Author: Dr. Vinay Kumar Singh
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, and may be easily spread like cold through coughing, sneezing, or spitting, their causative agent is known as bacilli (aerobic, rod-shaped spore-producing bacterium), into the air. (Gamer P et al., 2004).
Untreated, each person with active TB disease acts as infecting agent and infects many people. The people living in area having no proper ventilation, damp, poor drainage and poor sanitation are prone to infect with TB. Infected people with TB will not necessarily become sick with the disease until unless they have challenged immune system. The bacilli may stay dormant for years. WHO estimates that the largest number of new TB cases in 2008 occurred in the South-East Asia Region, which accounted for 35% of incident cases globally (Onyebujoh P et al., 2004).
An expected 1.7 million individuals passed on from TB in 2009. The most elevated number of cases was in the Africa Region. In 2008, the assessed per capita TB rate was steady or falling in every one of the six WHO regions. Subsequently, the quantity of new cases emerging every year is as yet expanding universally in the WHO areas of Africa, the Eastern Mediterranean and South-East Asia. In 2006, WHO propelled the new Stop TB Strategy. The center of this system is DOTS, the TB control approach propelled by WHO in 1995. Since its dispatch, 41 million patients have been dealt with under DOTS-based administrations.
The success rate achieved optimum, while perceiving the key difficulties of TB/HIV and MDR-TB. It is good enough but simultaneously also attracts practitioner and research workers to fight with some side effects. INH and RIF, the first line drugs used for tuberculosis chemotherapy (patients enrolled in DOTS), are associated with hepatotoxicity (Tasduq SA et al., 2005). Many studies have shown changes in LFT values, blood lipids including increase of triglycerides level, decrease of total cholesterol as well as lipoprotein levels (Zejc-Bajsarowicz M et al., 2005) in patients with chronic viral hepatitis.
DOTS Strategy, hepatotoxicity and hepatoprotection
In DOTS treatment oxidative stress is one of the key systems for INH+RIF-incited hepatic damage (Sodhi CP et al.,1997).The rate of hepatotoxicity has been accounted for to be substantially higher in developing nations like India (8%-30%) contrasted with that in developed nations (2%-3%) with a comparable measurements plan (Sharma SK, 2004).
Plants and plant products are used since many decades and found promising results in eradication of bacterial infections. (Cowan, 1999). Garlic (Allium sativum) is common plant being utilized as a nourishment and additionally society medication for quite a long time in everywhere throughout the world (Rivlin, 2001). In 1996, Reuter et al. depicted garlic a plant with different natural properties like antimicrobial, anti-cancer, antioxidant, immunomodulatory, anti-inflammatory, immunomodulatory, hypoglycemic, and against cardiovascular impacts (Reuter et al., 1996).
Diverse garlic extracts exhibited movement against Gram-negative and Gram-positive microbes including types of Escherichia, Salmonella, Staphylococcus, Streptococcus, Klebsiella, Proteus, Bacillus, clostridium, Helicobacter pylori (Cellin et al., 1996) and even acid-fast bacilli (AFB).
Allicin is thiosulfinate compound of garlic reported for for its antibacterial movement. Allicin is turned out to be against bacterial as it represses RNA synthesis (Feldberg et al., 1988). As indicated by Ayurvedic and Greek frameworks of medicine garlic is one of the established remedies for tuberculosis. A few studies support the in-vitro garlic affect against Mycobactrium tuberculosis (Rao et al., 1946). A couple of studies have likewise been demonstrating antimycobacterial action of garlic against various types of mycobacterium (Gupta et al., 1955; Abbruzzese et al., 1987; Jain, 1998; Gupta et al., 1999; Bolton et al., 1982; Delaha and Garagusi, 1985).
A few investigations have shown that garlic may decrease oxidative stress (Gedik N, 2005). Furthermore, its constituents decreases prompted hepatotoxicity in trial mice (Wang EJ, 1996) (Sumioka I et al., 2001). Also human studied proves effective role of garlic in hepatotoxicity and antioxidant property. (Singh et al., 2016). Entire garlic and aqueous garlic extracts display exhibit direct antioxidant effects and enhance the serum levels of two antioxidant enzymes, catalase and glutathione peroxidase (Shanker G et al., 2005). Garlic extract and allicin effectively scavenged exogenously created hydroxyl radicals in a dose dependent fashion.
Thus it is highly recommended to use garlic in formulated form for their hepatoprotective and antioxidant of property with ATT treatment in pulmonary tuberculosis.
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