Journal
JOURNAL OF INFECTION
Volume 74, Issue 1, Pages 10-21Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2016.08.021
Keywords
Tuberculosis; Diabetes; Angiogenesis; Biomarkers
Categories
Funding
- Indian Department of Biotechnology
- Indian Council of Medical Research
- National Institute for Allergy and Infectious Diseases, National Institutes of Health
- CRDF Global [USB1-31149-XX-13]
- Division of Intramural Research, NIAID [100000060]
- NIH [100000002]
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Background: Tuberculosis-diabetes co-morbidity (TB-DM) is characterized by increased inflammation with elevated circulating levels of inflammatory cytokines and other factors. Circulating angiogenic factors are intricately involved in the angiogenesis-inflammation nexus. Methods: To study the association of angiogenic factors with TB-DM, we examined the systemic levels of VEGF-A, VEGF-C, VEGF-D, VEGF-R1, VEGF-R2, VEGF-R3 in individuals with either TB-DM ( n = 44) or TB alone ( n = 44). Results: Circulating levels of VEGF-A, C, D, R1, R2 and R3 were significantly higher in TB-DM compared to TB individuals. Moreover, the levels of VEGF-A, C, R2 and/or R3 were significantly higher in TB-DM with bilateral or cavitary disease or with hemoptysis, suggesting an association with both disease severity and adverse clinical presentation. The levels of these factors also exhibited a significant positive relationship with bacterial burdens and HbA1c levels. In addition, VEGFA, C and R2 levelswere significantly higher (at 2 months of treatment) in culture positive compared to culture negative TB-DM individuals. Finally, the circulating levels of VEGF-A, C, D, R1, R2 and R3 were significantly reduced following successful chemotherapy at 6 months. Conclusion: Our data demonstrate that TB-DM is associated with heightened levels of circulating angiogenic factors, possibly reflecting both dysregulated angiogenesis and exaggerated inflammation. Published by Elsevier Ltd on behalf of The British Infection Association.
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