Coincident pre-diabetes is associated with dysregulated cytokine responses in pulmonary tuberculosis.
BACKGROUND
Cytokines play an important role in the pathogenesis of pulmonary tuberculosis (PTB)--Type 2 diabetes mellitus co-morbidity. However, the cytokine interactions that characterize PTB coincident with pre-diabetes (PDM) are not known.


METHODS
To identify the influence of coincident PDM on cytokine levels in PTB, we examined circulating levels of a panel of cytokines in the plasma of individuals with TB-PDM and compared them with those without PDM (TB-NDM).


RESULTS
TB-PDM is characterized by elevated circulating levels of Type 1 (IFNγ, TNFα and IL-2), Type 17 (IL-17A and IL-17F) and other pro-inflammatory (IL-1β, IFNβ and GM-CSF) cytokines. TB-PDM is also characterized by increased systemic levels of Type 2 (IL-5) and regulatory (IL-10 and TGFβ) cytokines. Moreover, TB antigen stimulated whole blood also showed increased levels of pro-inflammatory (IFNγ, TNFα and IL-1β) cytokines as well. However, the cytokines did not exhibit any significant correlation with HbA1C levels or with bacterial burdens.


CONCLUSIONS
Our data reveal that pre-diabetes in PTB individuals is characterized by heightened cytokine responsiveness, indicating that a balanced pro and anti - inflammatory cytokine milieu is a feature of pre-diabetes--TB co-morbidity.
National Institutes of Health-International Center for Excellence in Research, Chennai, India; National Institute for Research in Tuberculosis, Chennai, India.
Nathella Pavan
NP
Kumar
National Institute for Research in Tuberculosis, Chennai, India.
Vaithilingam V
VV
Banurekha
National Institute for Research in Tuberculosis, Chennai, India.
Dina
D
Nair
Government Stanley Medical Hospital, Chennai, India.
Rathinam
R
Sridhar
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
Hardy
H
Kornfeld
Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
Thomas B
TB
Nutman
National Institutes of Health-International Center for Excellence in Research, Chennai, India; Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
Subash
S
Babu
D000293:Adolescent; D000328:Adult; D000368:Aged; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000150:complications* / Q000503:physiopathology; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D055815:Young Adult
D016207:Cytokines