Molecular bases of the interaction of M. tuberculosis complex and anti-tuberculosis drugs: the current state of the problem and its epidemiological significance

According to the WHO Global Tuberculosis Report, published in 2022, tuberculosis and its drug-resistant forms are on the rise for the first time in lasted years. The ability to become immune to anti-tuberculosis drugs is a fundamental feature of the TB agent. In some cases, it develops a transient resistance to antibacterial drugs based on a combination of adaptive biological properties of mycobacterium without altering the genetic apparatus. This phenomenon is called drug-induced tolerance. Its development is associated with the slowing or altering of bacterial metabolism, increasing the thickness of the cell wall, activation of specific molecular pumps, removing medicinal substances from the cell outside the cell. The same and some other mechanisms are involved in the development of another phenomenon - drug resistance, which is associated with inherited changes in the genetic apparatus of mycobacterium. The review is devoted to the consideration of the molecular bases of mycobacterium tuberculosis interaction with anti-tuberculosis drugs and its epidemiological significance.