Department of Basic Medical Science for Nursing, Department of Primary Education, Yasuda Women's University, Hiroshima, Hiroshima 731-0153. Japan.
Department of Microbiology and Immunology, Shimane University School of Medicine, Izumo, Shimane 693-8501. Japan.
Curr Pharm Des. 2017;23(18):2644-2656. doi: 10.2174/1381612822666161202121550.
The high incidence of tuberculosis (TB) in the world, especially in developing countries, the resurgence of TB in industrialized countries, and the global increase in the prevalence of Mycobacterium avium complex infections in immunocompromised hosts have prompted the quest for novel antimycobacterial drugs. However, the development of such antimicrobial chemotherapeutics is currently making very slow progress even with using the bioinformatics-based methodology for drug design. It thus appears that devising improved administration protocols for clinical treatment against intractable mycobacterial infections using existing chemotherapeutics is more practical than awaiting the development of new antimycobacterial drugs. The potentiation of host immune responses using immunoadjunctive agents, alternatively called host-directed therapeutics (HDTs), may increase the efficacy of antimycobacterial regimens against mycobacteriosis. Particularly, the modulation of host immunity relating to macrophage antimicrobial functions may be beneficial to the immunoadjunctive therapy. This review will deal with the current status and future prospects regarding the development of HDTs useful for the clinical control of intractable mycobacterial infections.
结核病（TB）在世界范围内的高发病率，特别是在发展中国家，结核病在工业化国家的死灰复燃，以及免疫功能低下宿主中鸟分枝杆菌复合体感染的全球流行率增加，促使人们寻求新型抗分枝杆菌药物。然而，即使使用基于生物信息学的药物设计方法，此类抗菌化学疗法的开发目前进展非常缓慢。因此，与等待新的抗分枝杆菌药物的开发相比，使用现有的化学疗法设计针对难治性分枝杆菌感染的临床治疗的改进给药方案似乎更为实际。使用免疫佐剂（也称为宿主定向治疗（HDT））增强宿主免疫反应可能会提高抗分枝杆菌方案对分枝杆菌病的疗效。特别是，调节与巨噬细胞抗菌功能相关的宿主免疫可能有益于免疫佐剂治疗。这篇综述将讨论针对难治性分枝杆菌感染的临床控制有用的 HDT 的现状和未来前景。
