International Center for Excellence in Research, National Institute of Allergy and Infectious Diseases (NIAID), Chennai, India.
Stanley Medical College, Chennai, India.
Front Immunol. 2024 Aug 29;15:1447161. doi: 10.3389/fimmu.2024.1447161. eCollection 2024.
Tuberculosis (TB) remains a significant health concern in India, and its complexity is exacerbated by the rising occurrence of non-communicable diseases such as diabetes mellitus (DM). Recognizing that DM is a risk factor for active TB, the emerging comorbidity of TB and PDM (TB-PDM) presents a particular challenge. Our study focused on the impact of PDM on cytokine and chemokine profiles in patients with pulmonary tuberculosis TB) who also have PDM.
We measured and compared the cytokine (GM-CSF, IFN-γ, IL-1α/IL-1F1, IL-1β/IL-1F2, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p70, IL-13, IL-17/IL-17A, IL-18/IL-1F4, TNF-α) and chemokine (CCL1, CCL2, CCL3, CCL4, CCL11, CXCL1, CXCL2, CXCL9, CXCL10, and CXCL11) levels in plasma samples of TB-PDM, only TB or only PDM using multiplex assay.
We observed that PDM was linked to higher mycobacterial loads in TB. Patients with coexisting TB and PDM showed elevated levels of various cytokines (including IFNγ, TNFα, IL-2, IL-17, IL-1α, IL-1β, IL-6, IL-12, IL-18, and GM-CSF) and chemokines (such as CCL1, CCL2, CCL3, CCL4, CCL11, CXCL1, CXCL9, CXCL10, and CXCL11). Additionally, cytokines such as IL-18 and GM-CSF, along with the chemokine CCL11, were closely linked to levels of glycated hemoglobin (HbA1c), hinting at an interaction between glycemic control and immune response in TB patients with PDM.
Our results highlight the complex interplay between metabolic disturbances, immune responses, and TB pathology in the context of PDM, particularly highlighting the impact of changes in HbA1c levels. This emphasizes the need for specialized approaches to manage and treat TB-PDM comorbidity.
结核病（TB）仍然是印度的一个重大健康问题，其复杂性因糖尿病（DM）等非传染性疾病的发病率上升而加剧。鉴于 DM 是活动性结核病的一个危险因素，结核病和合并糖尿病（TB-PDM）的新出现合并症构成了一个特殊的挑战。我们的研究集中在合并糖尿病的肺结核（TB）患者中，研究 DM 对细胞因子和趋化因子谱的影响。
我们使用多重分析测量并比较了 TB-PDM、单纯 TB 和单纯 PDM 患者血浆样本中的细胞因子（GM-CSF、IFN-γ、IL-1α/IL-1F1、IL-1β/IL-1F2、IL-2、IL-4、IL-5、IL-6、IL-10、IL-12p70、IL-13、IL-17/IL-17A、IL-18/IL-1F4、TNF-α）和趋化因子（CCL1、CCL2、CCL3、CCL4、CCL11、CXCL1、CXCL2、CXCL9、CXCL10 和 CXCL11）水平。
我们发现 PDM 与 TB 中的更高的分枝杆菌负荷有关。合并 TB 和 PDM 的患者表现出多种细胞因子（包括 IFNγ、TNFα、IL-2、IL-17、IL-1α、IL-1β、IL-6、IL-12、IL-18 和 GM-CSF）和趋化因子（如 CCL1、CCL2、CCL3、CCL4、CCL11、CXCL1、CXCL9、CXCL10 和 CXCL11）水平升高。此外，细胞因子如 IL-18 和 GM-CSF，以及趋化因子 CCL11，与糖化血红蛋白（HbA1c）水平密切相关，提示在合并 PDM 的 TB 患者中，血糖控制与免疫反应之间存在相互作用。
我们的结果强调了代谢紊乱、免疫反应和 TB 病理学之间在 PDM 背景下的复杂相互作用，特别强调了 HbA1c 水平变化的影响。这强调了需要采用专门的方法来管理和治疗 TB-PDM 合并症。
