Study suggests vitamin C enhances tuberculosis drugs effectiveness

A new study conducted by researchers at the Albert Einstein College of Medicine, Bronx, NY, has proposed the use of vitamin C together with tuberculosis drugs for rapid eradication of the disease-causing pathogens. The studies were carried out on mice and in tissue cultures and the results have been published in the journal of American Society for Microbiology, Antimicrobial Agents and Chemotherapy.

Credit: Tatiana Shepeleva/ Shutterstock.com

Scientists treated mice infected with tuberculosis with anti-tuberculosis drugs or vitamin C alone, and with the combination of the drugs and vitamin C. Measurement of M. tuberculosis (Mtb) organ burden was taken at four and six weeks following treatment.

According to Dr. Catherine J. Vilcheze, the lead author and instructor at the Department of Microbiology & Immunology, Albert Einstein College of Medicine, vitamin C alone showed no activity on the affected mice models.

However, in two different experiments organ burden reduction was more rapid with the combination of  vitamin C and the first-line TB drugs (isoniazid and rifampicin) than the drugs without vitamin C. Tests on the infected tissue cultures also showed similar results by reducing the sterilization time of 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”. This is important as the treatment of drug susceptible TB takes six months and results in a few treatment mismanagements, thereby leading to the emergence and spread of drug-resistant TB,”

Dr. William R. Jacobs, Jr., Einstein College of Medicine

Treatment of TB requires a prolonged period as a subpopulation of Mtb cells can develop into Mtb persister cells—dormant cells virtually unaffected by the action antimicrobials.

Dr. Jacobs said that in former studies, scientists determined that high levels of vitamin C eliminate actively dividing cells, but minor vitamin C concentrations enhance respiration and hinder the formation of persisters. Adding the presence of TB drugs will then lead to rapid death of the cells.

It was in 1948 that a French study suggested vitamin C was safe and potentially beneficial for humans. Terminally ill patients with no side effects were provided with high daily doses of vitamin C.

Although the infection did not regress, that study characterized other effects as "remarkable"; bedridden patients regained appetite and physical activity.

Tuberculosis is considered a major global public health condition that affects the lungs and other organ systems. In 2016, 10 million people all over the world were affected by the disease, killing 1.7 million. In the United States, the total affected patients were only a few thousand, out of a population of around 3.30 million. Treatment of multidrug resistant TB takes a minimum of two years, and demands the use of toxic second-line TB drugs that have major side effects.

"Vitamin C is known to be safe and our current mouse studies suggest that vitamin C could enhance TB chemotherapy. A clinical trial of vitamin C with TB chemotherapies could demonstrate that such an adjunct therapy could reduce patients' exposure to toxic TB drugs and also reduce the spread of TB from infected individuals,” said Dr. Jacobs.

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