTBC strains to host/environmental stresses, including antibiotic action. Once the stress ceases (e.g., interruption of treatment), dormant cells can reactivate and cause symptomatic disease again. Therefore, a proper understanding of dormancy could guide the rational development of new treatment regimens that target dormant cells, reducing later relapse. Here, we briefly summarize the latest data on the genetics involved in the regulation of dormancy and discuss new approaches to TB treatment.

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休眠状态下结核分枝杆菌的新方法和治疗选择[评论]

在19世纪，结核病占四分之一的死亡人数的时代已经过去了。但是，结核分枝杆菌复杂的（MTBC）菌株仍然是单一传染病发病率和死亡率的主要原因，据报道有960万例，死亡150万人。据世界卫生组织估计，世界人口的三分之一感染了潜在的结核病。在过去的十年中，数项研究旨在确定这些潜伏感染中潜伏细菌的特征。转变为休眠状态的一般特征包括降低代谢活性的几种表型变化。人们认为这种低代谢状态会增加MTBC菌株对宿主/环境胁迫（包括抗生素作用）的抗性。一旦压力消除（例如治疗中断），休眠细胞就会重新激活并再次引起症状性疾病。所以，对休眠的正确理解可以指导针对休眠细胞的新治疗方案的合理开发，从而减少以后的复发。在这里，我们简要总结了有关调节休眠的遗传学的最新数据，并讨论了结核病治疗的新方法。