VITAMIN C AS AN ADD ON SUPPLEMENTATION TO STANDARD ANTITUBERCULAR TREATMENT IMPROVES SPUTUM SMEAR CONVERSION IN NEWLY DIAGNOSED DRUG SENSITIVE PULMONARY TUBERCULOSIS PATIENTS

Authors

  • Mrugank Patel Department of Pharmacology, Government Medical College, Surat, Gujarat, India. https://orcid.org/0009-0001-8070-9057
  • Anita Sinha Department of Pharmacology, Government Medical College, Surat, Gujarat, India.
  • Jeenal Mistry Department of Pharmacology, Government Medical College, Surat, Gujarat, India. https://orcid.org/0009-0007-3919-4614
  • Parul Vadgama Department of TB and Chest, Government Medical College, Surat, Gujarat, India.
  • Khushbu Rathod Department of Pharmacovigilance, APCER Life Sciences Limited, Ahmedabad, Gujarat, India.
  • Bhargavi Patel Department of Pharmacology, Dr. M. K. Shah Medical College and Research Centre and Smt. S. M. S. Multi-Specialty Hospital, Chandkheda, Ahmedabad, Gujarat, India. https://orcid.org/0009-0001-4710-4902

DOI:

https://doi.org/10.22159/ajpcr.2024.v17i1.48683

Keywords:

Tuberculosis, Vitamin C, Sputum Smear Conversion, Anti-tubercular Treatment

Abstract

Objective: This study was aimed to evaluate the effect of oral supplementation of Vitamin C along with standard anti-tubercular (anti-TB) drugs on the sputum smear conversion in newly diagnosed pulmonary tuberculosis (TB) patients.

Methods: This was a prospective, observational study in which 49 newly diagnosed pulmonary TB patients were given oral vitamin C supplementation along with standard anti-TB treatment during the intensive phase (2 months) of the treatment. An examination of the sputum smear at the end of the intensive phase of anti-tubercular treatment was done. At the end of the intensive phase, a comparison was done between the results of the sputum smear examination of the study population and the TB patients of the general population from the same locality who were receiving only standard anti-TB treatment and not add on Vitamin C supplementation.

Results: The comparison between the results of the study population (sputum conversion–100%) with those of the general population (sputum conversion–92.47%) shows a significant difference between both populations with p<0.05 (p=0.041).

Conclusion: This study showed that Vitamin C supplementation as an add-on therapy to the existing standard anti-TB treatment improves sputum smear conversion and decreases disease activity to a greater extent than routine standard anti-TB treatment alone.

Downloads

Download data is not yet available.

References

World Health Organization. Annual Report of Tuberculosis. Annual Global TB Report of WHO. Vol. 8. Geneva: World Health Organization; 2022. p. 1-68.

India TB [Report]. Ministry of Health and Family Welfare; 2023. Available from: https://tbcindia.gov.in/showfile.php?lid=3680

Padmapriyadarsini C, Shobana M, Lakshmi M, Beena T, Swaminathan S. Undernutrition & tuberculosis in India: situation analysis & the way forward. Indian J Med Res 2016;144:11-20. doi: 10.4103/0971- 5916.193278, PMID 27834321

Panush RS, Delafuente JC, Katz P, Johnson J. Modulation of certain immunologic responses by vitamin C. III. Potentiation of in vitro and in vivo lymphocyte responses. Int J Vitam Nutr Res Suppl 1982;23:35-47. PMID 6288604.

Famularo G, De Simone C, Trinchieri V, Mosca L. Carnitines and its congeners: A metabolic pathway to the regulation of immune response and inflammation. Ann N Y Acad Sci 2004;1033:132-8. doi: 10.1196/ annals.1320.012, PMID 15591010

Dunn ME. A study of vitamin C deficiency in patients with pulmonary tuberculosis. Ulster Med J 1945;14:17-33. PMID 20476328

Banerjee D. Vitamin deficiency and tuberculosis: Need for urgent clinical trial for managment of tuberculosis. J Nutr Health Food Sci 2014;2:1-6. doi: 10.15226/jnhfs.2014.00118

Safaryan MD, Karagezyan KG, Karapetyan ET, Avanesyan NA. Efficacy of antioxidative therapy in patients with pulmonary tuberculosis and correction of lipid peroxidation. Probl Tuberk 1990;68:40-4.

Vilchèze C, Hartman T, Weinrick B, Jacobs WR. Mycobacterium tuberculosis is extraordinarily sensitive to killing by a vitamin C-induced Fenton reaction. Nat Commun 2013;4:1881. doi: 10.1038/ncomms2898, PMID 23695675

Koppenol WH. The Haber-Weiss cycle -70 years later. Redox Rep 2001;6:229-34. doi: 10.1179/135100001101536373, PMID 11642713

Sikri K, Duggal P, Kumar C, Batra SD, Vashist A, Bhaskar A, et al. Multifaceted remodeling by vitamin C boosts sensitivity of Mycobacterium tuberculosis subpopulations to combination treatment by anti-tubercular drugs. Redox Biol 2018;15:452-66. doi: 10.1016/j. redox.2017.12.020, PMID 29413958

Vilchèze C, Kim J, Jacobs WR. Vitamin C potentiates the killing of Mycobacterium tuberculosis by the first-line tuberculosis drugs isoniazid and rifampin in mice. Antimicrob Agents Chemother 2018;62:e02165-17. doi: 10.1128/AAC.02165-17, PMID 29298757

Central TB Division. Technical and Operational Guidelines for TB control in India. New Delhi: Central TB Division; 2016.

Susanto L, Siregar Y, Kusumawati L. Vitamin C supplementation improve the sputum conversion culture rate in pulmonary tuberculosis treatment while rifampicin susceptible. IOP Conf Ser Earth Environ Sci 2018;125:012140. doi: 10.1088/1755-1315/125/1/012140

Khameneh B, Fazly Bazzaz BS, Amani A, Rostami J, Vahdati- Mashhadian N. Combination of anti-tuberculosis drugs with vitamin C or NAC against different Staphylococcus aureus and Mycobacterium tuberculosis strains. Microb Pathog 2016;93:83-7. doi: 10.1016/j. micpath.2015.11.006

Pei Z, Wu K, Li Z, Li C, Zeng L, Li F, et al. Pharmacologic ascorbate as a pro-drug for hydrogen peroxide release to kill mycobacteria. Biomed Pharmacother 2019;109:2119-27. doi: 10.1016/j.biopha.2018.11.078, PMID 30551469

Published

07-01-2024

How to Cite

Patel, M., A. Sinha, J. Mistry, P. Vadgama, K. Rathod, and B. Patel. “VITAMIN C AS AN ADD ON SUPPLEMENTATION TO STANDARD ANTITUBERCULAR TREATMENT IMPROVES SPUTUM SMEAR CONVERSION IN NEWLY DIAGNOSED DRUG SENSITIVE PULMONARY TUBERCULOSIS PATIENTS”. Asian Journal of Pharmaceutical and Clinical Research, vol. 17, no. 1, Jan. 2024, pp. 118-20, doi:10.22159/ajpcr.2024.v17i1.48683.

Issue

Section

Original Article(s)