STUDY OF NEUROTRANSMITTERS IN PULMONARY TUBERCULOSIS
Shubhangi M. Dalvi*, Nagsen N. Ramraje, Vinayak W. Patil, Rohit Hegde, Neelam Yeram
ABSTRACT
Background: Isoniazid is a ―first line‖ drug for treatment of
pulmonary tuberculosis (Mycobacterium tuberculosis) which inhibits
the synthesis of mycolic acid in the mycobacterial cell wall. Isoniazid
has significant effect on several biochemical pathways, including the
metabolism of pyridoxine (vitamin B6) substantially reducing its
activity, leading to clinical pyridoxine depletion. Pyridoxine is a
necessary cofactor for production of the neurotransmitter gammaaminobutyric
acid (GABA). Inactivation of pyridoxine leads to
depletion of GABA. The majority of tyrosine that does not get
incorporated into proteins is catabolized for energy production. One of
the significant fates of tyrosine is conversion to catecholamines i.e.
dopamine, norepinephrine, and epinephrine. The levels of Dopamine are also influenced by
pyridoxine. Low levels of dopamine tend to result in very serious depression or anxiety in TB
patients. Methods: Case–Control study comprised 50 control, 50 newly diagnosed TB (CAT
I) and 50 TB with multidrug-resistance (MDR). Blood samples analysed for Dopamine and GABA by Enzyme linked immunosorbant assay (ELISA), total proteins by Automated Chemistry analyser and vitamin C by HPLC. Results: The serum levels of Dopamine, GABA, and Total protein showed a remarkable decrease in tuberculosis patients than in control. Also, correlation studies show negative correlation among the parameters leading to increased inflammation. Conclusion: Protein, Vitamin C and Vitamin B6 plays role in catecholamine metabolism of Dopamine and GABA pathway. Decrease in levels leading to increase in inflammation due to alpha-TNF and cytokines causing progression of disease.
Keywords: Dopamine, GABA, Pulmonary Tuberculosis, Neurotransmitter.
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