TABLE 2.
Effect of DM on adaptive immunity in TB patients.
| Cell type | Different perspectives | Effects of DM on immune cells in patients with TB | Ref. |
|---|---|---|---|
| CD4+ T cell |
Pro‐inflammatory factors ↓ Anti‐inflammatory factors ↑ (Immune response ↓) |
(1) IFN‐γ and IL‐12 levels reduced in DM‐TB mice. (2) Production of IFN‐γ cytokine, IL‐10, and IL‐12 cytokine was lower in patients with DM‐TB. (3) IFN‐γ production was reduced at the time points of diagnosis, 30 days’ treatment, and 6 months’ treatment in the DM (p)‐TB group. (4) % of Th2 (CD4+IL‐4+, CD4+IL‐6+, and CD4+IL‐10+) T cells increased in DM‐TB patients. % of CD4+IL‐17a T cells increased in DM‐TB patients. (5) IL‐10 production was reduced in patients with DM‐TB compared to NDM‐TB. (6) Th2 (IL‐4, IL‐10) T cells increased in DM‐TB patients. |
[24, 101, 102, 103, 105, 106] |
|
Pro‐inflammatory factors ↑ Anti‐inflammatory factors ↓ (Tissue injury ↑) |
(1) Th1 (IFN‐γ, IL‐2, TNF‐α) and Th17 (IL‐17) T cells increased in DM‐TB patients. (2) TNF‐α, granulocyte monocyte–CSF, IFN‐γ, IL‐2, and IL‐1β levels increased in patients with DM‐TB and elevated HbA1c levels. (3) Th1 (TNF‐α, CX3CR1) and Th17 (IL‐17) responses increased in TB with Stable/increased‐HbA1c patients. Th2 (IL‐10) responses decreased in TB with Stable/increased‐HbA1c patients. (4) Th1 (IFN‐γ [PPD and WCL], TNFα [PPD and WCL], and IL‐2 [PPD]) cytokine genomes increased in LTBI‐DM/ LTBI‐PDM. Th17 (IL‐17A, IL‐17F, and IL‐22 [PPD and/or WCL]) cytokine genomes increased in LTBI‐DM/ LTBI‐PDM. |
[94, 104, 107, 108, 109] | |
| CD8+ T cell |
(1) CD8+ T cells secrete increased levels of pro‐inflammatory factors such as IFN‐γ, IL‐17, and IL‐2. (2) Expression of cytotoxic markers is significantly reduced. (3) Central memory CD8+ T cells are positively correlated with blood glucose levels, while naïve CD8+ T cells are negatively correlated. (4) The frequency of CD8+ T cells increases. |
[78, 110, 111] | |
| B cell |
(1) There is an increase in the frequency of memory B cells and a decrease in the frequency of naïve B cells. (2) Elevated blood glucose levels impair humoral immune function. (3) Apoptosis of B cells is suppressed by high blood glucose levels. |
[90, 112, 113] |
Abbreviations: DM, diabetes mellitus; IFN, interferon; IL, interleukin; TB, tuberculosis.