A review of molecular investigations on traditional Chinese medicinal plant-based therapies in multidrug-resistant tuberculosis

Introduction

The escalating threat of drug-resistant tuberculosis (TB) necessitates urgent exploration of alternative treatment methods. Traditional Chinese medicinal (TCM) plants, rich in bioactive phytochemicals, present promising options for addressing this challenge. This review critically examines the molecular mechanisms underlying the therapeutic efficacy of phytochemicals derived from selected TCM against drug-resistant TB.

Methods

We searched Google Scholar, Scopus, PubMed, and Web of Science, among other search engines, to locate publications about natural compounds that may be utilised to treat multidrug-resistant tuberculosis (MDR TB). Studies from 2007 to 2023 were included, which addressed gaps in our current knowledge of tuberculosis (TB) and the potential of natural compounds. We employed various search terms such as "Molecular targets and mechanisms," "pathophysiology," "nanotechnology," "natural products," "global statistics and multidrug-resistant TB," among others. We selected 108 of the 166 identified papers for evaluation. Only Traditional Chinese Medicinal Plant-Based Treatments for Multidrug-Resistant Tuberculosis were covered.

Results

Through an integrative analysis of recent research, we explored the multifaceted interactions between phytochemicals and various molecular targets within Mycobacterium tuberculosis (Mtb). We have highlighted prominent phytochemicals like curcumin from Curcuma longa, resveratrol from Polygonum cuspidatum, and berberine from Berberis spp., elucidating their mechanisms of action and potential synergistic effects with conventional anti-TB drugs. Additionally, we delved into the immunomodulatory properties of phytochemicals, emphasizing their ability to enhance host immune responses against TB infection.

Discussion

Innovative approaches such as network pharmacology and molecular docking (mannose receptor targets) are discussed for predicting and validating interactions between phytochemicals and Mtb targets. Moreover, we address challenges related to phytochemical bioavailability, pharmacokinetics, and formulation strategies, proposing methods to enhance their efficacy and clinical translation.

Conclusion

In conclusion, this review consolidating existing insights and identifying areas needing further research, this review offers a comprehensive framework for leveraging the therapeutic properties of phytochemicals from traditional medicinal plants, highlighting their potential as supplementary or alternative treatments for drug-resistant TB.