Revolutionary new immune-focused medicines are being developed by researchers as an additional treatment option for tuberculosis (TB) patients, especially those with drug-resistant strains of the disease. Known as host-directed therapies, these experimental drugs work to strengthen the body’s natural defenses and ability to fight off the bacteria that causes TB.
Associate Professor Susanna Brighenti from the Karolinska Institutet in Sweden will discuss her team’s research into this promising approach at an upcoming infectious disease conference in Barcelona. They have identified several host-directed therapies, specifically a class of drugs called histone deacetylase inhibitors, that have shown potential for reducing the growth of TB-causing bacteria inside immune cells by 50-75% – even without the use of antibiotics.
While newer antibiotics are in development, standard TB treatment currently involves taking multiple drugs daily for several months. mutations can also make the bacteria resistant to antibiotics, both new and existing types. Host-directed therapies could provide a complementary treatment option to assist antibiotics in boosting the immune response against TB. This may allow patients to take a lower dose of antibiotics for a shorter period of time to achieve the same results, reducing side effects and improving outcomes.
Rather than directly attacking the bacteria, host-directed therapies aim to restore or enhance the body’s natural infection-fighting abilities. They work by modulating certain immune pathways within infected cells to boost the production of antimicrobial proteins and molecules responsible for bacterial killing. Some therapies may also help rebalance overactive or suppressed inflammatory responses associated with TB infection.
If successfully implemented, immune-modulating adjunct treatments have the potential to revolutionize TB clinical management just as immunotherapy has transformed cancer, autoimmune disease, and asthma care. Carefully selected existing immunotherapies, such as anti-inflammatory drugs, could potentially be administered in the short-term as a bridging strategy. Longer-term, more targeted host-directed therapies currently in pre-clinical testing, such as specific HDAC inhibitors, may offer customized therapy when added to antibiotic regimens for treating severe or drug-resistant TB cases. Tailored, personalized medicine approaches will likely become increasingly important moving forward as well.
Further clinical research is still needed, but host-directed therapies show early promise as a supplemental treatment approach with the goal of improving outcomes for patients, reducing the threat of drug-resistant strains, and helping to curb the continued global burden of tuberculosis.
