Study of the Iron Chelating Effect of Green Tea in Smear Positive Tb Patients using Sputum Smear, Serum Malondialdehyde and Blood Iron Indices

Honarvar M R¹ Eghtesadi S², Gill P³, Jazayeri S⁴, Vakili M¹, Shamsardakani M R⁵, Abbasi A¹,EghtesadiM²

¹Golestan University of Medical Sciences, Iran

²Azad University, Iran

³Mazandaran University of Medical Sciences, Iran

⁴Iran University of Medical Sciences, Iran

⁵Tehran University of Medical Sciences, Iran

Abstract

The Golestan Province of Iran has a high position of the frequency and predominance of tuberculosis. The patients frequently experience the ill effects of weight reduction and unhealthiness, predominantly because of the elevated level of oxidative pressure as a result of the illness and diminished food consumption. Various examinations have been led on the impact of nourishment or supplementation for the improvement course of TB. Supplementation with large scale of micronutrients (like vitamin D, zinc or arginine) is successful during hostile to bacterial treatment and results in the improvement of the general states of the patients and quickens recuperation from TB as indicated by various investigations. Nutraceuticals, similar to green tea polyphenols, have indicated worthy properties as adjuvant treatment of various illnesses. In view of its dynamic polyphenol mixes, Green tea (GT) has a rummaging impact on free radicals and shows hostile to oxidant properties. Polyphenols battle aggravation through restraint of the amalgamation and capacity of incendiary middle people, like eicosanoids and cytokines. The expansion in the degree of fiery cytokines of the plasma might be related to ailing health in dynamic pneumonic TB. Oxidative pressure may smother the safe framework. In patients with TB, the utilization of cell reinforcement enhancements may handle oxidative pressure. Green tea can secure the invulnerable framework against oxidant mixes and free radicals through controlling oxidative pressure and lift its capacity also. Green tea may assist with quickening the procedure of recuperation and weight gain in TB patients through diminishing oxidative pressure. Pharmacotherapy with drugs hostile to tuberculosis brings about sustenance improvement and weight gain. We figured out that supplementation with green tea quickened weight gain in patients, since the blend of TB pharmacotherapy and mitigating mixes quicken recuperation from TB, yet the after effects of our mediation showed a slight increment in weight gain.

The Golestan Province of Iran has a high position of the frequency and predominance of tuberculosis. The patients frequently experience the ill effects of weight reduction and unhealthiness, predominantly because of the elevated level of oxidative pressure as a result of the illness and diminished food consumption. Various examinations have been led on the impact of nourishment or supplementation for the improvement course of TB. Supplementation with large scale of micronutrients (like vitamin D, zinc or arginine) is successful during hostile to bacterial treatment and results in the improvement of the general states of the patients and quickens recuperation from TB as indicated by various investigations. Nutraceuticals, similar to green tea polyphenols, have indicated worthy properties as adjuvant treatment of various illnesses. In view of its dynamic polyphenol mixes, Green tea (GT) has a rummaging impact on free radicals and shows hostile to oxidant properties. Polyphenols battle aggravation through restraint of the amalgamation and capacity of incendiary middle people, like eicosanoids and cytokines. The expansion in the degree of fiery cytokines of the plasma might be related to ailing health in dynamic pneumonic TB. Oxidative pressure may smother the safe framework. In patients with TB, the utilization of cell reinforcement enhancements may handle oxidative pressure. Green tea can secure the invulnerable framework against oxidant mixes and free radicals through controlling oxidative pressure and lift its capacity also. Green tea may assist with quickening the procedure of recuperation and weight gain in TB patients through diminishing oxidative pressure. Pharmacotherapy with drugs hostile to tuberculosis brings about sustenance improvement and weight gain. We figured out that supplementation with green tea quickened weight gain in patients, since the blend of TB pharmacotherapy and mitigating mixes quicken recuperationfrom TB, yet the after effects of our mediation showed a slight increment in weight gain.

Green tea with having iron-chelating properties can be valuable in TB treatment and the executives. We considered the impact of green tea utilization on iron status and improving the procedure of pneumonic tuberculosis treatment (quickening the negative sputum smear, decreasing the degree of oxidative pressure). Following the endorsement by Ethics Committee for Human Studies of Golestan and Tehran Universities of Medical Sciences and furthermore acquiring the composed assent of patients, this twofold blinded randomized clinical preliminary examination, was directed on patients with TB, who were relegated arbitrarily to the intercession gathering (41 patients) accepting 500 mg catechin of green tea separate and the benchmark group getting fake treatment for two months, since the start of attending hostile treatment to TB. Sputum assessment was completed on three slides utilizing the Ziehl-Neelson technique. From the start, the segment and dietary admission information were gotten. In the wake of getting 10 ml of venous blood, Hemoglobin (Hb), Transferrin, Ferritin, Total Iron Binding Capacity (TIBC), Iron and Serum malondialdehyde (MDA) were estimated toward the start and end of the examination. Sputum tests were gathered from the third week (at regular intervals) and the decrease of microbial load was additionally tried until sputum smear got negative. Information was handled utilizing autonomous and matched t-test, McNemar, Wilcoxon, Kaplan-Meier, Log-rank test, and Cox relapse model. P-esteem was accepted critical as under 0.05. Normal everyday vitality admission of patients was 1518±431 kcal, appropriation of which was: sugars (58%), protein (17%), and fat (22%). Vitamin D and Zinc admission of patients were less and iron admission was higher than the DRI. Weight changes in the two gatherings of fake treatment and green tea had the inclination of increment with a critical distinction at two and six month subsequent meet-ups (p 0.0001). In any case, there were no noteworthy changes when mediation contrasted with fake treatment. Sputum change time (days) was 52.5± 24.5 (median= 53 days) and 40.6 ± 22.5 (median= 29 days) in fake treatment and catechin gathering, respectively. The extent of patients in the green tea bunch dependent on the rule of; the brief length of being negative sputum smear; was essentially higher than the fake treatment gathering (p=0.032). To gauge the mean of iron status after intercession, ANCOVA test demonstrated mean contrast level (P-value) in the two gatherings for Hb, iron, TIBC, transferrin and ferritin as of 0.004, 0.56, 0.65, 0.38 and 0.16, respectively which implies that expansion of hemoglobin in the green tea bunch was noteworthy contrasted to the fake treatment gathering. There was only a 9.2 nmol/ml distinction between the two gatherings for MDA toward the start of the study, which was not factually huge (p=0.078) though, it was expanded to 24.8 nmol/ml after the mediation, showing a critical contrast (p<0.001). The decay esteem was evaluated to be -45.45±14.69 nmol/ml for catechin gathering and -19.91±18.38 nmol/ml for fake treatment gathering. Taking everything into account green tea can methodically lessen the fiery components and oxidants (diminishing of MDA as unsaturated fats oxidation marker), and subsequently, can improve the hematopoiesis and hemoglobin level. Subsequently, somehow irritation and harm in the lung are diminished, and assistant to antimicrobial treatment, quicken sputum smear transformation, infection enhancement, and treatment improvement. Various examinations have featured the job of green tea, especially its catechins in controlling fieryresponses. Green tea entangles receptive oxygen species (ROS) and is defensive against oxidative pressure. Agarwal and et al. indicated the impact of green tea extricate on the decrease of oxidative worry in patients accepting TB treatment. The patients in our examination were commonly underweight toward the start of the investigation, yet put on weight essentially two months after the initiation of the treatment. At long last, given the higher iron admission in spite of lower micronutrients and macronutrients in the diet of our patients, and thinking about the iron impact on mycobacterium endurance and the occurrence and worsening of provocative difficulties in patients, it appears that approach of required flour fortification with iron, particularly in regions, for example, Golestan, must be seen mindfully and its furt In this examination, green tea littly affected weight gain; in any case, its catechins substance are common mixes with moderately safe profiles, and the utilization of green tea as an adjuvant treatment in TB patients might be another technique for quicker restoration of these patients through shortening the chance to sputum smear transformation.her usage being changed carefully.

Conclusion:

In this examination, green tea littly affected weight gain; in any case, its catechins substance are common mixes with moderately safe profiles, and the utilization of green tea as an adjuvant treatment in TB patients might be another technique for quicker restoration of these patients through shortening the chance to sputum smear transformation.