Tuberc Respir Dis.  2008 Sep;65(3):177-182.

Standard Chemotherapy with Excluding Isoniazid in a Murine Model of Tuberculosis

Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Korea. shimts@amc.seoul.kr
  • 2Department of Microbiology and the Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND: Isoniazid (INH, H) is a key drug of the standard first-line regimen for the treatment of tuberculosis (TB), yet some reports have suggested that treatment efficacy was maintained even though INH was omitted from the treatment regimen.
METHODS
One hundred forty C57BL/6 mice were infected with the H37Rv strain of M. tuberculosis with using a Glas-Col aerosol generation device, and this resulted in depositing about 100 bacilli in the lung. Four weeks after infection, anti-TB treatment was initiated with varying regimens for 4-8 weeks; Group 1: no treatment (control), Group 2 (4HREZ): 4 weeks of INH, rifampicin (R), pyrazinamide (Z) and ethambutol (E), Group 3: 1HREZ/3REZ, Group 4: 4REZ, Group 5: 4HREZ/4HRE, Group 6: 1HREZ/3REZ/4RE, and Group 7: 4REZ/4RE. The lungs and spleens were harvested at several time points until 28 weeks after infection, and the colony-forming unit (CFU) counts were determined.
RESULTS
The CFU counts increased steadily after infection in the control group. In the 4-week treatment groups (Group 2-4), even though the culture was negative at treatment completion, the bacilli grew again at the 12-week and 20-week time points after completion of treatment. In the 8-week treatment groups (Groups 5-7), the bacilli did not grow in the lung at 4 weeks after treatment initiation and thereafter. In the spleens of Group 7 in which INH was omitted from the treatment regimen, the culture was negative at 4-weeks after treatment initiation and thereafter. However, in Groups 5 and 6 in which INH was taken continuously or intermittently, the bacilli grew in the spleen at some time points after completion of treatment.
CONCLUSION
TThe exclusion of INH from the standard first-line regimen did not affect the treatment outcome in a murine model of TB in the early stage of disease. Further studies using a murine model of chronic TB are necessary to clarify the role of INH in the standard first-line regimen for treating TB.

Keyword

Tuberculosis; Isoniazid; Mouse

MeSH Terms

Animals
Ethambutol
Isoniazid
Lung
Mice
Pyrazinamide
Rifampin
Spleen
Sprains and Strains
Stem Cells
Treatment Outcome
Tuberculosis
Ethambutol
Isoniazid
Pyrazinamide
Rifampin

Figure

  • Figure 1 Schedule of infection, treatment, and harvest of organs. Tx: Treatment; H: isoniazid; R: Rifampicin; E: Ethambutol; Z: Pyrazinamide.

  • Figure 2 M. tuberculosis CFU counts in the lung after 4 weeks of treatment. CFU: colony forming unit; H: isoniazid; R: Rifampicin; E: Ethambutol; Z: Pyrazinamide.

  • Figure 3 M. tuberculosis CFU counts in the lung after 8 weeks of treatment. CFU: colony forming unit; H: isoniazid; R: Rifampicin; E: Ethambutol; Z: Pyrazinamide.

  • Figure 4 M. tuberculosis CFU counts in the spleen after 8 weeks of treatment. CFU: colony forming unit; H: isoniazid; R: Rifampicin; E: Ethambutol; Z: Pyrazinamide.


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