One of the problems of tuberculosis treatment is that it takes months of antibiotics to kill the TB pathogen; it is for this reason that patients drop out midway and the bacteria develops resistance.
Vitamin C could make TB drugs work faster
A new study published in Antimicrobial agents and chemotherapy shows that vitamin C could expedite the action of TB drugs. In the study, the investigators treated Mycobacterium tuberculosis-infected mice with anti-tuberculosis drugs or vitamin C alone, or the drugs and vitamin C together. They measured M. tuberculosis (Mtb) organ burdens at four and six weeks post treatment.
India has the most TB patients
India has the largest TB burden in the world, the bacterial infection kills an estimated 480,000 Indians every year and more than 1,400 every day, a large fraction of those patients are infected by a bacteria that has some degree of resistance to standard TB drugs. India had the second highest total number of estimated MDR TB cases (99,000) in 2008, after China (100,000 cases). Vitamin C is a low cost drug so if subsequent studies prove its efficacy in making TB antibiotics more potent there may be implications for TB eradication in India and the world.
Vitamin C had no activity by itself, but in two independent experiments, the combination of vitamin C with the first-line TB drugs, isoniazid and rifampicin, reduced the organ burdens faster than the two drugs without vitamin C, said first author Catherine J. Vilcheze, Instructor Department of Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY.
The study shows that the addition of vitamin C to TB drug treatment potentiates the killing of Mtb and could shorten TB chemotherapy
Experiments in infected tissue cultures demonstrated similar results, shortening the time to sterilization of the tissue culture by seven days.
“Our study shows that the addition of vitamin C to TB drug treatment potentiates the killing of Mtb and could shorten TB chemotherapy
That’s important because treatment of drug susceptible tuberculosis takes six months resulting in some treatment mismanagement, potentially leading to the emergence and spread of drug-resistant TB,” said principal investigator William R. Jacobs Jr Investigator, Howard Hughes Medical Institute, Einstein College of Medicine.
In earlier studies, the investigators discovered that while high levels of vitamin C will kill actively dividing TB infected cells, lower concentrations will stimulate respiration and prevent the formation of persisters, said Dr. Jacobs. Then, in the presence of TB drugs, that increased respiration will lead to rapid death of the cells.
A French study conducted in 1948 suggested that vitamin C was safe for humans, and potentially beneficial. Investigators gave high daily doses of vitamin C to terminally ill patients with no side effects. While the infection did not regress, that study characterized other effects as “remarkable:” bedridden patients regained appetite and physical activity.
