Diabetes and immunity to tuberculosis.
Diabetes and immunity to tuberculosis.
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DOI：
10.1002/eji.201344301
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发表时间：
2014-03
影响因子：
5.4
通讯作者：
Kornfeld, Hardy
中科院分区：
文献类型：
--
作者：
Martinez, Nuria;Kornfeld, Hardy
过去十年中，结核病和糖尿病的双重负担引起了广泛关注，因为在结核病负担较高的国家，糖尿病患病率急剧上升。这两种重大疾病的汇合对全球公共卫生构成严重威胁；同时，它也提供了一个机会，让我们更多地了解可能与普通人群相关的人类结核病免疫力的关键要素。糖尿病对先天性和适应性免疫的一些影响已被确定，这些影响可能与结核病防御相关，但尚未在人类中得到验证，并且不太可能完全解释这两种疾病状态的相互作用。本综述提供了糖尿病人群中结核病的临床和流行病学特征的最新情况，并将其与了解结核病易感性和糖尿病其他并发症的机制基础的最新进展联系起来。本综述强调了值得进一步研究的问题，例如糖尿病/结核病相互作用中的地理宿主和病原体差异、高血糖诱导的表观遗传重编程在免疫功能障碍中的作用以及糖尿病对结核病引起的肺损伤和纤维化的影响。
The dual burden of tuberculosis and diabetes has attracted much attention in the past decade as diabetes prevalence has increased dramatically in countries already afflicted with a high burden of tuberculosis. The confluence of these two major diseases presents a serious threat to global public health; at the same time it also presents an opportunity to learn more about the key elements of human immunity to tuberculosis that may be relevant to the general population. Some effects of diabetes on innate and adaptive immunity which are potentially relevant to tuberculosis defense have been identified, but have yet to be verified in humans and are unlikely to fully explain the interaction of these two disease states. This review provides an update on the clinical and epidemiological features of tuberculosis in the diabetic population and relates them to recent advances in understanding the mechanistic basis of tuberculosis susceptibility and other complications of diabetes. Issues that merit further investigation, such as geographic host and pathogen differences in the diabetes/tuberculosis interaction, the role of hyperglycemia-induced epigenetic reprogramming in immune dysfunction and the impact of diabetes on lung injury and fibrosis caused by tuberculosis, are highlighted in this review.
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