STUDY ADVOCATES FOR THE INTEGRATION OF THE MICROBIOME INTO TUBERCULOSIS RESEARCH IN THE COUNTRY
Tuberculosis (TB) remains one of the leading causes of death from infectious diseases in Mozambique and worldwide. However, new scientific evidence suggests that combating the disease should go beyond the bacterium responsible for the infection and also consider the role of the human microbiome — the collection of microorganisms that inhabit the gut and lungs.
A recent scientific review led by Edson Mambuque, a researcher at the Manhiça Health Research Centre (CISM), highlights that understanding the interaction between tuberculosis and the so-called “beneficial bacteria” in the human body may open new perspectives for the diagnosis, treatment, and prevention of the disease, particularly in countries with a high TB burden such as Mozambique.
According to the researcher, the study emerged from the need to understand the human body as an integrated ecosystem. “We sought to understand how the bacteria that naturally live in the body influence susceptibility to tuberculosis, disease progression, and treatment response,” he explains.
Over the last decade, several studies have shown that people with tuberculosis often present imbalances in the gut microbiome, characterized by a reduction in beneficial bacteria and an increase in opportunistic microorganisms. However, factors such as nutrition, antibiotic use, the presence of comorbidities, geographical location, and methodological differences between studies make it difficult to compare results.
One of the main conclusions of the review is that the drugs used to treat tuberculosis do not affect only the bacteria causing the disease, but may also compromise microorganisms essential for maintaining the body’s balance. This situation may influence patients’ recovery and increase the risk of adverse effects, such as liver injury.
The study advocates for the adoption of more advanced scientific approaches, including the integration of multi-omics methods, which make it possible to understand not only the presence of microorganisms, but also their functions and interactions with the immune system. “It is not enough to identify which bacteria are present; it is essential to understand what they do and how they interact with the body,” Mambuque emphasizes.
Among the potential clinical applications highlighted are the development of microbiome-based diagnostic tools capable of identifying early signs of the disease through stool or blood tests, as well as complementary interventions such as the use of probiotics or nutritional strategies aimed at reducing the adverse effects of treatments.
For countries such as Mozambique, where factors such as malnutrition, HIV co-infection, and environmental conditions influence the progression of tuberculosis, the research suggests the need for strategies adapted to the local reality. “This work demonstrates that the response to TB depends not only on the pathogen itself, but also on the biological and social context in which people live,” adds the researcher.
Despite the advances, important scientific challenges remain, particularly the need to determine whether microbiome alterations are a cause or a consequence of the disease, as well as the need for longitudinal studies involving vulnerable populations, including children.
The researcher calls for greater investment in science and innovation in order to integrate microbiome research into public health policies. “This is a field with enormous potential to transform the way we prevent and treat tuberculosis, contributing to more personalized and effective medicine,” concludes Mambuque.
Reference:
Mambuque E, Del Amo-de Palacios A, Huete SG, Marsh CC, Theron G, García-Basteiro AL, Serrano-Villar S. Beyond bacilli: integrating the microbiome into the TB research agenda. Gut Microbes. 2026 Dec 31;18(1):2638004. doi: 10.1080/19490976.2026.2638004. Epub 2026 Mar 4. PMID: 41778780; PMCID: PMC12962612.
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