Progress in brucellosis immune regulation inflammatory mechanisms and diagnostic advances

Abstract

Brucellosis, a globally prevalent zoonotic disease caused by Brucella species, remains a major public health concern, especially in endemic regions. This study delves into the complex interactions between host immune responses and Brucella infection, focusing on both protective immunity and pathological inflammation. Key topics include pathogen recognition pathways, strategies employed by Brucella to evade immune defenses, and the collaborative roles of innate and adaptive immunity in driving disease progression. Emphasis is placed on how Brucella manipulates host immune regulation to establish chronic infection. From an epidemiological standpoint, this paper discusses transmission routes, risk factors, and the broader implications for global health. Additionally, this study reviews recent advancements in diagnostic techniques, particularly molecular diagnostics and novel biomarker discovery, aimed at enhancing detection accuracy and disease monitoring. Therapeutic strategies, including conventional antimicrobial treatments and emerging immune-based interventions, are also examined, with a focus on their limitations and future potential. This article further addresses challenges such as the heterogeneity of immune responses, obstacles to vaccine development, and the factors contributing to persistent infection. By clarifying the molecular and immunological mechanisms of brucellosis pathogenesis, this work underscores the importance of interdisciplinary approaches to improve understanding, diagnosis, treatment, and clinical management of this enduring infectious disease.

Keywords: Brucellosis; Chronic infection; Diagnostics; Immune response; Immunotherapy; Inflammation; Vaccine development.

Fig. 1

This schematic representation illustrates the pathogenesis of brucellosis, the complexity of host immune responses, and the corresponding clinical management strategies. It depicts multiple transmission routes, such as direct contact, oral ingestion, and occupational exposure, each of which can lead to systemic dissemination and the involvement of various organs, including the brain, lungs, liver, and gastrointestinal tract. The diagram highlights immune system activation, emphasizing the roles of both innate and adaptive immune components. In particular, natural killer (NK) cells, macrophages, and Toll-like receptors (TLRs) are shown to participate in the recognition of Brucella, facilitate antigen presentation, and initiate cytokine-mediated signaling cascades. Within the liver, interactions among Kupffer cells, hepatic stellate cells, and infiltrating immune cells contribute to local inflammation and disease progression. Natural killer cells are involved in the detection and elimination of infected host cells by releasing cytotoxic molecules, while macrophages function as antigen-presenting cells that trigger adaptive immune responses through TLR signaling. The figure also presents key diagnostic approaches, including the Rose Bengal Plate Test, polymerase chain reaction assays, and novel biomarker-based techniques, which aim to enhance detection sensitivity and specificity. Lastly, therapeutic strategies are outlined, encompassing conventional antibiotic regimens, immunomodulatory therapies, and emerging personalized treatment modalities

Fig. 2

Diagnosis and therapy of Brucellosis