Host-directed therapies targeting the tuberculosis granuloma stroma

Host-directed therapies targeting the tuberculosis granuloma stroma.

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Item Type: Review
Official URL:
Journal or Publication Title: Pathogens and Disease
Volume: 78
Number: 2
Date: 2020
Divisions: Immune-Vascular Interactions
Depositing User: General Admin
Identification Number: 10.1093/femspd/ftaa015
ISSN: 2049-632X
Date Deposited: 22 Dec 2020 03:32

Mycobacteria have co-evolved with their hosts resulting in pathogens adept at intracellular survival. Pathogenic mycobacteria actively manipulate infected macrophages to drive granuloma formation while subverting host cell processes to create a permissive niche. Granuloma residency confers phenotypic antimicrobial resistance by physically excluding or neutralising antibiotics. Host-directed therapies (HDTs) combat infection by restoring protective immunity and reducing immunopathology independent of pathogen antimicrobial resistance status. This review covers innovative research that has discovered ‘secondary’ symptoms of infection in the granuloma stroma are actually primary drivers of infection and that relieving these stromal pathologies with HDTs benefits the host. Advances in our understanding of the relationship between tuberculosis and the host vasculature, haemostatic system and extracellular matrix reorganisation are discussed. Preclinical and clinical use of HDTs against these stromal targets are summarised.

Oehlers, Stefan H
Hortle, Elinor
Last Modified: 05 Jan 2021 21:52

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