Overview of Metformin as a Host Targeted Therapy in Tuberculosis

Tuberculosis is a communicable disease caused by the organism Mycobacterium tuberculosis, the mortality and morbidity due to TB remains immense. Diabetes is a metabolic disorder where TB is an airborne infectious disease, but both are found to be interrelated. TB can trigger the diabetes and also worsen the glycaemic level in patients with pre-existing Diabetes. TB patients are at risk of developing diabetes owing to glucose intolerance. Most of the people with TB are usually diagnosed with DM at a later stage. Conversely, uncontrolled diabetes may leads to increased susceptibility to infections such as TB at immunological and cellular level. The current treatment for the tuberculosis is very effective, but the emergence of multi-drug resistance are inevitable, which drives us to develop new therapy for TB. Metformin as a Host directed therapy helps to reduce the intracellular growth of Mycobacterium tuberculosis in both diabetic and non-diabetic patients. Metformin works by activating AMPK (Adenosine monophosphate kinase), thus inhibits the intracellular growth and restricts the immunopathology of Mycobacterium tuberculosis . Therefore, incorporating metformin into the present standard TB regimen would be a better therapeutic option for TB.