Oxidative stress and immunological complexities in multidrug-resistant tuberculosis

Mycobacterium tuberculosis (Mtb), the causitive agent of Tuberculosis (TB) is the leading cause of infection. The infection is caused by aerosols and infects the alveolar macrophage. The lungs counteract against the infection by the antioxidant system in response to the oxidative stress (OS) caused. Mycobacteriumstimulates the lung macrophage to produce reactive oxygen species (ROS). Furthermore, the treatment involves long term multiple drug regimens resulting in poor patient compliance leading to multidrug resistance (MDR-TB). The different first-line and second-line antibiotics are administered in an inactive form which gets converted into the active form by the OS response system of the host and the Mtb. Mtb alters the redox balance via mycolic acid, NADH/NAD+ ratio, and antioxidant enzymes in response to stress. In the following chapter, we have discussed the role of oxidative stress in the host and the pathogen along with the immunological complexities and the genetic modifications resulting in multidrug-resistant tuberculosis. It also discusses the different strategies to target the Mtb infection.