“…Multiple different pressures may differentially select for variants related to ESX-1 activity. This secretion system influences virulence and antigenicity in MTBC (Garces et al, 2010; Lim et al, 2022) by controlling the secretion of the immunodominant antigens ESAT-6 ( esxA ) and CFP-10 ( esxB ) (Covert et al, 2001; Guinn et al, 2004; Hsu et al, 2003), stimulating the innate immune response and cytokine secretion (Pandey et al, 2009, p. 2; Stanley et al, 2007), and promoting the intracellular growth of the pathogen (Lewis et al, 2003; Stanley et al, 2003). Through modulating the immune response, as well as cellular permeability (Garces et al, 2010), ESX-1 function may also influence antibiotic activity or resistance (Torres Ortiz et al, 2021).…”