ESAT-6 has been shown to directly bind to the TLR2 receptor, inhibiting downstream signal transduction.[2] It has also been studied that the inactivation of ESAT-6 leads to decreased virulence of M. tuberculosis.[3] Secretion of the ESAT-6 protein is one of the main determining factors in the virulence of the M. tuberculosis.[3] ESAT-6 has more commonly become a marker for the TB diagnosis and treatment.[4] There is also the use of the ESAT increase the production of virulent factors that cause for the increase in pathogenicity of TB.[5]
ESAT-6 is one of the main proteins that is inhibited in the production of vaccines for M. tuberculosis[3][6] with the combination of the increased antigenic factors agβ5-A and the agβ5-C.[6] There are studies that are currently trying to connect the linkage between ESAT-6 and the epithelial cells that are in the lungs, which has shown the dependence on the induction of the IL-8 promoter.[7]