Cell Type-Specific Immunomodulation Induced by Helminthes: Effect on Metainflammation, Insulin Resistance and Type-2 Diabetes

Aravindhan, Vivekanandhan; Anand, Gowrishankar

doi:10.4269/ajtmh.17-0236

Cited by 16 publications

(21 citation statements)

References 166 publications

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Section: Helminth Infection As An Immunomodulation Strategymentioning

confidence: 99%

“…Infections serve as an important source of inflammation especially in tropical countries and can serve as a link between infections and metabolic diseases [3]. The link between infections and metabolic diseases is less well explored and in recent years has gained tremendous interest [3]. Changes in the lifestyle of people living in industrialized countries have led to a decrease in the infectious burden and an increase in the prevalence of allergic and autoimmune diseases [4].…”

Section: Helminth Infection As An Immunomodulation Strategymentioning

confidence: 99%

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Helminth Induced Immunomodulation against Metainflammation and Insulin Resistance

Aravindhan¹,

Manohar²

2022

Inflammation in the 21st Century

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Filariasis mediated immunomodulation against metabolic diseases is a recently identified novel phenomenon. There seems to be an inverse relationship between filarial infections and type-2 diabetes. Rapid elimination of filarial diseases, due to mass drug administration has somehow fueled the sudden and rampant increase in type-2 diabetes, at least in certain tropical countries, like India and Indonesia. Filarial infections are in a way unique, since they bring about immunomodulation, in contrast to inflammation which is triggered by viral and bacterial infections. This dampens immunity and confers better survival for the pathogen. However, this also attenuates chronic inflammation and insulin resistance and thereby confers protection against type-2 diabetes. This chapter elucidates the various immune mechanisms involved in immunomodulation against insulin resistance and type-2 diabetes induced by helminth infection.

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Section: Helminth Infection As An Immunomodulation Strategymentioning

confidence: 99%

Section: Helminth Infection As An Immunomodulation Strategymentioning

confidence: 99%

Helminth Induced Immunomodulation against Metainflammation and Insulin Resistance

Aravindhan¹,

Manohar²

2022

Inflammation in the 21st Century

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“…Epidemiology shows an inverse relationship between the decreasing prevalence of helminth infections and the increasing prevalence of metabolic diseases (hygiene hypothesis) [97]. One way by which helminth infections can modulate insulin resistance and the associated inflammation is by inducing a chronic low-grade immune suppression due to both Th2 and regulatory T cells which can quench inflammation and promote insulin sensitivity [98]. Schistosomiasis appears to protect against diabetes mellitus [78].…”

Section: Common Infections and Resistance To Antimicrobial Drugsmentioning

confidence: 99%

The diabetes pandemic and associated infections: suggestions for clinical microbiology

Toniolo¹,

Cassani

Puggioni

et al. 2019

Reviews in Medical Microbiology

129

124

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There are 425 million people with diabetes mellitus in the world. By 2045, this figure will grow to over 600 million. Diabetes mellitus is classified among noncommunicable diseases. Evidence points to a key role of microbes in diabetes mellitus, both as infectious agents associated with the diabetic status and as possible causative factors of diabetes mellitus. This review takes into account the different forms of diabetes mellitus, the genetic determinants that predispose to type 1 and type 2 diabetes mellitus (especially those with possible immunologic impact), the immune dysfunctions that have been documented in diabetes mellitus. Common infections occurring more frequently in diabetic vs. nondiabetic individuals are reviewed. Infectious agents that are suspected of playing an etiologic/triggering role in diabetes mellitus are presented, with emphasis on enteroviruses, the hygiene hypothesis, and the environment. Among biological agents possibly linked to diabetes mellitus, the gut microbiome, hepatitis C virus, and prion-like protein aggregates are discussed. Finally, preventive vaccines recommended in the management of diabetic patients are considered, including the bacillus calmette-Guerin vaccine that is being tested for type 1 diabetes mellitus. Evidence supports the notion that attenuation of immune defenses (both congenital and secondary to metabolic disturbances as well as to microangiopathy and neuropathy) makes diabetic people more prone to certain infections. Attentive microbiologic monitoring of diabetic patients is thus recommendable. As genetic predisposition cannot be changed, research needs to identify the biological agents that may have an etiologic role in diabetes mellitus, and to envisage curative and preventive ways to limit the diabetes pandemic.

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“…The inverse relationship between helminth infections and risk of metabolic disorders has been named “metabolic hygiene hypothesis”, after the framework of the hygiene hypothesis for the association between early childhood infections and allergies. Furthermore, inflammation is an established etiological factor for insulin resistance, a precursor phenotype on the pathway to DM [ 10 ]; however, the metabolic hygiene hypothesis has not been commonly tested. The objective of this study was therefore, to evaluate the epidemiological association of specific helminthic infections with glycaemia and DM in adults from the Lao PDR.…”

Section: Introductionmentioning

confidence: 99%

Association between helminth infections and diabetes mellitus in adults from the Lao People’s Democratic Republic: a cross-sectional study

Htun

Odermatt

Paboriboune³

et al. 2018

Infect Dis Poverty

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BackgroundAs a result of epidemiological transition, the health systems of low- and middle-income countries are increasingly faced with a dual disease burden of infectious diseases and emerging non-communicable diseases. Little is known about the mutual influence of these two disease groups. The aim of this study was to investigate the co-occurrence of helminth infections and diabetes mellitus in adults in Lao People’s Democratic Republic (Lao PDR).MethodsWe conducted a cross-sectional study among 1600 randomly selected adults aged 35 and older from four different socio-economical and ecological provinces. Information on socio-demographics, risk factors and health conditions was obtained from personal interviews. Clinical assessments including anthropometry (height, weight, waist and hip circumference) and blood pressure measurements were also conducted. Diabetes was classified based on self-reported diagnoses and a point-of-care glycated haemoglobin (HbA1c) test from finger prick blood samples. Stool samples for helminth diagnosis were examined with formalin-ether concentration technique for intestinal parasitic infections. The independent associations of helminth infections with diabetic status and HbA1c were assessed using multiple regression analyses.ResultsThe prevalence of pre-diabetes and diabetes was 37.3% and 22.8%, respectively. Fifty-six percent of diabetic cases were undiagnosed and 85% of diagnosed diabetic cases had poor glycemic control. Participants from rural areas and from southern parts of the country had higher infection rates, with Opisthorchis viverrini, being the most common helminth infection (30.5%). We found a positive association between Taenia spp. infections and HbA1c (β = 0.117; 95% CI: 0.042–0.200) and diabetes mellitus risk (OR = 2.98; 95% CI: 1.10–8.05). No other helminth species was associated with glycated hemoglobin.ConclusionsHyperglycaemia and diabetic rates in Lao PDR are alarmingly high, but consistent with other high rates in the region. Given the high rates of under-diagnosis and poorly-controlled glycaemia in diabetes mellitus patients, routine diabetes screening and treatment is essential for the local healthcare system. Large longitudinal cohorts integrating biomarkers are warranted in the search of causal diabetes mellitus risk factors in the region. Common intestinal helminth infections, including O. viverrini, are unlikely to explain the high diabetes mellitus rates observed.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0488-2) contains supplementary material, which is available to authorized users.

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Cell Type-Specific Immunomodulation Induced by Helminthes: Effect on Metainflammation, Insulin Resistance and Type-2 Diabetes

Cited by 16 publications

References 166 publications

Helminth Induced Immunomodulation against Metainflammation and Insulin Resistance

Helminth Induced Immunomodulation against Metainflammation and Insulin Resistance

The diabetes pandemic and associated infections: suggestions for clinical microbiology

Association between helminth infections and diabetes mellitus in adults from the Lao People’s Democratic Republic: a cross-sectional study

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