Impact of Diabetes Mellitus on Immune Response and Susceptibility to Melioidosis

Diabetes mellitus (DM) can cause impairment to both innate and adaptive immune responses, making individuals more vulnerable to infections like COVID-19, tuberculosis, and melioidosis. Melioidosis, caused by the bacterium Burkholderia pseudomallei, is a tropical disease particularly associated with diabetes, which is also recognized as the most significant risk factor for this disease. Notably, 39% of melioidosis patients have type 2 diabetes, with their infection risk being 13 times greater than that of non-diabetic individuals. Moreover, B. pseudomallei, an environmental opportunistic pathogen, often leads to severe illness in immunocompromised patients.

The pathophysiology of diabetes adversely affects key immune functions essential for combating infections, including impairments in leukocytes and neutrophils, inhibition of macrophages and monocytes, and dysfunction of natural killer cells. These deficiencies delay the activation and recruitment of immune cells needed to combat B. pseudomallei, giving the pathogen an advantage in surviving and adapting in diabetic patients. There remains a critical need to address knowledge gaps regarding the comorbidity of diabetes and infectious diseases, particularly the interplay between melioidosis and diabetes, to better understand the dysfunctional immune responses and pathogen adaptations under diabetic conditions. This understanding is vital for guiding effective therapeutic strategies.

Source: Uthaya Kumar, A., Ahmad Zan, M., Ng, CL. et al. Diabetes and Infectious Diseases with a Focus on Melioidosis. Curr Microbiol.2024;81(208). https://doi.org/10.1007/s00284-024-03748-z