New strategies for the treatment of tuberculosis: research progress and clinical translation in immune modulation and inflammation control
- 1Department of Pharmacy, Qingdao Public Health Clinical Center
- 2Department of Pharmacy, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital)
- 3The Prison of Shandong Province
Abstract
Tuberculosis (TB) remains a major global public health challenge, with treatment complicated by drug resistance, adverse effects, and suboptimal host immune responses. Whilst conventional anti-TB drugs are effective bactericidally, their immunomodulatory effects may, in certain contexts, contribute to immune imbalance and affect treatment outcomes. Host-directed therapy (HDT), which aims to modulate the host immune response to enhance pathogen control and limit immunopathology, has emerged as a promising adjunctive strategy. This narrative review critically evaluates the current evidence for HDT in TB, focusing on immunosenescence, trained immunity, cytokine and lipid mediator networks, immunometabolic reprogramming, neuroendocrine regulation, and repurposed drugs including metformin and statins. Importantly, we distinguish between evidence derived directly from TB models ( in vitro , animal, and clinical studies) and evidence extrapolated from other diseases, highlighting knowledge gaps and areas requiring further investigation. We propose that future progress depends on evidence-based stratification of HDT candidates, rigorous clinical trial design, and a personalised approach that accounts for patient comorbidities and immune status. This review aims to provide a balanced framework for advancing HDT from bench to bedside in TB therapy.
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BibTeX
@article{du2026strategies,
title = {{New strategies for the treatment of tuberculosis: research progress and clinical translation in immune modulation and inflammation control}},
author = {Shihao Du and Lulu Zhen and Ji Zhou and Di Deng},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1974232},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1974232/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - New strategies for the treatment of tuberculosis: research progress and clinical translation in immune modulation and inflammation control
AU - Shihao Du
AU - Lulu Zhen
AU - Ji Zhou
AU - Di Deng
PY - 2026
DA - 2026/10/14
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1974232
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1974232/full
AB - Tuberculosis (TB) remains a major global public health challenge, with treatment complicated by drug resistance, adverse effects, and suboptimal host immune responses. Whilst conventional anti-TB drugs are effective bactericidally, their immunomodulatory effects may, in certain contexts, contribute to immune imbalance and affect treatment outcomes. Host-directed therapy (HDT), which aims to modulate the host immune response to enhance pathogen control and limit immunopathology, has emerged as a promising adjunctive strategy. This narrative review critically evaluates the current evidence for HDT in TB, focusing on immunosenescence, trained immunity, cytokine and lipid mediator networks, immunometabolic reprogramming, neuroendocrine regulation, and repurposed drugs including metformin and statins. Importantly, we distinguish between evidence derived directly from TB models ( in vitro , animal, and clinical studies) and evidence extrapolated from other diseases, highlighting knowledge gaps and areas requiring further investigation. We propose that future progress depends on evidence-based stratification of HDT candidates, rigorous clinical trial design, and a personalised approach that accounts for patient comorbidities and immune status. This review aims to provide a balanced framework for advancing HDT from bench to bedside in TB therapy.
SN - 1664-3224
ER -