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Tuberculous Meningitis: an Update on the Pathogenesis and Neuroimmunology

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Abstract

Purpose of Review

Tuberculosis meningitis (TBM) carries the highest morbidity and mortality of any type of tuberculosis infection, yet the definitive mechanism(s) that result in TBM are largely unknown.

Recent Findings

Microglia as a bridge between the immune and nervous systems and its role in age related physiological changes that may lend some insight into why TBM is prevalent in pediatrics.

Summary

There are various hypotheses on how Mycobacterium tuberculosis, the etiological agent of tuberculosis, disseminates from the lungs to the central nervous system but these routes have been unobserved in existing animal models. This review aims to highlight the neuroimmunology of TBM, highlights the importance of age-dependent physiological changes, and recommends techniques commonly used in neurobiology to generate a more complete picture of TBM pathogenesis. We argue that age is an important consideration because TBM typically presents in children less than 5 years old. We hope that increasing the prevalence of longitudinal studies in TBM research with respect to age will aid in identifying definitive mechanism(s) that result in TBM and improve clinical outcomes.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgements

We acknowledge Dr. John Walrond (College of Veterinary Medicine and Biomedical Sciences, Colorado State University) for providing patient insight on neurobiology.

Funding

Monfort family professor award 2022.

Colorado State University, Microbiology, Immunology and Pathology, Henao-Tamayo start-up funds.

Author information

Authors and Affiliations

  1. Mycobacteria Research Laboratories, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, 80523, USA

    Sasipha Hokeness, Faye Lanni, Jessica Glycenfer, Andres Obregon-Henao & Marcela Henao-Tamayo

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  1. Sasipha Hokeness
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  2. Faye Lanni
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  4. Andres Obregon-Henao
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  5. Marcela Henao-Tamayo
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Contributions

S.H. wrote the main manuscript and created the figures F.L. helped with portions of the manuscript and guided the literature review J.G. helped with portions of the manuscript A.O.H helped with portions of the manuscript, guided the literature review, revised and edited M.H.T helped with portions of the manuscript, revised, edited and funded All authors reviewed the manuscript.

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Correspondence to Marcela Henao-Tamayo.

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Hokeness, S., Lanni, F., Glycenfer, J. et al. Tuberculous Meningitis: an Update on the Pathogenesis and Neuroimmunology. Curr Trop Med Rep 11, 1–10 (2024). https://doi.org/10.1007/s40475-023-00310-y

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