Heightened Plasma Levels of Heme Oxygenase-1 and Tissue Inhibitor of Metalloproteinase-4 as Well as Elevated Peripheral Neutrophil Counts Are Associated With TB-Diabetes Comorbidity
| Autor: | Alan Sher, Subash Babu, M. S. Jawahar, Nathella Pavan Kumar, Thomas B. Nutman, Bruno B. Andrade, Vaithilingam V. Banurekha, Rathinam Sridhar |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Tuberculosis endocrine system diseases Neutrophils India Cell Count Comorbidity Critical Care and Intensive Care Medicine Diabetes mellitus Prevalence Humans Medicine Original Research Aged biology business.industry C-reactive protein Acute-phase protein nutritional and metabolic diseases Type 2 Diabetes Mellitus Tissue Inhibitor of Metalloproteinases Middle Aged Tissue inhibitor of metalloproteinase medicine.disease Cross-Sectional Studies Diabetes Mellitus Type 2 Immunology Absolute neutrophil count biology.protein Cytokines Sputum Female Chemokines medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers Heme Oxygenase-1 Acute-Phase Proteins |
| Zdroj: | Chest. 145:1244-1254 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.13-1799 |
| Popis: | Background The increased prevalence of type 2 diabetes mellitus (T2DM) in countries endemic for TB poses a serious complication in the clinical management of this major infectious disease. Understanding the impact of T2DM on TB and the determinants of comorbidity is critical in responding to this growing public health problem with better therapeutic approaches. Here, we performed an exploratory study assessing a series of biologic parameters that could serve as markers of pathogenesis in TB with T2DM. Methods Cross-sectional analyses of levels of heme oxygenase-1 (HO-1), acute phase proteins, tissue metalloproteinases, and tissue inhibitors of metalloproteinase (TIMPs) as well as cytokines and chemokines were performed in plasma samples from individuals with active pulmonary TB or with coincident TB and T2DM from South India. Results Compared with patients with TB without diabetes, those with coincident T2DM exhibited increased Mycobacterium tuberculosis bacillary loads in sputum. Plasma levels of HO-1 but not of other acute phase proteins were higher in patients with TB and T2DM than in patients without diabetes, independent of bacillary sputum loads. HO-1 concentrations also positively correlated with random plasma glucose, circulating glycosylated hemoglobin, and low-density lipoprotein levels. Moreover, patients with coincident TB and T2DM exhibited increased plasma levels of TIMP-4 and elevated peripheral blood neutrophil counts, which, when considered together with HO-1, resulted in increased power to discriminate individuals with active TB with and without T2DM. Conclusions Elevated plasma levels of HO-1 and TIMP-4 and peripheral blood neutrophil counts are potential single and combined markers of pathogenesis in TB and T2DM. |
| Databáze: | OpenAIRE |
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