免疫疾患と免疫療法
オープンアクセス

概要

Diabetes-Tuberculosis Nexus: Is it a Global Double-Trouble Problem?

Aravindhan Vivekanandhan

Background: Diabetes impairs immunity which makes the patients more susceptible for tuberculosis (DiabetesTuberculosis synergy). Compared to active tuberculosis, the prevalence of latent tuberculosis infection (LTBI) among diabetes patients is poorly studied. Research Question: In, the present study the prevalence of LTBI among pre-diabetes and diabetes patients was studied, along with systemic and recall cytokine responses (n=804). Study Design and Methods: LTBI was screened by Quantiferon TB gold in Normal glucose tolerance ((NGT); n = 170), Prediabetes (PDM; n = 209), Newly diagnosed diabetes (NDM; n = 165) and Known diabetes (KDM; n = 260) subjects. Cytokine levels in serum and quantiferon supernatants was quantified by ELISA. Serum insulin, leptin, adiponectin and FGF-21 levels were also measured Results: The LTBI prevalence was found to be significantly lower among pre-diabetes and newly diagnosed diabetes subjects and identical in known diabetes subjects, compared to control (p<0.05). However, unexpectedly, the LTBI prevalence was higher in the hypertensive compared to non-hypertensive groups (p<0.05). The increased levels of TNF-α, IL-6 and IL1β in the PDM and NDM groups could account for the lower LTBI prevalence in these groups. Insulin levels were elevated due to co-morbidity with LTBI. Conclusion: The role played by cytokines and hormones in DM-TB synergy would be discussed.