Abstract

PHYTOTHERAPEUTIC APPROACHES FOR THE TREATMENT OF MULTIDRUG-RESISTANT TUBERCULOSIS: A COMPREHENSIVE REVIEW

Manjiri Jayawant*, Omkar Hulawale, Sahil Mishra, Avantika Bhanushali, Abhishek Dagade, Shivaji Giram and Priyanka Kalamkar

ABSTRACT

Multidrug-Resistant Tuberculosis (MDR-TB) poses a substantial global health threat, demanding novel strategies to combat its escalating prevalence and dire repercussions. The emergence of Mycobacterium tuberculosis strains resistant to conventional antibiotics has compelled the exploration of alternative therapeutic avenues. This review delves into the intricacies of MDR-TB and explores the potential of natural products as alternative anti- mycobacterial agents. MDR-TB, defined by resistance to isoniazid and rifampicin, presents a significant challenge, accounting for over 3% of newly reported TB cases globally. The incidence is markedly higher among individuals with previous TB treatment history. Conventional MDR-TB therapy entails extended regimens of second-line antibiotics,
accompanied by various challenges, including compliance issues and heightened risk of adverse effects. To address these challenges, researchers have turned to nature's pharmacopoeia for potential solutions. Natural products, rich in diverse bioactive compounds, offer an innovative approach to MDR-TB treatment by potentially circumventing resistance mechanisms. Phytotherapy, or herbalism, has emerged as a complementary or alternative approach in tackling MDR-TB. Phytotherapeutic agents may exhibit antimicrobial properties, synergize with conventional TB drugs, modulate the immune response, mitigate drug side effects, and serve as adjunctive therapy. Several phytotherapeutic agents have demonstrated promise in combating MDR-TB, including pomegranate fruit peel, green tea polyphenols, curcumin, Glycyrrhiza glabra, Alpinia galanga, and compounds like ursolic acid and hydroquinone. This review critically assesses the complexities of MDR-TB, emphasising the limitations of conventional approaches and exploring the untapped potential of natural and biological products. It underscores the importance of continued research and development in phytotherapeutic approaches, offering hope for more effective and sustainable treatments in the ongoing battle against this formidable global health challenge.

Keywords: Phytoconstituents, Natural products, MDR-TB, Antibiotic resistance.