Tuberculosis and Diabetes Mellitus: Relating Immune Impact of Co-morbidity with Challenges in Disease Management in High Burden Countries

Overview

Journal J Clin Tuberc Other Mycobact Dis

Date 2022 Dec 8

PMID 36478777

Authors

Uzair Abbas

Kiran Iqbal Masood

Aalia Khan

Muhammad Irfan

Nausheen Saifullah

Bushra Jamil

Zahra Hasan

Affiliations

Soon will be listed here.

Abstract

(MTB) is the causative agent of TB. TB incidence is high in many low resource settings where limited health systems make it difficult for screening of co-morbid conditions. Susceptibility to TB is increased with coincident diabetes mellitus (DM) or prediabetes. DM leads to chronic, subclinical inflammation in the host leading to compromised protective immunity against MTB, impacting TB treatment. This review focuses on the immunological impact of DM and prediabetes on TB infections, highlighting the importance of having effective diagnostic, treatment and management programs for early identification of hyperglycemia in TB patients to improve treatment outcomes. Further, it describes challenges in monitoring of TB and DM co-morbidity in a high-burden setting.

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References

Domingo-Gonzalez R, Prince O, Cooper A, Khader S . Cytokines and Chemokines in Mycobacterium tuberculosis Infection. Microbiol Spectr. 2016; 4(5). PMC: 5205539. DOI: 10.1128/microbiolspec.TBTB2-0018-2016. View

Faurholt-Jepsen D, Range N, PrayGod G, Jeremiah K, Faurholt-Jepsen M, Aabye M . Diabetes is a strong predictor of mortality during tuberculosis treatment: a prospective cohort study among tuberculosis patients from Mwanza, Tanzania. Trop Med Int Health. 2013; 18(7):822-9. DOI: 10.1111/tmi.12120. View

Viswanathan V, Kumpatla S, Aravindalochanan V, Rajan R, Chinnasamy C, Srinivasan R . Prevalence of diabetes and pre-diabetes and associated risk factors among tuberculosis patients in India. PLoS One. 2012; 7(7):e41367. PMC: 3406054. DOI: 10.1371/journal.pone.0041367. View

Wu Y, Ding Y, Tanaka Y, Zhang W . Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci. 2014; 11(11):1185-200. PMC: 4166864. DOI: 10.7150/ijms.10001. View

Jimenez-Corona M, Cruz-Hervert L, Garcia-Garcia L, Ferreyra-Reyes L, Delgado-Sanchez G, Bobadilla-Del-Valle M . Association of diabetes and tuberculosis: impact on treatment and post-treatment outcomes. Thorax. 2012; 68(3):214-20. PMC: 3585483. DOI: 10.1136/thoraxjnl-2012-201756. View

Nathan D, Davidson M, DeFronzo R, Heine R, Henry R, Pratley R . Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care. 2007; 30(3):753-9. DOI: 10.2337/dc07-9920. View

Kang Y, Kim S, Jo K, Kim H, Park S, Kim T . Impact of diabetes on treatment outcomes and long-term survival in multidrug-resistant tuberculosis. Respiration. 2013; 86(6):472-8. DOI: 10.1159/000348374. View

Perez-Guzman C, Torres-Cruz A, Villarreal-Velarde H, Vargas M . Progressive age-related changes in pulmonary tuberculosis images and the effect of diabetes. Am J Respir Crit Care Med. 2000; 162(5):1738-40. DOI: 10.1164/ajrccm.162.5.2001040. View

Walker C, Unwin N . Estimates of the impact of diabetes on the incidence of pulmonary tuberculosis in different ethnic groups in England. Thorax. 2010; 65(7):578-81. DOI: 10.1136/thx.2009.128223. View

10.

Abri S, Kasaeva T, Migliori G, Goletti D, Zenner D, Denholm J . Tools to implement the World Health Organization End TB Strategy: Addressing common challenges in high and low endemic countries. Int J Infect Dis. 2020; 92S:S60-S68. DOI: 10.1016/j.ijid.2020.02.042. View

11.

Grant R, Dixit V . Mechanisms of disease: inflammasome activation and the development of type 2 diabetes. Front Immunol. 2013; 4:50. PMC: 3592198. DOI: 10.3389/fimmu.2013.00050. View

12.

Sakamoto S, Nie J, Taniguchi T . Cutting edge: phorbol ester induction of IFN-gamma receptors leads to enhanced DR alpha gene expression. J Immunol. 1999; 162(8):4381-4. View

13.

Leung C, Lam T, Chan W, Yew W, Ho K, Leung G . Diabetic control and risk of tuberculosis: a cohort study. Am J Epidemiol. 2008; 167(12):1486-94. DOI: 10.1093/aje/kwn075. View

14.

Basnyat B, Caws M, Udwadia Z . Tuberculosis in South Asia: a tide in the affairs of men. Multidiscip Respir Med. 2018; 13:10. PMC: 5868053. DOI: 10.1186/s40248-018-0122-y. View

15.

Lin P, Maiello P, Gideon H, Coleman M, Cadena A, Rodgers M . PET CT Identifies Reactivation Risk in Cynomolgus Macaques with Latent M. tuberculosis. PLoS Pathog. 2016; 12(7):e1005739. PMC: 4933353. DOI: 10.1371/journal.ppat.1005739. View

16.

Niazi A, Kalra S . Diabetes and tuberculosis: a review of the role of optimal glycemic control. J Diabetes Metab Disord. 2013; 11(1):28. PMC: 3598170. DOI: 10.1186/2251-6581-11-28. View

17.

Allen M, Bailey C, Cahatol I, Dodge L, Yim J, Kassissa C . Mechanisms of Control of Mycobacterium tuberculosis by NK Cells: Role of Glutathione. Front Immunol. 2015; 6:508. PMC: 4593255. DOI: 10.3389/fimmu.2015.00508. View

18.

OGarra A, Redford P, McNab F, Bloom C, Wilkinson R, Berry M . The immune response in tuberculosis. Annu Rev Immunol. 2013; 31:475-527. DOI: 10.1146/annurev-immunol-032712-095939. View

19.

Tegegne B, Mengesha M, Teferra A, Awoke M, Habtewold T . Association between diabetes mellitus and multi-drug-resistant tuberculosis: evidence from a systematic review and meta-analysis. Syst Rev. 2018; 7(1):161. PMC: 6190557. DOI: 10.1186/s13643-018-0828-0. View

20.

Podell B, Ackart D, Obregon-Henao A, Eck S, Henao-Tamayo M, Richardson M . Increased severity of tuberculosis in Guinea pigs with type 2 diabetes: a model of diabetes-tuberculosis comorbidity. Am J Pathol. 2014; 184(4):1104-1118. PMC: 3969993. DOI: 10.1016/j.ajpath.2013.12.015. View