Does khat chewing increases the risk of Mycobacterium tuberculosis infection by macrophage immune modulation?

Drug abuse is a serious problem associated with different pathological outcomes including modulating the immune system. Drug abuse is rising in Saudi Arabia and so as TB, a disease of worldwide significance, caused by immunological modulation in the host system. Khat chewing is a common practice in Arabian Peninsula which is now gaining momentum in other parts of the world. It is considered as an addiction. It has been associated with different adverse outcomes such as periodontitis, oral leukoplakia and oral cancer and also has shown to promote apoptotic cell death through cysteine proteases. The active ingredient of khat, cathinone is shown to have immunomodulatory effect. In principle, this leads to enhanced susceptibility to various infections. The present study is designed to delineate the mechanism of immunomodulation produced by khat/cathinone in human/mouse macrophage. Further, this activity will be evaluated both in vivo and in vitro in response to infection with Mycobacterium smegmatis to get an insight if there exists a co relation between the Mycobacterium tuberculosis infection and khat chewing.