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Gut-derived PPAR-γ signaling and risk of bacterial enteric infection: insight from thiazolidinedione users in a US

Morgan Birabaharan1, David C Kaelber2, Victor Nizet3,4

  • 1Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, California, USA.

Medrxiv : the Preprint Server for Health Sciences
|October 14, 2024
PubMed
Abstract

Insights

Peroxisome proliferator-activated receptor-γ (PPAR-γ) agonists, like thiazolidinediones, may protect against bacterial enteric infections. This study found a reduced risk in diabetic patients using these drugs, suggesting a potential therapeutic role.

Area of Science:

  • Microbiology
  • Pharmacology
  • Gastroenterology

Background:

  • Antimicrobial resistance necessitates novel therapeutics for enteric infections.
  • Peroxisome proliferator-activated receptor-γ (PPAR-γ) signaling in mice limits pathogen colonization by reducing luminal oxygen and nitrate.
  • Human relevance of this PPAR-γ mechanism against enteric pathogens is unknown.

Purpose of the Study:

  • To investigate the role of PPAR-γ signaling in human enteric infection risk.
  • To assess if thiazolidinediones, PPAR-γ agonists, reduce bacterial enteric infection risk in diabetic patients.

Main Methods:

  • Utilized the TriNetX Analytics Platform, aggregating data from 117 million patients across 66 US healthcare organizations.
  • Compared bacterial enteric infection risk in diabetic patients prescribed thiazolidinediones versus other anti-diabetes medications.
  • Replicated findings by comparing thiazolidinedione users to users of DPP-4 inhibitors.

Main Results:

  • Observed a 22-49% lower risk of bacterial enteric infections in 85,117 thiazolidinedione users compared to other anti-diabetes medication users.
  • Risk reduction was consistent across high-risk individuals, irrespective of sex or age.
  • Direct comparison of thiazolidinedione users to DPP-4 inhibitor users showed similar protective effects.

Conclusions:

  • Findings support a potential protective role for PPAR-γ signaling against bacterial enteric infections in humans.
  • Results warrant further clinical investigation into PPAR-γ agonists as a therapeutic strategy.
  • Thiazolidinediones may offer a protective mechanism against enteric pathogens in diabetic populations.
Keywords:
PPAR gammaantimicrobial resistancebacterial enteric infectiongut microbiotathiazolidinediones

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