Helminth Infection, Gut Microbiome Alterations, and Their Impact on Pulmonary Tuberculosis Susceptibility

Area of Science:

• Immunology
• Microbiology
• Infectious Diseases

Background:

• Helminth infections and tuberculosis (TB) often co-occur in low- and middle-income countries.
• Helminths can directly affect immune responses and alter the gut microbiome, impacting susceptibility to Mycobacterium tuberculosis (Mtb).
• The gut-lung axis plays a crucial role in mediating these interactions through microbiome-derived metabolites.

Purpose of the Study:

• To review the current evidence on how helminth infections influence susceptibility to pulmonary TB.
• To examine the roles of helminth-induced immune changes and gut microbiome alterations via the gut-lung axis.

Main Methods:

• A narrative review approach was employed.
• Synthesized findings from experimental, observational, and clinical studies.
• Focused on helminth infection, gut microbiome, immune regulation, and TB.

Main Results:

• Helminths induce Th2-skewed immunity, potentially suppressing Th1 responses needed for Mtb control.
• Helminths alter gut microbiome composition, leading to changes like dysbiosis.
• Microbiome alterations, including short-chain fatty acids (SCFAs), can modulate systemic immunity, sometimes impairing antimycobacterial defenses.

Conclusions:

• Helminth-associated immune and microbiome changes may increase pulmonary TB susceptibility.
• Most current evidence is associative; causal links require further investigation.
• More research is needed to understand the gut-lung axis in helminth-TB coinfection and develop integrated strategies.