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Why Respiratory Infections Are More Deadly in Diabetes



  Why respiratory infections are more lethal in those with diabetes
Pulmonary sections 21
days after infection with MERS-CoV in normal mice (left) and diabetic mice (right). We find that normal mice resolve inflammation faster than diabetic mice, leading to prolonged weight loss and disease in diabetic mice. Credit: Medical University of Maryland

Since the Coronavirus in Middle East Respiratory Syndrome (MERS-CoV) first appeared in Saudi Arabia in 2012, there are more than 2,400 confirmed cases of infection, leading to more than 800 deaths – anxiety deaths from 35 percent. For this reason, researchers are eager to discover all the risk factors that contribute to the development of a serious or deadly disease. Current clinical data indicate that diabetes is a major risk factor in addition to other comorbidities, including kidney disease, heart disease, and pulmonary disease.

Researchers at the University of Maryland School of Medicine (UMSOM) and Jones Hopkins School of Medicine demonstrate in a new study published earlier this week in Journal of Clinical Investigation Insights how diabetes contributes to MERS mortality CoV infections and discovery can shed light on why other respiratory illnesses such as influenza or pneumonia can hit those with diabetes more severely.

They examined the relationship between diabetes and MERS-CoV in a mouse model and found that although the virus did not replicate more readily in diabetic mice compared with healthy controls, diabetic mice displayed a delayed and prolonged inflammatory response in the lung. Mice with diabetes have lower levels of inflammatory cytokines and fewer inflammatory macrophages and T cells. This indicates that the increased severity of MERS-CoV infection in patients with diabetes is likely due to a malfunction of the body's response to infection.

"Understanding how diabetes contributes to the severity of disease after MERS-CoV infection in this context is critical," said Assoc. Prof. Matthew Freeman, Associate Professor of Microbiology and Immunology, who is the author of the study. the step is to determine what leads to an altered immune response in diabetics and how to reverse these effects with therapeutic agents to treat patients. "

Follow-up studies could also explore whether healthcare providers need to redouble their management efforts and glucose levels in diabetic patients experiencing a dangerous respiratory infection and whether better management would help mitigate the effects of these infections.

"This is an important finding for diabetic patients and treating physicians," says Dian of UMSOM E. Albert Reese, MD, MBA, who is also executive vice president of medical affairs at the University of Maryland and John Z. and Akiko K. Bowers an excellent professor. "We have long known that diabetic patients have worse outcomes when they get a serious infectious disease, but this new concept of immune function may pave the way for better treatments."


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More information:
Kirsten A. Kulcsar et al, Comorbid diabetes leads to immune dysregulation and increased disease severity after infection with MERS-CoV, JCI Insight (2019). Doi: 10.1172 / jci.insight.131774

Provided by
University of Maryland School of Medicine

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Why Respiratory Infections Are More Deadly in Diabetes (2019, October 19)
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