Rifampicin-Induced Toxicity and the Ameliorative Potential of Cynodon dactylon: A Comprehensive Review

Abstract

Rifampicin is one of the primary agents used in the treatment of tuberculosis, as it remains an important component of tuberculosis prevention as well as treatment of other bacterial infections. However, besides its therapeutic roles, it also poses a threat of negative side effects, among which liver toxicity is the most prominent one. Mechanisms of rifampicin toxicity imply that its toxicity has several components, which might be either related to the disturbance of processes associated with the metabolism of foreign substances, activation of pregnane X receptor pathways, manifestation of oxidative stress and free radicals creation, as well as lipid peroxidation process, activation of the processes caused by reports of the endoplasmic reticulum, disabling of bile acids transport, lipid accumulation in the liver cells, inflammation activation in the organism and introduction of unusual ways of cells’ programmed death. All these processes might lead to the situations like liver malfunctioning, the release of certain enzymes into the blood, bilirubinism and symptoms of diseases. Studies conducted on animals show the presence of renal and systemic problems due to the action of the active components over a lengthy period of time. Cynodon dactylon (L.) Pers is a plant that has been used in traditional medicine. The data received from technical studies show that that it is made of phenols, flavonoids, carotenoids, alkaloids and glycosides, etc. The extracts obtained from this plant were shown to have the abilities to mitigate oxidative stress, provide antioxidant properties and prevent harm to the liver caused by other toxic substances. The aqueous extracts showed lower activities of serum transaminases and alkaline phosphatases and improved liver structure in rats exposed to paracetamol toxicity. Some synthetic diets with the extract are known to be effective in treatment of hepatic damage due to streptozotocin use. However, the evidence of what influence, if any, the Cynodon plant has on the activity of rifampicin is not enough. The objective of this review is to summarize the available in literature information on liver inflammation risk with rifampicin use and the potential of C. dactylon in preventing the consequences of this process. The reviewed aspects include the causes of liver impairment with rifampicin, oxidative processes in the human body, heats of the liver damage, composition of the plant, evidence of its protective action and mechanisms of such action.