Rifampicin, a widely used antibiotic to treat chronic and severe bacterial infections such as tuberculosis and leprosy, can be effective in dealing with complications arising out of elevated blood sugar in diabetes too, according to Indian researchers.
Rifampicin shows high glycation inhibition levels, according to a team of researchers from the National Chemical Laboratory (NCL) and National Centre for Cell Sciences (NCCS), Pune in the western indian state of Maharashtra.
Rifampicin shows higher glycation inhibition, a major intervention strategy in diabetic complications, say researchers led by Dr. Mahesh J Kulkarni.
Most of the diseases including diabetes that causes tissue damage result in glycation of body proteins leading to increase in tissue diameter.
A glycation inhibitor can help in controlling the long term damage of such diseases. This could help treatment of diabetes in a long way because most of the complications arising out of diabetes such as diabetic retinopathy (blindness), neuropathy (nerve damage) etc are related to tissue damage due to glycation.
Currently, Dr Kulkarni and his team including Sandeep B Golegaonkar, Hemangi S Bhonsle and Ramanamurthy Boppana are testing rifampicin in animals and clinical trials to evaluate the safety of the new use of the drug at the National Centre for Cell Sciences.
Glycation of proteins lead to the formation of Advanced Glycation End products (AGEs).
High blood sugar levels due to diabetes lead to the development of complications in the body, which arise because of a non-enzymatic reaction between glucose and proteins, Dr Kulkarni has proposed in the study.
The Indian researchers, however, find some hurdle on the way. The Patent Act of India does not allow them to patent the new property of rifampicin as the original drug has already been patented.
Dr Kulkarni’s team is also working on the repositioning of various other existing drugs.
The study has been recently published in the second issue of the European Journal of Mass Spectroscopy.
Finding new uses for an already existing drug has become an important area of research in the pharmaceutical industry in the recent years. Viagra and thalidomide. Recent examples of successful repositioning by drug companies include Viagra and thalidomide are among recent examples.
The active content in Vigra – sildenafil citrate – has been granted approval for treating pulmonary hypertension by various regulatory agencies including US FDA.
So is thalidomide, which has once been considered causing birth defects, is now found effective and approved for the treatment of diseases including cancer.
When an existing drug is tried for a new indication the medicine need not have to be taken again through toxicity tests and its safety profile is known. This is a significant advantage as it can save considerable time in development.
The additional use of rifampicin as a glycation inhibitor is a very significant development as rifampicin is already an approved drug for the treatment of tuberculosis.
If approved for the new indication, rifampicin could be used not only to control tissue damage complications due to diabetes, the its potent anti-glycating effects make the drug qualified for the treatment of complications related to ageing, Alzheimer’s diseases and Parkinson’s disease, experts said.
India is one of the largest producers of the drug rifampici. Compared to other costlier antibiotic drugs rifampicin is considered a cheaper alternative.
India, which currently has the highest number of diabetics in the world, may need to wait till the rifampicin therapy comes through clinical research in actual diabetic patients establishing its effects.
Rifampicin or rifampin is a bacteriostatic antibiotic drug of the rifamycin group. It is a semisynthetic compound derived from Streptomyces mediterranei. Rifampicin may be abbreviated RIF, RMP, RD or R.
Rifampicin inhibits DNA-dependent RNA polymerase in bacterial cells by binding its beta subunit, thus preventing transcription of messenger RNA (mRNA) and subsequent translation to proteins.
It is typically used to treat mycobacterium infections, including tuberculosis and leprosy; and also has a role in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) in combination with fusidic acid.
It is used in prophylactic therapy against Neisseria meningitidis (meningococcal) infection.
It is also used to treat Listeria species, Neisseria gonorrhoeae, Haemophilus influenzae and Legionella pneumophila.
For these non-standard indications, sensitivity testing should be done (if possible) before starting rifampicin therapy.
Rifampicin resistance develops quickly during treatment and rifampicin monotherapy should not be used to treat these infections – it should be used in combination with other antibiotics.
Enterobacteriaceae, Acinetobacter and Pseudomonas species are intrinsically resistant to rifampicin.
Adverse effects are chiefly related to the drug’s hepatotoxicity, and patients receiving rifampicin often undergo liver function tests including aspartate aminotransferase (AST).
The most common unwanted effects are fever, gastrointestinal disturbances, rashes and immunological reactions. Liver damage, associated with jaundice, has also been reported and in some rare cases has led to death.
Taking rifampicin can cause certain bodily fluids, such as urine, tears and semen, to become orange-red in colour. This may permanently stain soft contact lenses. It also may be excreted in breast milk, therefore breast feeding should be avoided.