Comprehensive review and reflective evaluation of cell therapies for tuberculosis

SUMMARY Tuberculosis (TB) remains a major infectious disease threatening global health. An estimated 2 billion people worldwide are infected with Mycobacterium tuberculosis (Mtb), and 5–10% of those with latent infection will develop active TB. Despite the success of existing anti-TB drugs in controlling transmission, significant challenges remain, including long treatment durations, severe side effects, suboptimal treatment adherence, and inevitable drug resistance. Even newly developed drugs may fail to keep pace with the rising number of drug-resistant cases. Moreover, these treatments do not adequately address persistent lung dysfunction after cure. A primary reason for these therapeutic challenges in TB management may be that all current anti-TB drugs are solely aimed at achieving antibacterial, bacteriostatic, or bactericidal efficacy, which neglects the critical role of host cellular responses during disease progression. Future strategies should explore the potential of cell-based therapies, an area that has received limited attention in previous reviews. From the perspective of cell therapy, this article comprehensively reviews key clinical studies, animal models, and in vitro experiments from recent decades that utilized cells or cytokines for TB treatment, providing clinicians and researchers with a unique perspective and support for developing more integrated therapeutic strategies toward ending TB.