As there is so much research going on efficacy of natural/herbal drugs in the management of tuberculosis and simultaneously there is emergence of MDR and XDR strains of this bacteria.
Treatment of disease Tuberculosis is already mentioned in Ayurveda. Infact there was treatment with many herbal and herbo-mineral formulations are mentioned for the same. The treatment mentioned in Charaka Samhita is a standing example for the same. Probably due to the trust on chemotherapy that these practices and medications are not followed or even followed but very remote. But theory does speak of treatment for tuberculosis.
I completely agree with Kamal that herbal drugs are addiditives not a replacement for antibiotics.
Yes sir, thank you so much for your kind and informative suggestions. I would like to address a point here;
Use of antibiotics in treating this disease is one of the major cause of emergence of MDR and XDR strains of this bacteria. So, what will be the role of using antibiotics therapy or herbal/traditional drugs in curing this disease in nearing future.
I woud obliged if you could ponder your thought over it...
Good day Bhavesh. I have been study natural dereved compounds with biological activity agains Mycobacterium tuberculosis. In fact,I found some essential oils that can kill the bacteria (bactericidal effect). So it is not crazy to think that in the future we can treat TB with phytodrug. However, to achieve manufacturing medicine, we must first find the active component and conduct studies in vitro and in vivo (animals and humans). This is a long timeline to past from from the herbal preparation (beverage, infusion, etc) to the pill. Currently plant products are used as additives, but I strongly believe that the future of successful treatment of tuberculosis may reside in a plant.
Dear Fernanda. Thank you very much for your suggestions made.
What will be the chances of this bacteria becoming resistant to plant based drugs?
Dear Fernanda, wish you all the best. Some naturally occurring molecules may show intriguing effects on M tuberculosis growth. Trerpenes / terpenoids (isoprene units), most major components of essential oils, exhibit interesting pharmacologic activities.
Several flavonoids and related (open ring) chalcones have also been evaluated against M tuberculosis, and quantitative structure activity relationships have been elucidated for inhibition of bacterial growth; some of these molecules exhibit up to 90% inhibition of growth of M tuberculosis in viro. Efforts tIo idetify new drug targets has shown that flavonoid inhibitors influence mycolic acids of M tuberculosis cell walls; some flavonoid molecules may affect the synthesis of unusual fatty acids involved in M tuberculosis cell growth. They may also modulate efflux in the case of MDR.
Bhavesh -
Flavonoids and related molecules with the potential to block efflux pumps may show promise as inhibitors of multidrug resistant M teuberculosis; they have membrane disruptive properties probably owing to specific interactions with proteins, and intercalation into DNA and RNA. Terpenes have some interesting effects on M tuberculosis growth as well. I agree with you insofar as identifying new therapies. Perhaps naturally occurring biologically active molecules can fulfill the function of - and develop into - adjunct medicines (drugs).
Herbal/ Natural remedies are not a substitute to Antibiotics. They can be used with extreme care in order to manage symptomatically, whatever the patient suffers from. But as Tb is a very dangerous infection, it needs to be treated with antibiotics for the patient him/herself, and the friends, family and people who have been in contact with the infected patient.
Bhavesh, as you mention tuberculosis (TB) is a life-threatening disease. With the current models of drug discovery and development, herbal/natural medicines may be used as supplements but unlikely to be used as first-line agents, especially for MDR and XDR TB. The current models are expensive, and is the main reason there are few large trials (multi-centre, randomized etc) for molecules which are out of patent. I feel the regulatory bodies (FDA, MHRA etc) have a role to play in identifying alternative models, to run alongside the Phase1-4 approach currently in favour.
In my view, their role will be for the identification of new molecules and moeties on which to base the development of new drugs. After all, moulds (fungi) are still a source of hope for new antibiotics, and artemisinin-based compounds and quinine continue to outperform the "pure" synthetic compounds in efficacy for treatment of malaria.
Good day Chithan. All your comments are highly interesting. Unfortunately I had not the opportunity to continue my research on MTB after my Master. Nevertheless; I agree with you about the importance of study naturally occurring compounds that have the cell wall of the bacteria as a target. This is because to have an impact on this bacterial structure reduces the possibility to develop resistance caused by the cellular lysis dead and the impossibility to pass the resistance characteristic through the progeny.
On the other hand, other substances currently researched as antimycobacterial are the Propolis and although their bacterial target is not known yet; It has been shown that promote the bactericidal effect of healthy people macrophages. This is also a very exciting research theme.
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