Tsukaguchi K, Yoneda T, Yoshikawa M, Tokuyama T, Fu A, Tomoda K, Narita N, Enoki Y, Tsukaguchi M, Shirai F
Second Department of Internal Medicine, Nara Medical University, Japan.
Kekkaku. 1992 Dec;67(12):755-60.
Patients with diabetes mellitus (DM) show an increased susceptibility to bacterial infections due to the presence of neutrophil dysfunction. Susceptibility to tuberculosis has also been reported in such patients, however, the reason remains unclear. This study measured the production of interleukin-1 beta (IL-1 beta), tumor necrosis factor alpha (TNF alpha) and interleukin-6 (IL-6) by the peripheral monocytes of patients diagnosed with pulmonary tuberculosis accompanied by DM (TB+DM) and patients without DM complications (TB) using age-matched, healthy control subjects for comparison. Also examined was the relationship between cytokine production and DM control. The results were as follows: (1) The production of IL-1 beta, TNF alpha and IL-6 in TB patients was significantly higher than that observed in the healthy control subjects. (2) The production of IL-1 beta, TNF alpha and IL-6 in TB+DM patients was significantly lower than that observed in the TB patients. (3) The production of IL-1 beta and TNF alpha in TB+DM patients with poor control was significantly lower than that observed in the patients with good control. (4) The TNF alpha production had a significant inverse correlation to HbA1c in the TB+DM patients. This study demonstrated that the production of cytokines is impaired in TB+DM patients and suggests a close correlation between tuberculosis immunity and DM.
糖尿病（DM）患者由于存在中性粒细胞功能障碍，对细菌感染的易感性增加。此类患者对结核病的易感性也有报道，然而，原因尚不清楚。本研究使用年龄匹配的健康对照受试者作为比较，测量了伴有糖尿病的肺结核患者（TB+DM）和无糖尿病并发症患者（TB）外周单核细胞中白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）的产生情况。还研究了细胞因子产生与糖尿病控制之间的关系。结果如下：（1）TB患者中IL-1β、TNF-α和IL-6的产生显著高于健康对照受试者。（2）TB+DM患者中IL-1β、TNF-α和IL-6的产生显著低于TB患者。（3）控制不佳的TB+DM患者中IL-1β和TNF-α的产生显著低于控制良好的患者。（4）TB+DM患者中TNF-α的产生与糖化血红蛋白（HbA1c）呈显著负相关。本研究表明，TB+DM患者的细胞因子产生受损，并提示结核病免疫与糖尿病之间存在密切关联。
