{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:24:56Z","timestamp":1789986296504,"version":"4.0.1"},"reference-count":55,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T00:00:00Z","timestamp":1702684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cBetter Health Outcomes\u201d award SBRI","award":["TS\/M009068\/1"],"award-info":[{"award-number":["TS\/M009068\/1"]}]},{"DOI":"10.13039\/501100006041","name":"Innovate UK","doi-asserted-by":"publisher","award":["TS\/M009068\/1"],"award-info":[{"award-number":["TS\/M009068\/1"]}],"id":[{"id":"10.13039\/501100006041","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The culture confirmation of Mycobacterium tuberculosis (MTB) remains the gold standard for the diagnosis of Tuberculosis (TB) with culture conversion representing proof of cure. However, over 40% of TB samples fail to isolate MTB even though many patients remain infectious due to the presence of viable non-culturable forms. Previously, we have shown that two short cationic peptides, T14D and TB08L, induce a hormetic response at low concentrations, leading to a stimulation of growth in MTB and the related animal pathogen Mycobacterium bovis (bTB). Here, we examine these peptides showing they can influence the mycobacterial membrane integrity and function through membrane potential reduction. We also show this disruption is associated with an abnormal reduction in transcriptomic signalling from specific mycobacterial membrane sensors that normally monitor the immediate cellular environment and maintain the non-growing phenotype. We observe that exposing MTB or bTB to these peptides at optimal concentrations rapidly represses signalling mechanisms maintaining dormancy phenotypes, which leads to the promotion of aerobic metabolism and conversion into a replicative phenotype. We further show a practical application of these peptides as reagents able to enhance conventional routine culture methods by stimulating mycobacterial growth. We evaluated the ability of a peptide-supplemented sample preparation and culture protocol to isolate the MTB against a gold standard routine method tested in parallel on 255 samples from 155 patients with suspected TB. The peptide enhancement increased the sample positivity rate by 46% and decreased the average time to sample positivity of respiratory\/faecal sampling by seven days. The most significant improvements in isolation rates were from sputum smear-negative low-load samples and faeces. The peptide enhancement increased sampling test sensitivity by 19%, recovery in samples from patients with a previously culture-confirmed TB by 20%, and those empirically treated for TB by 21%. We conclude that sample decontamination and culture enhancement with D-enantiomer peptides offer good potential for the much-needed improvement of the culture confirmation of TB.<\/jats:p>","DOI":"10.3390\/ijms242417555","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T03:59:24Z","timestamp":1702871964000},"page":"17555","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Specific Cationic Antimicrobial Peptides Enhance the Recovery of Low-Load Quiescent Mycobacterium tuberculosis in Routine Diagnostics"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8082-6811","authenticated-orcid":false,"given":"Tim J.","family":"Bull","sequence":"first","affiliation":[{"name":"Institute of Infection and Immunity, St. George\u2019s, University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tulika","family":"Munshi","sequence":"additional","affiliation":[{"name":"Institute of Infection and Immunity, St. George\u2019s, University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula M.","family":"Lopez-Perez","sequence":"additional","affiliation":[{"name":"TiKa Diagnostics Ltd., Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy C.","family":"Tran","sequence":"additional","affiliation":[{"name":"Institute of Infection and Immunity, St. George\u2019s, University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Cosgrove","sequence":"additional","affiliation":[{"name":"St. George\u2019s Hospital NHS Trust, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Bartolf","sequence":"additional","affiliation":[{"name":"St. George\u2019s Hospital NHS Trust, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Menichini","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Rindi","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Parigger","sequence":"additional","affiliation":[{"name":"Institute of Molecular Biosciences, Biophysics Division, University of Graz, Humboldstrasse 50\/III, 800 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-9369","authenticated-orcid":false,"given":"Nermina","family":"Malanovic","sequence":"additional","affiliation":[{"name":"Institute of Molecular Biosciences, Biophysics Division, University of Graz, Humboldstrasse 50\/III, 800 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Lohner","sequence":"additional","affiliation":[{"name":"Institute of Molecular Biosciences, Biophysics Division, University of Graz, Humboldstrasse 50\/III, 800 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4564-3125","authenticated-orcid":false,"given":"Carl J. H.","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Chemistry, Monash University, Clayton, VIC 3800, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anam","family":"Fatima","sequence":"additional","affiliation":[{"name":"School of Chemistry, Monash University, Clayton, VIC 3800, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisandra L.","family":"Martin","sequence":"additional","affiliation":[{"name":"School of Chemistry, Monash University, Clayton, VIC 3800, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4358-5294","authenticated-orcid":false,"given":"Semih","family":"Esin","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4448-2385","authenticated-orcid":false,"given":"Giovanna","family":"Batoni","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7131-0370","authenticated-orcid":false,"given":"Kai","family":"Hilpert","sequence":"additional","affiliation":[{"name":"Institute of Infection and Immunity, St. George\u2019s, University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1099\/mic.0.26560-0","article-title":"Quantitative relationships for specific growth rates and macromolecular compositions of Mycobacterium tuberculosis, Streptomyces coelicolor A3(2) and Escherichia coli B\/r: An integrative theoretical approach","volume":"150","author":"Cox","year":"2004","journal-title":"Microbiology"},{"key":"ref_2","unstructured":"(2023, September 01). 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