Association Between Diabetes Mellitus-Tuberculosis and the Generation of Drug Resistance.

IF 4.1 2区生物学 Q2 MICROBIOLOGY

Microorganisms Pub Date : 2024-12-20 DOI:10.3390/microorganisms12122649

Axhell Aleid Cornejo-Báez, Roberto Zenteno-Cuevas, Julieta Luna-Herrera

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引用次数: 0

Abstract

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains one of the leading infectious causes of death globally, with drug resistance presenting a significant challenge to control efforts. The interplay between type 2 diabetes mellitus (T2DM) and TB introduces additional complexity, as T2DM triples the risk of active TB and exacerbates drug resistance development. This review explores how T2DM-induced metabolic and immune dysregulation fosters the survival of Mtb, promoting persistence and the emergence of multidrug-resistant strains. Mechanisms such as efflux pump activation and the subtherapeutic levels of isoniazid and rifampicin in T2DM patients are highlighted as key contributors to resistance. We discuss the dual syndemics of T2DM-TB, emphasizing the role of glycemic control and innovative therapeutic strategies, including efflux pump inhibitors and host-directed therapies like metformin. This review underscores the need for integrated diagnostic, treatment, and management approaches to address the global impact of T2DM-TB comorbidity and drug resistance.

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糖尿病-结核与耐药性产生的关系。

由结核分枝杆菌（Mtb）引起的结核病（TB）仍然是全球导致死亡的主要传染性原因之一，耐药性对控制工作构成重大挑战。2型糖尿病（T2DM）和结核病之间的相互作用带来了额外的复杂性，因为T2DM使活动性结核病的风险增加了两倍，并加剧了耐药性的发展。这篇综述探讨了t2dm诱导的代谢和免疫失调如何促进结核分枝杆菌的存活，促进持久性和多药耐药菌株的出现。外排泵激活和异烟肼和利福平在T2DM患者中的亚治疗水平等机制被强调为抵抗的关键因素。我们讨论了T2DM-TB的双重综合征，强调血糖控制的作用和创新的治疗策略，包括外排泵抑制剂和宿主定向治疗，如二甲双胍。本综述强调需要采用综合诊断、治疗和管理方法来解决T2DM-TB合并症和耐药性的全球影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microorganisms Medicine-Microbiology (medical)

CiteScore

7.40

自引率

6.70%

发文量

2168

审稿时长

20.03 days

期刊介绍： Microorganisms (ISSN 2076-2607) is an international, peer-reviewed open access journal which provides an advanced forum for studies related to prokaryotic and eukaryotic microorganisms, viruses and prions. It publishes reviews, research papers and communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. Electronic files and software regarding the full details of the calculation or experimental procedure, if unable to be published in a normal way, can be deposited as supplementary electronic material.