2025 年第 1 期 第 20 卷

结核病中的脂质代谢途径及经其治疗结核病的研究进展

Research progress of lipid metabolic pathway in tuberculosis and its treatment of tuberculosis

作者：曹显凤1 张先明2

英文作者：Cao Xianfeng1 Zhang Xianming2

单位：1贵州医科大学临床医学院，贵阳550001；2贵州医科大学附属医院呼吸与危重症医学科，贵阳550001

英文单位：1School of Clinical Medicine Guizhou Medical University Guiyang 550001 China; 2Department of Respiratory and Critical Care Medicine the Affiliated Hospital of Guizhou Medical University Guiyang 550001 China

关键词：结核病；  结核分枝杆菌；  脂质代谢；  脂滴；  抗结核药物

英文关键词：Tuberculosis;  Mycobacteriumtuberculosis;  Lipidmetabolism;  Lipiddroplets;  Anti-tuberculosisdrugs

• 摘要：

• 脂质在结核分枝杆菌（Mtb）的生长和代谢中具有至关重要的作用。在Mtb感染期间，泡沫状巨噬细胞在肉芽肿中积累脂质，如甘油三酯和胆固醇，这些脂质可促进耐药性Mtb的形成，从而降低抗结核治疗的效果。因此，了解宿主和Mtb中脂质代谢物的变化至关重要。Mtb的缓慢生长和耐药性导致治疗时间延长，并伴有副作用和耐药性的风险。为提高抗结核药物的疗效，必须深入了解抗结核药物对Mtb脂质代谢的作用机制。本文主要通过讨论宿主和Mtb感染过程中脂质重编程对抗结核反应的影响，并分析脂质与抗菌药物及脂质代谢物之间的相互作用。此外，本文探讨了脂质对药物疗效的影响，以期为有效控制Mtb感染提供参考。

• Lipids play a crucial role in the growth and metabolism of Mycobacterium tuberculosis (Mtb). During Mtb infection, foamy macrophages accumulate lipids in granulomas, such as triglycerides and cholesterol, which can promote the formation of drug-resistant Mtb, thereby reducing the effectiveness of anti-tuberculosis treatment. Therefore, it is critical to understand the changes in lipid metabolites in the host and Mtb. The slow growth and drug resistance of Mtb results in prolonged treatment with associated risks of side effects and drug resistance. In order to improve the efficacy of anti-tuberculosis drugs, it is necessary to understand the mechanism of action of anti-tuberculosis drugs on lipid metabolism of Mtb. This paper mainly discusses the impact of lipids reprogramming by host and Mtb during infection on the anti-tuberculosis response, and analyzes the interactions between lipids, antibiotics, and lipid metabolites. In addition, this paper discusses the influence of lipids on drug efficacy, in order to provide reference for effective control of Mtb infection.