1. Persistent inflammation during anti-tuberculosis treatment with diabetes comorbidity.
- Author
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Kumar NP, Fukutani KF, Shruthi BS, Alves T, Silveira-Mattos PS, Rocha MS, West K, Natarajan M, Viswanathan V, Babu S, Andrade BB, and Kornfeld H
- Subjects
- Adult, Biomarkers blood, Brazil, Cohort Studies, Comorbidity, Cytokines blood, Female, Glycated Hemoglobin metabolism, Humans, India, Male, Middle Aged, Mycobacterium tuberculosis drug effects, Severity of Illness Index, Sputum microbiology, Tuberculosis, Pulmonary blood, Tuberculosis, Pulmonary diagnostic imaging, Antitubercular Agents adverse effects, Antitubercular Agents therapeutic use, Diabetes Mellitus pathology, Inflammation chemically induced, Tuberculosis, Pulmonary drug therapy
- Abstract
Diabetes mellitus (DM) increases risk for pulmonary tuberculosis (TB) and adverse treatment outcomes. Systemic hyper-inflammation is characteristic in people with TB and concurrent DM (TBDM) at baseline, but the impact of TB treatment on this pattern has not been determined. We measured 17 plasma cytokines and growth factors in longitudinal cohorts of Indian and Brazilian pulmonary TB patients with or without DM. Principal component analysis revealed virtually complete separation of TBDM from TB individuals in both cohorts at baseline, with hyper-inflammation in TBDM that continued through treatment completion at six months. By one year after treatment completion, there was substantial convergence of mediator levels between groups within the India cohort. Non-resolving systemic inflammation in TBDM comorbidity could reflect delayed lesion sterilization or non-resolving sterile inflammation. Either mechanism portends unfavorable long-term outcomes including risk for recurrent TB and for damaging immune pathology., Competing Interests: NK, KF, BS, TA, PS, MR, KW, MN, VV, SB, BA, HK No competing interests declared, (© 2019, Kumar et al.)
- Published
- 2019
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