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REVIEW article

Front. Med.

Sec. Infectious Diseases: Pathogenesis and Therapy

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1629008

Unraveling Brucellosis: Advances in Pathogenesis, Diagnostic Strategies, Therapeutic Innovations, and Public Health Perspectives

Provisionally accepted
  • 1College of Applied Medical Sciences, Qassim University, Buraidah, Saudi Arabia
  • 2Department of Veterinary Preventive Medicine, College of Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia

The final, formatted version of the article will be published soon.

Brucellosis remains one of the most impactful zoonotic diseases worldwide, posing major socioeconomic and public health challenges, particularly in low-and middle-income countries. This review presents recent progress in understanding the pathogenesis of Brucella species, emphasizing the role of key adhesins— SP29, SP41, BigA, BigB, BamA, BmaB, BmaC, Bp26, BtaF, and BtaE—in host‒pathogen interactions that drive adhesion, invasion, and immune evasion. We also critically assess current diagnostic approaches, including conventional culture techniques, serological assays, and emerging molecular platforms, which offer improved sensitivity and specificity. Current treatment regimens involve extended antibiotic combinations—typically doxycycline with rifampin or streptomycin—and may include surgical intervention in complicated cases. Additionally, the integration of nanotechnology-based drug delivery and traditional Chinese medicine offers promising adjunctive therapies. Although several animal vaccines exist, no approved vaccine is currently available for human use. Novel vaccine platforms, including live vectors, DNA subunits, and nanoparticle-based formulations, are under development. Finally, we address the disease's broad socioeconomic impact—ranging from livestock losses to healthcare burdens—and highlight ongoing challenges, such as diagnostic limitations, antimicrobial resistance, underreporting, and barriers to vaccine development. A One Health approach, alongside translational research and integrated surveillance, is vital to advancing prevention and control strategies for this neglected zoonosis.

Keywords: Brucellosis, Pathogenesis, diagnosis, Treatment regimens, Public Health

Received: 15 May 2025; Accepted: 22 Sep 2025.

Copyright: © 2025 Elbehiry and Almuzaini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ayman Elbehiry, ar.elbehiry@qu.edu.sa

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