Metabolic Consequences of Concomitant Strongyloides stercoralis Infection in Patients With Type 2 Diabetes Mellitus.

Abstract

BACKGROUND:

Human and animal studies have demonstrated that helminth infections are associated with a decreased prevalence of type 2 diabetes mellitus (T2DM). However, very little is known about their biochemical and immunological interactions.

METHODS:

To assess the relationship between a soil-transmitted helminth, Strongyloides stercoralis (Ss), and T2DM, we examined analytes associated with glycemic control, metabolic processes, and T-cell-driven inflammation at the time of Ss diagnosis and 6 months after definitive anthelmintic treatment. We measured plasma levels of hemoglobin A1c, glucose, insulin, glucagon, adipocytokines, and T-helper (TH) 1-, 2-, and 17- associated cytokines in patients with T2DM with (INF group) or without (UN group) Ss infection. In INF individuals, we again assessed the levels of these analytes 6 months following anthelmintic treatment.

RESULTS:

Compared to UN individuals, INF individuals exhibited significantly diminished levels of insulin and glucagon that increased significantly following therapy. Similarly, INF individuals exhibited significantly diminished levels of adiponectin and adipsin that reversed following therapy. INF individuals also exhibited significantly decreased levels of the TH1- and TH17- associated cytokines in comparison to UN individuals; again, anthelmintic therapy augmented these levels. As expected, INF individuals had elevated levels of TH2-associated and regulatory cytokines that normalized following definitive therapy. Multivariate analysis revealed that these changes were independent of age, sex, body mass index, and liver and renal function.

CONCLUSIONS:

Strongyloides stercoralis infection is associated with a significant modulation of glycemic, hormonal, and cytokine parameters in T2DM and its reversal following anthelmintic therapy. Hence, Ss infection has a protective effect on diabetes-related parameters.

• Authors: Anuradha Rajamanickam, Saravanan Munisankar, Yukthi Bhootra, Chandrakumar Dolla, Kannan Thiruvengadam, Thomas B Nutman, Subash Babu
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 69 Issue 4 Pg. 697-704 (08 01 2019) ISSN: 1537-6591 [Electronic] United States
• PMID: 30407548 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Chemical References

• Adipokines
• Anthelmintics
• Cytokines
• Pancreatic Hormones

Topics

• Adipokines (blood)
• Adult
• Animals
• Anthelmintics (therapeutic use)
• Cytokines (blood)
• Diabetes Mellitus, Type 2 (complications, metabolism)
• Female
• Humans
• Inflammation (metabolism)
• Male
• Middle Aged
• Pancreatic Hormones (blood)
• Strongyloides stercoralis
• Strongyloidiasis (complications, drug therapy, metabolism)
• Young Adult