Role of Oxidative Stress in the Pathology and Management of Human Tuberculosis

Figure 1

Interplay of oxidative stress and tuberculosis. Infection with drug-susceptible or MDR-TB can lead to active clinical disease in humans prompting diagnosis and the prescription of first- or second-line drugs, respectively. TB disease also leads to increased oxidative burden (ROS, RNI) in the lung that aids in the activation of TB prodrugs. Supplements such as vitamin C may augment the treatment of TB by inhibiting the emergence of “persisters” through mechanisms including downregulation of mycobacterial siderophore biosynthesis. Unsuccessful treatment can lead to subsequent TB relapse. Mycobacterium tuberculosis can also remain dormant in the host during a latent TB infection. Administration of supplements (cysteine, vitamin C, and AC2P36) may provide a pathway for inhibiting the reactivation of latent TB potentially by increasing the intramycobacterial OS and alteration in “lipid/thiol” biosynthesis.