Anti-Mycobacterium tuberculosis Effects of Folk Medicinal Plants in Iran: A Mini-Systematic Review

The emergence of drug resistance in Mycobacterium tuberculosis is a major challenge in tuberculosis treatment and control. In addition, multidrug resistance (MDR) and, more broadly, extensive drug resistance (XDR) have hampered treatment with common antibiotics. Thus, an herbal medicine containing antimicrobial capability can be a good alternative to antituberculosis drugs. In this study, we reviewed the effect of folk herbs in Iran as anti-Mycobacterium tuberculosis drugs. In this systematic analysis, keywords including medicinal plants, M. Tuberculosis infection, Tuberculosis disease, MTB, essential oils, and extracts were searched in Science Direct, Scopus, PubMed, Ovid, Cochrane, Scientific Information Database (SID), Iran Medex, Iran Doc, Magiran, and Google scholar where articles published from 2000 to 2020 were considered. The results indicated that Iranian native herbs such as Peganum harmala, Humulus lupulus, Capparis spinosa, Thymus vulgaris, Pulicaria gnaphalodes, Perovskia abrotanoides, Peganum harmala, Punica granatum, Digitalis sp., Citrus lemon, Rosa canina, Berberis vulgaris, Aloe vera, Mentha spp., Hypericum perforatum, Humulus lupulus, Trachyspermum copticum, Pelargonium graveolens, Levisticum officinale, and Dracocephalum kotschyi were all effective antibacterial against mycobacterial infection within 0.5 ug to 200 mg. Thymus vulgaris was shown to be the most effective than other antibacterial agents such as Streptomycin, Cycloserin Isoniazid, and Ethambutol (0.5-40 μg/mL). Herbal remedies may be an effective therapeutic option for antibiotic-resistant tuberculosis. Potential adverse effects and antibacterial properties, along with possible synergistic interactions with other plants and drugs, require further studies to clarify.