Cornejo-Báez Axhell Aleid, Zenteno-Cuevas Roberto, Luna-Herrera Julieta
Laboratorio de Inmunoquímica II, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Prolongación de Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomas, Delegación Miguel Hidalgo, Mexico City C.P. 11340, Mexico.
Instituto de Salud Pública, Universidad Veracruzana, Av. Luis Castelazo Ayala s/n, A.P. 57, Col. Industrial Animas, Xalapa C.P. 91190, Veracruz, Mexico.
Microorganisms. 2024 Dec 20;12(12):2649. doi: 10.3390/microorganisms12122649.
Tuberculosis (TB), caused by (), remains one of the leading infectious causes of death globally, with drug resistance presenting a significant challenge to control efforts. The interplay between type 2 diabetes mellitus (T2DM) and TB introduces additional complexity, as T2DM triples the risk of active TB and exacerbates drug resistance development. This review explores how T2DM-induced metabolic and immune dysregulation fosters the survival of , promoting persistence and the emergence of multidrug-resistant strains. Mechanisms such as efflux pump activation and the subtherapeutic levels of isoniazid and rifampicin in T2DM patients are highlighted as key contributors to resistance. We discuss the dual syndemics of T2DM-TB, emphasizing the role of glycemic control and innovative therapeutic strategies, including efflux pump inhibitors and host-directed therapies like metformin. This review underscores the need for integrated diagnostic, treatment, and management approaches to address the global impact of T2DM-TB comorbidity and drug resistance.
由（）引起的结核病（TB）仍然是全球主要的感染性死亡原因之一，耐药性给控制工作带来了重大挑战。2型糖尿病（T2DM）与结核病之间的相互作用增加了复杂性，因为T2DM使活动性结核病的风险增加两倍，并加剧了耐药性的发展。本综述探讨了T2DM诱导的代谢和免疫失调如何促进（）的存活，促进其持续存在以及多重耐药菌株的出现。T2DM患者中流出泵激活以及异烟肼和利福平亚治疗水平等机制被强调为耐药性的关键促成因素。我们讨论了T2DM - TB的双重共病问题，强调血糖控制和创新治疗策略的作用，包括流出泵抑制剂和如二甲双胍等宿主导向疗法。本综述强调需要综合的诊断、治疗和管理方法，以应对T2DM - TB合并症和耐药性对全球的影响。
