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Research Nugget

Natural Helpers for Tuberculosis Treatment

Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major health threat, especially in low-income countries such as South Africa. While effective TB drugs are available, they often cause serious side effects such as hepatotoxicity (liver damage) and immune suppression.

In response to this challenge, a research study funded by the NRF investigated seventeen medicinal plants for their potential to serve as adjuvants. These natural substances could support TB treatment by reducing side effects and enhancing the immune system.

Medicinal plants scientific names followed by their plant families in brackets:

  1. Agapanthus praecox subsp. minimus (Amaryllidaceae)
  2. Agapanthus praecox subsp. orientalis (Amaryllidaceae)
  3. Aloe arborescens (Xanthorrhoeaceae)
  4. Annona senegalensis (Annonaceae)
  5. Combretum bracteosum (Combretaceae)
  6. Crinum bulbispermum (Amaryllidaceae)
  7. Eucalyptus deglupta (Myrtaceae)
  8. Erythrina zeyheri (Leguminosae)
  9. Erythrophleum lasianthum (Leguminosae)
  10. Heteromorpha arborescens (Apiaceae)
  11. Melianthus major (Melianthaceae)
  12. Moringa drouhardii (Moringaceae)
  13. Moringa hildebrandtii (Moringaceae)
  14. Plectranthus neochilus (Lamiaceae)
  15. Searsia lancea (Anacardiaceae)
  16. Sutherlandia frutescens (Leguminosae)
  17. Tulbaghia violacea (Amaryllidaceae)

These plants were chosen because natural products and plant-based remedies make up nearly 50% of all drugs in clinical use. They are often safer, with fewer side effects and lower toxicity compared to synthetic drugs. South Africa’s rich biodiversity offers a promising source of traditional medicinal plants with potential antimycobacterial, antioxidant, hepatoprotective, and immunomodulatory benefits.

To achieve the research aims, Ethanolic extracts from the 17 plants were tested for:

  1. Antimycobacterial activity (against M. tuberculosis H37Rv strain)
  2. Cytotoxicity (on U937 monocyte lymphoma cells and HepG2 liver cells)
  3. Antioxidant activity (DPPH radical scavenging method)
  4. Hepatoprotective properties (tested on liver cells exposed to acetaminophen)
  5. Immunomodulatory potential (measured by IL-12 production in U937 cells)

Research key findings demonstrates that for:

Antimycobacterial activity:

Heteromorpha arborescens, Sutherlandia frutescens, Eucalyptus deglupta, and Plectranthus neochilus showed the strongest activity, each with minimum inhibitory concentration (MIC) values of 250 mg/ml. Searsia lancea showed moderate activity (MIC = 500 mg/ml).

Cytotoxicity:

Most extracts showed low to moderate toxicity. However, Heteromorpha arborescens was toxic to both liver and immune cells (IC₅₀ = 40 mg/ml and 72.4 mg/ml), suggesting it should be used with caution.

Antioxidant activity:

Strong antioxidant effects were seen in Eucalyptus deglupta and Melianthus major, with IC₅₀ values of 1.33 mg/ml and 1.32 mg/ml, respectively. Antioxidants are important for protecting TB patients from immune damage.

Hepatoprotective effects:

At 1/4 IC₅₀ concentrations, Searsia lancea, Sutherlandia frutescens, and Tulbaghia violacea offered significant liver protection. Searsia lancea showed the highest effect at 56.28% protection.

Immunomodulatory potential:

Cytokine tests showed that Eucalyptus deglupta and Sutherlandia frutescens boosted IL-12 levels, an important immune response marker. This means they may help the body fight TB more effectively.

In conclusion, this study highlights Eucalyptus deglupta, Searsia lancea, and Sutherlandia frutescens as promising adjuvant candidates for TB treatment. These plants demonstrated antimycobacterial, antioxidant, hepatoprotective, and immune-boosting properties with low toxicity, making them strong candidates for further preclinical and clinical testing.

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