Effects of host-directed therapies on the pathology of tuberculosis.

Mycobacterium tuberculosis, the causative agent of tuberculosis (TB), has co-evolved with the human immune system and utilizes multiple strategies to persist within infected cells, to hijack several immune mechanisms and to cause severe pathology and tissue damage in the host. This delays the efficacy of current antibiotic therapy and contributes to the evolution of multi-drug resistant strains. These challenges led to the development of the novel approach in TB treatment that involves therapeutic targeting of host immune response in order to control disease pathogenesis and pathogen growth viz. host-directed therapies (HDT). Such HDT approaches are capable of: (i) enhancing the effect of antibiotics, (ii) shortening treatment duration for any clinical form of TB (iii) promoting development of immunological memory that could protect against relapse and (iv) ameliorating the immunopathology including matrix destruction and fibrosis associated with TB. In this review we discuss TB-HDT candidates shown to be of clinical relevance and thus could be developed to reduce pathology, tissue damage and subsequent impairment of pulmonary function. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.