TITLE:
Gut Microbiota in Tuberculosis: Immune Mechanisms and Therapeutic Potential along the Gut-Lung Axis
AUTHORS:
Lizhi Wang, Pu Wang
KEYWORDS:
Tuberculosis, Gut-Lung Axis, Immunomodulation, Microbiota-Targeted Therapy
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.11,
November
4,
2026
ABSTRACT: Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains a major cause of illness and death worldwide. Growing evidence links the gut microbiota to host immunity, and this connection appears to matter in TB—shaping how the disease progresses and how patients respond to treatment. In this review, we first describe how the gut microbial community is altered in TB patients. We then examine whether anti-TB treatment leaves lasting marks on the microbiota, and discuss the possible routes by which gut microbes influence anti-MTB immunity. Finally, we consider adjunctive strategies that target the microbiota. Importantly, current evidence is largely derived from cross-sectional observational studies and animal models. These studies reveal associations between gut dysbiosis and TB and provide mechanistic insights into microbiota-mediated anti-MTB immunity, but they do not establish clinical benefit. Whether microbiota-targeted interventions can improve clinical outcomes in patients with TB remains to be demonstrated in large-scale randomized controlled trials. A clearer understanding of these interactions could help move TB care toward more precise prevention and personalized treatment.