Credit score: Anna Shvets from Pexels
Tuberculosis (TB) stays a significant world well being problem, affecting greater than 10 million folks yearly worldwide, with 1.25 million folks dying of TB yearly. Whereas steroids like dexamethasone are utilized in sure TB circumstances (e.g., TB meningitis), their impression on immune cells is just not effectively understood.
Given the renewed curiosity within the steroid dexamethasone, as a host-directed therapy through the COVID-19 pandemic, the Trinity Faculty Dublin workforce—primarily based at St James’s Hospital, Dublin—gives proof that treating sufferers with steroids could improve the operate of their macrophages to kill the mycobacteria, whereas diminishing pathways of inflammatory harm. The research is revealed within the journal Scientific Experiences.
The workforce’s purpose was to find out whether or not dexamethasone impacts the macrophage’s skill to struggle TB. Though glucocorticoids can reactivate TB, they’re paradoxically the one adjunctive host-directed therapies which can be advisable by the World Well being Group for TB. Steroids are given to sufferers alongside antimicrobials in sure circumstances; nonetheless, scientists do not absolutely perceive the impact of those medication on the immune system, particularly innate immune cells equivalent to macrophages.
The researchers studied immune cells referred to as macrophages derived from the blood of wholesome volunteers or remoted from lung fluid donated by sufferers present process routine bronchoscopies. By treating and infecting these macrophages within the lab with Mtb, the scientists may study and perceive how dexamethasone impacts the immune response that protects the lungs throughout an infection.
Key findings from the research
Dexamethasone, a potent glucocorticoid, reduces glycolysis in human lung and blood-derived macrophages. This reduces the quantity of power out there within the cell. Dexamethasone additionally lowered the manufacturing of each professional and anti inflammatory cytokines measured within the research, IL-1β, TNF, IL-6, IL-8 and IL-10. Though useful for immunity, limiting the manufacturing also can restrict harm from extreme irritation.
Mtb-infected macrophages have elevated survival once they had been handled with dexamethasone. This means that dexamethasone could defend macrophages from dying because of the dangerous results of an infection or detrimental immune responses to an infection.
Dexamethasone additionally reduces bacterial burden in contaminated macrophages, and the workforce recognized that that is a minimum of partly mediated by autophagy and phagosomal acidification. Dexamethasone can improve the macrophages’ skill to degrade and clear micro organism serving to to beat an infection with Mtb.
This research identifies that macrophages from totally different sources have differential responses to glucocorticoids. This highlights that tissue origin can affect how macrophages react to medication, which can be necessary for focusing on therapy methods. This is without doubt one of the first research to point out that dexamethasone can scale back irritation whereas preserving or enhancing antimicrobial operate in major human lung macrophages contaminated with Mtb.
How may this analysis change a affected person’s life?
The findings help using steroids as an additional remedy along with present antimicrobial therapies in TB therapy, particularly in circumstances with extreme irritation. Steroids may also be helpful with antimicrobials in TB preventative remedy, to cut back development from latent TB an infection to energetic TB illness. This research opens avenues for macrophage-targeted steroid therapies that stability irritation management with antimicrobial protection.
For now, researchers hope this research will hasten the restoration of TB sufferers who expertise debilitating signs, typically for months into present remedy.
Dr. Donal Cox, senior analysis fellow, Medical Medication, Trinity Faculty Dublin stated, “Our study shows that dexamethasone, which is known to dampen inflammation, can also help macrophages fight tuberculosis more effectively. This challenges the assumption that steroids always suppress immunity and opens the door to smarter, targeted adjunctive therapies that balance inflammation control with antimicrobial defense.”
Prof Joseph Keane, professor of medication, Trinity Faculty Dublin and Marketing consultant Respiratory Doctor, St James Hospital stated, “In scientific observe, steroids are essentially the most under-used adjunctive remedy for TB. We frequently depend on steroids to handle irritation in tuberculosis, significantly in extreme varieties like TB meningitis.
“What’s reassuring from this study, is that dexamethasone not only tempers inflammation but also appears to support the macrophage’s ability to control infection. This study provides new evidence to help us redefine steroid use in TB care—targeting inflammation without compromising antimicrobial defense.”
Growing steroid therapies that may be particularly focused to lung macrophages through mechanisms equivalent to inhaled nanoparticles is perhaps an choice to translating this into higher remedy. The workforce additionally desires to establish how steroids altered totally different metabolic pathways in human lung macrophages and never in blood-derived macrophages to allow them to exploit this to make steroid therapies higher sooner or later.
Extra data:
Lorraine Thong et al, Dexamethasone inhibits Mycobacterium tuberculosis-induced glycolysis however preserves antimicrobial operate in major human macrophages, Scientific Experiences (2025). DOI: 10.1038/s41598-025-20188-2
Supplied by
Trinity Faculty Dublin
Quotation:
Focused steroid use could supply a common complementary therapy to struggle TB (2025, October 10)
retrieved 11 October 2025
from https://medicalxpress.com/information/2025-10-steroid-universal-complementary-treatment-tb.html
This doc is topic to copyright. Other than any truthful dealing for the aim of personal research or analysis, no
half could also be reproduced with out the written permission. The content material is supplied for data functions solely.
