Diabetes and Infectious Diseases with a Focus on Melioidosis

Area of Science:

• Infectious Diseases
• Immunology
• Endocrinology

Background:

• Diabetes mellitus (DM) compromises both innate and adaptive immunity.
• Individuals with DM are more vulnerable to infections, including melioidosis, tuberculosis, and COVID-19.
• Melioidosis, caused by Burkholderia pseudomallei, disproportionately affects diabetic patients, with a 13-fold increased risk.

Purpose of the Study:

• To investigate the impact of diabetes on host immune responses to Burkholderia pseudomallei infection.
• To understand the mechanisms underlying increased susceptibility to melioidosis in diabetic individuals.
• To identify knowledge gaps in melioidosis-diabetes comorbidity for improved therapeutic strategies.

Main Methods:

• The study reviews existing literature on diabetes, immune dysfunction, and melioidosis pathogenesis.
• Analysis of immune cell functions (leukocytes, neutrophils, macrophages, monocytes, NK cells) in the context of diabetes.
• Examination of Burkholderia pseudomallei adaptation in diabetic hosts.

Main Results:

• Diabetes-induced pathophysiology impairs critical immune cell functions, including leukocyte and neutrophil activity, and inhibits macrophages, monocytes, and natural killer cells.
• These immune defects lead to delayed immune cell recruitment and activation against B. pseudomallei.
• The pathogen B. pseudomallei exploits these compromised host defenses, facilitating its survival and adaptation in diabetic patients.

Conclusions:

• Dysfunctional host immune responses in diabetes create a favorable environment for B. pseudomallei.
• Further research is needed to fill knowledge gaps regarding diabetes-melioidosis comorbidity.
• Understanding these interactions is crucial for developing effective treatments for melioidosis in diabetic populations.