Tuberculosis and diabetes: from bench to bedside and back.

Area of Science:

• Infectious Diseases
• Endocrinology
• Immunology

Background:

• Diabetes mellitus (DM) significantly elevates the risk of tuberculosis (TB) infection, progression from latent to active disease, and adverse treatment responses.
• In some regions, over 40% of new TB patients have co-existing DM, highlighting the global health impact.
• The precise biochemical and cellular mechanisms driving this increased susceptibility in diabetes and TB comorbidity remain poorly understood.

Purpose of the Study:

• To review basic research utilizing animal models to investigate the interaction between TB and DM.
• To assess how findings from animal studies correlate with and potentially explain clinical observations in humans with TB-DM comorbidity.
• To identify potential therapeutic targets and strategies for managing TB-DM.

Main Methods:

• Review of existing literature on animal models of TB-DM interaction.
• Analysis of studies examining biochemical and cellular mechanisms in animal models.
• Comparison of animal model findings with human clinical features of TB-DM.

Main Results:

• Animal models demonstrate that DM-induced immunopathy contributes to organ damage.
• Biochemical pathways implicated in diabetic complications (nephropathy, neuropathy, retinopathy, cardiovascular disease, delayed wound healing) are likely involved in TB-DM.
• Animal studies provide a foundation for understanding the clinical manifestations of TB-DM comorbidity.

Conclusions:

• Insights from animal models are crucial for understanding the pathogenesis of TB-DM.
• These models can guide the development of effective management strategies for patients with both conditions.
• Pre-clinical research using animal models is essential for developing novel therapeutic countermeasures against TB-DM.