Chemokines at the Crossroad of Diabetes-Tuberculosis Synergy

Abstract

The epidemic increase in diabetes mellitus (DM) is taking place in the world were one third of the population is latently infected with tuberculosis (TB). DM, as a chronic metabolic disease, weakens the immune system and increases the risk of Mycobacterium tuberculosis (M.tb) infection. In those who are already latently infected, it increases the risk of reactivation. This is called DM-TB synergy. While the role of immune cells and cytokines has been well studied in DM-TB synergy, the role played by chemokines is largely unrecognized. Chemokines are low molecular weight proteins that are rapidly secreted by both immune and non-immune cells and guide the directorial migration of these cells. Impairment in chemokine secretion or signaling can lead to delayed immune response and can mediate DM-TB synergy. This chapter describes the role played by various chemokines and their receptors in DM-TB synergy.