Outcome of Mycobacterium tuberculosis and Toll-like receptor interaction: immune response or immune evasion?

Mycobacterium tuberculosis (M. tuberculosis), the causative agent of tuberculosis, is an intracellular bacterium capable of surviving and persisting within host mononuclear cells. The host response against tubercle bacilli is dominated by fine-tuned interaction of innate and adaptive immune responses. Toll-like receptors (TLRs) play a critical role in the formation of this immune response by facilitating in elaboration of protective T helper type 1 (Th1) cytokines and microbicidal molecules, but the intracellular persistence of M. tuberculosis in the phagosome and processing and presentation of TLR ligands by host antigen-presenting cell leads to continuous and chronic TLR2 signaling. The prolonged stimulation of TLR ultimately results in elaboration of immunosuppressive cytokines and downregulation of antigen presentation by major histocompatibility complex (MHC) class II and therefore becomes beneficial for M. tuberculosis, resulting in its continued survival inside macrophages. An understanding of the host-pathogen interaction in tuberculosis is important to delineate the mechanisms that can modulate the immune response toward protection. This review focuses on the role of TLRs in immune response and immune evasion and how M. tuberculosis maintains its dominance over the host during infection. A precise understanding of the TLRs and M. tuberculosis interaction will undoubtedly lead to the development of novel therapies to combat tuberculosis.