Isoniazid with Multiple Mode of Action on Various Mycobacterial Enzymes Resulting in Drug Resistance

Lingaraja Jena, Tapaswini Naya

Abstract

Isoniazid (INH), is one of the drugs shown to be effective and has been extensively used in TB control. Interestingly tuberculosis showed predominant drug resistance to isoniazid and thus lead to multi drug therapy in TB treatment. However, isoniazid is still advocated in latent TB and use as prophylactic in HIV infection and in children for prevention of TB. It is of interest that different studies revealing interaction of isoniazid with around 117 enzymes of mycobacteria influencing metabolic pathways by number of ways in addition to inhibiting mycolic acid synthesis and thus affecting growth of mycobacteria. The purpose of this review is to present the various mechanisms of action of isoniazid at different enzymes of MTB causing drug resistance.