Proteomics Reveals Potential Targets for Drug-Resistant TB


Down-regulation of plasma exosome-derived apolipoproteins APOA1, APOB, and APOC1 indicates DR-TB status and lipid metabolism regulation in pathogenesis. 


  • Group case-controlled study assessed 17 drug resistant tuberculosis (DR-TB) and 33 non–drug resistant TB (NDR-TB) patients at The Fourth People’s Hospital of Taiyuan, China, from November 2018 to March 2019.

  • Plasma exosome purity and quality was determined by transmission electron microscopy, nanoparticle tracking analysis, and Western blot markers.

  • Proteins purified from plasma exosomes were characterized by SDS-Page with Western blotting and liquid chromatography coupled with tandem mass spectrometry techniques.

  • Functional proteomic differential analysis was achieved using the UniProt-GOA, Kyoto Encyclopedia of Genes and Genomes (KEGG), and STRING databases.


  • DR-TB patients tended to be older than NDR-TB patients.

  • Isolated plasma exosomes were morphologically characterized as being “close to pure.”

  • Differential gene expression analysis revealed 16 up-regulated and 10 down-regulated proteins from DR-TB compared with NDR-TB patient-derived plasma exosomes.

  • Protein-protein interaction modeling suggests that down-regulated apolipoproteins APOA1, APOB, and APOC1 have a role in mediating DR-TB development through their functions in lipid metabolism and protein transport.


Key apolipoproteins “may be involved in the pathogenesis of DR-TB via accelerating the formation of foamy macrophages and reducing the cellular uptake of anti-TB drugs.” 


The study led by Mingrui Wu, of Shanxi Medical University, Shanxi, China, and colleagues was published in the July 2023 issue of Tuberculosis.


This study is limited by an enrollment bias of at least twice as many men to women patients for both DR-TB and NDR-TB categories, reporting of some incomplete data collection characterizing the study population, and small sample size, which did not permit stratified analysis of the five types of DR-TB.


The authors report no relevant financial relationships.

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