Effect of Curcumin in Experimental Pulmonary Tuberculosis: Antimycobacterial Activity in the Lungs and Anti-Inflammatory Effect in the Brain

Unravelling the prophylactic anti-inflammatory potential of Koenigia tortuosa through modulation of cytokine levels and inflammatory markers in LPS-induced localized inflammation in Wistar rat models

Chronic inflammation, a pivotal factor in various chronic diseases, necessitates safe and effective treatments to alleviate disease severity and symptoms. Current interventional approaches, including synthetic steroids and non-steroidal anti-inflammatory drugs, pose safety concerns. Consequently, people seek plant-based alternatives as safer substitutes. Koenigia tortuosa, a medicinal plant with rich folklore claims, traditionally treats joint pain, swelling, dysentery and kidney related problems but lacks documentation. This study investigated anti-inflammatory properties of Koenigia tortuosa. Soxhlet extraction method was employed to obtain five different extracts of Koenigia tortuosa viz., hexane (95%), ethyl-acetate (99%), ethanol (99%), methanol (95%) and aqueous. Anti-inflammatory potential of different extracts was determined by both in vitro (including protein denaturation, nitric-oxide scavenging, proteinase inhibition, and erythrocyte membrane stabilization) and in vivo by performing histopathological studies and determining levels of various inflammatory markers like IL-1β, IL-6, IFN-γ and TNF-α using ELISA and, iNOS, PPAR-γ and COX-2 by Western blotting. GC-MS analysis was performed to reveal the bioactive compounds in extracts. At 600 μg/mL, two extracts, ethyl acetate and methanolic extract exhibited maximum inhibition of protein denaturation 75.07% ± 3.28% and 64.97% ± 1.73%, nitric oxide activity 88.06% ± 3.49% and 82.09% ± 3.61%, proteinase activity 82.06% ± 2.98% and 71.06% ± 3.58%, and erythrocyte-membrane haemolysis 84.94% ± 4.14% and 72.97% ± 4.68%, respectively (P < 0.001). In vivo studies using Wistar rats demonstrated no toxic effects of ethyl acetate and methanolic extract upon oral administration. These two extracts modulated cytokine levels and inflammatory markers, showing concentration dependent reductions in levels of IL-6, IL1-β, IFN-γ, TNF-α (P < 0.001), iNOS, COX-2 in LPS -induced inflammation in Wistar rats. At a dose of 100 mg/kgbwt, KTEA administration resulted in a substantial decrease in cytokine levels: IL1β from 68.99 ± 1.83 pg/mL to 31.68 ± 1.90 pg/mL (P < 0.001), IL6 from 80.40 ± 0.70 pg/mL to 39.47 ± 1.85 pg/mL (P < 0.01), TNFα from 71.34 ± 2.35 pg/mL to 29.37 ± 2.20 pg/mL (P < 0.001), and IFNγ from 120.27 ± 4.26 pg/mL to 68.07 ± 2.78 (P < 0.01) pg/mL. Similarly, a concentration dependent decrease in prostaglandins (273.68 pg/mL and 418.96 pg/mL by ethyl acetate and methanolic extract at 100 mg/kgbwt) and leukotrienes (239.37 pg/mL and 302.19 pg/mL by ethyl acetate and methanolic extract at 100 mg/kgBwt) were observed as compared with the LPS induced group (prostaglandins 1129.99 pg/mL and leukotrienes 558.67 pg/mL). We also observed that Koenigia tortuosa extracts improves the levels of lymphocytes and leukocytes. Notably, PPAR-γ expression exhibited a concentration dependent increase, suggesting potential anti-inflammatory effects through nuclear receptor modulation. Histopathological investigations demonstrated significant healing effects of extracts. Analysis using GC-MS unveiled the presence of bioactive compounds with potent anti-inflammatory properties. These findings suggest Koenigia tortuousa's anti-inflammatory mechanisms and potential therapeutic applications.

Curcumin enhances bedaquiline's efficacy against Mycobacterium abscessus: in vitro and in vivo evidence

In this study, we describe the combined effects of bedaquiline (BDQ) and the natural product curcumin (CUR) on Mycobacterium abscessus. In both in vitro and in vivo experiments, CUR enhanced BDQ's inhibitory effect. This combination reduced M. abscessus survival under nutrient-deprived, hypoxic, and acidic conditions, accelerated ATP depletion, mitigated BDQ-induced respiratory compensation, and effectively improved infection outcomes in both normal and immunosuppressed mice. Metabolomics analysis revealed that adding CUR to BDQ exacerbated BDQ-dependent downregulation of purine and pyrimidine metabolism and amino acid synthesis. Thus, BDQ-CUR combination therapy could potentially be applied to treat M. abscessus infections.IMPORTANCEMycobacterium abscessus is an emerging pathogen that causes pulmonary infections, particularly in immunocompromised patients. It exhibits natural resistance to many anti-tuberculosis drugs, posing significant challenges for both patients and physicians, thereby raising the need for innovative drug discovery. Here, we describe the combined effects of bedaquiline (BDQ) and curcumin (CUR) on M. abscessus. In vitro and in vivo studies have shown that CUR enhances the inhibitory effect of BDQ. Additionally, we investigated the synergistic effects at the metabolic level. Thus, these findings highlight the potential of BDQ-CUR combination therapy against M. abscessus infections.

Repurposed Drugs and Plant-Derived Natural Products as Potential Host-Directed Therapeutic Candidates for Tuberculosis

Tuberculosis (TB) is one of the leading causes of death due to infectious disease. It is a treatable disease; however, conventional treatment requires a lengthy treatment regimen with severe side effects, resulting in poor compliance among TB patients. Intermittent drug use, the non-compliance of patients, and prescription errors, among other factors, have led to the emergence of multidrug-resistant TB, while the mismanagement of multidrug-resistant TB (MDR-TB) has eventually led to the development of extensively drug-resistant tuberculosis (XDR-TB). Thus, there is an urgent need for new drug development, but due to the enormous expenses and time required (up to 20 years) for new drug research and development, new therapeutic approaches to TB are required. Host-directed therapies (HDT) could be a most attractive strategy, as they target the host defense processes instead of the microbe and thereby may prevent the alarming rise of MDR- and XDR-TB. This paper reviews the progress in HDT for the treatment of TB using repurposed drugs which have been investigated in clinical trials (completed or ongoing) and plant-derived natural products that are in clinical or preclinical trial stages. Additionally, this review describes the existing challenges to the development and future research directions in the implementation of HDT.

Antimycobacterial Activity of Solid Lipid Microparticles Loaded with Ursolic Acid and Oleanolic Acid: In Vitro, In Vivo, and Toxicity Assessments

Ursolic acid (UA) and oleanolic acid (OA) are hydrophobic triterpenoid isomers with demonstrated anti-mycobacterial (Mtb) and immune-regulatory properties, although their poor solubility limits clinical use. We report the development of solid lipid microparticles (SLMs) as delivery vehicles for UA and OA and evaluate their anti-Mtb efficacy in vitro and in vivo, as well as their acute toxicity. SLMs measured 0.7-0.89 µM in size, with complete in vitro release of OA and UA at 40 and 32 h, respectively. The minimum inhibitory concentration (MIC) of SLMs loaded with OA and UA was 40 µg/mL SLMs + 20 µg/mL OA + 20 µg/mL UA for drug-sensitive Mtb and 80 µg/mL SLMs + 40 µg/mL OA + 40 µg/mL UA for multidrug-resistant (MDR) Mtb. These SLMs showed an efficient reduction in Mtb burden in infected alveolar macrophages. In a murine model of late-stage progressive MDR-TB, aerosolized delivery of SLMs containing OA and UA via a metered-dose inhaler significantly reduced pulmonary bacterial loads and extended survival. In vivo, acute toxicity studies revealed no mortality or signs of toxicity. These findings demonstrate that SLMs are an optimal delivery system for terpenoids, providing potent in vitro and in vivo anti-TB activity with an excellent safety profile.

Focus on brain-lung crosstalk: Preventing or treating the pathological vicious circle between the brain and the lung

Recently, there has been increasing attention to bidirectional information exchange between the brain and lungs. Typical physiological data is communicated by channels like the circulation and sympathetic nervous system. However, communication between the brain and lungs can also occur in pathological conditions. Studies have shown that severe traumatic brain injury (TBI), cerebral hemorrhage, subarachnoid hemorrhage (SAH), and other brain diseases can lead to lung damage. Conversely, severe lung diseases such as acute respiratory distress syndrome (ARDS), pneumonia, and respiratory failure can exacerbate neuroinflammatory responses, aggravate brain damage, deteriorate neurological function, and result in poor prognosis. A brain or lung injury can have adverse effects on another organ through various pathways, including inflammation, immunity, oxidative stress, neurosecretory factors, microbiome and oxygen. Researchers have increasingly concentrated on possible links between the brain and lungs. However, there has been little attention given to how the interaction between the brain and lungs affects the development of brain or lung disorders, which can lead to clinical states that are susceptible to alterations and can directly affect treatment results. This review described the relationships between the brain and lung in both physiological and pathological conditions, detailing the various pathways of communication such as neurological, inflammatory, immunological, endocrine, and microbiological pathways. Meanwhile, this review provides a comprehensive summary of both pharmacological and non-pharmacological interventions for diseases related to the brain and lungs. It aims to support clinical endeavors in preventing and treating such ailments and serve as a reference for the development of relevant medications.

The advances in adjuvant therapy for tuberculosis with immunoregulatory compounds

Tuberculosis (TB) is a chronic bacterial disease, as well as a complex immune disease. The occurrence, development, and prognosis of TB are not only related to the pathogenicity of Mycobacterium tuberculosis (Mtb), but also related to the patient's own immune state. The research and development of immunotherapy drugs can effectively regulate the body's anti-TB immune responses, inhibit or eliminate Mtb, alleviate pathological damage, and facilitate rehabilitation. This paper reviews the research progress of immunotherapeutic compounds for TB, including immunoregulatory compounds and repurposing drugs, and points out the existing problems and future research directions, which lays the foundation for studying new agents for host-directed therapies of TB.

Identification of immune infiltration and cuproptosis-related molecular clusters in tuberculosis

Background

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (Mtb) infection. Cuproptosis is a novel cell death mechanism correlated with various diseases. This study sought to elucidate the role of cuproptosis-related genes (CRGs) in TB.

Methods

Based on the GSE83456 dataset, we analyzed the expression profiles of CRGs and immune cell infiltration in TB. Based on CRGs, the molecular clusters and related immune cell infiltration were explored using 92 TB samples. The Weighted Gene Co-expression Network Analysis (WGCNA) algorithm was utilized to identify the co-expression modules and cluster-specific differentially expressed genes. Subsequently, the optimal machine learning model was determined by comparing the performance of the random forest (RF), support vector machine (SVM), generalized linear model (GLM), and eXtreme Gradient Boosting (XGB). The predictive performance of the machine learning model was assessed by generating calibration curves and decision curve analysis and validated in an external dataset.

Results

11 CRGs were identified as differentially expressed cuproptosis genes. Significant differences in immune cells were observed in TB patients. Two cuproptosis-related molecular clusters expressed genes were identified. Distinct clusters were identified based on the differential expression of CRGs and immune cells. Besides, significant differences in biological functions and pathway activities were observed between the two clusters. A nomogram was generated to facilitate clinical implementation. Next, calibration curves were generated, and decision curve analysis was conducted to validate the accuracy of our model in predicting TB subtypes. XGB machine learning model yielded the best performance in distinguishing TB patients with different clusters. The top five genes from the XGB model were selected as predictor genes. The XGB model exhibited satisfactory performance during validation in an external dataset. Further analysis revealed that these five model-related genes were significantly associated with latent and active TB.

Conclusion

Our study provided hitherto undocumented evidence of the relationship between cuproptosis and TB and established an optimal machine learning model to evaluate the TB subtypes and latent and active TB patients.

Bioactive dietary components-Anti-obesity effects related to energy metabolism and inflammation

Obesity is the result of the long-term energy imbalance between the excess calories consumed and the few calories expended. Reducing the intake of energy dense foods (fats, sugars), and strategies such as fasting and caloric restriction can promote body weight loss. Not only energy in terms of calories, but also the specific composition of the diet can affect the way the food is absorbed and how its energy is stored, used or dissipated. Recent research has shown that bioactive components of food, such as polyphenols and vitamins, can influence obesity and its pathologic complications such as insulin resistance, inflammation and metabolic syndrome. Individual micronutrients can influence lipid turnover but for long-term effects on weight stability, dietary patterns containing several micronutrients may be required. At the molecular level, these molecules modulate signaling and the expression of genes that are involved in the regulation of energy intake, lipid metabolism, adipogenesis into white, beige and brown adipose tissue, thermogenesis, lipotoxicity, adipo/cytokine synthesis, and inflammation. Higher concentrations of these molecules can be reached in the intestine, where they can modulate the composition and action of the microbiome. In this review, the molecular mechanisms by which bioactive compounds and vitamins modulate energy metabolism, inflammation and obesity are discussed.

New Drugs and Novel Cellular Targets against Tuberculosis

Mycobacterium tuberculosis (Mtb) is the etiological agent of tuberculosis (TB), one of the most life-threatening communicable diseases, which causes 10 million new cases each year and results in an estimated 1 [...].

Curcumin-Impregnated Drug Delivery Systems May Show Promise in the Treatment of Diseases Secondary to Traumatic Brain Injury: Systematic Review

Background

Traumatic brain injury (TBI) is a major social health problem, especially in young adults, and progresses with advanced functional losses. In this study, curcumin was directed to the damaged brain tissue by crossing the blood–brain barrier through drug delivery systems. Thus, the study asked whether it can be effective in the treatment of TBI, which has not had a radical treatment method in clinics yet.

Methods

A comprehensive and systematic literature search in the PubMed electronic database was performed. Descriptive statistics were used to evaluate the data obtained. The results were presented as frequency and percentage (%) or amount.

Results

Two clinical trials investigated curcumin for the treatment of TBI. One study tested curcumin in living mammalian subjects using an amyloLipid nanovesicle. In three studies, curcumin was investigated together with the drug delivery system for the treatment of TBI.

Conclusion

Drug delivery systems prepared with nanomaterials may have a potential therapeutic effect in treating TBI by increasing neuroprotection because they can penetrate the central nervous system more rapidly.

Eukaryotic expression and immunogenicity of Ancylostoma ceylanicum calreticulin

Ancylostoma ceylanicum is a zoonotic soil-derived nematode that parasitizes human and animal intestines, causing malnutrition and iron-deficiency anemia. Calreticulin is a multifunctional protein involved in all stages of parasitic infection. Studies have found that parasites can secret calreticulin to regulate the host's immune response. To explore the immunogenicity of the eukaryotic expression plasmid of Ancylostoma ceylanicum calreticulin (Ace-CRT), we constructed a recombinant Ace-CRT eukaryotic expression plasmid (pEGFP-N3-Ace-CRT). Successful expression of the target protein in Human Embryonic Kidney (HEK) 293 T cells was confirmed by indirect immunofluorescence and Western blot analysis. BALB/c mice were immunized with pEGFP-N3-Ace-CRT plasmid. Measuring IgG antibody levels in immunized mice sera by ELISA showed that the recombinant plasmid stimulated IgG antibody production in mice. Spleen lymphocytes were collected from vaccinated mice to determine the proportion of T cell subsets and the expression levels of cytokines. Flow cytometry revealed that the percentage of CD3 + CD4+ and CD3 + CD8+ T cells in mice spleen in the immunization group was significantly higher than that in the control group. Recombinant plasmid immunization increased IL-4, IL-10, IL-12, and IL-13 expression while decreasing IL-5, IL-6, and INF-γ in mice spleens. These results indicate that the eukaryotic plasmid constructed in this study had good immunogenicity and mainly induced a T helper 2 response in the host, laying a foundation for screening candidate molecules for anti-hookworm vaccines.