Significance of the frequency of CD4+CD25+CD127− T‐cells in patients with pulmonary tuberculosis and diabetes mellitus

Sun, Qin; Zhang, Qing; Xiao, Heping; Cui, Haiyan; Su, Bo

doi:10.1111/j.1440-1843.2012.02184.x

Cited by 28 publications

(19 citation statements)

References 32 publications

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“…TB-DM cases also have a higher frequency of single- and double-cytokine producing CD4+ Th1 cells in response to Mtb antigens (for IFN-γ, TNF-α or IL-2) (37). These hyper-active responses in peripheral blood contrast with the results from few studies conducted at the site of infection (in bronchoalveolar lavage) where TB-DM patients appear to have reduced activation of immunity; one reported a lower proportion of activated alveolar macrophages (70), and another higher anti-inflammatory (IL-10) and lower pro-inflammatory (IFN-γ) cytokines (71). The impact of the host compartment (peripheral blood versus lung) requires further study.…”

Section: Biological Basis For the Association Between Tb And Dmcontrasting

confidence: 61%

Diabetes and Tuberculosis

2016

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The increase in type 2 diabetes mellitus (DM) patients in countries where tuberculosis (TB) is also endemic has led to the reemerging importance of DM as a risk factor for TB. DM causes a 3-fold increase in TB risk and a 2-fold increase in adverse TB treatment outcomes. Given the sheer numbers of DM patients worldwide, there are now more TB patients with TB-DM comorbidity than TB-HIV coinfection. There is an urgent need to implement strategies for TB prevention and control among the millions of DM patients exposed to Mycobacterium tuberculosis . This chapter summarizes the current epidemiological, clinical, and immunological knowledge on TB and DM and their clinical and public health implications. These include the underlying mechanisms for TB risk in DM patients and their clinical and sociodemographic characteristics that distinguish them from TB patients without DM. TB-DM comorbidity is posing a new challenge for integrating the short-term care for TB with the long-term care for DM, particularly in low- and middle-income countries.

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Section: Biological Basis For the Association Between Tb And Dmcontrasting

confidence: 61%

Diabetes and Tuberculosis

2016

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“…TB-DM cases also have a higher frequency of single- and double-cytokine producing CD4+ Th1 cells in response to Mtb antigens (for IFN-γ, TNF-α or IL-2) [24]. These hyper-active responses in peripheral blood contrast with the results from few studies conducted at the site of infection (in bronchoalveolar lavage) where TB-DM patients appear to have reduced activation of immunity; one reported a lower proportion of activated alveolar macrophages [26], and another higher IL-10 (which is anti-inflammatory) and lower IFN-γ[27]. The impact of the host compartment (peripheral blood versus lung) requires further study.…”

Section: Dysfunctional Innate and Adaptive Immunity To Mtb In Dm Pmentioning

confidence: 99%

Impact of diabetes on the natural history of tuberculosis

Restrepo¹,

Schlesinger²

2014

Diabetes Research and Clinical Practice

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Tuberculosis (TB) is the number one bacterial killer worldwide and the current increase in type 2 diabetes mellitus patients (DM), particularly in countries where TB is also endemic, has led to the re-emerging importance of DM2 as a risk factor for TB. There is an urgent need to implement strategies for TB prevention among the millions of DM patients exposed to Mycobacterium tuberculosis (Mtb) worldwide, but knowledge is limited on how and when DM2 alters the natural history of this infection. In this review we summarize the current epidemiological, clinical and immunologic studies on TB and DM and discuss the clinical and public health implications of these findings. Specifically, we evaluate the mechanisms by which DM patients have a higher risk of Mtb infection and TB development, present with signs and symptoms indicative of a more infectious TB infection, and are more likely to have adverse TB treatment outcomes, including death. Emphasis is placed on type 2 DM given its higher prevalence in contemporary times, but the underlying role of hyperglycemia and of type 1 DM is also discussed.

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“…20 In the broncho alveolar lavage of TB-DM patients, Sun et al also found higher baseline IL-10, but lower IFN-γ suggesting the lung compartment may have a biased Th2 response in DM. 55 …”

Section: Impact Of Dm On the Natural History Of Tbmentioning

confidence: 99%

Host-pathogen interactions in tuberculosis patients with type 2 diabetes mellitus

Restrepo¹,

Schlesinger²

2013

Tuberculosis

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Tuberculosis (TB) is known to be fueled by HIV as well as social and economic factors. With progression of the diabetes mellitus (DM) pandemic in countries where TB is also endemic, focus is increasing on the potential links between DM and TB. Despite the magnitude of the DM-TB association woldwide, it is striking how little we know about the underlying biology that promotes this association which is a major concern to public health. In this review we summarize current findings regarding the alterations in the innate and adaptive immune responses of DM patients to Mycobacterium tuberculosis (Mtb). Current findings suggest underperforming innate immunity followed by a hyper-reactive cellular response to Mtb, but the contribution of these altered responses to TB susceptibility or to the more adverse clinical outcomes of TB patients with DM remains unclear. Elucidating the basic mechanisms underlying the higher susceptibility of DM patients to TB should lead to a strategy for stratification of the millions of DM patients worldwide into those with the highest TB risk for targeted TB prevention.

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Significance of the frequency of CD4+CD25+CD127− T‐cells in patients with pulmonary tuberculosis and diabetes mellitus

Abstract: In patients with pulmonary tuberculosis and DM, the imbalance between Treg and effector T-cells at pathological sites may be associated with weakened immunity and clinical manifestations of TB.

Cited by 28 publications

References 32 publications

Diabetes and Tuberculosis

Diabetes and Tuberculosis

Impact of diabetes on the natural history of tuberculosis

Host-pathogen interactions in tuberculosis patients with type 2 diabetes mellitus

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