Gut microbiota and tuberculosis infection: interaction and therapeutic potential

Abstract

Pulmonary tuberculosis (PTB), caused by Mycobacterium tuberculosis (MTB), is a serious chronic infectious disease. Although significant progress has been made in the prevention and treatment of MTB, current anti-tuberculosis therapies still face numerous challenges. The human gut microbiota, a complex ecosystem, plays a role in host metabolism, immune regulation, and health maintenance. Recent studies have increasingly highlighted a close relationship between gut microbiota and PTB. The gut microbiota, through the gut-lung axis, mediates the immune processes of PTB, while MTB infection can disrupt the ecological balance of the gut microbiome. This review aims to summarize the changes in gut microbiota among PTB patients and their relationship with clinical manifestations, explore the role of gut microbiota in PTB immunity, and further analyze the potential application of gut microbiota therapy in PTB treatment. The goal is to provide clear direction for future research on gut microbiota and lung diseases and propose new strategies for MTB treatment.

Keywords: Mycobacterium tuberculosis (MTB); gut microbiota; gut-lung axis; immune processes; metabolism; tuberculosis (TB).

Figure 1.

Effect of pulmonary tuberculosis and anti-tuberculosis treatment on intestinal flora diversity. When TB infection occurs, the composition of the gut flora changes dramatically. Moreover, the use of antibiotics during antituberculosis treatment causes a further imbalance in gut flora diversity. This imbalance in the gut flora can trigger significant changes in the immune system and immune cells, which in turn can affect the course of tuberculosis treatment.

Figure 2.

Immunomodulatory effects of the gut microbiota and their metabolites on PTB. The gut microbiome and its metabolites can modulate the activation state of host immune cells and further regulate pulmonary immunity through the intestinal lung axis, thus affecting the immune process of tuberculosis.

Figure 3.

Immunological mechanisms of intestinal microbiota in regulating pulmonary tuberculosis. Alterations in the gut microbiome can affect the host’s immune function. Specific gut microbial communities play a key role in inducing distinct immunophenotypes or cytokine responses. Its regulation of immune cells can be divided into the regulation of both innate immunity and adaptive immunity. The effect of intestinal microbiota and its metabolites on innate immunity mainly regulates the activity of macrophages and dendritic cells, while the regulation of adaptive immunity by intestinal microbiota mainly involves Th 17, Th 1 and Tregs lymphocytes. Through the above regulation, the intestinal flora can further influence the immune process of pulmonary tuberculosis.

Figure 4.

Advanced technologies in deciphering the complex relationship between gut microbiota and TB. Exploring the correlation between intestinal flora and tuberculosis can be achieved through a variety of modern methods, including: metagenomic sequencing technology, metabolomics, metatranscriptomics and metaproteomics.

Figure 5.

Strategies for targeting gut microbiota in TB treatment. Gut microbial therapy can be involved in the treatment and defense of pulmonary tuberculosis. The main manifestations are: 1) improve the ability to resist MTB infection by supplementing probiotics and prebiotics. 2) fecal bacteria transplantation regulates the balance of intestinal flora in the adjuvant treatment of pulmonary tuberculosis. 3) the intestinal flora regulates the pharmacokinetics of antidrugs to change the activity and toxicity of drugs.