A review of pro-inflammatory and anti-inflammatory roles of cytokines in tuberculosis disease management.

Abstract

Tuberculosis (TB) remains a significant global health challenge, with cytokines playing pivotal roles in the immune response against Mycobacterium tuberculosis (Mtb), the causative agent of TB. This systematic review has elucidated the pro-inflammatory and anti-inflammatory functions of cytokines in TB immunity, emphasizing their intricate interplay and potential implications for TB pathogenesis and therapy. Pro-inflammatory cytokines, including TNF-α, IL-1, and IFN-γ, serve as alarm signals, initiating the immune response and orchestrating the activation of immune cells. They are instrumental in granuloma formation, macrophage activation, and adaptive immunity. The balance between pro-inflammatory and anti-inflammatory cytokines is crucial for effectively combating Mtb while avoiding excessive tissue damage. On the other hand, anti-inflammatory cytokines, such as IL-10 and TGF-β, act as regulators to prevent immunopathology and maintain immune balance. They modulate T cell responses, suppress overactive immune reactions, and protect lung tissues from damage, all while avoiding immune exhaustion. Key research gaps include the complex interplay of cytokines, host genetic influences, the impact of different Mtb strains, the development of immunotherapies, and the role of cytokines in drug-resistant TB. Advancing our understanding of these aspects will contribute to more effective TB management strategies. In conclusion, cytokines are central to TB immunity, and their roles are multifaceted. A deeper understanding of the intricate cytokine networks is vital for the development of innovative approaches, including vaccines and immunotherapies, to combat TB and ultimately reduce its global impact. Continuing research in this field is of paramount importance in the ongoing efforts to control and eradicate TB.