The role of interferon-gamma in the increased tuberculosis risk in type 2 diabetes mellitus

  • J. E. Stalenhoef
  • B. Alisjahbana
  • E. J. Nelwan
  • J. van der Ven-Jongekrijg
  • T. H. M. Ottenhoff
  • J. W. M. van der Meer
  • R. H Nelwan
  • M. G. Netea
  • R. van Crevel
Article

DOI: 10.1007/s10096-007-0395-0

Cite this article as:
Stalenhoef, J.E., Alisjahbana, B., Nelwan, E.J. et al. Eur J Clin Microbiol Infect Dis (2008) 27: 97. doi:10.1007/s10096-007-0395-0

Abstract

As patients with diabetes mellitus are at increased risk of developing tuberculosis, we hypothesized that this susceptibility to mycobacterial infection is due to a defective Th1-cytokine response. To explore this hypothesis, we examined four groups of subjects in Indonesia: 23 patients with tuberculosis, 34 patients with tuberculosis and diabetes, 32 patients with diabetes only and 36 healthy controls. Ex-vivo production of interferon (IFN)γ, tumour necrosis factor-α and interleukin (IL)-1β, 6, 10, -12 and -4 was measured following stimulation with Mycobacterium tuberculosis, Escherichia coli lipopolysaccharide and phytohaemagglutinin. Patients with active tuberculosis were found to have lower IFNγ levels and a higher production of other pro-inflammatory cytokines and IL-4, both in the presence and absence of diabetes. Diabetes patients without tuberculosis, however, showed strongly reduced non-specific IFNγ production, which is essential for inhibition of the initial growth of M. tuberculosis. Our data suggest that a defective non-specific immune response in diabetes may contribute to an increased susceptibility to develop tuberculosis.

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • J. E. Stalenhoef
    • 1
    • 5
  • B. Alisjahbana
    • 2
  • E. J. Nelwan
    • 3
  • J. van der Ven-Jongekrijg
    • 1
  • T. H. M. Ottenhoff
    • 4
  • J. W. M. van der Meer
    • 1
  • R. H Nelwan
    • 3
  • M. G. Netea
    • 1
  • R. van Crevel
    • 1
  1. 1.Department of Internal MedicineRadboud University Nijmegen Medical CenterNijmegenThe Netherlands
  2. 2.Internal Medicine Department, Hasan Sadikin Hospital Padjadjaran UniversityBandungIndonesia
  3. 3.Infectious Disease Working Group, Medical FacultyUniversity of IndonesiaJakarta PusatIndonesia
  4. 4.Department of Immunohematology and Blood TransfusionLeiden University Medical CenterLeidenThe Netherlands
  5. 5.Department of Internal MedicineOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands

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