Additive Effects of Glutathione in Improving Antibiotic Efficacy in HIV–M.tb Co-Infection in the Central Nervous System: A Systematic Review Original paper
Researched by:
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Divine Aleru
ID
Divine Aleru
Read MoreI am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
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Divine Aleru
Read More
Researched by:
-
Divine Aleru
ID
Divine Aleru
Read More
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Divine Aleru
What was studied?
The study systematically reviews the potential benefits of glutathione (GSH) supplementation in improving antibiotic efficacy for individuals co-infected with HIV and Mycobacterium tuberculosis (M.tb), particularly in cases involving the central nervous system (CNS). It synthesizes evidence on how GSH can aid in reducing oxidative stress, improving immune function, and enhancing treatment outcomes.
Who was studied?
The review encompasses preclinical and clinical studies focusing on individuals with HIV and tuberculosis co-infection. It specifically highlights the impact of GSH and its precursors on microbial control, immune modulation, and outcomes related to CNS involvement in these co-infected patients.
What were the most important findings?
The review found that GSH supplementation, particularly in the form of liposomal glutathione (L-GSH), can significantly improve the efficacy of first-line tuberculosis antibiotics, reduce bacterial loads, and enhance immune responses in individuals with HIV-M.tb co-infection. Studies demonstrated that GSH supplementation restores Th1 cytokine responses, mitigates inflammation, and stabilizes immune functions, particularly in macrophages, which are essential for controlling M.tb infections. Furthermore, GSH reduced oxidative stress and improved granuloma stability, a crucial factor in controlling M.tb growth and dissemination. Additionally, it was found that N-acetylcysteine (NAC), a precursor of GSH, also improved the effectiveness of TB antibiotics and enhanced immune function in co-infected individuals.
What are the greatest implications of this study?
The review underscores GSH’s potential as an adjunct therapy in managing HIV-M.tb co-infection, especially in the CNS, where complications like tuberculosis meningitis (TBM) and neurocognitive disorders significantly increase morbidity and mortality. By restoring redox homeostasis, GSH supplementation may enhance current treatment regimens, improve immune recovery, and mitigate chronic inflammation. The study advocates for further research to explore CNS-targeted GSH formulations and their integration into existing HIV and TB management protocols, which could improve clinical outcomes and reduce complications such as drug resistance and immune reconstitution inflammatory syndrome (IRIS).
Glutathione
Glutathione, the body’s most important intracellular antioxidant, plays a far-reaching role in the immune system that goes beyond simply neutralizing oxidative stress. As a crucial player in nutritional immunity, glutathione helps regulate nutrient competition between the host and pathogens, ensuring that pathogens are deprived of essential nutrients, like cysteine, that are critical for their survival. Through its involvement in redox signaling, cytokine production, and immune cell activation, glutathione contributes to immune resilience, particularly under nutrient-limited conditions.