Abstract

Mycobacterium tuberculosis can survive within its host for extended periods of time without any clinical symptoms of disease and reactivate when the immune system is weakened. A detailed understanding of how M. tuberculosis enters into and exits out of dormancy, is necessary in order to develop new strategies for tackling tuberculosis. Omics methodologies are unsupervised and unbiased to any hypothesis, making them useful tools for the discovery of new drug targets. This review summarizes the findings of transcriptomic and proteomic approaches toward understanding dormancy and reactivation of M. tuberculosis. Within the granuloma of latently infected individuals, the bacteria are dormant, with a marked slowdown of growth, division and metabolism. In vitro models have attempted to simulate these features by subjecting the bacterium to hypoxia, nutrient starvation, potassium depletion, growth in the presence of vitamin C, or growth in the presence of long-chain fatty acids. The striking feature of all the models is the upregulation of the DosR regulon, which includes the transcriptional regulator Rv0081, one of the central hubs of dormancy. Also upregulated are chaperone proteins, fatty acid and cholesterol degrading enzymes, the sigma factors SigE and SigB, enzymes of the glyoxylate and the methylcitrate cycle, the Clp proteases and the transcriptional regulator ClgR. Further, there is increased expression of genes involved in mycobactin synthesis, fatty acid degradation, the glyoxylate shunt and gluconeogenesis, in granulomas formed in vitro from peripheral blood mononuclear cells from latently infected individuals compared to naïve individuals. Genes linked to aerobic respiration, replication, transcription, translation and cell division, are downregulated during dormancy in vitro, but upregulated during reactivation. Resuscitation in vitro is associated with upregulation of genes linked to the synthesis of mycolic acids, phthiocerol mycocerosate (PDIM) and sulfolipids; ribosome biosynthesis, replication, transcription and translation, cell division, and genes encoding the five resuscitation promoting factors (Rpfs). The expression of proteases, transposases and insertion sequences, suggests genome reorganization during reactivation.

Highlights

  • THE GRANULOMA IN TUBERCULOSISTuberculosis (TB) remains a global health problem with 1,000,000 new cases and 1,400,000 deaths in 2019 (World Health Organization, 2020)

  • M. tuberculosis remains in a dormant state, in latently infected individuals, with reactivation occurring when the immune system weakens

  • The Rv0079 to Rv0087 cluster, featuring the transcriptional regulator Rv0081 which likely directs feed forward loops (FFLs) which are crucial to the adaptation to hypoxia, the chaperones acr or hspX, acr2, tgs1, the regulator clgR, cation transporting ATPases, thioredoxin, genes involved in fatty acid degradation, sigma factors such as SigE, SigB, and SigH, and genes/proteins of the mycobacterial Clp protease

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Summary

Introduction

THE GRANULOMA IN TUBERCULOSISTuberculosis (TB) remains a global health problem with 1,000,000 new cases and 1,400,000 deaths in 2019 (World Health Organization, 2020). In vitro models of dormancy (most notably hypoxia, vitamin C exposure, potassium depletion and nutrient starvation) have reported the induction of several of the transcripts of extracytoplasmic function (ECF) sigma factors.

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Conclusion

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