据医学网站medicalxpress周日报道，哈佛大学医学院的科研人员在对耐药性肺结核研究中发现39个新型耐药性基因，这将为开发肺结核新药和诊疗手段提供新的工具。
此项研究将有助于更好地了解这些基因在肺结核中所起到的作用。
耐药性肺结核是指耐一种或一种以上抗结核药物的肺结核病。2011年3月21日下午，卫生部公布了全国肺结核疫情现状，目前中国结核病年发病人数约为130万，位居全球第2位，仅次于印度。另外我国是全球22个结核病高负担国家之一，耐药肺结核病疫情严峻，每年新发耐多药肺结核患者数约为12万，广泛耐药肺结核患者9000例。 （生物谷 Bioon.com）
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Over the last few decades researchers have used the tools of molecular biology to identify a handful of individual mutations that allow TB to withstand many of the key therapeutics that doctors use to treat it. These genetic markers serve as clues for new drug development and as tools for diagnosing drug-resistant strains of TB. But the pace of discovery has proven too slow in the face of the complex array of rapidly mutating bacterial strains.
A new method of analyzing whole genome sequences of TB, applied to a massive set of strains of the bacteria collected from clinics around the world, has revealed 39 new genes associated with elevated drug resistance. The results were published Sept. 1, 2013 in Nature Genetics.
"We have found that more genes might be implicated in resistance than previously thought, and this means that we can start to unravel the role of these genes," said Megan Murray, HMS professor of global health and social medicine. "This is significant because it implicates new mechanisms in the evolution of resistance that can be further studied now and raises the possibility of more specific targets for the detection of resistance through molecular methods."
These new data suggest that acquiring resistance is a multistep process, perhaps requiring low-level resistance mutations prior to the ones that are well known. The findings also suggest that some of these new genes are involved in resistance that may confer "global" resistance traits, helping strains become resistant to a group of antibiotics rather than just one or a single class.
"Several of the genes we identified are related to the bacteria's regulation of cell walls; since many classes of drugs target the cell walls, we speculate that changes to the structure or metabolism of the cell walls might confer resistance to a wide variety of drugs," said first author Maha Farhat, HMS instructor in medicine and assistant physician at Massachusetts General Hospital.
