Research Journal of Pharmacy and Technology

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Overview of Metformin as a Host Targeted Therapy in Tuberculosis


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1 Department of Pharmacy Practice, SRM College of Pharmacy, SRMIST, Kattankulathur, India
     

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Tuberculosis is a communicable disease caused by the organism Mycobacterium tuberculosis, the mortality and morbidity due to TB remains immense. Diabetes is a metabolic disorder where TB is an airborne infectious disease, but both are found to be interrelated. TB can trigger the diabetes and also worsen the glycaemic level in patients with pre-existing Diabetes. TB patients are at risk of developing diabetes owing to glucose intolerance. Most of the people with TB are usually diagnosed with DM at a later stage. Conversely, uncontrolled diabetes may leads to increased susceptibility to infections such as TB at immunological and cellular level. The current treatment for the tuberculosis is very effective, but the emergence of multi-drug resistance are inevitable, which drives us to develop new therapy for TB. Metformin as a Host directed therapy helps to reduce the intracellular growth of Mycobacterium tuberculosis in both diabetic and non-diabetic patients. Metformin works by activating AMPK (Adenosine monophosphate kinase), thus inhibits the intracellular growth and restricts the immunopathology of Mycobacterium tuberculosis. Therefore, incorporating metformin into the present standard TB regimen would be a better therapeutic option for TB.

Keywords

Tuberculosis, Metformin, Diabetes Mellitus, Host-Directed Therapy, Immune Response.
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  • Naik B, Kumar AM, Satyanarayana S, Suryakant MD, Swamy NM, Nair S, Isaakidis P, Harries AD. Is screening for diabetes among tuberculosis patients feasible at the field level? Public Health Action. 2013 Nov 4; 3(1):34-7

  • Sagavkar Sandhyarani R, Devkar Swati R. Tuberculosis: A Review. Asian J. Pharm. Res. 2018; 8(3): 191-194.

  • Restrepo BI, Camerlin AJ, Rahbar MH, Wang W, Restrepo MA, Zarate I, Mora-Guzmán F, Crespo-Solis JG, Briggs J, McCormick JB, FisherHoch SP. Cross-sectional assessment reveals high diabetes prevalence among newly-diagnosed tuberculosis cases. Bulletin of the World Health Organization. 2011; 89: 352-9.

  • Hazaratali Panari, Vegunarani. M. Study on Complications of Diabetes Mellitus among the Diabetic Patients. Asian J. Nur. Edu. and Research. 2016; 6(2): 171-182.

  • Balakrishnan S, Vijayan S, Nair S, Subramoniapillai J, Mrithyunjayan S, Wilson N, Satyanarayana S, Dewan PK, Kumar AM, Karthickeyan D, Willis M. High diabetes prevalence among tuberculosis cases in Kerala, India. PloS one. 2012 Oct 15; 7(10): e46502.

  • Sandip Zine, Shweta A. Patankar, Sushmita S. Raopati. Rise of Antibiotic Resistance in Tuberculosis. Research J. Pharm. and Tech 2018; 11(7): 3201-3204

  • Karumbi J, Garner P. Directly observed therapy for treating tuberculosis. The Cochrane database of systematic reviews. 2015 May 29(5):1.

  • Joshi JM. Tuberculosis chemotherapy in the 21st century: Back to the basics. Lung India: Official Organ of Indian Chest Society. 2011 Jul; 28(3):193.

  • Beysel S, Unsal IO, Kizilgul M, Caliskan M, Ucan B, Cakal E. The effects of metformin in type 1 diabetes mellitus. BMC endocrine disorders. 2018 Dec; 18(1):1.

  • Rojas LB, Gomes MB. Metformin: an old but still the best treatment for type 2 diabetes. Diabetology& metabolic syndrome. 2013 Dec; 5(1):6.

  • Annette Babu, Ravichandran Veerasamy, Shalini Sivadasan. Metformin- A Drug of Plant Origin. Research J. Pharm. and Tech 2018; 11(6): 2701-2708.

  • Wang YW, He SJ, Feng X, Cheng J, Luo YT, Tian L, Huang Q. Metformin: a review of its potential indications. Drug design, development and therapy. 2017; 11: 2421.

  • Lee YJ, Han SK, Park JH, Lee JK, Kim DK, Chung HS, Heo EY. The effect of metformin on culture conversion in tuberculosis patients with diabetes mellitus. The Korean journal of internal medicine. 2018 Mar 16.

  • Kaufmann SH, Dorhoi A, Hotchkiss RS, Bartenschlager R. Hostdirected therapies for bacterial and viral infections. Nature Reviews Drug Discovery. 2018 Jan; 17(1):35.

  • Marupuru S, Senapati P, Pathadka S, Miraj SS, Unnikrishnan MK, Manu MK. Protective effect of metformin against tuberculosis infections in diabetic patients: an observational study of south Indian tertiary healthcare facility. Brazilian Journal of Infectious Diseases. 2017 Jun;21(3): 312-6.

  • Mihaylova MM, Shaw RJ. The AMPK signalling pathway coordinates cell growth, autophagy and metabolism. Nature cell biology. 2011 Sep;13(9): 1016.

  • Singhal A, Jie L, Kumar P, Hong GS, Leow MK, Paleja B, Tsenova L, Kurepina N, Chen J, Zolezzi F, Kreiswirth B. Metformin as adjunct antituberculosis therapy. Sci Transl Med 6: 263ra159.

  • Winslow GM, Cooper A, Reiley W, Chatterjee M, Woodland DL. Early T‐cell responses in tuberculosis immunity. Immunological reviews. 2008 Oct; 225(1): 284-99.

  • Suleiman S, Azhar S, Aweis I, Daud M, Mohamed AJ, Razak Muttalif A, Moussa MA. Role of diabetes in the prognosis and therapeutic outcome of tuberculosis. International journal of endocrinology. 2012; 2012.

  • Tseng CH. Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients. Journal of clinical medicine. 2018 Sep 9; 7(9):264.

  • Aishwarya J. Ramalingam. History of Antibiotics and Evolution of Resistance. Research J. Pharm. and Tech. 8(12): Dec., 2015; Page 1719-1724

  • J. Divya Maria, Vijey Aanandhi. M. An Overview on Antibiotic use and resistance. Research J. Pharm. and Tech. 2017; 10(8): 2793-2796.

  • Sreeja. M.K, Gowrishankar N.L, Adisha. S, Divya. K.C. Antibiotic Resistance-Reasons and the Most Common Resistant Pathogens – A Review. Research J. Pharm. and Tech. 2017; 10(6): 1886-1890.

  • Abdullah Noor-Hashimah, Nyi Nyi Naing, Che Wan Aminuddin, Wan Mohammad Wan Mohd Zahiruddin, Hamzah Wan Mansor, Hussin Hani, Salleh Rosemi, Nadiah Wan-Arfah. Health Service Delays in Diagnosis and Treatment among Tuberculosis Patients in Kelantan, Malaysia. Research J. Pharm. and Tech 2018; 11(8): 3711-3717

  • Abdullah Noor-Hashimah, Nyi Nyi Naing, Che Wan Aminuddin, Wan Mohammad Wan Mohd Zahiruddin, Hamzah Wan Mansor, Hussin Hani, Salleh Rosemi, Nadiah Wan-Arfah. Health Service Delays in Diagnosis and Treatment among Tuberculosis Patients in Kelantan, Malaysia. Research J. Pharm. and Tech 2018; 11(8): 3711-3717.

  • P. Mangala Gowri, G. Bhuvaneswari, C. Manoj, R. Varatharajan, Subhashini, Jomcy, Epsimal. Assess the knowledge and associated factors of DOTS defaulter among Tuberculosis clients. Research J. Pharm. and Tech 2018; 11(6):2313-2316.


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  • Overview of Metformin as a Host Targeted Therapy in Tuberculosis

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Authors

A. Priyadharshini
Department of Pharmacy Practice, SRM College of Pharmacy, SRMIST, Kattankulathur, India
S. P. Ahalya
Department of Pharmacy Practice, SRM College of Pharmacy, SRMIST, Kattankulathur, India
Maria Alex
Department of Pharmacy Practice, SRM College of Pharmacy, SRMIST, Kattankulathur, India
Sunitha Elza Mathew
Department of Pharmacy Practice, SRM College of Pharmacy, SRMIST, Kattankulathur, India

Abstract


Tuberculosis is a communicable disease caused by the organism Mycobacterium tuberculosis, the mortality and morbidity due to TB remains immense. Diabetes is a metabolic disorder where TB is an airborne infectious disease, but both are found to be interrelated. TB can trigger the diabetes and also worsen the glycaemic level in patients with pre-existing Diabetes. TB patients are at risk of developing diabetes owing to glucose intolerance. Most of the people with TB are usually diagnosed with DM at a later stage. Conversely, uncontrolled diabetes may leads to increased susceptibility to infections such as TB at immunological and cellular level. The current treatment for the tuberculosis is very effective, but the emergence of multi-drug resistance are inevitable, which drives us to develop new therapy for TB. Metformin as a Host directed therapy helps to reduce the intracellular growth of Mycobacterium tuberculosis in both diabetic and non-diabetic patients. Metformin works by activating AMPK (Adenosine monophosphate kinase), thus inhibits the intracellular growth and restricts the immunopathology of Mycobacterium tuberculosis. Therefore, incorporating metformin into the present standard TB regimen would be a better therapeutic option for TB.

Keywords


Tuberculosis, Metformin, Diabetes Mellitus, Host-Directed Therapy, Immune Response.

References