Effectiveness of butterfly pea (<i>Clitoria ternatea</i>) flower extract as an adjuvant therapy for the treatment of pulmonary tuberculosis patients

Introduction: Tuberculosis (TB) is the main cause of infectious death. Butterfly pea flower therapy could potentially improve the expression of inflammatory cytokines in patients undergoing TB treatment. This study aimed to evaluate the success of adjuvant butterfly pea flower therapy in TB patients. Methods: A total of 28 TB patients who met the inclusion and exclusion criteria were divided into (1) the anti-TB plus butterfly pea flower group and (2) the anti-TB group, consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol. Analysis of the interferon-γ (IFN-γ) and interleukin-10 (IL-10) cytokines was carried out using the enzyme-linked immunosorbent assay. The profiles of hemoglobin (Hb), leukocytes, platelets, hematocrit (Ht), granulocytes, and erythrocyte sedimentation rate (ESR) were analyzed using a hematology analyzer. Microscopic analysis of Mycobacterium tuberculosis was carried out by Ziehl-Nielsen staining. Evaluation of clinical symptoms included fever, cough, shortness of breath and jaundice. Results: Administration of adjuvant butterfly pea flower therapy to anti-TB therapy increased the pro-inflammatory IFN-γ compared to anti-TB therapy (1.03 ± 0.82 vs 0.49 ± 0.39 pg/mL; P&lt;0.05), the anti-inflammatory IL-10 increased insignificantly (1.16 ± 0.96 vs 0.78 ± 0.79 pg/mL; P&gt;0.05). Adjuvant of butterfly pea flower also provided statistically significant benefits in reducing leukocytes, platelets, and acid-fast bacilli (AFBs) and improving the symptoms of cough and shortness of breath (P&gt;0.05). This adjuvant therapy did not cause side effects. Conclusion: Adjuvant butterfly pea flowers may provide benefits for TB patients under anti-TB therapy. Further research is still needed to confirm the adjuvant effect of butterfly pea flower on a large number of TB patients.