Infections in patients with diabetes mellitus: A review of pathogenesis

Casqueiro, Juliana; Casqueiro, Janine; Alves, Crésio de Aragão Dantas

doi:10.4103/2230-8210.94253

Cited by 689 publications

(428 citation statements)

References 71 publications

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“…This observation accords with earlier studies that mentioned a higher severity of infections in patients with diabetes (18). Specific factors like hyperglycemia-related impairment of the immune response, vascular insufficiency, sensory peripheral neuropathy, and autonomic neuropathy seem to be possible explanations for this increased severity of infections among diabetic patients (8,18,19). Another possible explanation for using more second-line antiinfectives is that children and adolescents with type 1 diabetes did not respond to the first-line anti-infectives that were initially prescribed and the physician was forced to prescribe a second-line anti-infective for them.…”

Section: Discussionsupporting

confidence: 80%

Population-Based Cohort Study of Anti-Infective Medication Use before and after the Onset of Type 1 Diabetes in Children and Adolescents

Farsani¹,

Souverein²,

Vorst³

et al. 2014

Antimicrob Agents Chemother

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A population-based cohort study was conducted in the Dutch PHARMO database to investigate prevalence and patterns of antiinfective medication use in children and adolescents with type 1 diabetes (T1D) before and after the onset of this disease. All patients <19 years with at least 2 insulin prescriptions (1999 to 2009) were identified (T1D cohort) and compared with an age-and sex-matched (ratio: 1 up to 4) diabetes-free reference group. The prevalence and average number of anti-infective use was studied from (up to) 8 years before until a maximum of 4 years after the onset of T1D. A total of 925 patients with T1D and 3,591 children and adolescents in the reference cohort (51% boys, mean age of 10.1 [standard deviation, 4.5] years) were included. The overall prevalence of anti-infective use (62.6 compared to 52.6%, P < 0.001) and average number of prescriptions (2.71 compared to 1.42 per child, P < 0.001) in the T1D cohort were significantly higher than those in the reference cohort after the onset of diabetes. This pattern was consistent across sex and age categories and already observed in the year before the onset of type 1 diabetes. Patients in the T1D cohort received more antibacterials (49.8 compared to 40%, P < 0.001), antimycotics (4.0 compared to 1.3%, P < 0.001), antivirals (2.5 compared to 0.4%, P < 0.001), and second-line antibiotics, such as aminoglycosides, quinolones, and third-generation cephalosporins and carbapenems. Our findings that elevated anti-infective use in the T1D cohort exists in the period before the onset of type 1 diabetes and the consumption of more second-line anti-infective compounds in this time period warrant further research.

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Section: Discussionsupporting

confidence: 80%

Population-Based Cohort Study of Anti-Infective Medication Use before and after the Onset of Type 1 Diabetes in Children and Adolescents

Farsani¹,

Souverein²,

Vorst³

et al. 2014

Antimicrob Agents Chemother

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“…Along with cancer, SOD2 deficiencies have been implicated in a number of other diseases, such as age-related macular degeneration and diabetes (57)(58)(59)(60). It is known that some diabetic and cancer patients are more susceptible to infection (61,62). However, deficiencies of SOD2 in these patients cannot be directly attributed to increased susceptibility to infection because of the number of other complex mutations present in these patients.…”

Section: Discussionmentioning

confidence: 99%

Neutralization of Mitochondrial Superoxide by Superoxide Dismutase 2 Promotes Bacterial Clearance and Regulates Phagocyte Numbers in Zebrafish

et al. 2015

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T he roles that mitochondria play in antiviral signaling, via mitochondrial antiviral-signaling protein and promotion of inflammation and apoptosis, are well established (1-3); however, their importance in innate immunity is only now becoming clear. While mitochondria can promote inflammation via NF-B signaling and NLRP3 inflammasome formation, inflammation can lead to mitochondrial dysfunction, which can compound the severity of exaggerated inflammatory conditions such as sepsis (4-10). As the site of the electron transport chain within cells, mitochondria are a major source of reactive oxygen species (ROS) (mainly superoxide anions). ROS play diverse roles in cellular and organismal health, especially in innate immunity and inflammation. While the use of ROS to clear infections is beneficial to the host, inappropriate ROS production or lack of ROS neutralization can damage host DNA, proteins, and cell membranes. ROS-induced cellular damage can contribute to the undesired side effects of infectious and inflammatory diseases. Mechanisms are in place in hosts, and even some pathogens, to chemically convert ROS into less toxic compounds; however, overproduction of ROS can overwhelm host antioxidants. Thus, a better understanding of the impact of mitochondria, ROS, and mechanisms for neutralization of ROS on innate immunity could lead to improved treatments for infectious diseases and inflammatory disorders.The cellular mechanisms to neutralize ROS include the glutathione system, catalases, and the superoxide dismutase (SOD) family of enzymes. As superoxide producers, mitochondria are equipped with nuclear-encoded, mitochondrially localized SODs (SOD2, MnSOD) that convert superoxide into hydrogen peroxide. The deleterious effects of mitochondrial superoxide are demonstrated by mutations in SOD2 being implicated in idiopathic cardiomyopathy, age-related macular degeneration, aberrant brain morphology, motor neuron disease, vascular complications of diabetes, and cancer, whereas overexpression of SOD2 increases the Drosophila life span (11,(69)(70)(71)(72). Despite the importance of SOD2 and the regulation of ROS for health, surprisingly little is known about the role of SOD2 in immunity. Numerous studies have implicated SOD2 in the immune response, but few have defined functional roles for SOD2 in immunity. SOD2 is upregulated in response to lipopolysaccharide (LPS), poly(I·C), beta-glucan, and numerous pathogens in multiple cell types and organisms (12-17). Functionally, SOD2 was found to be necessary for the phorbol myristate acetate-induced respiratory burst response and cell survival upon poly(I·C) exposure in vitro (16,17). In a mouse model with SOD2 deleted specifically from thymocytes, the animals did not mount an effective adaptive immune response to influenza virus infection because of disrupted T-cell

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“…Diabetes remains a major public health issue of epidemic stature that begets many complications such as loss of vision, angiopathy, reduced blood flow leading to tissue hypoxia and ulcers with difficult healing (Casqueiro et al 2012). Type-2 diabetes is treated both by controlled diet and hypoglycaemic drugs.…”

Section: Anti-diabeticmentioning

confidence: 99%

Emerging trends in nutraceutical applications of whey protein and its derivatives

Patel

2015

J Food Sci Technol

125

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The looming food insecurity demands the utilization of nutrient-rich residues from food industries as valueadded products. Whey, a dairy industry waste has been characterized to be excellent nourishment with an array of bioactive components. Whey protein comprises 20 % of total milk protein and it is rich in branched and essential amino acids, functional peptides, antioxidants and immunoglobulins. It confers benefits against a wide range of metabolic diseases such as cardiovascular complications, hypertension, obesity, diabetes, cancer and phenylketonuria. The protein has been validated to boost recovery from resistance exercise-injuries, stimulate gut physiology and protect skin against detrimental radiations. Apart from health invigoration, whey protein has proved its suitability as fat replacer and emulsifier. Further, its edible and antimicrobial packaging potential renders its highly desirable in food as well as pharmaceutical sectors. Considering the enormous nutraceutical worth of whey protein, this review emphasizes on its established and emerging biological roles. Present and future scopes in food processing and dietary supplement formulation are discussed. Associated hurdles are identified and how technical advancement might augment its applications are explored. This review is expected to provide valuable insight on whey protein-fortified functional foods, associated technical hurdles and scopes of improvement.

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Infections in patients with diabetes mellitus: A review of pathogenesis

Cited by 689 publications

References 71 publications

Population-Based Cohort Study of Anti-Infective Medication Use before and after the Onset of Type 1 Diabetes in Children and Adolescents

Population-Based Cohort Study of Anti-Infective Medication Use before and after the Onset of Type 1 Diabetes in Children and Adolescents

Neutralization of Mitochondrial Superoxide by Superoxide Dismutase 2 Promotes Bacterial Clearance and Regulates Phagocyte Numbers in Zebrafish

Emerging trends in nutraceutical applications of whey protein and its derivatives

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