Title:Deciphering Tuberculous Meningitis: From Clinical Challenges to Novel
Models and Pathogenic Pathways
Volume: 24
Author(s): Mohamad Mosa Mubarak, Shahnawaz Majeed, Hadiya Amin Kantroo, Zubair Ahmad Wani, Abbass Malik, Zahoor Ahmad*Ishfaq Ahmad Baba
Affiliation:
- Clinical Microbiology PK/PD Division, CSIR - Indian Institute of Integrative Medicine, Sanatnagar, Srinagar,
190005, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
Keywords:
Tuberculous Meningitis, blood-brain barrier, glial cells, inflammatory response, Matrix Metalloproteinases, MMPs, host-pathogen genetics, granuloma, in-vivo models, in-vitro models, SARS-COVID-19
Abstract: During and after the COVID-19 pandemic,Tuberculosis (TB) has reestablished with
higher figures due to interruptions in the Directly Observed Treatment Short course (DOTS) despite underreporting. The rising consequences would have extended to extra-pulmonary forms of
TB as well, including Tuberculous Meningitis (TBM). Considering the fact that TBM is the most
dangerous and worst form of TB, we found the need to scan the literature to highlight various aspects of TBM. Epidemiology of TBM is proportionally less frightening, but the consequent mortalities and morbidities are more alarming than pulmonary TB. Here, we address critical research
gaps in Tuberculous Meningitis that warrant further investigations. The highlighted aspects encompass a comprehensive understanding of TBM's clinical presentation and improved diagnostic tools
for timely detection, the exploration of innovative chemotherapies and surgical interventions, the
unraveling of the role of the blood-brain barrier in disease onset, investigating of the contributions
of various brain cells to TBM development, deciphering the complex inflammatory response, exploring the involvement of Matrix Metalloproteinases in tissue damage, delving into host-pathogen genetics influencing susceptibility, utilizing robust in-vivo and in-vitro models for mechanistic insights, and more importantly between TBM and SARS-COVID-19 are discussed. Addressing
these gaps will substantially advance our understanding of TBM's complex pathogenesis, contributing to more effective diagnostic, therapeutic, and preventive strategies against this debilitating disease.
