时间标签：数据日期 2026-10-31 · 生成时间 2026-11-01 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/10/28–2026/10/31 ｜ 情报发生日期 2026-10-31
研究问题
This narrative review critically evaluates current mechanistic insights, promising strategies, and translational challenges in immune modulation and inflammation control for pulmonary TB.
方法
We conducted a focused literature search in PubMed (2015–2026) using keywords including “tuberculosis,” “host-directed therapy,” “immunomodulation,” “inflammation,” and “repurposed drugs.” Unlike previous reviews, our primary objective is to critically assess the strength of evidence for each HDT candidate, explicitly distinguishing between: (1) direct evidence from TB-specific studies; (2) indirect evidence extrapolated from other diseases; and (3) purely hypothetical mechanisms.；However, this remains a speculative framework requiring dedicated investigation in TB-specific models and patient cohorts ().；The most direct clinical evidence for metformin in TB comes from a randomised controlled trial in which metformin add-on therapy did not improve sputum culture conversion rates at 8 weeks ().
核心结论
Although Directly Observed Short-course Chemotherapy (DOTS) is effective, its extended period of use, serious toxic side effects, and possible immunosuppression of the host immune system together lead to poor patient adherence to treatment, treatment failure, recurrence, and the emergence of drug-resistant strains ().；Therefore, an attenuation of the inflammatory response is to be expected in HDT; at the same time, it must not be too strong, or the immune system will be unable to fight against Mtb and thus allow bacteria to multiply more freely ().；With the increase of the world’s population’s age, many older adults have been facing higher burdens of pulmonary tuberculosis in recent years. ‖ 结论：These results have added to our knowledge of the reasons for tuberculosis and, more importantly, provided HDT with an all-encompassing list of targets at the level of epigenetics and systemic physiology.
局限
To enhance scientific rigor, we adopt the following evidence hierarchy: Level A (RCTs in TB patients); Level B (observational studies in TB patients); Level C (preclinical TB animal models); Level D (in vitro TB studies); Level E (evidence extrapolated from non-TB diseases); Level F (hypothetical mechanisms).；The distinction between acute immunomodulation and bona fide trained immunity warrants further investigation.
对本项目的价值
★☆☆☆☆ 炎症衰老是几乎所有慢性老年病的公共通路，也是最有希望做「抗炎但保留免疫」解耦的靶点。
全文来源
PMC JATS 全文（正文 38,335 字符，已过标题/DOI 逐字归属校验）
原文题录
- 英文标题：New strategies for the treatment of tuberculosis: research progress and clinical translation in immune modulation and inflammation control.
- 期刊与标识：Front Immunol · PMID 42953363 · DOI 10.3389/fimmu.2026.1974232
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