Musyoki Victor Moses, Mureithi Marianne, Heikinheimo Annamari, Maleche-Obimbo Elizabeth, Njaanake Kariuki, Anzala Omu
Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya.
KAVI-Institute of Clinical Research, University of Nairobi, Nairobi, Kenya.
PLoS One. 2025 Jan 13;20(1):e0316810. doi: 10.1371/journal.pone.0316810. eCollection 2025.
The lung environment harbours a community of microbes that play a significant role in health and disease, including innate protection against pathogenic microorganisms. Infection with Mycobacterium tuberculosis, psychological stress associated with the tuberculosis (TB) disease, and the metabolites from the rifampicin treatment regimen have been reported to induce hyperglycemia and consequently type 2 diabetes mellitus (T2DM) in individuals not previously diabetic. The high glucose concentration is proposed to alter the composition of the lung microbiota and airway homeostasis, exerting an influence on TB disease and treatment outcomes. In this systematic review, we propose to synthesize literature on TB-induced hyperglycemia and its impact on lung microbiota and secretion of airway mucus in individuals not previously diabetic. A systematic search will be carried out on PubMed, EMBASE, MEDLINE, PROQUEST, Cochrane, SCOPUS, and manually on Google Scholar and references of relevant articles to identify other studies. We will review published articles that include studies on TB-induced hyperglycemia, pulmonary microbiome, mucin secretion, and (or) airway surface liquid upon TB diagnosis and during treatment. The quality of the study articles will be assessed using the modified Newcastle-Ottawa Scale (NOS). Meta-analysis will be conducted using random effect model for heterogeneity to pool estimates on microbial diversity. Egger's test will be performed to explore any selective reporting bias. The findings of the systematic review and the meta-analysis will be reported as per the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol guidelines. This protocol was developed and uploaded onto the International Prospective Register of Systematic Reviews (PROSPERO) database, registration number: CRD42024482248.
肺部环境中存在着微生物群落，它们在健康和疾病中发挥着重要作用，包括对致病微生物的天然保护。据报道，结核分枝杆菌感染、与结核病相关的心理压力以及利福平治疗方案产生的代谢产物会导致血糖升高，进而使非糖尿病个体患上2型糖尿病（T2DM）。高血糖浓度被认为会改变肺部微生物群的组成和气道稳态，对结核病及治疗结果产生影响。在本系统评价中，我们建议综合关于结核病诱发的高血糖及其对非糖尿病个体肺部微生物群和气道黏液分泌影响的文献。我们将在PubMed、EMBASE、MEDLINE、PROQUEST、Cochrane、SCOPUS上进行系统检索，并手动在谷歌学术以及相关文章的参考文献中查找，以识别其他研究。我们将回顾已发表的文章，这些文章包括关于结核病诊断时及治疗期间结核病诱发的高血糖、肺部微生物组、黏蛋白分泌和（或）气道表面液体的研究。研究文章的质量将使用改良的纽卡斯尔-渥太华量表（NOS）进行评估。将使用随机效应模型进行荟萃分析，以汇总微生物多样性的估计值，以处理异质性。将进行Egger检验以探索是否存在任何选择性报告偏倚。系统评价和荟萃分析的结果将按照系统评价和荟萃分析的首选报告项目（PRISMA）协议指南进行报告。本方案已制定并上传至国际前瞻性系统评价注册库（PROSPERO）数据库，注册号：CRD42024482248。
