Tuberculosis is a highly infectious disease declared a global health emergency by the World Health Organization, with approximately one third of the world's population being latently infected with Mycobacterium tuberculosis. Tuberculosis treatment consists in an intensive phase and a continuation phase. Unfortunately, the appearance of multi drug-resistant tuberculosis, mainly due to low adherence to prescribed therapies or inefficient healthcare structures, requires at least 20 months of treatment with second-line, more toxic and less efficient drugs, i.e., capreomycin, kanamycin, amikacin and fluoroquinolones. Therefore, there exists an urgent need for discovery and development of new drugs to reduce the global burden of this disease, including the multi-drug-resistant tuberculosis. To this end, many plant species, as well as marine organisms and fungi have been and continue to be used in various traditional healing systems around the world to treat tuberculosis, thus representing a nearly unlimited source of active ingredients. Besides their antimycobacterial activity, natural products can be useful in adjuvant therapy to improve the efficacy of conventional antimycobacterial therapies, to decrease their adverse effects and to reverse mycobacterial multi-drug resistance due to the genetic plasticity and environmental adaptability of Mycobacterium. However, even if some natural products have still been investigated in preclinical and clinical studies, the validation of their efficacy and safety as antituberculosis agents is far from being reached, and, therefore, according to an evidence-based approach, more high-level randomized clinical trials are urgently needed.

结核病是一种高度传染性疾病，被世界卫生组织宣布为全球卫生紧急事件，世界上约三分之一的人口潜伏感染结核分枝杆菌。结核病治疗包括强化阶段和持续阶段。不幸的是，多重耐药结核病的出现，主要是由于对处方疗法的依从性较低或医疗机构效率低下，需要使用二线、毒性更大且效率较低的药物（即药物）进行至少 20 个月的治疗。例如，卷曲霉素、卡那霉素、阿米卡星和氟喹诺酮类药物。因此，迫切需要发现和开发新药以减轻这种疾病（包括耐多药结核病）的全球负担。为此，许多植物物种以及海洋生物和真菌已经并将继续用于世界各地的各种传统治疗系统中来治疗结核病，从而代表了几乎无限的活性成分来源。除了其抗分枝杆菌活性外，由于分枝杆菌的遗传可塑性和环境适应性，天然产物还可用于辅助治疗，以提高常规抗分枝杆菌疗法的疗效，减少其不良反应并逆转分枝杆菌的多重耐药性。然而，即使一些天然产物仍在临床前和临床研究中进行研究，其作为抗结核药物的有效性和安全性的验证还远远没有达到，因此，根据基于证据的方法，需要更高水平的随机研究迫切需要进行临床试验。