Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia.
Institute of Systems Biology, Universiti Kebangsaan Malaysia, Bangi, Malaysia.
Curr Microbiol. 2024 Jun 4;81(7):208. doi: 10.1007/s00284-024-03748-z.
Diabetes mellitus (DM) leads to impaired innate and adaptive immune responses. This renders individuals with DM highly susceptible to microbial infections such as COVID-19, tuberculosis and melioidosis. Melioidosis is a tropical disease caused by the bacterial pathogen Burkholderia pseudomallei, where diabetes is consistently reported as the most significant risk factor associated with the disease. Type-2 diabetes is observed in 39% of melioidosis patients where the risk of infection is 13-fold higher than non-diabetic individuals. B. pseudomallei is found in the environment and is an opportunistic pathogen in humans, often exhibiting severe clinical manifestations in immunocompromised patients. The pathophysiology of diabetes significantly affects the host immune responses that play a critical role in fighting the infection, such as leukocyte and neutrophil impairment, macrophage and monocyte inhibition and natural killer cell dysfunction. These defects result in delayed recruitment as well as activation of immune cells to target the invading B. pseudomallei. This provides an advantage for the pathogen to survive and adapt within the immunocompromised diabetic patients. Nevertheless, knowledge gaps on diabetes-infectious disease comorbidity, in particular, melioidosis-diabetes comorbidity, need to be filled to fully understand the dysfunctional host immune responses and adaptation of the pathogen under diabetic conditions to guide therapeutic options.
糖尿病（DM）可导致先天和适应性免疫应答受损。这使得糖尿病患者极易受到微生物感染，如 COVID-19、结核病和类鼻疽。类鼻疽是一种由细菌病原体伯克霍尔德菌引起的热带病，糖尿病一直被报道为与该病相关的最重要危险因素。在 39%的类鼻疽患者中观察到 2 型糖尿病，感染的风险比非糖尿病个体高 13 倍。伯克霍尔德菌存在于环境中，是人类的机会性病原体，在免疫功能低下的患者中常表现出严重的临床表现。糖尿病的病理生理学显著影响宿主免疫反应，这些反应在对抗感染中起着关键作用，如白细胞和中性粒细胞损伤、巨噬细胞和单核细胞抑制以及自然杀伤细胞功能障碍。这些缺陷导致免疫细胞延迟募集和激活以靶向入侵的伯克霍尔德菌。这为病原体在免疫功能低下的糖尿病患者中生存和适应提供了优势。然而，需要填补关于糖尿病-传染病合并症，特别是类鼻疽-糖尿病合并症的知识空白，以充分了解病原体在糖尿病条件下的功能失调宿主免疫反应和适应性，从而指导治疗选择。
