National Institute of Health, National Institute for Research in Tuberculosis, International Center for Excellence in Research.
National Institute for Research in Tuberculosis, Chennai, India.
Clin Infect Dis. 2019 Aug 1;69(4):697-704. doi: 10.1093/cid/ciy935.
Human and animal studies have demonstrated that helminth infections are associated with a decreased prevalence of type 2 diabetes mellitus (T2DM). However, very little is known about their biochemical and immunological interactions.
To assess the relationship between a soil-transmitted helminth, Strongyloides stercoralis (Ss), and T2DM, we examined analytes associated with glycemic control, metabolic processes, and T-cell-driven inflammation at the time of Ss diagnosis and 6 months after definitive anthelmintic treatment. We measured plasma levels of hemoglobin A1c, glucose, insulin, glucagon, adipocytokines, and T-helper (TH) 1-, 2-, and 17- associated cytokines in patients with T2DM with (INF group) or without (UN group) Ss infection. In INF individuals, we again assessed the levels of these analytes 6 months following anthelmintic treatment.
Compared to UN individuals, INF individuals exhibited significantly diminished levels of insulin and glucagon that increased significantly following therapy. Similarly, INF individuals exhibited significantly diminished levels of adiponectin and adipsin that reversed following therapy. INF individuals also exhibited significantly decreased levels of the TH1- and TH17- associated cytokines in comparison to UN individuals; again, anthelmintic therapy augmented these levels. As expected, INF individuals had elevated levels of TH2-associated and regulatory cytokines that normalized following definitive therapy. Multivariate analysis revealed that these changes were independent of age, sex, body mass index, and liver and renal function.
Strongyloides stercoralis infection is associated with a significant modulation of glycemic, hormonal, and cytokine parameters in T2DM and its reversal following anthelmintic therapy. Hence, Ss infection has a protective effect on diabetes-related parameters.
人体和动物研究表明，寄生虫感染与 2 型糖尿病（T2DM）的患病率降低有关。然而，关于它们的生化和免疫相互作用知之甚少。
为了评估土壤传播的寄生虫，即 Strongyloides stercoralis（Ss）与 T2DM 之间的关系，我们在 Ss 诊断时和明确驱虫治疗后 6 个月时检查了与血糖控制、代谢过程和 T 细胞驱动的炎症相关的分析物。我们测量了 T2DM 患者（INF 组有或无 Ss 感染）的血浆血红蛋白 A1c、葡萄糖、胰岛素、胰高血糖素、脂肪细胞因子和 T 辅助（TH）1、2 和 17 相关细胞因子水平。在 INF 个体中，我们再次在驱虫治疗后 6 个月评估这些分析物的水平。
与 UN 个体相比，INF 个体的胰岛素和胰高血糖素水平明显降低，治疗后明显增加。同样，INF 个体的脂联素和 adipsin 水平明显降低，治疗后逆转。与 UN 个体相比，INF 个体的 TH1 和 TH17 相关细胞因子水平也明显降低；再次，驱虫治疗增强了这些水平。如预期的那样，INF 个体的 TH2 相关和调节细胞因子水平升高，在明确治疗后恢复正常。多变量分析显示，这些变化与年龄、性别、体重指数以及肝肾功能无关。
Ss 感染与 T2DM 患者的血糖、激素和细胞因子参数的显著调节有关，并且在驱虫治疗后得到逆转。因此，Ss 感染对与糖尿病相关的参数具有保护作用。
