Four advances that could change tuberculosis treatment

As of early 2025, tuberculosis cases are increasing in the U.S. This disease, often shortened to TB, causes significant lung damage and, if not treated, is almost always lethal. World TB Day on March 24 raises awareness about the disease and commemorates Robert Koch’s discovery of the source bacterium Mycobacterium tuberculosis. More than a century later, scientists continue refining TB diagnosis methods and treatment strategies, some of which are in these four ACS journal articles. Reporters can request free access to these papers by emailing newsroom@acs.org. 

1. Fluorescence for a faster TB diagnosis. Currently, testing saliva samples for M. tuberculosis is time-consuming because of the bacterium’s slow growth and resistance to stains used in imaging. To develop a faster method, researchers targeted a protein that the bacterium uses to steal iron ions from its host’s cells. In a study published in ACS Central Science, the team explains how to label the iron-transporter protein with a fluorescent tag, which turns on after releasing the iron inside the M. tuberculosis cells. In separate tests on saliva from 11 people diagnosed with TB, the fluorescence technique identified infectious levels of the bacterium within 10 minutes.  

2. White blood cell-focused M. tuberculosis therapy. A type of white blood cell called a macrophage gets taken over during a tuberculosis infection, becoming an incubator for the pathogen. So, researchers report in ACS Infectious Diseases that they have developed sugar-coated nanoparticles that get absorbed by infected macrophages. And once inside, the nanoparticles interrupted critical cellular pathways and prompted the damaged cells to be recycled. In infected mice, 6 weeks of nanoparticle treatment significantly reduced the amount of M. tuberculosis in the lungs. 

3. A potential nasal treatment for tuberculous meningitis. If M. tuberculosis reaches cerebrospinal fluid, the result can be tuberculous meningitis — a life-threatening inflammation around a person’s brain and spinal cord. To get the TB drug clofazimine across the blood-brain barrier, researchers have encapsulated it inside tiny particles and created a nasal spray. According to their study in ACS infectious Diseases, the spray didn’t adversely affect mice with tuberculous meningitis. A 4-week treatment significantly reduced the bacterial burden within the animals’ brains and lungs compared to untreated mice.  

4. Light-activated particles inactivate bacteria. Many new TB cases are multidrug resistant. So, a research team wanted to improve treatment efficacy and reduce the risk of further antimicrobial resistance by creating a photoreactive therapy. They encapsulated light-activated particles inside nanometer-wide spheres. When the nanospheres were injected into mice, red laser light triggered the particles to produce reactive oxygen species that inactivated Mycobacterium marinum, a bacterium that causes TB-like illness in fish. The initial animal study results are published in ACS Omega. 

Additionally in March 2025, ACS Webinars and ACS Publications co-hosted a virtual event, “Disrupt & Destroy: Starving Tuberculosis with Smarter Science,” about innovative drug strategies and cutting-edge TB research. The webinar is available to watch on demand.  

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