SCRUB TYPHUS: MOLECULAR MECHANISM AND THERAPEUTICS PERSPECTIVE

Abstract

Despite deaths related to scrub typhus declining in recent decades due to epidemiological control, the infection caused by the intracellular bacterium Orientia tsutsugamushi continues to represent a significant public event in endemic areas. In this paper, the molecular mechanisms of such pathogenesis and the status of existing therapy strategies were discussed. Scrub typhus epidemiology is a disease with diverse clinical presentations dictated by the involvement of the complex interplay between the bacterium’s life cycle and host immune response. Although the mechanisms of virulence are recognized to include interactions involving outward membrane proteins in host cell invasion, as well as vascular inflammation downstream from signaling pathways, little has been revealed by recent research. Advancements have not, however, overcome the fact that current treatment regimens, based on antibiotics such as doxycycline, must overcome emerging resistance and its delays. In this study, we integrate findings from 30 peer‐reviewed studies to present a comprehensive overview of the pathogen’s epidemiology, life cycle, pathogenesis, and therapeutic interventions. We further discuss gaps in current research and propose future directions aimed at improving molecular diagnostics and targeted therapy. The ultimate goal is to foster enhanced clinical management and to inform the development of novel therapeutic approaches that address both microbial virulence and host response, thereby reducing morbidity and mortality associated with scrub typhus.