Featured Research

from universities, journals, and other organizations

Method To Prevent Liver Damage Induced By Anti-tuberculosis Treatment?

September 19, 2008
World Journal of Gastroenterology
Anti-tuberculosis treatment is known to cause liver damage in 4 percent to 11 percent of patients mandating to stop the treatment till the liver enzymes come to normal. In ~0.1 percent cases this could prove fatal. A trial conducted by botanical research group in India on Tuberculosis cases proved the efficacy of two Ayurvedic herbs taken as adjuvant, to prevent serious liver damage entirely even in high risk and immunocompromised patients and to enhance efficacy of conventional drugs on tuberculosis.

About one third of the world's population has latent tuberculosis and roughly 9 million cases of active tuberculosis emerge annually resulting in 2-3million deaths. Most new cases occur in the most populated nations like India and China.

Related Articles

Combination chemotherapy containing Isoniazid (INH), Rifampicin (RMP), Pyrazinamide (PZA) with or without ethambutol for initial 2 months followed by a continuation phase of 4-6 months of Isoniazid and Rifampicin is the preferred regimen for successful treatment and for preventing acquired resistance.

Drug induced hepatotoxicity is a potentially serious adverse effect of antituberculosis (ATT) regimen. A higher risk of hepatotoxicity has been reported in Indian patients (up to 11.5%) than in their western counterpart (up to 4.3%). The only measure available for managing hepatotoxicity is stopping the offending agents, once there is an evidence of liver damage and reintroducing the same after normalization of liver enzymes. Preventive therapy of contacts causes severe hepatotoxicity more often than curative treatment of clinical tuberculosis. Search for non-toxic and highly effective new compounds for treating tuberculosis or an effective vaccine conferring sustained protective immunity have yet not seen the face of success.

A new research article addresses this question. The research team led by Dr. Meghna Adhvaryu of Bapalal Vaidya Botanical research center, Departrment of Biosciences, Veer Narmad South Gujarat University Surat, India in joint effort with Dr. Bhasker Vakharia running a charitable mobile clinic in tribal belt of district surat, conducted a clinical trial of two Ayurvedic herbs in a modified form used as an adjuvant to conventional ATT to evaluate their ability to prevent hepatotoxicity.

The pathogenesis of hepatotoxicity is not entirely clear but INH and RMP induced damage may involve oxidative stress, lipid peroxidation, choline deficiency leading to lowering of phospholipids protein synthesis with alteration in cell wall configuration, reduced glutathione level and activation of CYP2E1. It is well known that some non toxic herbs are having opposite activities in the form of membrane stabilizing, anti-oxidative and CYP2E1 inhibitory effects. A review of available literature suggests that reduction in lipid peroxide content in tissue and increase in superoxide dismutase, catalase, glutathione, glutathione-s-transferase and glutathione peroxidase activities should help to maintain liver cell integrity and control the increase in level of liver enzymes.

Initially four potential candidate herbs were tested in a guinea pig model of ATT induced hepato-toxicity and marked hepato-protective ability was demonstrated. The research article was published on 21st June 2007 in the World Journal of Gastroenterology. Two herbs viz. Curcuma longa and Tinospora cordifolia were selected for further study due to their higher efficacy, very safe toxicological profile and synergistic action when used in combination.

The results of clinical trial proved the safety and efficacy of the formulation as an adjuvant to conventional ATT in preventing liver damage beyond doubt by limiting the incidence of hepatotoxicity (mild) to 0.06% as against 14% due to conventional treatment alone in the control group, according to the journal. Malnourished, HIV positive, Hepatitis B/C virus carrier. Sickle trait positive, relapse cases, cases with extensive or miliary disease, COPD, asthma, Diabetes mellitus, hypertension… all were recruited in both the group, which may account for the higher incidence of hepatotoxicity in control group but at the same time the similar patients in trial group not only escaped liver damage but showed a higher cure rate and better resolution of lesions.

This result encourages for further research and trials with immunocompromised, multidrug resistant and non-responding patients and also latent TB cases who are subjected to a potentially serious risk by preventive treatment.

Looking at the scenario as described earlier, the results of this trial carries utmost significance and applicability at mass level tuberculosis control programs and might help curb the resurgence of TB in developed countries after advent of HIV and AIDS.

Story Source:

The above story is based on materials provided by World Journal of Gastroenterology. Note: Materials may be edited for content and length.

Journal Reference:

  1. Adhvaryu et al. Prevention of hepatotoxicity due to anti tuberculosis treatment: A novel integrative approach. World Journal of Gastroenterology, 2008; 14 (30): 4753 DOI: 10.3748/wjg.14.4753

Cite This Page:

World Journal of Gastroenterology. "Method To Prevent Liver Damage Induced By Anti-tuberculosis Treatment?." ScienceDaily. ScienceDaily, 19 September 2008. <www.sciencedaily.com/releases/2008/09/080919142358.htm>.
World Journal of Gastroenterology. (2008, September 19). Method To Prevent Liver Damage Induced By Anti-tuberculosis Treatment?. ScienceDaily. Retrieved January 30, 2015 from www.sciencedaily.com/releases/2008/09/080919142358.htm
World Journal of Gastroenterology. "Method To Prevent Liver Damage Induced By Anti-tuberculosis Treatment?." ScienceDaily. www.sciencedaily.com/releases/2008/09/080919142358.htm (accessed January 30, 2015).

Share This

More From ScienceDaily

More Health & Medicine News

Friday, January 30, 2015

Featured Research

from universities, journals, and other organizations

Featured Videos

from AP, Reuters, AFP, and other news services

CDC: Get Vaccinated for Measles

CDC: Get Vaccinated for Measles

Reuters - US Online Video (Jan. 30, 2015) The CDC is urging people to get vaccinated for measles amid an outbreak that began at Disneyland and has now infected more than 90 people. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Obama To Outline New Plan For Personalized Medicine

Obama To Outline New Plan For Personalized Medicine

Newsy (Jan. 30, 2015) President Obama is expected to speak with drugmakers Friday about his Precision Medicine Initiative first introduced last week. Video provided by Newsy
Powered by NewsLook.com
Oxfam Calls for Massive Aid for Ebola-Hit West Africa

Oxfam Calls for Massive Aid for Ebola-Hit West Africa

AFP (Jan. 29, 2015) Oxfam International has called for a multi-million dollar post-Ebola "Marshall Plan", with financial support given by wealthy countries, to help Guinea, Sierra Leone and Liberia to recover. Duration: 01:10 Video provided by AFP
Powered by NewsLook.com
Are We Winning The Fight Against Ebola?

Are We Winning The Fight Against Ebola?

Newsy (Jan. 29, 2015) The World Health Organization announced the fight against Ebola has entered its second phase as the number of cases per week has steadily dropped. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.


Breaking News:

Strange & Offbeat Stories

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News


Free Subscriptions

Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile

Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?

Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins