Macrophage and Mycobacterium: The war without beginning or end

Mechanisms of macrophage polarization towards M1 phenotype or M2 phenotype, as well as of macrophage transformation into foam cells upon interaction with mycobacteria, are discussed. The possible effects of Mycobacterium tuberculosis (Mtb) on macrophage polarization and activation are analyzed. The role of different cell-death pathways (apoptosis, necrosis, and autophagy) in mycobacteria persistence in vitro and in vivo is elucidated. The most likely means of macrophage reprogramming to increase their microbicidal activity for the purpose of tuberculosis treatment and prevention are analyzed.