Abstract
Tuberculosis (TB) is a serious public health problem worldwide. The combination of various anti-TB drugs is mainly used to treat TB in clinical practice. Despite the availability of effective antibiotics, effective treatment regimens still require long-term use of multiple drugs, leading to toxicity, low patient compliance, and the development of drug resistance. It has been confirmed that immune recognition, immune response, and immune regulation of Mycobacterium tuberculosis (Mtb) determine the occurrence, development, and outcome of diseases after Mtb infection. The research and development of TB-specific immunotherapy agents can effectively regulate the anti-TB immune response and provide a new approach toward the combined treatment of TB, thereby preventing and intervening in populations at high risk of TB infection. These immunotherapy agents will promote satisfactory progress in anti-TB treatment, achieving the goal of “ultra-short course chemotherapy.” This review highlights the research progress in immunotherapy of TB, including immunoreactive substances, tuberculosis therapeutic vaccines, chemical agents, and cellular therapy.
Highlights
Tuberculosis (TB) is a leading infectious disease caused by Mycobacterium tuberculosis (Mtb), which invades the host
Macrophages, NK cells and other innate immune cell populations can produce “trained immunity,” and the immune system can mount a faster and more effective protective immune response after the second invasiveness of Mtb (Divangahi et al, 2021); (2) If the invasiveness of Mtb is balanced with host immunity, Mtb may turn into a dormant state, presenting immune escape and a symbiotic state with the host (Gong and Wu, 2021); (3) When the invasiveness of Mtb is stronger than the host immunity, Mtb will replicate in the granuloma, which may undergo caseous necrosis, liquefaction, and cavitation, leading to a spread of Mtb and an initiation of active TB (Khan et al, 2016; de Martino et al, 2019)
Studies have shown that IL-2 can induce differential expression of genes in peripheral blood mononuclear cells (PBMCs) stimulated with Mtb, and reduce or clear sputum bacteria in about 60% of patients with MDR-TB combined with chemotherapy (Johnson B. et al, 1998; Johnson B.J. et al, 1998)
Summary
Tuberculosis (TB) is a leading infectious disease caused by Mycobacterium tuberculosis (Mtb), which invades the host. Mtb mainly survives and proliferates in alveolar macrophages and other innate immune cells of the host. Since the protective responses of the host against TB are based on the production of innate immune cells and the interaction between activated macrophages and specific T cells, enhancing protective immunity or regulating adaptive immune responses against TB may be valuable adjuvant treatments for advanced disease. Anti-TB immunotherapy mainly includes activating immune activity, enhancing protective immunity, and suppressing adverse immune responses and inflammatory damage. The research and development of TB-specific immunotherapy agents can effectively regulate the anti-TB immune response, provide a new way for the combined treatment of TB, prevent and intervene in populations at high risk of TB infection, which will make TB treatment achieve a significant effect, and achieve the goal of “ultra-short course chemotherapy.”.
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