Department of Tuberculosis III, Wuhan Pulmonary Hospital, Wuhan, Hubei, China.
Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Front Immunol. 2024 Jan 8;14:1305325. doi: 10.3389/fimmu.2023.1305325. eCollection 2023.
Tuberculosis (TB) is caused by the bacterial pathogen and is one of the principal reasons for mortality and morbidity worldwide. Currently, recommended anti-tuberculosis drugs include isoniazid, rifampicin, ethambutol, and pyrazinamide. TB treatment is lengthy and inflicted with severe side-effects, including reduced patient compliance with treatment and promotion of drug-resistant strains. TB is also prone to other concomitant diseases such as diabetes and HIV. These drug-resistant and complex co-morbid characteristics increase the complexity of treating MTB. Host-directed therapy (HDT), which effectively eliminates MTB and minimizes inflammatory tissue damage, primarily by targeting the immune system, is currently an attractive complementary approach. The drugs used for HDT are repositioned drugs in actual clinical practice with relative safety and efficacy assurance. HDT is a potentially effective therapeutic intervention for the treatment of MTB and diabetic MTB, and can compensate for the shortcomings of current TB therapies, including the reduction of drug resistance and modulation of immune response. Here, we summarize the state-of-the-art roles and mechanisms of HDT in immune modulation and treatment of MTB, with a special focus on the role of HDT in diabetic MTB, to emphasize the potential of HDT in controlling MTB infection.
结核病(TB)是由细菌病原体引起的,是全球死亡和发病的主要原因之一。目前,推荐的抗结核药物包括异烟肼、利福平、乙胺丁醇和吡嗪酰胺。结核病的治疗时间长,且副作用严重,包括降低患者对治疗的依从性和促进耐药菌株的产生。结核病也容易并发其他疾病,如糖尿病和 HIV。这些耐药性和复杂的合并症特征增加了治疗结核分枝杆菌的复杂性。宿主定向治疗(HDT)通过靶向免疫系统,有效地消除结核分枝杆菌并最小化炎症组织损伤,目前是一种有吸引力的补充治疗方法。用于 HDT 的药物是实际临床实践中具有相对安全性和疗效保证的重新定位药物。HDT 是治疗结核分枝杆菌和糖尿病结核分枝杆菌的一种潜在有效治疗干预措施,可以弥补现有结核病治疗方法的不足,包括降低耐药性和调节免疫反应。在这里,我们总结了 HDT 在免疫调节和治疗结核分枝杆菌中的最新作用和机制,特别强调了 HDT 在糖尿病结核分枝杆菌中的作用,以强调 HDT 在控制结核分枝杆菌感染方面的潜力。