Abstract

Isoniazid represents a first-line anti-tuberculosis medication in prevention and treatment. This prodrug is activated by a mycobacterial catalase-peroxidase enzyme called KatG in Mycobacterium tuberculosis), thereby inhibiting the synthesis of mycolic acid, required for the mycobacterial cell wall. Moreover, isoniazid activation by KatG produces some radical species (e.g., nitrogen monoxide), that display anti-mycobacterial activity. Remarkably, the ability of mycobacteria to persist in vivo in the presence of reactive nitrogen and oxygen species implies the presence in these bacteria of (pseudo-)enzymatic detoxification systems, including truncated hemoglobins (trHbs). Here, we report that isoniazid binds reversibly to ferric and ferrous M. tuberculosis trHb type N (or group I; Mt-trHbN(III) and Mt-trHbN(II), respectively) with a simple bimolecular process, which perturbs the heme-based spectroscopic properties. Values of thermodynamic and kinetic parameters for isoniazid binding to Mt-trHbN(III) and Mt-trHbN(II) are K = (1.1±0.1)×10−4 M, k on = (5.3±0.6)×103 M−1 s−1 and k off = (4.6±0.5)×10−1 s−1; and D = (1.2±0.2)×10−3 M, d on = (1.3±0.4)×103 M−1 s−1, and d off = 1.5±0.4 s−1, respectively, at pH 7.0 and 20.0°C. Accordingly, isoniazid inhibits competitively azide binding to Mt-trHbN(III) and Mt-trHbN(III)-catalyzed peroxynitrite isomerization. Moreover, isoniazid inhibits Mt-trHbN(II) oxygenation and carbonylation. Although the structure of the Mt-trHbN-isoniazid complex is not available, here we show by docking simulation that isoniazid binding to the heme-Fe atom indeed may take place. These data suggest a direct role of isoniazid to impair fundamental functions of mycobacteria, e.g. scavenging of reactive nitrogen and oxygen species, and metabolism.

Highlights

  • Tuberculosis (TB) affects about 15 million people, and there are about 9 million new cases per year

  • Isoniazid binding to Mt-trHbN(III) Mixing of the Mt-trHbN(III) and isoniazid solutions brings about a shift of the optical absorption maximum of the Soret band from 406 nm (i.e., Mt-trHbN(III)) to 410 nm (i.e., MttrHbN(III)-isoniazid) and a change of the extinction coefficient from e406 nm = 1.416105 M21 cm21 (i.e., Mt-trHbN(III)) to e410 nm = 1.096105 M21 cm21 (i.e., Mt-trHbN(III)-isoniazid)

  • Values of the apparent pseudo-first order rate constant for isoniazid binding to Mt-trHbN(III) are wavelength-independent at fixed drug concentration, but they depend on the isoniazid concentration

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Summary

Introduction

Tuberculosis (TB) affects about 15 million people, and there are about 9 million new cases per year. Note that about 3% of all newly diagnosed patients are affected by multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). The selection and transmission of multidrug-resistant tuberculosis indicates the resistance to at least isoniazid and rifampicin, the two fundamental components of any regimen for the treatment of drug-susceptible tuberculosis [16,17,18,19]. XDR-TB is resistant to rifampicin and isoniazid, two so-called ‘‘first-line’’ antituberculosis drugs, in addition to any antibiotic from the fluoroquinolone group, and at least one of the three injectable anti-tuberculosis drugs (amikacin, capriomycin, and kanamycin) [15,17,21,22]. The management of MDR-TB and XDR-TB is a challenge which should be undertaken by experienced clinicians at centres equipped with reliable laboratory service for mycobacterial culture and in vitro sensitivity testing as it requires prolonged use of expensive second-line drugs with a significant potential for toxicity [6,10,13,17,20,23,24,25]

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