Abstract

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.