Decreased prevalence of lymphatic filariasis among diabetic subjects associated with a diminished pro-inflammatory cytokine response (CURES 83).
Decreased prevalence of lymphatic filariasis among diabetic subjects associated with a diminished pro-inflammatory cytokine response (CURES 83).
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DOI：
10.1371/journal.pntd.0000707
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发表时间：
2010-06-15
影响因子：
3.8
通讯作者：
Babu S
中科院分区：
文献类型：
--
作者：
Aravindhan V;Mohan V;Surendar J;Muralidhara Rao M;Pavankumar N;Deepa M;Rajagopalan R;Kumaraswami V;Nutman TB;Babu S
流行病学研究表明，淋巴丝虫病（LF）的发病率与变态反应和自身免疫的发病率呈负相关。然而，LF和2型糖尿病之间的相互关系尚不清楚，因此，作为CURES研究的一部分，进行了一项横断面研究，以评估糖尿病受试者中LF的基线患病率和血清阳性的相关性（n = 1416）。 与糖尿病前期受试者[9.1%]（p = 0.0095）和非糖尿病受试者[10.4%]（p = 0.0463）相比，糖尿病受试者（新诊断受试者[5.7%]和治疗中受试者[4.3%]）的LF患病率显著降低。 在糖尿病受试者中也观察到丝虫抗原负荷显著降低（p =0.04）。 LF阳性的糖尿病受试者血清促炎细胞因子IL-6和GM-CSF水平显著低于LF阴性的受试者。而抗炎细胞因子IL-10、IL-13和TGF-β的水平在两组之间无显著差异。虽然直接的因果关系尚未显示，LF和糖尿病的患病率之间似乎有一个惊人的负相关关系，这是由减少促炎细胞因子反应在亚洲印度人糖尿病和伴随LF反映。儿童蠕虫感染可以通过免疫调节降低过敏和自身免疫性疾病的风险和严重程度，蠕虫感染的减少可能是这些疾病在西方世界流行率增加的原因（卫生假说）。我们假设，相同的免疫调节作用可以对代谢性疾病如肥胖、糖尿病、高血压和动脉粥样硬化产生影响，其中炎症起着至关重要的作用（扩展卫生假说）。为了验证这一假设，我们研究了在CURES（钦奈城乡流行病学研究）研究的糖尿病、糖尿病前期和非糖尿病受试者中淋巴丝虫病（LF）的患病率。根据我们的假设，我们发现糖尿病受试者与非糖尿病和糖尿病前期受试者相比，LF的患病率降低。这与丝虫抗原负荷和抗丝虫抗体水平降低有关。即使在调整了社会经济地位、年龄和性别之后，这种关联仍然很显著。有趣的是，在糖尿病受试者中，与丝虫阴性者相比，丝虫阳性者的促炎标志物（TNF-α，IL-6和GM-CSF）水平降低。根据这些发现，由于大规模药物管理，丝虫感染的发病率下降可能对印度糖尿病的患病率产生意想不到的不利影响。
Epidemiological studies have shown an inverse correlation between the incidence of lymphatic filariasis (LF) and the incidence of allergies and autoimmunity. However, the interrelationship between LF and type-2 diabetes is not known and hence, a cross sectional study to assess the baseline prevalence and the correlates of sero-positivity of LF among diabetic subjects was carried out (n = 1416) as part of the CURES study. There was a significant decrease in the prevalence of LF among diabetic subjects (both newly diagnosed [5.7%] and those under treatment [4.3%]) compared to pre-diabetic subjects [9.1%] (p = 0.0095) and non-diabetic subjects [10.4%] (p = 0.0463). A significant decrease in filarial antigen load (p = 0.04) was also seen among diabetic subjects. Serum cytokine levels of the pro-inflammatory cytokines—IL-6 and GM-CSF—were significantly lower in diabetic subjects who were LF positive, compared to those who were LF negative. There were, however, no significant differences in the levels of anti-inflammatory cytokines—IL-10, IL-13 and TGF-β—between the two groups. Although a direct causal link has yet to be shown, there appears to be a striking inverse relationship between the prevalence of LF and diabetes, which is reflected by a diminished pro-inflammatory cytokine response in Asian Indians with diabetes and concomitant LF. Childhood helminth infections can reduce the risk and severity of allergies and autoimmune diseases, by means of immunomodulation, and a decrease in helminth infections could potentially account for the increased prevalence of these diseases in the western world (hygiene hypothesis). We hypothesized that the same immunomodulatory effect can have an impact on metabolic diseases like obesity, diabetes, hypertension and atherosclerosis, wherein inflammation plays a crucial role (extended hygiene hypothesis). To test this hypothesis, we examined the prevalence of lymphatic filariasis (LF) among diabetic, pre-diabetic and non-diabetic subjects who were part of the CURES (Chennai Urban Rural Epidemiology Study) study. In accordance with our hypothesis, we found reduced prevalence of LF among diabetic subjects compared to non-diabetic and pre-diabetic subjects. This was associated with decreased filarial antigen load and anti-filarial antibody levels. The association remained significant even after adjusting for socioeconomic status, age and gender. Interestingly, within the diabetic subjects, those who were filarial positive had reduced levels of pro-inflammatory markers (TNF-α, IL-6 and GM-CSF) compared to those who were filarial negative. In light of these findings, the decreasing incidence of filarial infection due to mass drug administration could potentially have an unexpected adverse impact on the prevalence of diabetes in India.
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影响因子：
5.1
作者：
CHANG, FY;SHAIO, MF
通讯作者：
SHAIO, MF
DOI：
10.4269/ajtmh.2008.79.558
发表时间：
2008-10-01
影响因子：
3.3
作者：
Talaat, Kawsar R.;Kumarasamy, Nagalingeswaran;Nutman, Thomas B.
通讯作者：
Nutman, Thomas B.
影响因子：
3.1
作者：
Babu, S;Shultz, LD;Rajan, TV
通讯作者：
Rajan, TV
影响因子：
3.1
作者：
Babu, S;Kumaraswami, V;Nutman, TB
通讯作者：
Nutman, TB
影响因子：
6.4
作者：
Hubner, Marc P.;Stocker, J. Thomas;Mitre, Edward
通讯作者：
Mitre, Edward