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Vitamin C may improve TB treatment


Injections of vitamin C increase effectiveness of drug therapy in mice

A study in mice suggests that adding vitamin C to the regime might increase the efficiency of TB treatment. TB drug treatment is lengthy and drug resistance develops quickly so new approaches are desperately needed. Shortening the time for treatment saves money, prevents the development of drug resistance and enables patients to return to normal life sooner.

TB is in the top 10 diseases worldwide. Nearly 10 million people catch it each year and just under 2 million die, mainly in low and middle income countries. Ending TB by 2030 is one of the Sustainable Development Goals. TB treatment typically involves giving 4 drugs over 6 months with close supervision to ensure compliance. Treating drug resistant strains can take up to two years, according to WHO.

This study was done by researchers from William Jacobs’ lab at Albert Einstein College of Medicine and colleagues. They made a surprising discovery in 2013 that high doses of vitamin C killed TB bacteria but not some other bacteria in lab cultures. They thought this could be happening because vitamin C induced production of DNA damaging free radicals. This study follows up on that work by exploring whether vitamin C can work in live animals to stop TB.

The researchers led by Catherine Vilchèze, treated mice with TB infections using combinations of vitamin C alone, vitamin C with anti-TB drugs (isoniazid and rifampicin) and anti-TB drugs alone. They then measured the number of TB bacteria in the mice at 4 and 6 weeks after the start of treatment. They used an intravenous dose of 3 g/kg vitamin C which brought vitamin C levels in the mice’s blood close to the levels of vitamin C that inhibited growth of TB bacteria in the earlier cell culture experiments. This dose is much higher than could be achieved by oral supplements The body tightly controls levels of vitamin C in blood and its absorption from supplements decreases with increased intake.

The combination of vitamin C with the drugs reduced the number of TB bacteria in lungs faster than drugs alone, reports the study. Vitamin C alone had no effect.

While the results are encouraging, the authors stress that the safety of such a high vitamin C dose needs further research. The maximum regarded as tolerable in the diet is 2 g/day for an adult. Some studies have used high doses intravenously as therapy.

The authors speculate that vitamin C stimulates increased respiration in the TB cells which renders them more open to attack by the drugs.

Reference

Vitamin C potentiates the killing of Mycobacterium tuberculosis by the first-line tuberculosis drugs isoniazid and rifampicin in mice. Catherine Vilchèze, John Kim and William R. Jacobs Jr, Antimicrobial agents and chemotherapy, 2018. doi: 10.1128/AAC.02165-17 http://aac.asm.org/content/early/2017/12/05/AAC.02165-17.abstract

More information about vitamin C

Article details

  • Author(s)
  • I. Hoskins
  • Date
  • 10 January 2018
  • Subject(s)
  • Nutrition & disease