Aurum Institute, Johannesburg 2193, South Africa.
Division of AIDS, National Institutes of Health, Bethesda, Maryland 20852, USA.
Nat Rev Immunol. 2015 Apr;15(4):255-63. doi: 10.1038/nri3813. Epub 2015 Mar 13.
Improved treatments are needed for nearly all forms of Mycobacterium tuberculosis infection. Adjunctive host-directed therapies have the potential to shorten tuberculosis treatment duration, prevent resistance and reduce lung injury by promoting autophagy, antimicrobial peptide production and other macrophage effector mechanisms, as well as by modifying specific mechanisms that cause lung inflammation and matrix destruction. The range of candidates is broad, including several agents approved for other clinical indications that are ready for evaluation in Phase II clinical trials. The promise of new and existing host-directed therapies that could accelerate response and improve tuberculosis treatment outcomes is discussed in this Opinion article.
需要改进对几乎所有形式的结核分枝杆菌感染的治疗方法。辅助性宿主导向疗法具有缩短结核病治疗时间、预防耐药性和减少肺损伤的潜力,其作用机制包括促进自噬、抗菌肽产生和其他巨噬细胞效应机制,以及通过改变导致肺部炎症和基质破坏的特定机制。候选药物种类繁多,包括几种已批准用于其他临床适应证的药物,这些药物已准备好进行 II 期临床试验评估。本文观点讨论了新的和现有的宿主导向疗法的前景,这些疗法可能会加速反应并改善结核病治疗结果。