Host-Pathogen Interactions in Mycobacterium tuberculosis: Molecular Mechanisms and Implications for Treatment

Worldwide, tuberculosis (TB) due to Mycobacterium tuberculosis is a major public health problem with high morbidity and mortality. This review reviewed the molecular mechanisms and their implications for treatment of M. tuberculosis infection, as well as the complex host pathogen interactions underpinning M. tuberculosis infection. The ability of the pathogen to avoid the host immune responses by utilizing critical strategies for the evasion, for instance, inhibition of phagosome-lyosome fusion and modulation of the host cell pathways are discussed first. T cells play a critical role in the adaptive immune response, and granulomas develop, which are then examined in detail. It importantly informs current treatment protocols which struggle to overcome issues of patient compliance, drug resistance and toxicity. Explored are novel therapeutic approaches targeting bacterial cell wall synthesis, virulence factors and the use of host directed therapies. Recent advances in the development of vaccines, including the innovative endeavors that hope to improve or replace the BCG vaccine, are also reviewed. The review ends by anticipating future directions in TB management, which could be facilitated through efforts related to personalized medicine, and combination therapies, as well as rapid diagnostics to change how we think about treatment. The insights from this study are important for developing novel strategies to fight TB and to bring down its burden globally.