The potential role of probiotics and their bioactive compounds in the management of pulmonary tuberculosis.

The significance of gut microbiota in human health is well recognized, yet its effects on pulmonary infectious diseases like tuberculosis (TB) are not thoroughly comprehended. While anti-TB drugs and preventive strategies are indispensable, the incorporation of adjunct therapies, including probiotics and their bioactive compounds, could provide potential biotherapeutic benefits. This review strives to collate the recent experimental and clinical investigations into the manipulation of the gut microbiome through probiotics, exploring their potential to sustain eubiosis, enhance recovery from TB, and mitigate the adverse effects of anti-TB therapies. The multi-pronged mechanisms by which probiotics act against M. tuberculosis include their immunomodulatory properties, the promotion of autophagy, direct inhibition of the pathogen growth via bacteriocin production, the reduction of adverse effects from anti-TB drugs, and a diminished risk of comorbidities. Future research should prioritize high-quality randomized controlled trials that integrate omics with personalized microbiome-based therapeutic approaches to combat TB.