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Singh K, Hussain T, Gupta B, Pati S. A Comparative Investigation on Cytokine Expression in Pulmonary Tuberculosis and Comorbidity with Type 2 Diabetes Mellitus. Int J Mycobacteriol 2024; 13:165-170. [PMID: 38916387 DOI: 10.4103/ijmy.ijmy_40_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/26/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Mycobacterium tuberculosis (Mtb) is the causative agent of tuberculosis (TB), with a high global prevalence and mortality rate. To control the gruesome pathogen, a deep understanding of pathophysiology and host-pathogen interaction is essential for early diagnosis and novel drug development. Cytokines play a crucial role in infection and susceptibility, and their expressions could serve as potential biomarkers to enhance our understanding of Mtb pathophysiology for improved therapeutic approaches. This cross-sectional study investigates the levels of four important T-cell immune-mediated cytokines: interleukins (IL-6 and IL-10), interferon-gamma (IFN-γ), and tumor necrosis factor-alpha in 80 cohort samples, with 20 people in each group. METHODS Following proper ethics and patient consent, we collected blood samples and isolated serum from all four groups: TB, type 2 diabetes mellitus (T2DM), type 2 diabetes-TB comorbidity (T2DM + TB), and a healthy individual as a control group (C). Furthermore, cytokine expression was measured in individual serum samples through the enzyme-linked immunosorbent assay method using commercial kits (Diaclone, French). Statistical significance was observed by analyzing triplicate data using t-tests and the one-way ANOVA method with GraphPad Prism 10. RESULTS The results showed that all four cytokine levels were higher (P ≤ 0.0001) than the control, especially IL-6, IL-10, and IFN-γ, which were found to be upregulated in T2DM + TB samples (P ≤ 0.0001) than individual TB or T2DM samples. CONCLUSION The high levels of cytokines in comorbidity cases raise the risk of insulin resistance and the severity of TB infection. These levels of expression could be used to keep track of the Mtb infection status or severity, aid in early diagnosis as a possible biomarker, and suggest possible treatment plans.
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Affiliation(s)
- Khusbu Singh
- ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
- KIIT School of Biotechnology, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, Odisha, India
| | - Tahziba Hussain
- ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Bhawna Gupta
- KIIT School of Biotechnology, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, Odisha, India
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar, Odisha, India
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Aravindhan V, Yuvaraj S. Immune-endocrine network in diabetes-tuberculosis nexus: does latent tuberculosis infection confer protection against meta-inflammation and insulin resistance? Front Endocrinol (Lausanne) 2024; 15:1303338. [PMID: 38327565 PMCID: PMC10848915 DOI: 10.3389/fendo.2024.1303338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024] Open
Abstract
Tuberculosis patients with diabetes, have higher sputum bacillary load, delayed sputum conversion, higher rates of drug resistance, higher lung cavitary involvement and extra-pulmonary TB infection, which is called as "Diabetes-Tuberculosis Nexus". However, recently we have shown a reciprocal relationship between latent tuberculosis infection and insulin resistance, which has not been reported before. In this review, we would first discuss about the immune-endocrine network, which operates during pre-diabetes and incipient diabetes and how it confers protection against LTBI. The ability of IR to augment anti-TB immunity and the immunomodulatory effect of LTBI to quench IR were discussed, under IR-LTB antagonism. The ability of diabetes to impair anti-TB immunity and ability of active TB to worsen glycemic control, were discussed under "Diabetes-Tuberculosis Synergy". The concept of "Fighter Genes" and how they confer protection against TB but susceptibility to IR was elaborated. Finally, we conclude with an evolutionary perspective about how IR and LTBI co-evolved in endemic zones, and have explained the molecular basis of "IR-LTB" Antagonism" and "DM-TB Synergy", from an evolutionary perspective.
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Affiliation(s)
- Vivekanandhan Aravindhan
- Department of Genetics, Dr Arcot Lakshmanasamy Mudaliyar Post Graduate Institute of Basic Medical Sciences (Dr ALM PG IBMS), University of Madras, Chennai, India
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Ding Y, Chen Y, Feng W, Huang G, Dong M, Zhao T, Chen N, Yang L, Mao G, Wu X. Persistent immune injury induced by short-term decabromodiphenyl ether (BDE-209) exposure to female middle-aged Balb/c mice. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:111325-111343. [PMID: 37814044 DOI: 10.1007/s11356-023-30148-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023]
Abstract
Decabromodiphenyl ether (BDE-209), widely used in various industries for its excellent flame-retardant performance, could be enriched in humans and is closely associated with immune impairment. In addition, immune system is gradually declined and becoming more sensitive to environmental pollutants in the ageing process. Therefore, the immunotoxicity of BDE-209 (4, 40, and 400 mg/kg/day) to middle-aged mice and its recovery and susceptibility was first to be comprehensively investigated in this study. The results showed that BDE-209 exposure could lead to oxidative injury to immune organs (spleen, thymus, and liver), impair humoral (immunoglobulins), cellular (lymphopoiesis), and non-specific immunity, and disturb the expressions of the genes related to Th1/Th2 balance (T helper cells) in the middle-aged mice. In addition, Integrated Biomarker Response (IBR) indicated that BDE-209-induced immune impairment was challenging to self-regulated, and even exacerbated after 21 days of recovery and oxidative injury in immune organs could be the main reason. Furthermore, factorial analysis showed that middle-aged mice exposed to BDE-209 suffered from greater immune impairment than adult mice, and the immune impairment in aged mice is more difficult to be self-repaired than that in adult mice. It can be seen that the aged tend to suffer from BDE-209-induced persistent immune impairment and health threats.
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Affiliation(s)
- Yangyang Ding
- School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
- The Laboratory Animal Research Center of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Yao Chen
- School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
- Institute of Environmental Health and Ecological Security, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Weiwei Feng
- School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
- Institute of Environmental Health and Ecological Security, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Guijuan Huang
- School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Mingyue Dong
- School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Ting Zhao
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Na Chen
- Zhenjiang Food and Drug Supervision and Inspection Center, Zhenjiang, Jiangsu, China
| | - Liuqing Yang
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Guanghua Mao
- School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, Jiangsu, China.
| | - Xiangyang Wu
- School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, Jiangsu, China
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Kumar NP, Babu S. Impact of diabetes mellitus on immunity to latent tuberculosis infection. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1095467. [PMID: 36993821 PMCID: PMC10012073 DOI: 10.3389/fcdhc.2023.1095467] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023]
Abstract
Tuberculosis (TB) is an infectious disease that poses a major health threat and is one of the leading causes of death worldwide. Following exposure to Mycobacterium tuberculosis (M.tb) bacilli, hosts who fail to clear M.tb end up in a state of latent tuberculosis infection (LTBI), in which the bacteria are contained but not eliminated. Type 2 diabetes mellitus (DM) is a noncommunicable disease that can weaken host immunity and lead to increased susceptibility to various infectious diseases. Despite numerous studies on the relationship between DM and active TB, data on the association between DM and LTBI remains limited. Immunological data suggest that LTBI in the presence of DM leads to an impaired production of protective cytokines and poly-functional T cell responses, accounting for a potential immunological mechanism that could leads to an increased risk of active TB. This review highlights the salient features of the immunological underpinnings influencing the interaction between TB and DM in humans.
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Affiliation(s)
- Nathella Pavan Kumar
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
- *Correspondence: Nathella Pavan Kumar, ,
| | - Subash Babu
- International Centre for Excellence in Research, National Institutes of Health, Chennai, India
- Laboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
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Aravindhan V, Bobhate A, Sathishkumar K, Patil A, Kumpatla S, Viswanathan V. Unique Reciprocal Association Seen Between Latent Tuberculosis Infection and Diabetes Is Due to Immunoendocrine Modulation (DM-LTB-1). Front Microbiol 2022; 13:884374. [PMID: 35832818 PMCID: PMC9271927 DOI: 10.3389/fmicb.2022.884374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022] Open
Abstract
Aim The prevalence of latent tuberculosis infection (LTBI) among diabetes patients is poorly studied. In the present study, the prevalence of LTBI among pre-diabetes and diabetes patients was studied, along with immunoendocrine biomarkers (n = 804). Methods LTBI was screened by Quantiferon TB gold in Normal glucose tolerance [(NGT); n = 170, [Pre-diabetes (PDM; n = 209), Newly diagnosed diabetes (NDM; n = 165) and Known diabetes (KDM; n = 260) subjects. CRP, TNF-α, IL-6, IL-1β, IFN-β, IL-12, IFN-γ, IL-2, insulin, leptin, and adiponectin levels in serum and IFN-γ levels in quantiferon supernatants were quantified by ELISA. The expression of T-bet was quantified using qRT-PCR. Serum TBARS and nitrite levels were quantified by colorimetry. Results The LTBI prevalence was 32% in NGT, 23% in PDM, 24% in NDM, and 32% in KDM groups, with an adjusted OR of 0.61 (p < 0.05). Downregulation of CRP, TNF-α, and nitrites and upregulation of adiponectin could be responsible for LTBI mediated protection against insulin resistance (IR), while the high levels of IL-1β, IL-12, and leptin could be responsible for IR mediated anti-TB immunity. The defective antigen-specific IFN-γ response, as seen in the KDM group, could be responsible for the low detection rate of LTBI and high probability of endogenous reactivation. Conclusion There appears to be a biphasic relationship between diabetes-latent tuberculosis: At the early stages of diabetes it is reciprocal, while at a late stage it is synergistic, this important phenomenon obviously needs further research.
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Affiliation(s)
- Vivekanandhan Aravindhan
- Department of Genetics, Dr. ALM PG IBMS, University of Madras, Chennai, India
- *Correspondence: Vivekanandhan Aravindhan
| | - Anup Bobhate
- Prof. M. Viswanathan Diabetes Research Centre, Chennai, India
| | - Kuppan Sathishkumar
- Department of Genetics, Dr. ALM PG IBMS, University of Madras, Chennai, India
| | - Aruna Patil
- ESIC-PGIMSR Medical College and Hospital, Chennai, India
| | | | - Vijay Viswanathan
- Prof. M. Viswanathan Diabetes Research Centre, Chennai, India
- Vijay Viswanathan
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Aravindhan V, Bobhate A, Sathishkumar K, Viswanathan V. Serum levels of novel anti-inflammatory cytokine Interleukin-38 in diabetes patients infected with latent tuberculosis (DM-LTB-3). J Diabetes Complications 2022; 36:108133. [PMID: 35090823 DOI: 10.1016/j.jdiacomp.2022.108133] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
Abstract
IL-38 is a recently discovered, novel anti-inflammatory cytokine, which belongs to the IL-1β family. The role played by this cytokine in diabetes-tuberculosis nexus is not known. Serum levels of IL-38, TNF-α, IL-6, and IL-1β in Normal Glucose Tolerance (NGT) and chronic Diabetes (DM) subjects, both with and without latent tuberculosis (LTB) (n = 256) were quantified by ELISA. While, serum levels of IL-38 were significantly reduced, the levels of TNF-α, IL-6, and IL-1β were not altered, in LTB infected diabetes patients. While no significant secretion of IL-38 was detected in the quantiferon supernatant, secretion of TNF-α, IL-6, and IL-1β was significantly reduced in LTB infected diabetes patients. The decreased systemic levels of IL-38 and reduced in vitro secretion of other pro-inflammatory cytokines might represent a crucial pathway associated with diabetes-tuberculosis nexus.
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Affiliation(s)
| | - Anup Bobhate
- Prof. M. Viswanathan Diabetes Research Centre, Chennai, India
| | - Kuppan Sathishkumar
- Dept of Genetics, Dr ALM PG IBMS, University of Madras, Taramani, Chennai, India
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