title: Oxidative stress and TB outcomes in patients with diabetes mellitus?
abstract: In patients with diabetes mellitus, TB treatment outcomes are poorer. Most parameters, when measured, reflect the slower bacteriological conversion from positivity to negativity and higher risks of disease relapse and mortality, as well as a greater propensity to develop drug-resistant TB. Aside from the well-known immunological dysfunction inherent to patients with diabetes mellitus, oxidative stress is likely a major underlying mechanism adversely impacting their TB treatment outcomes. Mycobacterium tuberculosis persisters, formed as a result of the core dormancy response to stress, possibly play a central role in this hypothesis. This hypothetical model also underscores the paramount importance of programmatic management of TB and diabetes mellitus, in collaboration, to improve the outcomes of patients with both diseases. The validity of these ideas could be further ascertained by laboratory and clinical research.
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Wing Wai
authors.initials: WW
authors.lastname: Yew
authors.affiliation: Tuberculosis and Chest Service, Centre for Health Protection, Department of Health, Hong Kong, China.
authors.forename: Chi Chiu
authors.initials: CC
authors.lastname: Leung
authors.affiliation: Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D048909:Diabetes Complications / Q000378:metabolism* / Q000382:microbiology; D003920:Diabetes Mellitus / Q000276:immunology / Q000378:metabolism* / Q000382:microbiology; D019468:Disease Management; D006801:Humans; D055985:Latent Tuberculosis / Q000150:complications / Q000378:metabolism / Q000382:microbiology; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000254:growth & development / Q000502:physiology; D018384:Oxidative Stress; D012307:Risk Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications* / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality
chemical_list: D000995:Antitubercular Agents