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  4. EXPLORING HOST-DIRECTED THERAPEUTICS IN TUBERCULOSIS

EXPLORING HOST-DIRECTED THERAPEUTICS IN TUBERCULOSIS

File(s)
Lee_cornellgrad_0058F_14734.pdf (5.58 MB)
Permanent Link(s)
http://doi.org/10.7298/y4zs-qf39
https://hdl.handle.net/1813/117198
Collections
Cornell Theses and Dissertations
Author
Lee, Bom Nae Rin
Abstract

Tuberculosis (TB), caused by the pathogen Mycobacterium tuberculosis (Mtb), remains a significant global health challenge. Despite the availability of vaccines and antibiotics, Mtb's ability to persist within host cells complicates its eradication and highlights the urgent need for innovative therapeutic approaches. Host-directed therapies (HDTs), which aim to bolster the host's immune defenses against Mtb, represent a promising strategy.Here, I explore the use of HDTs by screening epigenetic modifiers to reprogram macrophages, the primary cellular niche of Mtb, for enhanced bacterial control. A high-throughput screen of an epigenetic compound library identified several promising candidates across diverse pathways, including PRC2 inhibitors. Notably, PRC2-targeting compounds demonstrated remarkable efficacy in enhancing macrophage function by preserving mitochondrial integrity and increasing reactive oxygen species (ROS) production, leading to a significant reduction in Mtb burden both in vitro and in vivo. Importantly, genetic knockout of EZH2, the core enzymatic component of PRC2 in macrophage recapitulated the protective effects observed with pharmacological inhibitors, demonstrating that both genetic and drug-based targeting of PRC2 independently validated its role in macrophage-mediated Mtb control. Additionally, I repurposed Tilorone, commonly known as an interferon inducer, as an HDT for TB. Tilorone was found to reprogram macrophage metabolism, boosting glycolysis and TCA cycle activity, which in turn elevated ROS and nitric oxide (NO) levels essential for controlling intracellular Mtb. Short-term in vivo treatment with Tilorone, when combined with antibiotics, showed a marked reduction in bacterial burden. However, prolonged treatment led to metabolic exhaustion, underscoring the need for precise dosing strategies to maximize therapeutic benefits. Together, these findings emphasize the therapeutic potential of HDTs, using both epigenetic modifiers and Tilorone, to optimize macrophage function and enhance antibiotic efficacy against TB. This approach advances our understanding of TB pathogenesis and opens new avenues for treatment by targeting the host’s immune system rather than the pathogen directly, addressing persistent challenges in TB control. These contributions mark an important step toward developing HDT-based strategies that could significantly improve long-term outcomes for TB patients.

Description
189 pages
Date Issued
2024-12
Keywords
Mycobacterium Tuberculosis
•
Tuberculosis
Committee Chair
Russell, David
Committee Member
Altier, Craig
Roberson, Mark
Aguilar-Carreno, Hector
Degree Discipline
Biomedical and Biological Sciences
Degree Name
Ph. D., Biomedical and Biological Sciences
Degree Level
Doctor of Philosophy
Rights
Attribution 4.0 International
Rights URI
https://creativecommons.org/licenses/by/4.0/
Type
dissertation or thesis
Link(s) to Catalog Record
https://newcatalog.library.cornell.edu/catalog/16921958

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