Transient drug-tolerance and permanent drug-resistance rely on the trehalose-catalytic shift in Mycobacterium tuberculosis

Jae Jin Lee, Sun Kyung Lee, Naomi Song, Temitope O. Nathan, Benjamin M. Swarts, Seok Yong Eum, Sabine Ehrt, Sang Nae Cho, Hyungjin Eoh

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53 Citations (Scopus)


Stochastic formation of Mycobacterium tuberculosis (Mtb) persisters achieves a high level of antibiotic-tolerance and serves as a source of multidrug-resistant (MDR) mutations. As conventional treatment is not effective against infections by persisters and MDR-Mtb, novel therapeutics are needed. Several approaches were proposed to kill persisters by altering their metabolism, obviating the need to target active processes. Here, we adapted a biofilm culture to model Mtb persister-like bacilli (PLB) and demonstrated that PLB underwent trehalose metabolism remodeling. PLB use trehalose as an internal carbon to biosynthesize central carbon metabolism intermediates instead of cell surface glycolipids, thus maintaining levels of ATP and antioxidants. Similar changes were identified in Mtb following antibiotic-treatment, and MDR-Mtb as mechanisms to circumvent antibiotic effects. This suggests that trehalose metabolism is associated not only with transient drug-tolerance but also permanent drug-resistance, and serves as a source of adjunctive therapeutic options, potentiating antibiotic efficacy by interfering with adaptive strategies.

Original languageEnglish
Article number2928
JournalNature communications
Issue number1
Publication statusPublished - 2019 Dec 1

Bibliographical note

Funding Information:
This work was supported by start-up funding from the Department of Molecular Microbiology and Immunology, KSOM, USC, the Donald E. & Delia B. Baxter Foundation, the L.K. Whittier Foundation, Wright Foundation and NIH R21 AI139386 to H. E., NIH R15 AI117670 to B.M.S., and the Ministry of Health and Welfare of Republic of Korea to S.Y.E. and S.N.C.

Publisher Copyright:
© 2019, The Author(s).

All Science Journal Classification (ASJC) codes

  • Chemistry(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Physics and Astronomy(all)


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