Anti-tuberculous Effects of Statin Therapy: A Review of Literature

Abstract

Tuberculosis (TB) is a chronic infection caused by Mycobacterium tuberculosis (M. TB). It is transmitted through respiratory droplets. Increased cholesterol level is a predisposing factor for TB. M. TB uses cholesterol in the host macrophage membranes to bind and enter the macrophages. Statins are the drugs that are prescribed to hyperlipidemic patients to maintain their lipid levels in the normal range, thereby reducing the risk of stroke and cardiovascular events. Moreover, statins aid in reducing the levels of cholesterol in human macrophages. Therefore, a reduction in the membrane cholesterol minimizes the entry of TB pathogen inside macrophages. Furthermore, acting as vitamin D3 analogs and positively influencing pancreatic beta-cell function in a chronic diabetic state, statins minimize the occurrence of M. TB infection among diabetic population as well. This review aims to provide a comprehensive detail of all in vitro, in vivo, and retrospective studies that investigated the effects of statins in relation to the prevention or treatment of TB infection.

CRISPR Interference Reveals That All- Trans -Retinoic Acid Promotes Macrophage Control of Mycobacterium tuberculosis by Limiting Bacterial Access to Cholesterol and Propionyl Coenzyme A

“…Mechanistically, this study proposed that ATRA increases lysosomal acidification via NPC2-mediated reduction in lysosomal cholesterol, thereby promoting Mtb control. Other research has tied ATRA efficacy to autophagy ( 6 ), and targeting cholesterol biosynthesis with statins reduces Mtb growth through an autophagy-dependent mechanism ( 30 , 31 ). These processes may be related, as cholesterol accumulation in macrophages during Mtb infection can interfere with phagolysosomal maturation and autophagic clearance of mycobacteria ( 32 , 33 ).…”

Cardiovascular morbidity and mortality among persons diagnosed with tuberculosis: A systematic review and meta-analysis

“…In TB medicine, statins have potential for improving TB treatment outcomes [ 58 ], and are being considered as host-directed therapy in two trials where they are used as adjuvants to TB chemotherapy [ 59 – 61 ]. While not designed to assess the efficacy of statins for CVD prevention in TB patients, dose-safety data from these trials may inform future trials for TB patients with such a goal, similar, perhaps, to the REPRIEVE trial for HIV patients [ 57 ].…”

The Role of Lipid and the Benefit of Statin in Augmenting Rifampicin Effectivity for a Better Leprosy Treatment

“…At present, available data regarding the effect of statin administration are minimal in leprosy patients, most only exist in tuberculosis. Tuberculosis infection has several immunopathogenesis similarities with leprae, as they are both caused by mycobacterium species, and current studies on tuberculosis cases present statin as a promising therapeutic agent in two publications by Tahir et al [67] and Alffenaar et al [68]. In vivo studies in mice also showed statin adjuvant in MDT-TB shorten the treatment time and reduce recurrence rates [55], [69].…”