Photodynamic therapy: A paradigm shift in overcoming drug‑resistant tuberculosis (Review)

Tuberculosis (TB) poses a notable threat to global public health. Conventional antibiotic treatments are hampered by long treatment courses, notable toxicity and rising levels of drug resistance. By contrast, photodynamic therapy (PDT) offers a promising alternative to antibiotics. This approach employs photosensitizers (PSs), light and oxygen to generate reactive oxygen species, which induce oxidative stress to eliminate Mycobacterium tuberculosis. The present review explores the mechanisms, benefits and primary challenges of PDT in the context of TB treatment. The present review also discusses advanced strategies that address hurdles, such as the robust mycobacterial cell wall, hypoxic environments and biofilm formation. These strategies include rational PS design, innovative nanodelivery systems and synergistic combination therapies. The present review also explores pathways for future clinical translation, highlighting the potential of PDT as a viable supplement or alternative to traditional TB chemotherapy through interdisciplinary innovation.