title: The pregnane X receptor in tuberculosis therapeutics.
abstract: BACKGROUND
  Among the infectious diseases, tuberculosis (TB) remains the second most common cause of death after HIV. TB treatment requires the combination of multiple drugs including the rifamycin class. However, rifamycins are activators of human pregnane X receptor (PXR), a transcription factor that regulates drug metabolism, drug resistance, energy metabolism and immune response. Rifamycin-mediated PXR activation may affect the outcome of TB therapy.
  
  
  METHODS
  This review describes the role of PXR in modulating metabolism, efficacy, toxicity and resistance to anti-TB drugs; as well as polymorphisms of PXR that potentially affect TB susceptibility.
  
  
  CONCLUSIONS
  The wide range of PXR functions that mediate drug metabolism and toxicity in TB therapy are often underappreciated and thus understudied. Further studies are needed to determine the overall impact of PXR activation on the outcome of TB therapy.
authors.affiliation: a Center for Pharmacogenetics, Department of Pharmaceutical Sciences , School of Pharmacy, University of Pittsburgh , Pittsburgh , PA 15261 , USA.
authors.forename: Amina I
authors.initials: AI
authors.lastname: Shehu
authors.affiliation: b Department of Hepatology, the 6th People's Hospital of Zhengzhou , the Hospital for Infectious Diseases in Henan Province , Zhengzhou , China.
authors.forename: Guangming
authors.initials: G
authors.lastname: Li
authors.affiliation: a Center for Pharmacogenetics, Department of Pharmaceutical Sciences , School of Pharmacy, University of Pittsburgh , Pittsburgh , PA 15261 , USA.
authors.forename: Wen
authors.initials: W
authors.lastname: Xie
authors.affiliation: a Center for Pharmacogenetics, Department of Pharmaceutical Sciences , School of Pharmacy, University of Pittsburgh , Pittsburgh , PA 15261 , USA.
authors.forename: Xiaochao
authors.initials: X
authors.lastname: Ma
mesh_terms: D000818:Animals; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D006801:Humans; D011110:Polymorphism, Genetic; D000077297:Pregnane X Receptor; D011987:Receptors, Steroid / Q000187:drug effects / Q000235:genetics / Q000378:metabolism*; D012294:Rifamycins / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents; D000077297:Pregnane X Receptor; D011987:Receptors, Steroid; D012294:Rifamycins
keywords: metabolism; pregnane X receptor; therapeutics; toxicity; tuberculosis