Development and study of a herbal composition that is promising in the complex therapy of tuberculosis

Introduction. Tuberculosis is a socially significant disease both in the territory of the Russian Federation and worldwide. The high resistance of Mycobacterium tuberculosis and the high toxicity of existing chemotherapeutic drugs necessitate the development of new medications. Plant-based medicinal agents are promising for complex tuberculosis therapy, as they can support the patient’s weakened body, reduce the side effects of chemotherapeutic drugs, and strengthen lung tissue.

Aim. To develop the plant-based medicinal composition for the complex therapy of tuberculosis.

Materials and methods. Fourteen pharmacopoeial types of medicinal plant raw materials and three plant-based compositions derived from them were analyzed. The studies were conducted according to the methodologies outlined in the State Pharmacopoeia of the Russian Federation (15th edition).

Results and discussion. Based on scientific data, three compositions of plant-based formulations for the complex therapy of pulmonary tuberculosis were proposed. The quantitative content of the main groups of biologically active substances (BAS) – polysaccharides, tannins, flavonoids, and ascorbic acid – was studied in 14 types of medicinal plant raw materials and three plant-based compositions. A plant-based composition variant with the maximum BAS content was identified. The mutual influence of components on the extraction efficiency of BAS from the raw materials was established.

Conclusion. The plant-based medicinal composition for the complex therapy of tuberculosis was developed, and the main groups of BAS in its hydrophilic fraction were quantitatively determined.

1. Nguta J. M., Appiah-Opong R., Nyarko A. K., Yeboah-Manu D., Addo P. G. A. Medicinal plants used to treat TB in Ghana. International Journal of Mycobacteriology. 2015;4(2):116–123. DOI:10.1016/j.ijmyco.2015.02.003.

2. Pandit R., Singh P. K., Kumar V. Natural remedies against multi-drug resistant Mycobacterium tuberculosis. Journal of Tuberculosis Research. 2015;3(4):171–183. DOI: 10.4236/jtr.2015.34024.

3. Fauziyah P. N., Sukandar E. Y., Ayuningtyas D. K. Combination effect of antituberculosis drugs and ethanolic extract of selected medicinal plants against multi-drug resistant Mycobacterium tuberculosis isolates. Scientia Pharmaceutica. 2017;85(1):14. DOI: 10.3390/scipharm85010014.

4. Earl E. A., Altaf M., Murikoli R. V., Swift S., O’Toole R. Native New Zealand plants with inhibitory activity towards Mycobacterium tuberculosis. BMC Complementary and Alternative Medicine. 2010;10:25. DOI: 10.1186/1472-6882-10-25.

5. Salmerón-Manzano E., Garrido-Cardenas J. A., Manzano-Agugliaro F. Worldwide research trends on medicinal plants. International Journal of Environmental Research and Public Health. 2020;17(10):3376. DOI: 10.3390/ijerph17103376.

6. Ji H.-F., Li X.-J., Zhang H.-Y. Natural products and drug discovery: Can thousands of years of ancient medical knowledge lead us to new and powerful drug combinations in the fight against cancer and dementia. EMBO reports. 2009;10(3):194–200. DOI: 10.1038/embor.2009.12.

7. Anand U., Jacobo-Herrera N., Altemimi A., Lakhssassi N. A comprehensive review on medicinal plants as antimicrobial therapeutics: potential avenues of biocompatible drug discovery. Metabolites. 2019;9(11):258. DOI: 10.3390/metabo9110258.

8. Bassetti M., Poulakou G., Ruppe E., Bouza E., Van Hal S. J., Brink A. Antimicrobial resistance in the next 30 years, humankind, bugs and drugs: a visionary approach. Intensive Care Medicine. 2017;43:1464–1475. DOI: 10.1007/s00134-017-4878-x.

9. Dar R. A., Shahnawaz M., Qazi P. H. General overview of medicinal plants: A review. The Journal of Phytopharmacology. 2017;6(6):349–351. DOI: 10.31254/phyto.2017.6608.

10. Uritu C. M., Mihai C. T., Stanciu G.-D., Dodi G., Alexa-Stratulat T., Luca A., Leon-Constantin M.-M., Stefanescu R., Bild V., Melnic S., Tamba B. I. Medicinal plants of the family Lamiaceae in pain therapy: A review. Pain Research and Management. 2018;2018:7801543. DOI: 10.1155/2018/7801543.

11. Jain C., Khatana S., Vijayvergia R. Bioactivity of secondary metabolites of various plants: a review. International Journal of Pharmaceutical Sciences and Research. 2019;10(2):494–504. DOI: 10.13040/IJPSR.0975-8232.10(2).494-04.

12. Eliseeva T., Yampolsky A. Rosehip (lat. Rōsa). Journal of Healthy Nutrition and Dietetics. 2020;1(11):67–77. (In Russ.) DOI: 10.59316/.vi11.67.

13. Nuriddinovich K. F., Fazliddinovna N. D. Medicinal properties of rosa canina. ACADEMICIA: An International Multidisciplinary Research Journal. 2022;12(5):489–492. DOI: 10.5958/2249-7137.2022.00456.6.

14. Karatoprak G. Ş., İlgün S. Viburnum opulus L. In: Gürağaç Dereli F. T., Ilhan M., Belwal T. Novel Drug Targets With Traditional Herbal Medicines. Scientific and Clinical Evidence. Cham: Springer International Publishing; 2022. P. 569–583. DOI: 10.1007/978-3-031-07753-1_38.

15. Kim M. E., Murzagulova K. B., Evseeva S. B. Possibility of natural raw materials use in the formulation of adjuvant therapy of tuberculosis: experience of folk medicine, modern state of studies. Pharmacy & pharmacology. 2017;5(5):404–421. (In Russ.) DOI: 10.19163/2307-9266-2017-5-5-404-421.

16. Kajszczak D., Zakłos-Szyda M., Podsędek A. Viburnum opulus L.—A review of phytochemistry and biological effects. Nutrients. 2020;12(11):3398. DOI: 10.3390/nu12113398.

17. Burlacu E., Nisca A., Tanase C. A comprehensive review of phytochemistry and biological activities of Quercus species. Forests. 2020;11(9):904. DOI: 10.3390/f11090904.

18. Şöhretoğlu D., Renda G. The polyphenolic profile of Oak (Quercus) species: A phytochemical and pharmacological overview. Phytochemistry Reviews. 2020;19(6):1379–1426. DOI: 10.1007/s11101-020-09707-3.

19. Zhao Y., Li J., Cao G., Zhao D., Li G., Zhang H., Yan M. Ethnic, Botanic, Phytochemistry and Pharmacology of the Acorus L. Genus: A Review. Molecules. 2023;28(20):7117. DOI: 10.3390/molecules28207117.

20. Yadav D., Srivastava S., Tripathi Y. B. Acorus calamus: A review. International Journal of Scientific Research in Biological Sciences. 2019;6(4):62–67. DOI: 10.26438/ijsrbs/v6i4.6267.

21. Rante H., Alam G., Permana A. D., Burhamzah R., Ali A., Budiarti M. Investigation of Antituberculosis from Medicinal Plant of Community Ethnic in South Sulawesi. Infectious Disorders - Drug Targets. 2020;20(6):893–897. DOI: 10.2174/1871526520666191216121302.

22. Patil P., Joshi S., Prajapati A. K. A review on plants possesses anti tubercular activity. Journal of Preventive Medicine and Holistic Health. 2023;9(2):50–56. DOI: 10.18231/j.jpmhh.2023.012.

23. Tin N. H., Tien N. M., Tien L. T. D., Trinh B. T. N., Van Thanh V., Khang D. T., Hang P. T., Yen T. H., Hai T. Q., Tam T. T. T. Phytochemical and pharmacological review of licorice (Glycyrrhiza sp.) - A traditional local herb for the future of medicine. Tạp chí Y Dược học Cần Thơ. 2022;8(4):71–80. DOI: 10.58490/ctump.2022i4.473.

24. Ji X., Liu N., Huang S., Zhang C. A comprehensive review of licorice: the preparation, chemical composition, bioactivities and its applications. The American Journal of Chinese Medicine. 2024;52(3):667–716. DOI: 10.1142/S0192415X24500289.

25. Shaikh S., Ahmad K., Lim J. H., Ahmad S. S., Lee E. J., Choi I. Biological insights and therapeutic potential of Glycyrrhiza uralensis and its bioactive compounds: an updated review. Archives of Pharmacal Research. 2024;47:871–892. DOI: 10.1007/s12272-024-01522-0.

26. Sun J., Zhang Q., Yang G., Li Y., Fu Y., Zheng Y., Jiang X. Isoliquiritigenin attenuates Mycobacterium tbuerculosis-induced inflammation through Notch1/NF-kB and MAPK signaling pathways. Journal of Ethnopharmacology. 2022;294:115368. DOI: 10.1016/j.jep.2022.115368.

27. Zhou X., Zhao L., Liu X., Li X., Jia F., Zhang Y., Wang Y. Antimycobacterial and synergistic effects of 18β-Glycyrrhetinic acid or glycyrrhetinic acid-30-piperazine in combination with isoniazid, rifampicin or streptomycin against Mycobacterium bovis. Phytotherapy Research. 2012;26(2):253–258. DOI: 10.1002/ptr.3536.

28. Bobkova N. V., Kulikova L. A. Medicinal plants in the treatment and prevention of respiratory diseases (review). Herbarium. 2025;2(1):40–53. (In Russ.) DOI: 10.33380/3034-3925-2025-2-1-18.

29. Ermakova V. A., Samylina I. A., Kovaleva T. Yu., Brovchenko B. V., Dorovskikh E. A., Bobkova N. V. Licorice (Glycyrrhiza) roots: analysis of the requirements of the pharmacopoeia. Pharmacy. 2019; 68(6):16–19. (In Russ.) DOI: 10/29296/25419218-2019-06-03.

30. Ali S. I., Gopalakrishnan B., Venkatesalu V. Pharmacognosy, phytochemistry and pharmacological properties of Achillea millefolium L.: a review. Phytotherapy Research. 2017;31(8):1140–1161. DOI: 10.1002/ptr.5840.

31. Al-Snafi A. E. The pharmacology of Equisetum arvense - A review. IOSR Journal of Pharmacy. 2017;7(2):31–42. DOI: 10.9790/3013-0702013142.

32. Kizi K. S. A. Pharmacological properties of Plantago major L. and its active constituents. International Journal of Medical Science and Public Health Research. 2022;3(4):9–12. DOI: 10.37547/ijmsphr/Volume03Issue04-03.

33. Pelapelapon A. A., Rohmawaty E., Herman H. Evaluation of the hepatoprotective effect of Plantago major extract in a rifampicin-isoniazid induced hepatitis rat model. Trends in Sciences. 2023;20(4):6331. DOI: 10.48048/tis.2023.6331.

34. Dănăilă-Guidea S. M., Eremia M. C., Dinu L. D., Miu D.-M. Helichrysum arenarium: From cultivation to application. Applied Sciences. 2022;12(20):10241. DOI: 10.3390/app122010241.

35. Umaz A., Umaz K., Aydın F., Aydın I. Determination of multi-elemental analysis and antioxidant activities of Helichrysum arenarium (L.) Moench species. Hacettepe University Journal of the Faculty of Pharmacy. 2023;43(2):128–141. DOI: 10.52794/hujpharm.1118558.

36. Jalil B., Pischel I., Feistel B., Suarez C., Blainski A., Spreemann R., Roth-Ehrang R., Heinrich M. Wild thyme (Thymus serpyllum L.): a review of the current evidence of nutritional and preventive health benefits. Frontiers in Nutrition. 2024;11:1380962. DOI: 10.3389/fnut.2024.1380962.

37. Jarić S., Mitrović M., Pavlović P. Review of ethnobotanical, phytochemical, and pharmacological study of Thymus serpyllum L. Evidence-Based Complementary and Alternative Medicine. 2015;2015:101978. DOI: 10.1155/2015/101978.

38. Pourazar Dizaji Sh., Soleimani N., Afrugh P., Saedi S. In vitro antibacterial activity of Thymus vulgaris essential oil against Mycobacterium tuberculosis. Infection Epidemiology and Microbiology. 2018;4(2):47–51. DOI: 10.29252/modares.iem.4.2.47.

39. Dhakal N., Joshi R., Acharya S., Bhandari S., Subedi A., Nath M. Exploring the diverse ethnopharmacological applications of Urtica dioica L.: an extensive review. Journal of Agricultural Sciences and Engineering. 2024;6(2):60–72. DOI: 10.48309/jase.2024.192244.

40. Puri S., Shrivastava R. Study of Antimicrobial Properties of Himalayan Flora against Pathogenic Bacterial Species. Solan: Jaypee University of Information Technology; 2019. 46 p.

41. Soltani S., Shakeri A., Iranshahi M., Boozari M. A review of the phytochemistry and antimicrobial properties of Origanum vulgare L. and subspecies. Iranian Journal of Pharmaceutical Research. 2021;20(2):268–285. DOI: 10.22037/ijpr.2020.113874.14539.

42. Li X.-T., Zhou J.-C., Zhou Y., Ren Y.-S., Huang Y.-H., Wang S.-M., Tan L., Yang Z.-Y., Ge Y.-W. Pharmacological effects of Eleutherococcus senticosus on the neurological disorders. Phytotherapy Research. 2022;36(9):3490–3504. DOI: 10.1002/ptr.7555.

43. Li X., Chen C., Leng A., Qu J. Advances in the extraction, purification, structural characteristics and biological activities of Eleutherococcus senticosus polysaccharides: a promising medicinal and edible resource with development value. Frontiers in Pharmacology. 2021;12:753007. DOI: 10.3389/fphar.2021.753007.

44. Zhang S., Wang Y., Liu T., Li X., Wang M., Qiu Y. Optimization of the extraction process of effective components of Eleutherococcus senticosus using mathematical models. Journal of Food Quality. 2024;1:1–13. DOI: 10.1155/2024/5538373.

45. Gerontakos S., Taylor A., Avdeeva A. Y., Shikova V. A., Pozharitskaya O. N., Casteleijn D., Wardle J., Shikov A. N. Findings of Russian literature on the clinical application of Eleutherococcus senticosus (Rupr. & Maxim.): A narrative review. Journal of Ethnopharmacology. 2021;278:114274. DOI: 10.1016/j.jep.2021.114274.

46. Bhusal K. K., Magar S. K., Thapa R., Lamsal A., Bhandari S., Maharjan R., Shrestha S., Shrestha J. Nutritional and pharmacological importance of stinging nettle (Urtica dioica L.): A review. Heliyon. 2022;8(6):e09717. DOI: 10.1016/j.heliyon.2022.e09717.

47. Lombrea A., Antal D., Ardelean F., Avram S., Pavel I. Z., Vlaia L., Mut A.-M., Diaconeasa Z., Dehelean C. A., Soica C., Danciu C. A recent insight regarding the phytochemistry and bioactivity of Origanum vulgare L. essential oil. International Journal of Molecular Sciences. 2020;21(24):9653. DOI: 10.3390/ijms21249653.

48. De Santis F., Poerio N., Gismondi A., Nanni V., Di Marco G., Nisini R., Thaller M. C., Canini A., Fraziano M. Hydroalcoholic extract from Origanum vulgare induces a combined anti-mycobacterial and anti-inflammatory response in innate immune cells. PLoS ONE. 2019;14(3):e0213150. DOI: 10.1371/journal.pone.0213150.

49. Jurkšienė G., Sirgedaitė-Šėžienė V., Juškauskaitė A., Baliuckas V. Identification of Alnus incana (L.) Moenx. × Alnus glutinosa (L.) Gaertn. hybrids using metabolic compounds as chemotaxonomic markers. Forests. 2023;14(1):150. DOI: 10.3390/f14010150.

50. Dahija S., Čakar J., Vidic D., Maksimović M, Parić A. Total phenolic and flavonoid contents, antioxidant and antimicrobial activities of Alnus glutinosa (L.) Gaertn., Alnus incana (L.) Moench and Alnus viridis (Chaix) DC. extracts. Natural Product Research. 2014;28(24):2317–2320. DOI: 10.1080/14786419.2014.931390.

51. Li H., Webster D., Johnson J. A., Gray C. A. Anti-mycobacterial triterpenes from the Canadian medicinal plant Alnus incana. Journal of Ethnopharmacology. 2015;165:148–151. DOI: 10.1016/j.jep.2015.02.042.

52. Ushanova V. M., Voronin V. M., Repyakh S. M. Study of the influence of components of medicinal plant raw materials on the composition of the obtained extracts. Chemistry of plant raw materials. 2001;3:105–110. (In Russ.)

53. Le T. M., Nguyen Ch. D., Ha A. C. Combination of Phyllanthus amarus Schum. & Thonn. and Gymnema sylvestre R. Br. for treatment of diabetes and its long-term complications. Fine Chemical Technologies. 2021;16(3):232–240. DOI: 10.32362/2410-6593-2021-16-3-232-240.