Mycobacterium tuberculosis, the causative agent of tuberculosis (TB), has co-evolved with the human immune system and utilizes multiple strategies to persist within infected cells, to hijack several immune mechanisms, and to cause severe pathology and tissue damage in the host. This delays the efficacy of current antibiotic therapy and contributes to the evolution of multi-drug-resistant strains. These challenges led to the development of the novel approach in TB treatment that involves therapeutic targeting of host immune response to control disease pathogenesis and pathogen growth, namely, host-directed therapies (HDTs). Such HDT approaches can (1) enhance the effect of antibiotics, (2) shorten treatment duration for any clinical form of TB, (3) promote development of immunological memory that could protect against relapse, and (4) ameliorate the immunopathology including matrix destruction and fibrosis associated with TB. In this review we discuss TB-HDT candidates shown to be of clinical relevance that thus could be developed to reduce pathology, tissue damage, and subsequent impairment of pulmonary function. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

中文翻译：

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宿主定向疗法对结核病病理的影响。

结核分枝杆菌（TB）的病原体已经与人类免疫系统共同进化，并利用多种策略在感染的细胞中持续存在，劫持了几种免疫机制，并在宿主中造成严重的病理和组织损伤。这延迟了当前抗生素疗法的功效，并促进了多药耐药菌株的进化。这些挑战导致了结核病治疗新方法的发展，该方法涉及治疗性靶向宿主免疫反应以控制疾病的发病机理和病原体生长，即宿主定向疗法（HDT）。此类HDT方法可以（1）增强抗生素的作用；（2）缩短任何临床形式的TB的治疗时间；（3）促进可以预防复发的免疫记忆的发展，（4）改善免疫病理，包括与结核相关的基质破坏和纤维化。在这篇综述中，我们讨论了被证明具有临床意义的TB-HDT候选物，因此可以减少病理，组织损伤和随后的肺功能损害。©2020英国和爱尔兰病理学会。由John Wiley＆Sons，Ltd.出版