Advances in Host-Pathogen Interactions in Tuberculosis: Emerging Strategies for Therapeutic Intervention

Tuberculosis (TB) remains one of the most challenging infectious diseases, with Mycobacterium tuberculosis (Mtb) employing sophisticated mechanisms to evade host immunity and establish persistent infections. This review explores recent advances in understanding Mtb's immune evasion strategies; granuloma dynamics; and emerging immunotherapeutic approaches. Key findings highlight the manipulation of host autophagy; metabolic reprogramming; and cytokine pathways by Mtb to sustain its survival within host cells. Insights into granuloma formation reveal the critical role of bacterial lipids; immune modulation; and hypoxia-driven dormancy in maintaining chronic infection. Innovative therapeutic strategies, including host-directed therapies; epigenetic interventions; and immunomodulators, hold promise for improving TB management and combating drug-resistant strains. Despite these advancements, significant challenges remain, including the development of effective vaccines; addressing latent TB; and ensuring equitable access to novel treatments. The integration of advanced technologies such as artificial intelligence and multi-omics approaches, alongside global collaboration, is essential to overcome these hurdles. This review underscores the importance of a multidisciplinary approach to tackling TB, with the ultimate goal of eradicating this global health threat.