Antacids Can Speed Up Tuberculosis Treatment

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Highlights:

• Tuberculosis typically takes months to treat with multiple drugs
• Shortening the duration of tuberculosis treatment is needed to thwart the global burden of the disease
• Commonly available and already approved antacids shorten the duration of treatment and stop the bacteria to become antibiotic-resistant

Tuberculosis (TB) may be curable with shorter treatments, suggest the findings of a study that was published in the Proceedings of the National Academy of Sciences (PNAS).

Reducing the Global Burden of Tuberculosis

TB is routinely treated for months using a combination of medications. This creates logistical difficulties in finishing treatment for a large number of persons. As a result, it is commonly agreed that shorter TB treatment is required to reduce the disease's global burden.

Using Antacids to Treat Tuberculosis

Heartburn medications such as omeprazole, pantoprazole, lansoprazole, and rabeprazole are inexpensive, widely available, safe, and previously approved. The researchers discovered that these medications prevent the germs that cause tuberculosis from developing resistance to antibiotics used to treat the sickness.

Professor Lalita Ramakrishnan and colleagues from the University of Cambridge and the Medical Research Council Laboratory of Molecular Biology in Cambridge led the study.

‘Researchers discovered that over-the-counter medications widely used to treat heartburn could cut tuberculosis treatment time by half. These medications may also minimize the likelihood of the bacterium that causes tuberculosis becoming antibiotic resistant.’

Professor Ramakrishnan and her colleagues set out to discover why TB therapy typically entails taking antibiotics for several months.

In 2021, an estimated 10.6 million individuals worldwide became ill with tuberculosis, and 1.6 million died as a result of the disease.

Why Treating Tuberculosis Takes Long

When we are infected, TB bacteria penetrate our tissues and invade macrophages, which are immune system cells. When they arrive, they activate pumps in their cell membranes that release the antibiotics we use against them. This makes the germs resistant to medications, which is why treating tuberculosis takes so long.

Ramakrishnan and her colleagues decided to examine whether verapamil, a cardiac and blood pressure medicine that blocks human cell membrane pumps, could also block the bacterial cell membrane pump in this current investigation.

To accomplish this, they used an ingenious method in which they tagged an antibiotic often used to treat tuberculosis, rifampicin, with a fluorescent marker to watch exactly how the bacteria processed the medicine. This allowed them to see for themselves that verapamil does indeed prevent the bacteria from ejecting rifampicin.

The researchers next wondered if other medications often used to treat a variety of illnesses that also happen to block human cell membrane pumps could have the same effect on the TB bacterial pumps as verapamil.

Common OTC Medicine Helps with Tuberculosis Treatment

Professor Lalita Ramakrishnan said, "That's when my Ph.D. student, Alex Lake, decided to screen these drugs and bingo, many of them worked. The most stunning of all was the class of proton pump inhibitors that are among the most widely used, over-the-counter drugs for heartburn, reflux, and gastritis - omeprazole, pantoprazole, lansoprazole, rabeprazole. Not only do they work, but they work as well as or possibly with even greater potency than verapamil. This is very cool because one of the holy grails of TB treatment is whether can we come up with shortening regimes. And since active drug pumps are thought to enable bacteria to develop drug resistance, there is a possibility that these drugs could at the same time reduce the chances of drug resistance, a significant problem in TB treatment."

Understanding Basic Cellular Mechanisms Helps Accelerate Tuberculosis Treatment

Dr. Stephen Oakeshott, Head of Infection and Immunity at the Medical Research Council, part of UK Research and Innovation, said, "This exciting work is a great example of how understanding basic cellular mechanisms can directly unlock pathways to future treatment regimes. The potential for repurposing cheap and easily accessible drugs to accelerate TB treatment could have an enormous health impact worldwide and we look forward to seeing this discovery move forward."

So yet, this research has only been done in cells. More research will be required before proceeding to clinical trials to investigate potential treatment regimens for drug combinations in patients.

Source: Medindia

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