Coincident pre-diabetes is associated with dysregulated cytokine responses in pulmonary tuberculosis

• Published in: PloS one 2014-11, Vol.9 (11), p.e112108-e112108
• Main Authors: Kumar, Nathella Pavan, Banurekha, Vaithilingam V, Nair, Dina, Sridhar, Rathinam, Kornfeld, Hardy, Nutman, Thomas B, Babu, Subash
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antigens; Bacteria; Biology and Life Sciences; Cytokines; Cytokines - blood; Diabetes; Diabetes mellitus; Female; Glucose; Granulocyte-macrophage colony-stimulating factor; Hemoglobin; Humans; Identification methods; Infections; Infectious diseases; Inflammation; Interleukin 10; Interleukin 2; Interleukin 5; Laboratories; Lymphocytes; Male; Medicine and Health Sciences; Middle Aged; Morbidity; Mycobacterium tuberculosis; Parasitic diseases; Pathogenesis; Pathogens; Plasma; Prediabetic State - complications; Prediabetic State - physiopathology; Tuberculosis; Tuberculosis, Pulmonary - blood; Tuberculosis, Pulmonary - complications; Tuberculosis, Pulmonary - physiopathology; Tumor necrosis factor-α; Young Adult; γ-Interferon
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0112108

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. 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). 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. 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.