The Potential of Natural Diterpenes Against Tuberculosis: An Updated Review

Every year, 10 million people are affected by tuberculosis (TB). Despite being a preventable and curable disease, 1.5 million people die from TB each year, making it the world's top infectious disease. Many of the frontline antibiotics cause painful and disagreeable side effects. To mitigate the side effects from the use of chemically synthesized or clinical anti-tubercular drugs, there are many research studies focussed on natural products as a source of potential anti-tuberculosis drugs. Among different phytoconstituents, several classes of diterpenoids exert significant antimicrobial effects. This review explores diterpenoids as potential anti-tubercular drugs from natural sources. A total of 204 diterpenoids isolated from medicinal plants and marine species are discussed that inhibit the growth of Mycobacterium tuberculosis. The literature from 1994-2018 is reviewed, and 158 diterpenoids from medicinal plants, as well as 40 diterpenoids from marines, are alluded to have antituberculosis properties. The antitubercular activities discussed in the review indicate that the type of diterpenoids, the Mtb strains, substituents attached to diterpenoids and their position in the diterpenoids general skeleton can change the compounds antimycobacterial inhibitory effects.