The gut and lung microbiota in pulmonary tuberculosis: susceptibility, function, and new insights into treatment

Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(12):1355-1364. doi: 10.1080/14787210.2023.2283036. Epub 2023 Nov 24.

Abstract

Introduction: Tuberculosis (TB) is a chronic infectious disease caused by mycobacterium tuberculosis (Mtb) that poses a major threat to human health.

Areas covered: Herein, we aim to review the alteration of the microbiota in gut and respiratory during TB development, the potential function and mechanisms of microbiota in the pathogenesis of Mtb infection, and the impact of antibiotic treatment on the microbiota. In addition, we discuss the potential new paradigm for the use of microbiota-based treatments such as probiotics and prebiotics in the treatment of TB.

Expert opinion: Studies have shown that trillions of micro-organisms live in the human gut and respiratory tract, acting as gatekeepers in maintaining immune homeostasis and respiratory physiology and playing a beneficial or hostile role in the development of TB. Anti-TB antibiotics may cause microecological imbalances in the gut and respiratory tract, and microbiome-based therapeutics may be a promising strategy for TB treatment. Appropriate probiotics and prebiotics supplementation, along with antimycobacterial treatment, will improve the therapeutic effect of TB treatment and protect the gut and respiratory microbiota from dysbiosis.

Keywords: Dysbiosis; gut; lung; microbiota; tuberculosis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Dysbiosis / microbiology
  • Humans
  • Lung / microbiology
  • Microbiota*
  • Mycobacterium tuberculosis* / physiology
  • Prebiotics
  • Probiotics* / therapeutic use
  • Tuberculosis* / drug therapy
  • Tuberculosis, Pulmonary* / drug therapy

Substances

  • Anti-Bacterial Agents
  • Prebiotics