Understanding the action of INH on a highly INH-resistant Mycobacterium tuberculosis strain using Genechips.

The availability of the complete sequence of Mycobacterium tuberculosis genome coupled with microarray technology has enabled a high-throughput approach to the pharmacogenomics of this organism. Isoniazid (INH) is a first-line drug for the treatment of tuberculosis and the microarray approach has generated new insight into the action of INH on a drug-susceptible strain. It has also shown that INH does not induce any significant change in gene expression when applied to a catalase-negative INH-resistant strain, which is expected because catalase activity is required to convert the prodrug INH to its active form. But it has yet to be determined how a partially resistant strain responds to INH. In this study, we explore the mechanism of INH against a highly INH-resistant strain, compare drug-induced gene-expression profiles between resistant and susceptible strains, and determine whether or not and how the resistant strain responds to INH at low and high concentrations. The global gene-expression profiles of the resistant strain in response to INH treatments were obtained using the Affymetrix oligonucleotide GeneChips. The results showed that the resistant strain did not exhibit the characteristic gene-expression signature of type II fatty acid synthase (FAS-II) inhibition when exposed to low-level INH, but it responded with that specific pattern under high-level INH, although the response profile was somewhat shrunken relative to that for a susceptible strain. We found that INH acted on the FAS-II pathway in both resistant and susceptible strains, and little evidence suggested that INH might kill resistant bacteria via other mechanisms. This suggests that there may be potential benefit of treating INH-resistant bacteria with INH at a level that is effective and safe.