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Dispersal and migration

The causative agent, Mycobacterium tuberculosis ( MTB ), infected 10.8 million people and caused 1.25 million deaths in 2023 ( Mycobacterium bovis , is the only licensed vaccine for TB, but has little protective effect against pulmonary disease in adolescents and adults ( The importance of cell-mediated immunity (CMI) in controlling TB, primarily through a T-helper 1 CD4+ T-cell response, has been demonstrated in HIV-infected individuals

They promote the expression of catabolic enzymes (e.g., MMP-1, -2, -3, -13, and ADAMTS-4/5) and inhibit anabolic proteins like aggrecan and collagen II by activating signaling pathways such as NF-B, MAPK, and Toll-like receptors (TLR), ultimately leading to ECM degradation and tissue destruction (Yang et al., 2025

[DOI] [PMC free article] [PubMed] [Google Scholar] 359.Gong, M