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Elevated circulating levels of monocyte activation markers among tuberculosis patients with diabetes co‐morbidity
Author(s) -
Kumar Nathella P.,
Moideen Kadar,
Bhootra Yukthi,
Nancy Arul,
Viswanathan Vijay,
Shruthi Basavaradhya S.,
Sivakumar Shanmugam,
Natarajan Mohan,
Kornfeld Hardy,
Babu Subash
Publication year - 2019
Publication title -
immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.297
H-Index - 133
eISSN - 1365-2567
pISSN - 0019-2805
DOI - 10.1111/imm.13023
Subject(s) - diabetes mellitus , medicine , tuberculosis , metformin , monocyte , c reactive protein , gastroenterology , disease , immunology , endocrinology , inflammation , pathology
Summary Alteration in the frequency of monocyte subsets is a hallmark of tuberculosis–diabetes co‐morbidity ( TB ‐ DM ). To study this association, we examined the plasma levels of sCD 14, sCD 163, C‐reactive protein ( CRP ) and soluble tissue factor ( sTF ) in individuals with TB ‐ DM , TB or diabetes mellitus ( DM ), and in healthy controls ( HC ). Circulating levels of sCD 14, sCD 163 and sTF were significantly increased in TB ‐ DM and DM compared with TB and HC ; however, CRP was significantly increased in TB ‐ DM and TB compared with DM and HC . During longitudinal follow up, sCD 14, CRP and sTF levels remained significantly increased in TB ‐ DM compared with TB from baseline (pre‐treatment), during treatment (2nd month) and at the completion (6th month) of anti‐ TB treatment ( ATT ), whereas sCD 163 was significantly higher in TB ‐ DM compared with TB only at baseline. Moreover, the levels of sCD 14 and sCD 163 were significantly higher in TB ‐ DM individuals with bilateral and cavitary disease and exhibited a significant positive relationship with bacterial burden. Levels of sCD 14, sCD 163 and CRP exhibited a positive relationship with HbA1c levels. Within the TB ‐ DM group, those with known diabetes before incident TB ( KDM ) exhibited significantly higher levels of sCD 14 and sCD 163 compared with individuals with newly diagnosed DM with TB ( NDM ). Finally, KDM individuals on metformin treatment exhibited significantly lower levels of sCD 14, sCD 163 and CRP compared with those on non‐metformin‐containing regimens. Our data demonstrate that systemic monocyte activation marker levels reflect baseline disease severity and extent in TB ‐ DM , differentiate KDM from NDM and are modulated by ATT and metformin therapy.