Manipulation and exploitation of host immune system by pathogenic <i>Mycobacterium tuberculosis</i> for its advantage.

<i>Mycobacterium tuberculosis</i> (<i>Mtb</i>) can become a long-term infection by evading the host immune response. Coevolution of <i>Mtb</i> with humans has resulted in its ability to hijack the host's immune systems in a variety of ways. So far, every <i>Mtb</i> defense strategy is essentially dependent on a subtle balance that, if shifted, can promote <i>Mtb</i> proliferation in the host, resulting in disease progression. In this review, the authors summarize many important and previously unknown mechanisms by which <i>Mtb</i> evades the host immune response. Besides recently found strategies by which <i>Mtb</i> manipulates the host molecular regulatory machinery of innate and adaptive immunity, including the intranuclear regulatory machinery, costimulatory molecules, the ubiquitin system and cellular intrinsic immune components will be discussed. A holistic understanding of these immune-evasion mechanisms is of foremost importance for the prevention, diagnosis and treatment of tuberculosis and will lead to new insights into tuberculosis pathogenesis and the development of more effective vaccines and treatment regimens.