{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:04:35Z","timestamp":1785409475387,"version":"3.56.0"},"reference-count":73,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003286","name":"Kuwait Foundation for the Advancement of Sciences","doi-asserted-by":"publisher","award":["RA AM-2023-022"],"award-info":[{"award-number":["RA AM-2023-022"]}],"id":[{"id":"10.13039\/501100003286","id-type":"DOI","asserted-by":"publisher"}]},{"award":["RA AM-2023-022"],"award-info":[{"award-number":["RA AM-2023-022"]}],"id":[{"id":"https:\/\/ror.org\/03xr9q522","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Tuberculosis (TB) remains a leading cause of death from a single infectious agent, and its outcome is shaped not only by Mycobacterium tuberculosis (Mtb) itself, but also by the host\u2019s metabolic state. This review synthesises current understanding of how Mtb reprograms macrophage immunometabolism and how this reprogramming propagates to a systemic level, culminating in skeletal muscle dysregulation and TB-associated cachexia. We describe the molecular mechanisms by which Mtb subverts phagosomal maturation, the glycolytic (Warburg-like) switch governed by HIF-1\u03b1 and accumulation of immunomodulatory tricarboxylic acid cycle intermediates, and the M1\/M2 polarisation balance that dictates bacterial containment versus persistence. We then trace the cytokine- and metabolite-mediated circuits (TNF-\u03b1, IL-6, IL-1\u03b2, lactate, ketone bodies, free fatty acids) that link infected macrophages to ubiquitin\u2013proteasome and autophagy\u2013lysosome-driven muscle proteolysis, mitochondrial dysfunction and oxidative stress. Building on these mechanisms, we propose an immunometabolic and muscle-derived biomarker framework that, although still requiring clinical validation, may offer value for diagnosis, host-response stratification and treatment monitoring, and we discuss host-directed therapeutic strategies that target macrophage metabolism and muscle preservation. By integrating immunity, metabolism and systemic pathology at the molecular level, this work highlights translational opportunities relevant to the host immunity, diagnosis and treatment of tuberculosis.<\/jats:p>","DOI":"10.3390\/ijms27136062","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:43:14Z","timestamp":1783345394000},"page":"6062","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tuberculosis and Cellular Metabolism: Insights into the Crosstalk Between Macrophage Immunometabolism and Muscle Dysregulation"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4660-338X","authenticated-orcid":false,"given":"Mohammed J. A.","family":"Haider","sequence":"first","affiliation":[{"name":"Department of Biological Sciences, Faculty of Science, Kuwait University, Sabah Al-Salem University City, Safat, Kuwait City 13060, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3538-759X","authenticated-orcid":false,"given":"Halemah","family":"AlSaeed","sequence":"additional","affiliation":[{"name":"Immunology and Microbiology Department, Dasman Diabetes Institute, Dasman, Kuwait City 15462, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5825-7701","authenticated-orcid":false,"given":"Fatema","family":"Al-Rashed","sequence":"additional","affiliation":[{"name":"Immunology and Microbiology Department, Dasman Diabetes Institute, Dasman, Kuwait City 15462, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sankar, P., and Mishra, B.B. (2023). Early innate cell interactions with Mycobacterium tuberculosis in protection and pathology of tuberculosis. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1260859"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Marakalala, M.J., Martinez, F.O., Pl\u00fcddemann, A., and Gordon, S. (2018). Macrophage Heterogeneity in the Immunopathogenesis of Tuberculosis. Front. Microbiol., 9.","DOI":"10.3389\/fmicb.2018.01028"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Phelan, J.J., McQuaid, K., Kenny, C., Gogan, K.M., Cox, D.J., Basdeo, S.A., O\u2019Leary, S., Tazoll, S.C., Maoldomhnaigh, C.\u00d3., and O\u2019Sullivan, M.P. (2020). Desferrioxamine Supports Metabolic Function in Primary Human Macrophages Infected With Mycobacterium tuberculosis. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.00836"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1016\/j.cell.2022.08.018","article-title":"mTOR-regulated mitochondrial metabolism limits mycobacterium-induced cytotoxicity","volume":"185","author":"Lee","year":"2022","journal-title":"Cell"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1038\/ni.3434","article-title":"Mycobacterium tuberculosis induces the miR-33 locus to reprogram autophagy and host lipid metabolism","volume":"17","author":"Ouimet","year":"2016","journal-title":"Nat. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.1002\/jcsm.13596","article-title":"Prognostic Impact and Prevalence of Cachexia in Patients with Heart Failure: A Systematic Review and Meta-Analysis","volume":"15","author":"Prokopidis","year":"2024","journal-title":"J. Cachex-Sarcopenia Muscle"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.tube.2009.02.002","article-title":"Man and mouse TB: Contradictions and solutions","volume":"89","author":"Apt","year":"2009","journal-title":"Tuberculosis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1093\/infdis\/jiy675","article-title":"Undernutrition and Tuberculosis: Public Health Implications","volume":"219","author":"Sinha","year":"2018","journal-title":"J. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Fines, D.M., Schichnes, D., Knight, M., Anaya-Sanchez, A., Thuong, N., Cox, J., and Stanley, S.A. (2023). Mycobacterial formation of intracellular lipid inclusions is a dynamic process associated with rapid replication. bioRxiv.","DOI":"10.1101\/2023.08.10.552809"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.4049\/jimmunol.150.7.2920","article-title":"Macrophage phagocytosis of virulent but not attenuated strains of Mycobacterium tuberculosis is mediated by mannose receptors in addition to complement receptors","volume":"150","author":"Schlesinger","year":"1993","journal-title":"J. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1084\/jem.20021787","article-title":"Collaborative Induction of Inflammatory Responses by Dectin-1 and Toll-like Receptor 2","volume":"197","author":"Gantner","year":"2003","journal-title":"J. Exp. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/imr.12263","article-title":"Sensing of Mycobacterium tuberculosis and consequences to both host and bacillus","volume":"264","author":"Stamm","year":"2015","journal-title":"Immunol. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1046\/j.1365-2958.1999.01279.x","article-title":"Mycobacterium tuberculosis phagosome","volume":"31","author":"Deretic","year":"1999","journal-title":"Mol. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"E1360","DOI":"10.1073\/pnas.1200484109","article-title":"Janus-faced liposomes enhance antimicrobial innate immune response in Mycobacterium tuberculosis infection","volume":"109","author":"Greco","year":"2012","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1128\/iai.59.5.1823-1831.1991","article-title":"Evidence that vesicles containing living, virulent Mycobacterium tuberculosis or Mycobacterium avium in cultured human macrophages are not acidic","volume":"59","author":"Crowle","year":"1991","journal-title":"Infect. Immun."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1084\/jem.188.2.351","article-title":"Host Resistance to Intracellular Infection: Mutation of Natural Resistance-associated Macrophage Protein 1 (Nramp1) Impairs Phagosomal Acidification","volume":"188","author":"Hackam","year":"1998","journal-title":"J. Exp. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1080\/15548627.2024.2366748","article-title":"The different roles of V-ATPase a subunits in phagocytosis\/endocytosis and autophagy","volume":"20","author":"Chen","year":"2024","journal-title":"Autophagy"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Clarke, M., Maddera, L., Engel, U., and Gerisch, G. (2010). Retrieval of the Vacuolar H+-ATPase from Phagosomes Revealed by Live Cell Imaging. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0008585"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Zhai, W., Wu, F., Zhang, Y., Fu, Y., and Liu, Z. (2019). The Immune Escape Mechanisms of Mycobacterium tuberculosis. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20020340"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4518","DOI":"10.1128\/IAI.68.8.4518-4522.2000","article-title":"Growth of Mycobacterium tuberculosis in a Defined Medium Is Very Restricted by Acid pH and Mg2+Levels","volume":"68","author":"Piddington","year":"2000","journal-title":"Infect. Immun."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"109671","DOI":"10.1016\/j.isci.2024.109671","article-title":"Mycobacterial SapM hampers host autophagy initiation for intracellular bacillary survival via dephosphorylating Raptor","volume":"27","author":"Zhang","year":"2024","journal-title":"iScience"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1038\/s41467-017-00279-z","article-title":"The mycobacterial phosphatase PtpA regulates the expression of host genes and promotes cell proliferation","volume":"8","author":"Wang","year":"2017","journal-title":"Nat. Commun."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"de Armentia, M.M.L., Amaya, C., and Colombo, M.I. (2016). Rab GTPases and the Autophagy Pathway: Bacterial Targets for a Suitable Biogenesis and Trafficking of Their Own Vacuoles. Cells, 5.","DOI":"10.3390\/cells5010011"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ahmad, F., Rani, A., Alam, A., Zarin, S., Pandey, S., Singh, H., Hasnain, S.E., and Ehtesham, N.Z. (2022). Macrophage: A Cell With Many Faces and Functions in Tuberculosis. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.747799"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.molimm.2020.11.020","article-title":"Mycobacterium tuberculosis EsxL induces TNF-\u03b1 secretion through activation of TLR2 dependent MAPK and NF-\u03baB pathways","volume":"130","author":"Pattanaik","year":"2021","journal-title":"Mol. Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/j.immuni.2011.12.002","article-title":"Innate and Adaptive Interferons Suppress IL-1\u03b1 and IL-1\u03b2 Production by Distinct Pulmonary Myeloid Subsets during Mycobacterium tuberculosis Infection","volume":"35","author":"Andrade","year":"2011","journal-title":"Immunity"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1038\/s42003-022-03387-9","article-title":"Human M1 macrophages express unique innate immune response genes after mycobacterial infection to defend against tuberculosis","volume":"5","author":"Khan","year":"2022","journal-title":"Commun. Biol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e39169","DOI":"10.7554\/eLife.39169","article-title":"Mycobacterium tuberculosis induces decelerated bioenergetic metabolism in human macrophages","volume":"7","author":"Cumming","year":"2018","journal-title":"eLife"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Cumming, B.M., Pacl, H.T., and Steyn, A.J.C. (2020). Relevance of the Warburg Effect in Tuberculosis for Host-Directed Therapy. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.576596"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/j.tim.2020.04.010","article-title":"Immunometabolism during Mycobacterium tuberculosis Infection","volume":"28","author":"Howard","year":"2020","journal-title":"Trends Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.cellimm.2009.10.007","article-title":"Role of TLR2- and TLR4-mediated signaling in Mycobacterium tuberculosis-induced macrophage death","volume":"260","author":"Rojas","year":"2010","journal-title":"Cell. Immunol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Maoldomhnaigh, C.\u00d3., Cox, D.J., Phelan, J.J., Mitermite, M., Murphy, D.M., Leisching, G., Thong, L., O\u2019lEary, S.M., Gogan, K.M., and McQuaid, K. (2021). Lactate Alters Metabolism in Human Macrophages and Improves Their Ability to Kill Mycobacterium tuberculosis. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.663695"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.cmet.2014.12.005","article-title":"Pyruvate Kinase M2 Regulates Hif-1\u03b1 Activity and IL-1\u03b2 Induction and Is a Critical Determinant of the Warburg Effect in LPS-Activated Macrophages","volume":"21","author":"Curtis","year":"2015","journal-title":"Cell Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"16022","DOI":"10.1038\/cddiscovery.2016.22","article-title":"Hypoxia and classical activation limits Mycobacterium tuberculosis survival by Akt-dependent glycolytic shift in macrophages","volume":"2","author":"Matta","year":"2016","journal-title":"Cell Death Discov."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Gong, D., Shi, W., Yi, S.-J., Chen, H., Groffen, J., and Heisterkamp, N. (2012). TGF\u03b2 signaling plays a critical role in promoting alternative macrophage activation. BMC Immunol., 13.","DOI":"10.1186\/1471-2172-13-31"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zhu, J., Fan, J., Xia, Y., Wang, H., Li, Y., Feng, Z., and Fu, C. (2023). Potential therapeutic targets of macrophages in inhibiting immune damage and fibrotic processes in musculoskeletal diseases. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1219487"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Viola, A., Munari, F., S\u00e1nchez-Rodr\u00edguez, R., Scolaro, T., and Castegna, A. (2019). The Metabolic Signature of Macrophage Responses. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.01462"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Park, J.-H., Shin, J.-M., Yang, H.-W., Kim, T.H., Lee, S.H., Shin, O.S., and Park, I.-H. (2024). Matrix metalloproteinase-12 by M2 macrophages induced epithelial to mesenchymal transition in chronic rhinosinusitis with nasal polyps. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0313097"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"105042","DOI":"10.1016\/j.archoralbio.2021.105042","article-title":"M2-like macrophage infiltration and transforming growth factor-\u03b2 secretion during socket healing process in mice","volume":"123","author":"Horibe","year":"2021","journal-title":"Arch. Oral Biol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Bo, H., Moure, U.A.E., Yang, Y., Pan, J., Li, L., Wang, M., Ke, X., and Cui, H. (2023). Mycobacterium tuberculosis-macrophage interaction: Molecular updates. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1062963"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Shim, D., Kim, H., and Shin, S.J. (2020). Mycobacterium tuberculosis Infection-Driven Foamy Macrophages and Their Implications in Tuberculosis Control as Targets for Host-Directed Therapy. Front. Immunol., 11, Erratum in Front. Immunol. 2020, 11, 1601. https:\/\/doi.org\/10.3389\/fimmu.2020.01601. PMID: 32477367; PMCID: PMC7235167.","DOI":"10.3389\/fimmu.2020.00910"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"52294","DOI":"10.18632\/oncotarget.10561","article-title":"TGF-\u03b2 induces M2-like macrophage polarization via SNAIL-mediated suppression of a pro-inflammatory phenotype","volume":"7","author":"Zhang","year":"2016","journal-title":"Oncotarget"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S1043-2760(02)00668-9","article-title":"Peroxisome proliferator-activated receptor-\u03b3 in macrophage lipid homeostasis","volume":"13","author":"Lee","year":"2002","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1038\/s42003-021-02769-9","article-title":"Aggregation state of Mycobacterium tuberculosis impacts host immunity and augments pulmonary disease pathology","volume":"4","author":"Kolloli","year":"2021","journal-title":"Commun. Biol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"5593","DOI":"10.4049\/jimmunol.1103038","article-title":"Mycobacterium tuberculosis Modulates Macrophage Lipid-Sensing Nuclear Receptors PPAR\u03b3 and TR4 for Survival","volume":"188","author":"Mahajan","year":"2012","journal-title":"J. Immunol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Krueger, G., Faisal, S., and Dorhoi, A. (2025). Microenvironments of tuberculous granuloma: Advances and opportunities for therapy. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1575133"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e02550-18","DOI":"10.1128\/mBio.02550-18","article-title":"Biphasic Dynamics of Macrophage Immunometabolism during Mycobacterium tuberculosis Infection","volume":"10","author":"Shi","year":"2019","journal-title":"mBio"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"5922","DOI":"10.1097\/MS9.0000000000002446","article-title":"Cachexia in tuberculosis in South-East Asian and African regions: Knowledge gaps and untapped opportunities","volume":"86","author":"Mistry","year":"2024","journal-title":"Ann. Med. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.lfs.2016.11.033","article-title":"TNF-\u03b1 and cancer cachexia: Molecular insights and clinical implications","volume":"170","author":"Patel","year":"2017","journal-title":"Life Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s12944-018-0657-0","article-title":"Interleukin-6 induces fat loss in cancer cachexia by promoting white adipose tissue lipolysis and browning","volume":"17","author":"Han","year":"2018","journal-title":"Lipids Health Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2939","DOI":"10.2337\/diabetes.54.10.2939","article-title":"Tumor Necrosis Factor-\u03b1 Induces Skeletal Muscle Insulin Resistance in Healthy Human Subjects via Inhibition of Akt Substrate 160 Phosphorylation","volume":"54","author":"Plomgaard","year":"2005","journal-title":"Diabetes"},{"key":"ref_52","first-page":"E469","article-title":"Skeletal muscle atrophy and the E3 ubiquitin ligases MuRF1 and MAFbx\/atrogin-1","volume":"307","author":"Bodine","year":"2014","journal-title":"Am. J. Physiol. Metab."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.cmet.2007.11.001","article-title":"FoxO3 Controls Autophagy in Skeletal Muscle In Vivo","volume":"6","author":"Mammucari","year":"2007","journal-title":"Cell Metab."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.cmet.2007.11.004","article-title":"FoxO3 Coordinately Activates Protein Degradation by the Autophagic\/Lysosomal and Proteasomal Pathways in Atrophying Muscle Cells","volume":"6","author":"Zhao","year":"2007","journal-title":"Cell Metab."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"E410","DOI":"10.1152\/ajpendo.00039.2012","article-title":"JAK\/STAT3 pathway inhibition blocks skeletal muscle wasting downstream of IL-6 and in experimental cancer cachexia","volume":"303","author":"Bonetto","year":"2012","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1186\/s12967-026-07906-8","article-title":"Role of mitochondrial dysfunction in muscle wasting in cancer cachexia: A narrative review","volume":"24","author":"Su","year":"2026","journal-title":"J. Transl. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2480","DOI":"10.1002\/jcsm.13035","article-title":"PGC1\u03b1 overexpression preserves muscle mass and function in cisplatin-induced cachexia","volume":"13","author":"Huot","year":"2022","journal-title":"J. Cachex-Sarcopenia Muscle"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1093\/cid\/ciac915","article-title":"Impact of Undernutrition on Tuberculosis Treatment Outcomes in India: A Multicenter, Prospective, Cohort Analysis","volume":"76","author":"Sinha","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Bhargava, A., Chatterjee, M., Jain, Y., Chatterjee, B., Kataria, A., Bhargava, M., Kataria, R., D\u2019Souza, R., Jain, R., and Benedetti, A. (2013). Nutritional Status of Adult Patients with Pulmonary Tuberculosis in Rural Central India and Its Association with Mortality. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0077979"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"17070","DOI":"10.1074\/jbc.M312021200","article-title":"Tumor Necrosis Factor \u03b1 Produces Insulin Resistance in Skeletal Muscle by Activation of Inhibitor \u03baB Kinase in a p38 MAPK-dependent Manner","volume":"279","author":"Teruel","year":"2004","journal-title":"J. Biol. Chem."},{"key":"ref_61","first-page":"1","article-title":"Mechanisms Linking Inflammation to Insulin Resistance","volume":"2015","author":"Chen","year":"2015","journal-title":"Int. J. Endocrinol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"7","DOI":"10.56782\/pps.183","article-title":"Drugs and chemical substances inducing diabetes\u2014Review of the literature","volume":"22","author":"Oleksa","year":"2024","journal-title":"Prospect. Pharm. Sci."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1038\/nm.3804","article-title":"The ketone metabolite \u03b2-hydroxybutyrate blocks NLRP3 inflammasome\u2013mediated inflammatory disease","volume":"21","author":"Youm","year":"2015","journal-title":"Nat. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.tube.2015.02.038","article-title":"Metabolomics specificity of tuberculosis plasma revealed by 1H NMR spectroscopy","volume":"95","author":"Zhou","year":"2015","journal-title":"Tuberculosis"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Collins, J.M., Jones, D.P., Sharma, A., Khadka, M., Liu, K.H., Kempker, R.R., Prideaux, B., Maner-Smith, K., Tukvadze, N., and Shah, N.S. (2021). TCA cycle remodeling drives proinflammatory signaling in humans with pulmonary tuberculosis. PLoS Pathog., 17.","DOI":"10.1101\/2021.01.23.21250380"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"57581","DOI":"10.18632\/oncotarget.11420","article-title":"Identification of novel host biomarkers in plasma as candidates for the immunodiagnosis of tuberculosis disease and monitoring of tuberculosis treatment response","volume":"7","author":"Jacobs","year":"2016","journal-title":"Oncotarget"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.1093\/jn\/130.10.2413","article-title":"Leucine Stimulates Translation Initiation in Skeletal Muscle of Postabsorptive Rats via a Rapamycin-Sensitive Pathway","volume":"130","author":"Anthony","year":"2000","journal-title":"J. Nutr."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"McGlory, C., Calder, P.C., and Nunes, E.A. (2019). The Influence of Omega-3 Fatty Acids on Skeletal Muscle Protein Turnover in Health, Disuse, and Disease. Front. Nutr., 6.","DOI":"10.3389\/fnut.2019.00144"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1097\/SPC.0000000000000015","article-title":"Selective androgen receptor modulators for the prevention and treatment of muscle wasting associated with cancer","volume":"7","author":"Dalton","year":"2013","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1056\/NEJMoa011110","article-title":"Tuberculosis Associated with Infliximab, a Tumor Necrosis Factor \u03b1\u2013Neutralizing Agent","volume":"345","author":"Keane","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1152\/japplphysiol.00371.2004","article-title":"N-acetylcysteine enhances muscle cysteine and glutathione availability and attenuates fatigue during prolonged exercise in endurance-trained individuals","volume":"97","author":"Medved","year":"2004","journal-title":"J. Appl. Physiol."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Khan, N., Vidyarthi, A., Nadeem, S., Negi, S., Nair, G., and Agrewala, J.N. (2016). Alteration in the Gut Microbiota Provokes Susceptibility to Tuberculosis. Front. Immunol., 7.","DOI":"10.3389\/fimmu.2016.00529"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/S2213-2600(18)30501-0","article-title":"The microbiome and tuberculosis: State of the art, potential applications, and defining the clinical research agenda","volume":"7","author":"Naidoo","year":"2019","journal-title":"Lancet Respir. Med."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/13\/6062\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:12:51Z","timestamp":1783487571000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/13\/6062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":73,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["ijms27136062"],"URL":"https:\/\/doi.org\/10.3390\/ijms27136062","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]}}}