Tuberculosis (TB) is a formidable infectious disease that remains a major cause of death worldwide today. Escalating application of genomic techniques has expedited the identification of increasing number of mutations associated with drug resistance in Mycobacterium tuberculosis. Unfortunately the prevalence of bacillary resistance becomes alarming in many parts of the world, with the daunting scenarios of multidrug-resistant tuberculosis (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB) and total drug-resistant tuberculosis (TDR-TB), due to number of resistance pathways, alongside some apparently obscure ones. Recent advances in the understanding of the molecular/ genetic basis of drug targets and drug resistance mechanisms have been steadily made. Intriguing findings through whole genome sequencing and other molecular approaches facilitate the further understanding of biology and pathology of M. tuberculosis for the development of new therapeutics to meet the immense challenge of global health.

Buruli ulcer (BU) is an emerging infectious disease that causes disfiguring skin ulcers. The causative agent, Mycobacterium ulcerans, secretes toxin called mycolactone that triggers inflammation and immunopathology. Existing treatments are lengthy and consist of drugs developed for tuberculosis. Here, we report that a pyrazolo[1,5-a]pyridine-3-carboxamide, TB47, is highly bactericidal against M. ulcerans both in vitro and in vivo. In the validated mouse model of BU, TB47 alone reduces M. ulcerans burden in mouse footpads by more than 2.5 log₁₀ CFU compared to the standard BU treatment regimen recommended by the WHO. We show that mutations of ubiquinol-cytochrome C reductase cytochrome subunit B confer resistance to TB47 and the dissimilarity of CydABs from different mycobacteria may account for their differences in susceptibility to TB47. TB47 is highly potent against M. ulcerans and possesses desirable pharmacological attributes and low toxicity that warrant further assessment of this agent for treatment of BU.

The targeted transport of nanomedicines is often impeded by various biological events in the body. Viruses can hijack host cells and utilize intracellular transcription and translation biological events to achieve their replication. Inspired by this, a strategy to hijack endogenous products of biological events to assemble into intracellular functional nanoparticles is established. It has been shown that, following tumor vessel destruction therapy, injected cell permeable small molecule drugs bisphosphonate can hijack the hemorrhagic product iron and self‐assemble into peroxidase‐like nanoparticles within tumor‐infiltrating macrophages. Unlike free drugs, the generated intercellular nanoparticles can specifically stress mitochondria, resulting in immune activation of macrophages in vitro and polarizing tumor‐associated macrophages (TAMs) from immunosuppressive to tumoricidal and increasing the recruitment of T cells deep within tumor. The hijacking self‐assembly strategy significantly inhibits tumor growth compared with the treatment of vascular‐disrupting agents alone. Using bisphosphonate to hijack the metabolite associated with hemorrhage, iron, to fabricate functional nanoparticles within specific cells, which may open up new nanotechnology for drug delivery and small molecular drug development.

Conventional radiotherapy compromises antitumor immunity through collateral damage to immune cells. While boron neutron capture therapy (BNCT) enables tumor-selective ¹⁰B (n, α) ⁷Li reactions, clinical agents like boronophenylalanine (BPA) suffer from excessive dosing and exhibit immune-metabolic inertia. We report a biomineralized albumin-based BNCT agent (Albumin@MnB) synthesized from clinically accessible borax, manganese, and albumin, which unlocks neutron capture-triggered immunotherapeutic activation. Albumin@MnB achieves potent tumor suppression at reduced boron doses, demonstrating superior efficacy compared with BPA. Importantly, Albumin@MnB enhances intratumoral immune cell infiltration and suppresses distant tumor growth, synergizing with adoptive T cell immunotherapy and immune checkpoint inhibitors. By integrating tumor-specific radiolytic energy deposition with metabolic reprogramming and immune activation, this strategy establishes boron neutron capture immunotherapy (BNCI) as a multimodal therapeutic paradigm that bridges targeted radiolysis with systemic antitumor immunity.