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CAN MULTI-DRUG RESISTANT TB BE TREATED WITH LASER THERAPY?

Although the main treatment of tuberculosis (TB) is anti-TB drugs, tests conducted by medical experts and researchers show that the use of low-level laser therapy (LLLT) can improve the results of medications or conventional medicines.

This was the conclusion of medical researchers in Kharkov Institute of Physicians Advanced Training in Kharkov, Ukraine and other medical schools and hospitals in Russia and India.

Tuberculosis remains a major global health problem. It causes ill-health among millions of people each year and ranks as the second leading cause of death from an infectious disease worldwide.

There were approximately 210 000 deaths from Multi drug resistant (MDR)-TB (range, 130 000–290 000), according to reports with the latest estimate counted 9 million new TB cases in 2013 and 1.5 million TB deaths.

India is having the largest load of TB cases with an estimate of 2.0 million–2.3 million cases (i.e., one third of the world load). Globally an estimate of the burden of MDR-TB was 480,000 new cases of MDR-TB in 2013 and more than half of these cases were in India, China and Russian Federation. This total includes cases of primary and acquired MDR-TB.

The emergence of multidrug-resistant tuberculosis and more recently, extensively drug-resistant TB (XDR-TB) is a major threat to global TB control since the therapeutic cure rate is low in such cases.

The first goal in the control of tuberculosis has to have rapid conversion to acid-fast bacillus (AFB) smear negativity of TB patient since every open case of TB is likely to generate eight more cases of tuberculosis in one year.

Tuberculosis is a serious bacterial infection that can affect different parts of the body; most frequently it affects the lungs (pulmonary TB). Some bacteria can be drug resistant, and some people may have the infection alongside another medical condition.

People suffer from severe cough, weakness and sweats, and some people still die from TB even though effective drug treatment has been around for many years.

SYMPTOMS OF TB

Although your body may harbor the bacteria that cause tuberculosis, your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between:

  • Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn’t contagious. It can turn into active TB, so treatment is important for the person with latent TB and to help control the spread of TB. An estimated 2 billion people have latent TB.
  • Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later.

Signs and symptoms of active TB include:

  • Coughing that lasts three or more weeks
  • Coughing up blood
  • Chest pain, or pain with breathing or coughing
  • Unintentional weight loss
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Loss of appetite

Tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.

CAUSES OF TB

Tuberculosis (TB) is caused by a type of bacterium called mycobacterium which spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings. Although
tuberculosis is contagious, it’s not easy to catch.

As reported in the journal Nature Genetics, their findings indicate that TB mycobacterium emerged some 70,000 years ago among humans in Africa. It then migrated with them, slowly spreading around the world as the population expanded.

How TB managed to stick with humans over such a long period of time has been a scientific mystery. On one hand, TB is an exclusively human pathogen, and needs human hosts to survive. On the other, it is extremely effective at killing those humans it does infect, which would appear to threaten the survival of the TB bacteria itself.

The genetic research of a medical researcher team helps to explain this paradox. It reveals that some 20,000 to 30,000 years ago, TB bacteria developed the ability to go dormant in its hosts, then reemerge decades later. This ability may have developed as a survival strategy in the age of small, widely dispersed populations of hunter-gatherers, when TB might otherwise have killed off its isolated hosts quietly and died out itself, without gaining the opportunity to spread.

TREATMENT OF TUBERCULOSIS AND USE OF LLLT

Medications are the cornerstone of tuberculosis treatment. But treating TB takes much longer than treating other types of bacterial infections.

TB Disease can be cured by using special drugs that kill TB germs. But

TB germs are strong. It takes at least six to nine months of mediation to wipe them all out. It is very important that you take all your medicine.

Active tuberculosis, particularly if it’s a drug-resistant strain, will require several drugs at once The most common medications used to treat tuberculosis include:

  • Isoniazid.
  • Rifampin (Rifadin, Rimactane)
  • Ethambutol (Myambutol)
  • Pyrazinamide.

One of the ways to treat TB, could be to have alternative therapeutic approach such as low level laser therapy (LLLT).

It has been proposed that LLLT may help the drugs to be more effective. There are a number of different devices for giving the laser treatment, some giving the treatment externally (to the body or acupuncture sites), some using internal treatment (for blood or lungs) at varying doses.

The review of trials found only one randomized trial where the data were poorly reported, and it did not clarify the potential benefits and harms. Low level laser therapy should only be used in randomized controlled trials until its value is evaluated.

Although the exact mechanism by which beneficial effects of LLLT observed in tuberculosis is not known but it has been observed that nitrogen laser irradiation leads to temporary inactivation of drug sensitive as well as drug resistant clinical isolate of MTB6.

UVA radiation has been reported to lead to alteration in cell membrane properties via damage to membrane lipid. Nitrogen laser irradiation alters the fluidity of lipid region of the cell wall.

Further work is now required to evaluate the basic mechanism of action of laser and optimize the parameter as far as dose delivery and duration of laser irradiation is concerned.

FOOD FOR TB PATIENTS

To give your body the vitamins, minerals, and other nutrients it needs to fight active tuberculosis and regain your strength and stamina, you need to eat a diet containing a variety of healthy foods, such as:

  • Leafy, dark-colored greens like kale and spinach, for their high iron and B-vitamin content
  • Plenty of whole grains, like whole wheat pastas, breads, and cereals
  • Antioxidant-rich, brightly-colored vegetables, such as carrots, peppers, and squash, and fruits, like tomatoes, blueberries, and cherries — think of buying produce in a full rainbow of colors
  • Unsaturated fats like vegetable or olive oil, instead of butter
  • Rava Ladoo or Ragi Porridge: You may lose a lot of weight due to sickness and loss of appetite. Therefore, you need to take calorie-dense foods. Rava ladoos or a wholesome porridge made with ragi grains can provide the energy needed.
  • Khichdi: A hot bowl of khichdi made with rice, dal and seasonal vegetables is one of the best ways to load up on carbohydrate, proteins and all the other nutrients required by the body. It is a complete meal in itself and is easy to digest.
  • Soybean: It helps strengthen your immune system which is necessary to fight the TB-causing bacteria.
  • Paneer: Paneer or cottage cheese can be sliced into small pieces and added to your khichdi or other meals. Paneer is a high source of protein which helps in building muscles and giving your strength.

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639679/
http://www.cliniquetagmed.com/can-laser-cure-tuberculosis.html
http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD003490.pub2/abstract
https://www.gov.uk/dfid-research-outputs/low-level-laser-therapy-for-treating-tuberculosis-182322
file:///C:/Users/qwe/Downloads/Documents/ibrt06i3p135.pdf
https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250
https://www.ndtv.com/india-news/tuberculosis-treatment-8-foods-that-can-help-you-recover-faster-1721320

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