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Front Immunol. 2017 Jun 30;8:772. doi: 10.3389/fimmu.2017.00772. eCollection 2017.

Non-Steroidal Anti-inflammatory Drugs As Host-Directed Therapy for Tuberculosis: A Systematic Review.

Author information

1
Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany.
2
Experimental Tuberculosis Unit (UTE), Fundació Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Catalonia, Spain.
3
Department of Pulmonary Diseases & Tuberculosis and Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherland.
4
Department of Infectious Diseases, University Medical Center Groningen, University of Groningen, Groningen, Netherland.
5
Perinatal HIV Research Unit, University of Witwatersrand, Johannesburg, South Africa.
6
Division of Infection and Immunity, University College London (UCL), London, United Kingdom.
7
National Institute of Health Research's Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
8
Department of Microbiology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
9
Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
10
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.

Abstract

Lengthy, antimicrobial therapy targeting the pathogen is the mainstay of conventional tuberculosis treatment, complicated by emerging drug resistances. Host-directed therapies, including non-steroidal anti-inflammatory drugs (NSAIDs), in contrast, target host factors to mitigate disease severity. In the present Systematic Review, we investigate whether NSAIDs display any effects as therapy of TB and discuss possible mechanisms of action of NSAIDs as adjunctive therapy of TB. Ten studies, seven preclinical studies in mice and three clinical trials, were included and systematically reviewed. Our results point toward a beneficial effect of NSAIDs as adjunct to current TB therapy regimens, mediated by decreased lung pathology balancing host-immune reaction. The determination of the best timing for their administration in order to obtain the potential beneficial effects needs further investigation. Even if the preclinical evidence requires clinical evaluation, NSAIDs might represent a potential safe, simple, and cheap improvement in therapy of TB.

KEYWORDS:

host-directed therapies; infectious diseases; non-steroidal anti-inflammatory drugs; systematic review; tuberculosis

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