Turning the tide against TB: Remaking ineffective host defenses into mechanisms for tuberculosis control

Abstract

Most antibiotics, including the drugs currently used for treating tuberculosis (TB), were first discovered as molecules that inhibit bacterial growth in laboratory culture conditions and later translated to infection models and clinical use. Mycobacterium tuberculosis (Mtb) has evolved specifically to survive in its human host, and it is in this infectious context that new drugs need to work. The host environment is characterized by a multitude of antimicrobial defenses induced by the immune system, and we can leverage these defenses to kill Mtb in vivo. Mtb employs a diverse set of responses to survive host defenses. By blocking these responses, we can make Mtb more susceptible to host immunity, turning these previously impotent defenses into effective strategies of immune control.