Coenzyme F420 (F420)

Coenzyme F420 is a specialized, low-potential redox cofactor found in certain bacteria and archaea, including mycobacteria such as *Mycobacterium tuberculosis*. It functions as an electron carrier for various enzymes involved in redox reactions, and is essential for the survival of *M. tuberculosis* under host immune stress, drug activation, and detoxification. Alterations in F420 structure or abundance can impact susceptibility to anti-TB drugs. Its unique presence and essentiality make it an attractive target for therapeutic intervention against TB infections.

Coenzyme F420 is essential for the activation of drugs like delamanid and pretomanid, which are prodrugs that require reduction by F420-dependent enzymes to become active. Inhibiting F420 biosynthesis or function prevents drug activation and leads to resistance.