Tuberculosis: Immunopathogenesis and Therapeutic Strategies

Dear Colleagues,

Tuberculosis (TB) is the ninth leading cause of death worldwide, and every 20 seconds a person dies from TB disease. Of the 10.4 million people that fell ill with TB last year, 0.6 million were infected with multidrug-resistant TB (MDR-TB). Despite the efficacious ‘four-drug’ standard regiment for TB, the global cure rate is only 54% for MDR-TB compared to 83% for drug-susceptible TB. New anti-TB drugs such as bedaquiline, delamanid and pretomanid are successfully used to treat MDR/XDR infections, however, Mycobacterium tuberculosis (Mtb) effectively develops resistance also to these new compounds and clinical resistance was reported less than three years after their introduction. This underscores the need to find new treatment strategies that could cure or improve clinical outcome of serious TB infections and combat the problems with drug-resistance. It is conceivable that the effect of old as well as new antimicrobial agents could be improved by host-directed therapies that restore protective immunity. Mtb has evolved a remarkable ability to manipulate the human immune response including epigenetic changes induced by virulent bacteria as well as changes in host cell metabolism or tissue-remodelling that will compromise immune functions at the site of infection. New findings related to immunopathogenesis in TB would enhance the development of immunomodulatory interventions that can strengthen host cell functions and support conventional chemotherapy.

In this Special Issue, we welcome the submission of original research, review, opinion, and perspective articles focusing on, but not limited to, the following areas of interest:

• Molecular basis of drug resistance;
• Identification of novel anti-TB drugs;
• Molecules targeting key pathways for mycobacterial survival and replication;
• Epigenetic changes induced by virulent mycobacteria;
• Immunometabolic changes in tb disease;
• Studies of host–pathogen interactions in vivo, ex vivo, in situ and in vitro;
• Local immune responses in granulomatous TB lesions;
• Tissue repair and remodelling mechanisms with relevance for immune cell function in TB;
• Research and advances on therapeutic agents that can enter TB lesions;
• Novel compounds with relevance for host-directed therapies in TB.

Dr. Susanna Brighenti
Dr. Gabriela Godaly
Guest Editors

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