Repurposing the anti-diabetic drug Metformin into an anti-tuberculosis drug: Metformin (trade name: Glucophage, Glumetza, Glucophage XR, Fortamet), the widely used drug in the treatment of TIIDM,  deacetylates RelA/p65, inhibits inflammatory gene expression downstream of RelA/p65, inhibits TB pathogenesis, increases the efficacy of anti-TB drug, and promotes M. tuberculosis clearance via upregulation of its target gene, 8/April/2019, 9.50 pm

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Introduction: What they say:

A study from the Singapore Immunology Network, Agency for Science, Technology and Research, Singapore; and Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore shows that “Host sirtuin 1 regulates mycobacterial immunopathogenesis and represents a therapeutic target against tuberculosis.” This study was published, in the 24 March 2017 issue of the Science Family of Journals “Science Immunology,”  by Prof. Amit Singhal, Catherine Y. Cheng, and others.


What we say:

On the foundation of this interesting finding, Dr L Boominathan PhD, Director-cum-chief Scientist of GBMD, reports that:  Repurposing the anti-diabetic drug Metformin into an anti-tuberculosis drug: Metformin (trade name: Glucophage, Glumetza, Glucophage XR, Fortamet), the widely used drug in the treatment of TIIDM,  deacetylates RelA/p65, inhibits inflammatory gene expression downstream of RelA/p65, inhibits TB pathogenesis, increases the efficacy of anti-TB drug, and promotes M. tuberculosis clearance via upregulation of its target gene

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What is known?

Prof. Amit Singhal’s research team has recently shown that: (1) Mycobacterium tuberculosis (Mtb) inhibits Sirtuin-1 (SIRT1) expression, while its activation inhibits the growth of drug-susceptible/resistant strains of Mtb; (2) Myeloid cell–specific SIRT1 deficient mice are more susceptible to Mycobacterium tuberculosis-mediated infection; (3) Sirtuin-1 activators deacetylate RelA/p65 and inhibit the expression of its downstream target (inflammatory) genes; and (4) Sirtuin-1 activators improve lung pathology, inhibit chronic-inflammatory responses and augment efficacy of anti-TB drugs in Mtb-infected mice, suggesting that Sirtuin-1 activators may be used to increase the efficacy of anti-TB drugs.


From the Significance of the study to Public health relevance:

Given that: (1) nearly 2.5 billion people out of 7.4 billion total world population are infected with M. tuberculosis; (2) majority of population in Asian and African countries test positive in tuberculin tests; (3) molecular pathways involved and the mechanism of development of drug-resistant tuberculosis is far from understood; (4) treating drug-resistant tuberculosis is still a daunting task; (5) tuberculosis is the second-leading cause of death–first being the HIV–due to an infectious disease; (6) in 2010, out of the 88 lakhs patients test positive for TB, 14.5 lakhs patients died; (7) billions of dollars are being spent each year globally for the treatment of tuberculosis; and (8) most of the TB cases are registered in developing countries—that cannot afford high-cost required for the treatment of drug-resistant TB—compared to developed countries, there is an urgent need to find: (i) a way to inhibit drug-resistant tuberculosis; (ii) a cheaper alternative to the existing expensive drugs; and (iii) a side-effect-free-Natural product-based drug that prevents relapse/recurrence of drug-resistant TB.


From research findings to Therapeutic opportunity:

This study suggests that Metformin, by decreasing the expression of its target gene, it may: (1) deacetylate RelA/p65; (2) inhibit the expression of inflammatory genes that function downstream of RelA/p65; (3) inhibit chronic inflammation; (4) ameliorate lung pathology; (5) promote clearance of tuberculosis; and (6) enhance efficacy of anti-TB drugs (Figure 1).

Figure 1. Mechanistic insights into how Metformin functions as an anti-tuberculosis agent. Clioquinol enhances the efficacy of anti-TB drugs via up regulation of its target genes

Figure 2. The chemical structure of Metformin. Metformin may aid in the treatment of drug-resistant tuberculosis(TB). 

Together, pharmacological formulations encompassing “Metformin or its analogs, either alone or in combination with other anti-TB drugs,“ may be used to treat drug-resistant tuberculosis.


Details of the research findings:

Idea roposed/Formulated by: Dr L Boominathan Ph.D.

Terms & Conditions apply http://genomediscovery.org/registration/terms-and-conditions/

Undisclosed mechanistic information: How Metformin deacetylates RelA/p65 to combat drug-resistant tuberculosis

Amount: $300#

# Research cooperation

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References:

Web: http://genomediscovery.org or http://newbioideas.com

Citation: Boominathan, L., Repurposing the anti-diabetic drug Metformin into an anti-tuberculosis drug: Metformin (trade name: Glucophage, Glumetza, Glucophage XR, Fortamet), the widely used drug in the treatment of TIIDM,  deacetylates RelA/p65, inhibits inflammatory gene expression downstream of RelA/p65, inhibits TB pathogenesis, increases the efficacy of anti-TB drug, and promotes M. tuberculosis clearance via upregulation of its target gene, 8/April/2019, 9.50 pm, Genome-2-BioMedicine Discovery center (GBMD), http://genomediscovery.org

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