Immunobiology Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India.
Department of Molecular Medicine, Jamia Hamdard University, New Delhi, India.
Microbiol Spectr. 2024 Jul 2;12(7):e0041224. doi: 10.1128/spectrum.00412-24. Epub 2024 May 29.
The host immune responses play a pivotal role in the establishment of long-term memory responses, which effectively aids in infection clearance. However, the prevailing anti-tuberculosis therapy, while aiming to combat tuberculosis (TB), also debilitates innate and adaptive immune components of the host. In this study, we explored how the front-line anti-TB drugs impact the host immune cells by modulating multiple signaling pathways and subsequently leading to disease relapse. Administration of these drugs led to a reduction in innate immune activation and also the cytokines required to trigger protective T cell responses. Moreover, these drugs led to activation-induced cell death in the mycobacterial-specific T cell leading to a reduced killing capacity. Furthermore, these drugs stalled the T cell differentiation into memory subsets by modulating the activation of STAT3, STAT4, FOXO1, and NFκB transcription factors and hampering the Th1 and Th17-mediated long-term host protective memory responses. These findings suggest the urgent need to augment directly observed treatment, short-course (DOTS) therapy with immunomodulatory agents to mitigate the adverse effects linked to the treatment.IMPORTANCEAs a central component of TB eradication initiatives, directly observed treatment, short-course (DOTS) therapy imparts immune-dampening effects during the course of treatment. This approach undermines the host immune system by delaying the activation process and lowering the immune response. In our investigation, we have unveiled the impact of DOTS on specific immune cell populations. Notably, the signaling pathways involving STAT3 and STAT4 critical for memory responses and NFκβ associated with pro-inflammation were substantially declined due to the therapy. Consequently, these drugs exhibit limited effectiveness in preventing recurrence of the disease. These observations highlight the imperative integration of immunomodulators to manage TB infection.
宿主免疫反应在建立长期记忆反应中起着关键作用,这有效地有助于清除感染。然而,现有的抗结核疗法虽然旨在对抗结核病 (TB),但也削弱了宿主的先天和适应性免疫成分。在这项研究中,我们通过调节多个信号通路来探索一线抗结核药物如何影响宿主免疫细胞,从而导致疾病复发。这些药物的给药导致先天免疫激活减少,也导致触发保护性 T 细胞反应所需的细胞因子减少。此外,这些药物导致分枝杆菌特异性 T 细胞中的激活诱导细胞死亡,从而降低杀伤能力。此外,这些药物通过调节 STAT3、STAT4、FOXO1 和 NFκB 转录因子的激活,阻止 T 细胞分化为记忆亚群,并阻碍 Th1 和 Th17 介导的长期宿主保护性记忆反应,从而导致 T 细胞分化停滞。这些发现表明迫切需要用免疫调节剂来增强直接观察治疗,短期疗程 (DOTS) 治疗,以减轻与治疗相关的不良影响。
重要性
作为结核病根除计划的核心组成部分,直接观察治疗,短期疗程 (DOTS) 治疗在治疗过程中会产生免疫抑制作用。这种方法通过延迟激活过程和降低免疫反应来破坏宿主免疫系统。在我们的研究中,我们已经揭示了 DOTS 对特定免疫细胞群体的影响。值得注意的是,与记忆反应相关的 STAT3 和 STAT4 以及与前炎症相关的 NFκβ 的信号通路显著下降,这是由于该疗法引起的。因此,这些药物在预防疾病复发方面效果有限。这些观察结果强调了必须整合免疫调节剂来管理结核病感染。