Oxidative Stress and Reduced Vitamins C and E Levels Are Associated with Multi-Drug Resistant Tuberculosis

Abstract

Background: Tuberculosis (TB) still remains a major cause of morbidity and mortality worldwide. In Nigeria, there is little information on antioxidant status of TB patients. In this study, effects of oxidative stress markers and vitamins C and E were investigated in pulmonary TB patients attending a health care facility in Nigeria. Methods: Sputum specimens were processed for acid-fast bacilli (AFB) while rifampicin resistance was determined by GeneXpert/Rif assay. Patients were screened for HIV after adequate counselling. Assays for hydrogen peroxide (H 2 O 2), malondialdehyde (MDA), protein carbonyl (PC), myeloperoxidase (MPx), xanthine oxidase (XO), catalase (CAT), superoxide dismutase (SOD), reduced glutathione (GSH), glutathione S-transferase (GST), glutathione peroxidase (GPx), α-tocopherol and ascorbic acid were estimated using standard methods. Results: Of the 83 recruited subjects, 29 (34.9%) were AFB negative, 30 (36.1%) were AFB positive while 24 (29.0%) were positive for rifampicin resistance. Overall, HIV prevalence was 6.0% while higher rate of 16.7% was found among the rifampicin resistant subjects. Plasma concentrations of H2O2, MDA and PC and also MPx and XO activities were significantly higher among rifampicin resistant subjects compared with AFB positive and AFB negative groups (P < 0.05). Plasma concentration of GSH and the activities of SOD, GST and GPX were significantly reduced in rifampicin resistant subjects compared with the 2 other groups (P < 0.05). The plasma activity of CAT was similar between rifampicin resistant and AFB positive subjects but significantly lower when compared with AFB negative group. Rifampicin resistant subjects had significantly lower concentrations of α-tocopherol and ascorbic acid compared with 2 other groups (P < 0.05). Conclusion: This study revealed that resistance of TB patients to rifampicin may be due to induction of oxidative stress. Administration of vitamins C and E may be beneficial by reducing the severity of the disease.

The Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis of &lt;i&gt;Mycobacterium tuberculosis&lt;/i&gt;: A Systematic Review

“…However, if the compounds are present in detectable concentrations in the breath of TB patients, then this could be a game-changer in the battle against this pathogen [44]. Although an automated rapid nucleic acid amplification test has been endorsed by WHO recently, this technology and other WHO -endorsed diagnostic methods are not yet widely available in most countries, particularly in sub-saharan Africa and Asia where the disease is of high-burden [40]. The unavailability of the rapid methods are serious challenges to early detection of the pathogen, thereby enhancing opportunity for persistence of the bacterium in the population.…”

“…TB care for children is not consistently integrated into HIV and primary health care and maternal and child health programmes. Patient-centred approaches are not fully established in most high-burden MDR-TB countries and there is a lack of mechanisms/initiatives for communitybased treatment [40]. Consequently, management of TB in children is outdated in some countries.…”

“…These include: Behavioral indulgence in risk factors such as smoking and alcohol consumption. Both globally and regionally, TB and MDR-TB occur among men than women owing to risk factors such as smoking, alcohol consumption or imprisonment [40] which may lead to immunosuppression and predispose the subject to opportunistic infections.…”

“…Multidrug-and extensively drug-resistant tuberculosis (M/XDR-TB) is a man-made phenomenon that emerges as a result of inadequate treatment of tuberculosis and/or poor airborne infection control in health care facilities and congregate settings. In 2009, almost 330,000 new and relapsed cases of TB (5.6% of the global burden) and more than 46,000 deaths due to TB were reported in the WHO European Region, the majority of them in 18 countries which have made it a high priority to stop TB [40]. Among the main causes for the emergence of MDR-TB is inadequate and inappropriate treatment.…”

Biochemical changes in blood and tissues of Wistar rats following administration of anti-tuberculosis drugs

“…Specifically, in PTB infection, tissue inflammation secondary to release of free radicals from macrophages, poor dietary intake of micronutrients and side effects of anti-TB drugs were factors contributing to oxidative stress (Wiid et al, 2004). Availability of antioxidants to neutralise the harmful effects of the generated free radicals may be one of the factors determining severity of the disease (Alli et al, 2014). High serum concentration of lipid peroxidation (Kwiatkowka et al, 1999) and low plasma cholesterol levels were reportedly seen in PTB infection (Akiibinu et al, 2007).…”