Major Global Killer Tamed by Hydrogen

M ycobacterium tuberculosis, the causative agent of tuberculosis (TB) has only one hostus. Specimens of our earliest known upright ancestors, Homo erectus, from more than 500,000 years ago show pathology consistent with TB disease, and whole genome sequences of TB strains have been constructed from the remains of Peruvian mummies that were over 1000 years old. Despite our long and intimate relationship with the bacterium, we still know remarkably little about how we have adapted to provide its living quarters and conversely what adaptations the pathogen has made to respond to our defense systems. Since bedaquiline, the first new antituberculosis drug in decades, was approved for the treatment of TB in 2012, all eyes have been on energy metabolism. That’s because bedaquiline inhibits the proton-pumping ATP synthase that fuels the mycobacterial cell.