Is Metformin Poised for a Second Career as an Antimicrobial?

Abstract BackgroundMetformin, a widely used anti‐hyperglycemic, has a good safety profile, reasonably manageable side‐effects, is inexpensive and causes a desirable amount of weight loss. In four studies of patients with tuberculosis (one prospective and three retrospective), metformin administration resulted in better outcomes. In mice with several models of endotoxemia, metformin diminished levels of pro‐inflammatory cytokines and improved survival. Laboratory studies showed effectiveness of the drug on multiple pathogens, including Trichinella spiralis, Staphylococcus aureus, Pseudomonas aeruginosa, Hepatitis B virus, Hepatitis C virus and human immunodeficiency virus. Metformin administration in humans and mice produced major changes in the composition of the gut microbiota. These recently discovered microbe‐modulating properties of the drug have led investigators to predict wide therapeutic utility for metformin. The recent easing in FDA guidelines regarding administration of metformin to patients with kidney disease, and reduced anxiety about patient safety in terms of lactic acidosis, increase the probability of broadening of metformin's usage as a treatment for infectious agents. In this text we review articles pertinent to metformin's effects on microorganisms, both pathogens and commensals. We highlight the possible role of metformin in a wide range of infectious diseases and a possible expansion of its therapeutic profile in this field. MethodsA systematic ...
Source: Diabetes/Metabolism Research and Reviews - Category: Endocrinology Authors: Tags: REVIEW ARTICLE Source Type: research