Role of resuscitation promoting factors in reactivation of latent tuberculosis during high glucose conditions employing human granuloma in vitro model

Exploring the multifaceted roles of resuscitation-promoting factors in tuberculosis: Implications for diagnosis, vaccine development, and drug targeting

Tuberculosis (TB) remains a significant global health challenge, necessitating continued research efforts to unravel its complex pathogenesis and advance diagnostic, therapeutic, and preventive strategies. Resuscitation-promoting factors (Rpfs) are peptidoglycan-hydrolyzing enzymes that have gained attention due to their key roles in TB infection dynamics. This review aims to provide a comprehensive overview of Rpfs in TB, highlighting their immunological roles, diagnostic potential, and implications for vaccine development and drug targeting through both in silico and experimental approaches. Rpfs exhibit diverse roles in TB, influencing bacterial resuscitation from dormancy, and immune modulation through interactions with host immune cells, such as dendritic cells, and they are potential targets for novel diagnostic and therapeutic interventions. Their ability to stimulate immune responses, particularly interferon-γ production by T cells, underscores their potential as vaccine candidates against TB. Moreover, Rpfs represent promising targets for drug discovery, with inhibitors potentially disrupting bacterial resuscitation and growth.

Tuberculosis vaccines and therapeutic drug: challenges and future directions

Tuberculosis (TB) remains a prominent global health challenge, with the World Health Organization documenting over 1 million annual fatalities. Despite the deployment of the Bacille Calmette-Guérin (BCG) vaccine and available therapeutic agents, the escalation of drug-resistant Mycobacterium tuberculosis strains underscores the pressing need for more efficacious vaccines and treatments. This review meticulously maps out the contemporary landscape of TB vaccine development, with a focus on antigen identification, clinical trial progress, and the obstacles and future trajectories in vaccine research. We spotlight innovative approaches, such as multi-antigen vaccines and mRNA technology platforms. Furthermore, the review delves into current TB therapeutics, particularly for multidrug-resistant tuberculosis (MDR-TB), exploring promising agents like bedaquiline (BDQ) and delamanid (DLM), as well as the potential of host-directed therapies. The hurdles in TB vaccine and therapeutic development encompass overcoming antigen diversity, enhancing vaccine effectiveness across diverse populations, and advancing novel vaccine platforms. Future initiatives emphasize combinatorial strategies, the development of anti-TB compounds targeting novel pathways, and personalized medicine for TB treatment and prevention. Despite notable advances, persistent challenges such as diagnostic failures and protracted treatment regimens continue to impede progress. This work aims to steer future research endeavors toward groundbreaking TB vaccines and therapeutic agents, providing crucial insights for enhancing TB prevention and treatment strategies.

Analysis of Risk Factors for Restenosis after Interventional Treatment of Tuberculous Airway Stenosis

INTRODUCTION

Airway stenosis is the most common and serious complication of tracheobronchial tuberculosis (TBTB). Systemic anti-tuberculosis treatment is the basic treatment for TBTB airway stenosis, and supplemented with tracheoscopic intervention, it can effectively minimize the occurrence of TBTB stenosis or reduce the degree of stenosis; however, some patients still have restenosis after the intervention. However, some patients still have restenosis after intervention.

METHODS

We retrospectively collected the clinical data of patients diagnosed with tuberculous airway stenosis in the Second Hospital of Lanzhou University and Lanzhou Pulmonary Hospital from January 2021 to June 2023. The patients were divided into the restenosis group and the non-restenosis group according to whether or not restenosis occurred in the airway within 1 year of the intervention, and the differences in the clinical data between the two groups were compared, and the variables with statistically significant differences in the univariate analysis were analyzed by multifactorial binary logistic regression.

RESULTS

A total of 154 patients with tuberculous airway stenosis were included in this study, including 64 patients in the restenosis group, and the restenosis rate was 41.6%. Univariate analysis showed that the systemic immune inflammation index (SII) was higher in the restenosis group than in the non-restenosis group, and the composition of diabetic patients, stenosis length >3 cm, and positive antacid staining of tracheal secretions were higher in the restenosis group than in the non-restenosis group (all p < 0.05). The composition of microscopically inactive, anti-tuberculosis treatment before intervention and balloon dilatation was lower (all p < 0.05). Multifactorial binary logistic regression analysis showed that diabetes (OR = 5.758, 95% CI: 1.434-23.119), stenosis length (OR = 6.349, 95% CI: 2.653-15.197), SII (OR = 1.002, 95% CI: 1.001-1.003), anti-tuberculosis treatment before interventional therapy (OR = 0.250, 95% CI: 0.084-0.746), and TBTB microscopic classification and staging (OR = 0.306, 95% CI: 0.099-0.941) were independent influencing factors of restenosis after interventional therapy for tuberculous airway stenosis.

CONCLUSION

Diabetes, stenosis length >3 cm, and high SII were independent risk factors for restenosis after intervention for tuberculous airway stenosis, before interventional anti-tuberculosis treatment and microscopic inactivity were independent protective factors.

Tuberculosis and lung cancer: metabolic pathways play a key role

Despite the fact that some cases of tuberculosis (TB) are undiagnosed and untreated, it remains a serious global public health issue. In the diagnosis, treatment, and control of latent and active TB, there may be a lack of effectiveness. An understanding of metabolic pathways can be fundamental to treat latent TB infection and active TB disease. Rather than targeting Mycobacterium tuberculosis, the control strategies aim to strengthen host responses to infection and reduce chronic inflammation by effectively enhancing host resistance to infection. The pathogenesis and progression of TB are linked to several metabolites and metabolic pathways, and they are potential targets for host-directed therapies. Additionally, metabolic pathways can contribute to the progression of lung cancer in patients with latent or active TB. A comprehensive metabolic pathway analysis is conducted to highlight lung cancer development in latent and active TB. The current study aimed to emphasize the association between metabolic pathways of tumor development in patients with latent and active TB. Health control programs around the world are compromised by TB and lung cancer due to their special epidemiological and clinical characteristics. Therefore, presenting the importance of lung cancer progression through metabolic pathways occurring upon TB infection can open new doors to improving control of TB infection and active TB disease while stressing that further evaluations are required to uncover this correlation.

Cellular Immunity of Patients with Tuberculosis Combined with Diabetes

Tuberculosis (TB) is one of humanity's three major infectious diseases. Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia due to impaired insulin secretion or impaired insulin function. It has been reported that DM is a primary risk factor for TB disease. Given the increasing public health threat to people's health, more and more studies have focused on diabetes complicated by TB. Hyperglycemia can affect the function of human immune cells, promote primary infections and reactivation of TB, and increase the susceptibility and severity of TB. However, the immunological mechanism behind it is still not clear. By reviewing the related articles on tuberculosis complicated with diabetes published in recent years, this paper expounds on the effect of hyperglycemia on innate immunity and adaptive immunity of patients with TB. This review provides new insights for elucidating the immunological mechanism of TB complicated with DM and lays the foundation for finding potential targets for preventing and treating TB combined with DM.