Ranganathan N Iyer, Eswara Prasad Chelluri and Lakshmi Kiran Chelluri
Multi drug resistant tuberculosis in patients with co-morbidities such as diabetes mellitus, HIV and other respiratory disorders is a major challenge for intervention. There is an upsurge in these cases in South East Asia and Africa. Failed therapy protocols of MDR/XDR tuberculosis has placed a demand for new therapeutic strategies. Immunotherapy has been in vogue for a long time with negligible success rates. Co-morbidities in patients compound and complicate the existing treatment options which necessitate a search for amenable and comprehensive treatment protocols. One such approach is mesenchymal stem cell adjunct therapy t for MDR/XDR- TB. Whilst Mesenchyma stem cells are an interesting option, inherent problems related to the dose and timing of administration warrant extensive clinical research before their acceptance in clinical management protocols. The mechanism of action of these cells is illunderstood at the present time and awaits further supportive experimental data. It appears that stem cell therapy could be an option to complement existing therapeutic protocols for the management of drug resistant tuberculosis. The current review deals with the mechanistic and surrogate markers of therapeutic benefit of such novel approaches.