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Gut microbiome, metabolic and genetic dysregulation in T2DM and TB. T2DM upregulates Lactobacillus and Firmicutes taxa of the gut microbiota. Lactobacillus promotes further T2DM development, while Firmicutes upregulate butyrate production. Butyrate inhibits Mtb-induced cytokine production, activation, and antigen presentation by DCs and CTLs. In addition, T2DM lowers specific amino acids and gene transcripts. Collectively, these mechanisms increase TB susceptibility.
