Pulmonary Tuberculosis and Diabetes Comorbidity is Associated with Heightened Systemic Th1, Th17, Treg Cytokines and Others Biochemical Parameters

Abstract

Background: This study aims to evaluate the impact of type 2 diabetes on pulmonary tuberculosis immune response. Methods: The tuberculosis diagnosis was based on the sputum smear and positivity of culture, whereas type 2 diabetes was diagnosis based on fasting blood sugar, 2-h PG, and glycated haemoglobin. Standardized techniques were used to obtain liver enzymes and lipid profiles whereas ELISA cytokine assay system was used to measured plasma cytokines levels. Results: fasting blood glucose (p<0.0001), 2hPG (p = 0.0097) and Glycated haemoglobin percentage (p <0.0001) in TB patients with diabetes were found to be significantly high as compare with TB patients without diabetes. While total cholesterol (p= 0.0093), serum triglycerides (p= 0.0001) and low-density lipoprotein cholesterol (p= 0.0086), were significantly high among Tb with diabetes, whereas High density lipoprotein cholesterol found to be significantly (p = 0.0002) elevated among TB patients without diabetes. TB and diabetes linked with increase concentration of Th1 (IFN-γ and TNF-α), Th17 (IL-17A) and Treg cytokines. The systemic levels of analysed cytokines show a positive increase associated with the HbA1c levels among TB patients except with IL-6 where there was no association with glycated haemoglobin. A significantly increased association was found between IL-22 and IFN-γ plasmatic levels. Conclusion: Our study shows an increase in characterized TB diabetics patients in cytokine response, signalizing that type 2 diabetes potentially participate in chronic inflammation that increases pathology and low control of tuberculosis.