Table 1.
Immunomodulating host-directed therapies for treatment of TB in humans
| Therapeutics | Composition | No. of patients | TB type (outcome) | Refs |
|---|---|---|---|---|
| Mycobacterium vaccae | Killed, intradermal | NA | Meta-analysis of 54 studies on newly diagnosed pulmonary TB (improved sputum conversion and X-ray changes) | 36 |
| Capsule | 41 (two arms)Φ | Faster smear conversion | 42 | |
| RUTI® | Detoxified cellular fragments of Mycobacterium tuberculosis | NA | Phase I and II clinical trials on LTBI cases or healthy volunteers (immunogenic, reasonable tolerability) | 46,47 |
| Autologous MSC | MSC | 30 | MDR or XDR patients (21/30 with radiologic improvement) | 54 |
| V5 immunitor | Inactivated pooled blood | 55 (two arms) | Re-treatment or proven MDR (higher rate of sputum conversion) | 62 |
| Cytokines and cytokine inhibitor | IL-2 | 50 (two arms)¥ | MDR-TB patients (better sputum conversion rate) | 73 |
| 23 (three arms) | MDR-TB patients (decrease AFB smear counts with daily IL-2 compared to control or pulse IL-2) | 71 | ||
| 110 (two arms)¥ | New TB patients (significant delays in culture conversion) | 72 | ||
| IFN-γ | 5 | MDR-TB patients (all smear negative/improved) | 67 | |
| 7 | MDR-TB cases (no marked microbiologic effect) | 68 | ||
| 6 | MDR-TB cases (no marked microbiologic effect) | 69 | ||
| Etanercept | 16§ | HIV-positive TB cases (more rapid culture conversion compared to historical control) | 76 | |
| Drugs/compounds | High dose steroid | 187 (two arms)§ | HIV-positive TB cases (increased culture conversion at 1 month) | 79 |
| Levamisole | 50§ | Newly diagnosed pulmonary TB patients (improved radiology but no effect on smear conversion) | 82 | |
| Albendazole | 135 (two arms)§ | New pulmonary TB patients (no effect on clinical, radiologic, and microbiologic outcome) | 83 | |
| Thalidomide | 15 (two arms)¥ | 9/15 HIV-positive (clinical improvement) | 102 | |
| 30 (two arms)§ | HIV-positive (no clinical difference) | 103 |
Notes:
Φ
different groups including drug-susceptible and drug-resistant cases;
¥
newly diagnosed pulmonary TB with drug-resistant or MDR-TB as exclusion criteria;
§
newly diagnosed pulmonary TB and no drug susceptibility data reported. All TB cases were treated with multidrug-treatment regimen.
Abbreviations: AFB, acid-fast bacilli; HIV, human immunodeficiency virus; IFN, interferon; IL, interleukin; LTBI, latent TB infection; MDR, multidrug-resistant; MSC, mesenchymal stem cells; NA, not applicable; XDR, extensively drug-resistant; TB, tuberculosis.