Host Directed Therapies for Tuberculous Meningitis

A dysregulated host immune response significantly contributes to morbidity and mortality in tuberculous meningitis (TBM). Effective directed therapies (HDTs) are critical improve survival clinical outcomes. Currently only one HDT, dexamethasone, is proven mortality. However, there no evidence dexamethasone reduces morbidity, how it uncertain, has benefit HIV co-infected individuals. Further research on these aspects of its use, as well alternative HDTs such aspirin, thalidomide other immunomodulatory drugs needed. Based new knowledge from pathogenesis studies, repurposed therapeutics which act upon small molecule drug targets may also have a role TBM. Here we review existing literature investigating TBM, propose rationale for the use novel drugs. We discuss variable responses support personalised approach TBM.