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

Kumar, N.P .; Banurekha, V.V .; Dina, N.; Sridhar, R .; Kornfeld, H .; Nutman, T.B .; Babu, S .

PLoS One; 2014; 9; e112108.

Abstract: 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 (IFN g , TNF a and IL-2), Type 17 (IL-17A and IL-17F) and other pro-inflammatory (IL-1 b , IFN b and GM-CSF) cytokines. TB-PDM is also characterized by increased systemic levels of Type 2 (IL-5) and regulatory (IL-10 and TGF b ) cytokines. Moreover, TB antigen stimulated whole blood also showed increased levels of pro-inflammatory (IFN g , TNF a and IL-1 b ) cytokines as well. However, the cytokines did not exhibit any significant correlation with HbA1C levels or with bacterial burdens.

Conclusion: 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.

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