Journal
CLINICAL INFECTIOUS DISEASES
Volume 61, Issue -, Pages S200-S216Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/civ621
Keywords
tuberculosis; host-directed therapy; precision medicine; immunometabolism; signaling pathways
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Funding
- National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH)
- US Department of Health and Human Services [HHSN272200800014C]
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The lack of novel antimicrobial drugs in development for tuberculosis treatment has provided an impetus for the discovery of adjunctive host-directed therapies (HDTs). Several promising HDT candidates are being evaluated, but major advancement of tuberculosis HDTs will require understanding of the master or core cell signaling pathways that control intersecting immunologic and metabolic regulatory mechanisms, collectively described as immunometabolism. Core regulatory pathways conserved in all eukaryotic cells include poly (ADP-ribose) polymerases (PARPs), sirtuins, AMP-activated protein kinase (AMPK), and mechanistic target of rapamycin (mTOR) signaling. Critical interactions of these signaling pathways with each other and their roles as master regulators of immunometabolic functions will be addressed, as well as how Mycobacterium tuberculosis is already known to influence various other cell signaling pathways interacting with them. Knowledge of these essential mechanisms of cell function regulation has led to breakthrough targeted treatment advances for many diseases, most prominently in oncology. Leveraging these exciting advances in precision medicine for the development of innovative next-generation HDTs may lead to entirely new paradigms for treatment and prevention of tuberculosis and other infectious diseases.
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