Repurposing Metformin: An Update On Mechanism And Exploring Therapeutic Horizons

Abstract

Metformin, a mostly prescribed drug for managing type II diabetes mellitus, has gained attention for its potential therapeutic benefits beyond glycaemic control. This review explores the multifaceted role of metformin as a potential adjuvant in various medical conditions, focusing on its antituberculosis activity, its impact on polycystic ovary syndrome (PCOS), and its anticancer properties. In the context of tuberculosis (TB), metformin has shown promise as an adjunctive treatment. Clinical studies have provided evidence of improved treatment outcomes in TB patients when metformin is added to conventional antituberculosis regimens. Furthermore, metformin enhances the host's immune response, potentially aiding in controlling latent TB infections. However, these findings are predominantly based on retrospective studies, highlighting the need for well-designed prospective clinical trials to establish metformin's role in TB therapy. Metformin's influence on PCOS, a common disorder affecting women of reproductive age, is another area of interest. Studies suggest that metformin can improve insulin sensitivity, regulate menstrual cycles, and reduce hyperandrogenism in PCOS patients. Its potential role in enhancing fertility and metabolic outcomes makes metformin a valuable option for PCOS management. Additionally, metformin has attracted attention for its anticancer properties. Preclinical and epidemiological data have indicated potential benefits in reducing cancer risk and improving outcomes in various malignancies. Metformin's ability to modulate key cellular pathways, such as AMP-activated protein kinase (AMPK) and mTOR, contributes to its anticancer effects. Metformin's versatile pharmacological profile extends its potential utility in diverse medical conditions, including tuberculosis, PCOS, and cancer. Continued research and prospective clinical assessments are essential to elucidate its precise mechanisms of action and to establish metformin's place as a valuable adjunctive therapy in these disorders.