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Lookup NU author(s): Dr Othman AlmusaimiORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Mycobacterium tuberculosis infections continue to pose a significant global health challenge, particularly due to the rise of multidrug-resistant strains, random mycobacterial mutations, and the complications associated with short-term antibiotic regimens. Currently, five approved drugs target cell wall biosynthesis in Mycobacterium tuberculosis. This review provides a comprehensive analysis of these drugs and their molecular mechanisms. Isoniazid, thioamides, and delamanid primarily disrupt mycolic acid synthesis, with recent evidence indicating that delamanid also inhibits decaprenylphosphoryl-β-D-ribose-2-epimerase, thereby impairing arabinogalactan biosynthesis. Cycloserine remains the sole approved drug that inhibits peptidoglycan synthesis, the foundational layer of the mycobacterial cell wall. Furthermore, ethambutol interferes with arabinogalactan synthesis by targeting arabinosyl transferase enzymes, particularly embB- and embC-encoded variants. Beyond these, six promising molecules currently in Phase II clinical trials are designed to target arabinan synthesis pathways, sutezolid, TBA 7371, OPC-167832, SQ109, and both benzothiazinone derivatives BTZ043 and PBTZ169, highlighting advancements in the development of cell wall-targeting therapies.
Author(s): Diab A, Dickerson H, Al Musaimi O
Publication type: Review
Publication status: Published
Journal: Pharmaceuticals
Year: 2025
Volume: 18
Issue: 1
Print publication date: 01/01/2025
Online publication date: 09/01/2025
Acceptance date: 07/01/2025
ISSN (electronic): 1424-8247
Publisher: MDPI
URL: https://doi.org/10.3390/ph18010070
DOI: 10.3390/ph18010070
Notes: This article belongs to the Special Issue Advances in Drug Analysis and Drug Development.
