Review of Medicinal Plants used to Treat Tuberculosis

Pallavi Zode¹*, Vinod Thakre²

¹Assistant Professor, Department of Pharmacy,

Nagpur College of Pharmacy, Nagpur, Maharashtra, India.

²Associate Professor, Department of Pharmaceutics,

Nagpur College of Pharmacy, Nagpur, Maharashtra, India.

*Corresponding Author Email: pallavizode325@gmail.com

ABSTRACT:

The deadly infection known as tuberculosis (TB), It is caused by the germs Mycobacterium tuberculosis, is quite difficult for humans to treat. For the treatment of tuberculosis, more than twenty allopathic medications are used. All of the drugs have side effects, including hepatitis, vomiting, nausea, and hypersensitivity reactions. The use of herbal medications is becoming more and more popular as a result of these adverse consequences of allopathic medicine. Due to Mycobacterium tuberculosis demonstrating significant resistance to conventional allopathic medications and developing the conditions known as extensively drug-resistant tuberculosis (XDR-TB) and multidrug-resistant tuberculosis (MDR-TB), the interest in herbal therapies is also growing. Emphasising the value of anti-TB medicinal herbs is the goal of this review. In this review, approximately twelve plants that may be used to treat tuberculosis are discussed.

KEYWORDS: Mycobacterium tuberculosis, Causes, Allopathic Medication, Medicinal plants, Natural compound.

INTRODUCTION:

Tuberculosis is additionally called 'TB' or ‘Consumption’, it is a constant granulomatous sickness. It is an airborne contamination sickness normally caused “Mycobacterium tuberculosis (MTB) microbes”¹. A genus of acid-fast bacilli, Mycobacteria are members of the Mycobacteriacae family². Tuberculosis are usually influence by the lung (Pulmonary TB), yet in addition impacted the CNS (Meningitis), lymphatic system, circulatory system (Miliary TB), genitourinary system, bones and joints¹.

The disease can manifest in two forms: latent TB infection (LTBI) and active TB disease. In LTBI, the bacteria are present in the body but are in a dormant state and do not cause any symptoms. However, they can become active and cause disease in the future if the immune system weakens³. When a contaminated patient coughs, talks, sneezes, spits, laughs, or sings, it may occur⁴.

A compromised immune system, travel or residence in a region where tuberculosis is common, poverty, substance misuse, and genetics are among the risk factors for tuberculosis⁵.

Human have confronting more sort of infections mostly brought about by microorganisms. Step by step builds the illnesses, the man acquainted a few antibiotics with tackle the issue of contaminations. In any case, with the passage of time, microbes became impervious to antibiotics⁶. The state of TB is further complicated by drug resistance, diabetes, smoking, and other related variables, making it difficult to control⁷. This expansion in the obstruction of microscopic organisms is a result of inordinate utilization of anti-toxin and abuse of antibiotics. An increasing number of bacteria are practically resistant to all antibiotics available in the market. Multidrug resistance has been shown in Escherichia coli, Staphylococcus faecium, Mycobacterium tuberculosis, Shigella dysenteriae, Staphylococcus aureus, Haemophilus influenza, etc⁸. There is a great demand for and interest in creating novel tubercular medications. Determining which tubercule bacillus targets make for effective therapeutic targets is essential for creating new tubercular medications⁹. This work will focus on the disaster caused by the Mycobacterium tuberculosis, TB treatment's harmful side effects from allopathic medications, as well as the necessity and application of herbal remedies to treat the fatal illness⁸.

CAUSES:

1. Mycobacterium tuberculosis (MTB): A type of pathogenic microorganisms that belongs to the Mycobacteriaceae family and is the cause of tuberculosis¹⁰. Is an aerobic bacterium with a moderate growth rate that divides every 16 to 20 hours. Since MTB lacks the synthetic trait of either gramme positive or gramme negative bacteria, it is not classified as either¹⁰. It is non-motile, doesn't produce spores, and needs oxygen to grow¹⁰.

Four other mycobacterium that cause tuberculosis are included in the Mycobacterium tuberculosis complex: M. bovis, M. Canetti¹¹, M. africanum¹¹, and M. microti¹¹.

2. Smoking: Smoking expanding the danger of contracting tuberculosis and weakens the reaction to treatment of the illness. Cigarette smoking causes the powerlessness of tuberculosis. Anyway, the macrophages of smokers are depleted from their day-by-day openness to smoke, making them incapable to effectively work. This implies they are as of now not ready to react to the test of killing disease ¹¹.

3. HIV: One significant risk factor for TB is HIV. HIV-positive individuals are thought have a 20–30 times higher chance of contracting tuberculosis than HIV-negative individuals¹³. One of the primary causes of illness and death for HIV-positive individuals is tuberculosis¹³.

4. Diabetes Mellitus: Patients with diabetes have an incredibly high three-fold higher chance of contracting tuberculosis¹⁴. It is a major risk factor for tuberculosis and may have an impact on how the disease manifests and how well therapy works. Diabetes patients may experience worsening glycemic control and glucose intolerance as a result of TB¹⁴.

5. Alcohol: Heavy utilization of alcohol was closely associated with higher rates of tuberculosis; on normal mishandling liquor expanded the danger of contracting tuberculosis by 35%¹⁵.

6. Undernutrition: Undernutrition expanded the risk of tuberculosis which in turn, can lead to malnutrition. Undernutrition is not the only risk factor for the progression of a dormant TB infection into an active illness, but also increased the medication harmfulness, relapse & death once tuberculosis develops¹⁵.

Allopathic treatment of tuberculosis those antibiotics are utilized are summarized in Table 1. Which are equally beneficial for the treatment of other bacterial disease. Anti-TB drug are rifampicin, isoniazide, ethambutol, pyrazinamide should be taken daily in the initial two months of treatment and followed by daily dose of isoniazid and rifampicin for four months in constant phase¹⁷. There is now a strain of Mycobacterium TB that is totally immune to all drugs used to treat tuberculosis, both first- and second-line drugs for TB treatment.

Table 1. WHO-Recommended First- and Second-line Medications

First-Line Drugs (Oral)	Rifampicin, Isoniazid, Pyrazinamide, Ethambutol, Streptomycin
Fluoroquinolones	Moxifloxacin, Levofloxacin, Of loxacin and Gatifloxacin
Second-Line Drugs Injectable Bacteriostatic Anti-TB Drugs (oral)	Para-amino salicyl, Ethinomide, Cycloserin, Kanamycin, Amikacin, Capreomycin
Newer Drugs	Ciprofloxacin, Clarithromycin Azithromycin Rifabutin

Due to the negative effects of Everyone is now interested in herbal remedies as an alternative to chemical-based anti-TB drugs, which patients usually have to take for long periods of time.

Table 2 summaries the adverse reactions to oral first- and second-line drugs. Because herbal medicines are an unprocessed blend of many plant chemicals, they have less side effects, are less expensive, and are effective against a variety of diseases¹⁹.

Table 4. Plant Profile

Plant name (Botanical)	Family	Part Used	Chemical onstituents	Anti-TB activity / MIC values
Allium sativum^19,20	Amaryllidaceae	Bulb	Either lipids and fixed oils or derivatives of phenol and arylamine	MIC of Acalyphaindica, Adhatodavasica and Allium sativam is 5,10 and 1.25mg/mL respectively against HRv37 strain of M. tuberculosis
Piper nigrum L²¹.	Piperaceae	Seeds	Piperine	MICs for acetone extract and ethanol extract combination against M. tuberculosis H37Rv are 100 micro g/mL and 50 micro g/mL, respectively.
Humulus Lupulus²²	Cannabaceae	Whole plant	_	MIC against resistant and sensitive strains of M. tuberculosis is 8 and 4 mg/mL respectively
Mallotus philippensis (Linn.) Muell Arg.^23,24	Euphorbiaceae	Leaves	Ursolic acid and beta-sitosterol	In the ethyl acetate fraction, the MIC for M. tuberculosis H37RV and H37Ra is 0.125 mg/mL and 0.25 mg/mL, respectively.
Withania somnifera (Linn.)²⁵	Solanaceae	Fresh leaves and roots	_	1.0 mg/mL-64.47% and 0.01 mg/mL-17.88% Inhibition of M. tuberculosis H37Rv.
Actiniopteris radiata Linn.²⁶	Actiniopteridace ae	Whole plant	_	M. tuberculosis H37Rv was susceptible to the MIC of n-Hexane, chloroform, and ethanolic extracts, which were 12.5, 3.125, and 25 μg/mL.
Alstonia scholaris²⁷	Apocynaceae	Bark, flower, fruit and leaf	_	M. tuberculosis H37Rv can be inhibited by butanol extracts of bark and flowers with MICs of 500 and 100 μg/mL, respectively.
Ranunculi ternati radix²⁸	Ranunculaceae	Whole plant	_	With MIC values of 1.0 mg/mL on the MDR2314-2 and XDR1220 strains of M. tuberculosis, the 70% ethanol-eluted portion of the ethanol extract from macro porous resin (EEPMR) demonstrated strong antitubercular action.
Plumeria bicolor²⁹	Apocynaceae	Bark	Plumericin and iso-Plumericin	Plumericin showed better anti-TB activity than isoplumericin with MIC values of 1.3 ± 0.15, 1.5 ± 0.13, 2.0 ± 0.07, 2.1 ± 0.12 and 2.0 ± 0.14 μg/mL and MBC values of 2.5 ± 0.18, 2.9 ± 0.20, 3.8 ± 0.27, 3.6 ± 0.22 and 3.7 ± 0.32 μg/mL, respectively against all four sensitive as well as MDR clinical isolates of M. tuberculosis
Kaempferia galanga³⁰	Zingiberaceae	Rhizome	Ethylmp- methoxycinnamat e	MIC of Ethyl p- methoxycinnamate (EPMC) is 0.242–0.485 Mm against M. tuberculosis H37Rv, H37Ra, multidrug resistant (MDR) and drug susceptible clinical isolates measured by resazurin microtitre assay
Andrographis paniculata³¹	Acanthaceae	Leaf	Andrographolide	MIC of A. paniculata methanolic extract against drug-sensitive clinical isolates of M. tuberculosis, MDR, and H37Rv was 250μg/mL.
Lantana hispida³²	Verbenaceae	Ariel part	Oleanolic acid and ursolic acid	Measured using the Microplate Alamar Blue Assay (MABA), the minimum inhibitory concentration (MIC) of both drugs varied between 12.5μg/mL and 50μg/mL for M. tuberculosis H37Rv and four mono-resistant variants of the same strain.

CONCLUSION:

Herbs are an excellent source of phytoconstituents, which contain a variety of disease-causing inhibitory effects. Every phytochemical would have a unique way of preventing illness. Until now, one of the most deadly illnesses was tuberculosis. A variety of synthetic medications are used to treat tuberculosis. It is proven that synthetic medications have anarchic adverse effects. Unlike synthetic medications, plant-based sources of medication are safe and effective. It has been demonstrated that the plants listed above are anti-tuberculic. This analysis suggests that there is a global surge in demand for phyto pharmaceuticals, mostly due to two factors: first, the harmful side effects of allopathic treatments; and second, the special capacity of many plants to combat the fatal tuberculosis bacterium. The scientific community will benefit from the development of viable herbal-based tuberculosis medications.

CONFLICT OF INTEREST STATEMENT:

Authors declare that they have no conflicts of interest.

AUTHORS' CONTRIBUTIONS:

Ms. Pallavi Zode Conceived the study, conducted the literature review, and wrote the manuscript draft and contributed to the data analysis, interpretation of findings, and revision of the manuscript.

Dr. Vinod Thakre Provided critical review of the manuscript and helped with final revisions.

ACKNOWLEDGEMENTS:

We are grateful to Ms.Sema Wakodkar for her helpful support and thankful to friends for their kind assistance.

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Received on 11.04.2025 Revised on 16.06.2025

Accepted on 05.08.2025 Published on 10.10.2025

Available online from October 18, 2025

Res. J. Pharmacognosy and Phytochem. 2025; 17(4):296-300.

DOI: 10.52711/0975-4385.2025.00047

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Group	Drug	Adversarial Effects
First-Line Drugs (Oral)	Rifampicin	Hepatotoxicity, Nausea, Anorexia, Immunological Reaction, Fatigue, Abdominal Pain, Headache, Ataxia etc.
	Isoniazid, Ethambutol	Hepatotoxic, Vomiting, Nausea, Epigastric Pain, Coma etc.
	Pyrazinamide	Nausea, Hypersensitivity, Hepatotoxicity etc. Kidney Failure, Acute Arthritis etc.
Second-Line Drugs	Fluoroquinolones	Affect CNS, Gastrointestinal, Cardiovascular and Endocrine system, Urinary tract etc.
Second-Line Drugs	Injectable Bacteriostatic Anti-TB drugs (oral)	Neurotoxic, Ototoxic, Nephrotoxic, Hypersensitivity Psychiatric and Neurological adverse effects.

*Allium sativum*	*Piper sigrum*	*Humulus lupulus*
*Mallotus philippensis*	*Withania somnifera*	*Actiniopteris radiata*
*Alstonia scholaris*	*Ranunculi ternati radix*	*Plumeria bicolor*
*Kaempferia galanga*	*Andrographis paniculata*	*Lantana hispida*

CAUSES:

Table 1. WHO-Recommended First- and Second-line Medications

Table 2. Adverse Effect Caused by Anti-TB Drugs

CONCLUSION: