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The mycobacterial menaquinone-dependent respiratory chain is a vital metabolic pathway in Mycobacterium tuberculosis (Mtb) responsible for generating the proton motive force (PMF) required for ATP synthesis and maintaining redox balance (Cook et al., 2014, PMID: 24511371). This system is unique because it utilizes menaquinone (MK-9) as the sole lipophilic electron carrier, whereas mammalian cells use ubiquinone (Hards et al., 2020, PMID: 32661241). The chain consists of various electron donors like NADH dehydrogenase 2 (NDH-2) and terminal oxidases such as the cytochrome bcc-aa3 supercomplex and cytochrome bd oxidase (Bald et al., 2017, PMID: 28341641). Targeting this pathway has proven highly effective in treating multi-drug resistant tuberculosis, as evidenced by the clinical success of bedaquiline, which inhibits the F1Fo-ATP synthase (Andries et al., 2005, PMID: 15647434). Other novel agents like telacebec (Q203) target the QcrB subunit of the cytochrome bcc complex, further validating the respiratory chain as a cornerstone for modern anti-mycobacterial drug discovery (Pethe et al., 2013, PMID: 23913001).
Inhibition of ATP synthase, inhibition of the cytochrome bcc complex (QcrB), and disruption of the proton motive force through electron transport interference.
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