Exosome-mediated bidirectional immune dysregulation in tuberculosis: proteomic profiling reveals strain-specific strategies of virulent H37Rv and attenuated H37Ra

Conclusively, Mtb exploits exosomes as "virulence vectors" to deliver RhoGDI and death signals (e.g., Caspse-9), paralyzing systemic immunity while optimizing intracellular survival. Virulence-specific cargo sorting informs novel diagnostics and therapies against TB. However, given the limitations of the in vitro model, future research should incorporate in vivo models and clinical trials to validate these findings.