Link Between Diabetes and UTIs Uncovered by New Research

E. coli Infecting Mouse Bladder

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Huge clumps of E. coli (purple) infecting diabetic mouse bladder. Credit: Soumitra Mohanty

Both kind 1 and kind 2 diabetes are related to lowered immunity and recurrent infections. Scientists at Karolinska Institute in Sweden have found that the immune system of individuals with diabetes has decrease ranges of the antimicrobial peptide psoriasin. This compromises the urinary bladder’s cell barrier, growing the chance of urinary tract an infection.

Diabetes is a standard illness that impacts well being in some ways. It outcomes from a scarcity of insulin and/or decreased insulin motion. Insulin is a hormone that regulates glucose (sugar) and thus power to the cells. When an individual has kind 1 diabetes, the physique stops producing insulin, whereas in kind 2 diabetes, the cells have turn into much less delicate to insulin, which contributes to excessive blood glucose ranges.

One impact of diabetes is that it compromises the innate immune system. This leaves many individuals with elevated susceptibility to common infections, akin to urinary tract infections (UTI)s brought on by E. coli micro organism. In folks with diabetes, these usually tend to result in common blood poisoning (sepsis) originating within the urinary tract.

An endogenous antibiotic

Scientists at Karolinska Institute have now investigated whether or not glucose ranges in folks with diabetes (kind 1, kind 2, or pre-diabetes) are linked with psoriasin, an endogenous antibiotic that is part of the innate immune system. Their examine was revealed in the present day (September 20) within the journal Nature Communications.

Using urine, urinary bladder cells, and blood serum samples from patients, the investigators analyzed levels of psoriasin and other peptides necessary for ensuring that the bladder mucosa remains intact and protects against infection. The results were then verified in mice and urinary bladder cells with and without infection.

“We found that high glucose concentrations reduce the levels of the antimicrobial peptide psoriasin, while insulin has no effect,” says Annelie Brauner. She led the study and is a professor at the Department of Microbiology, Tumor and Cell Biology, Karolinska Institute. “People with diabetes have lower levels of psoriasin, which weakens the cells’ protective barrier function and increases the risk of bladder infection.”

Oestrogen therapy reduced bacterial population

Professor Brauner’s research group has previously shown that treatment with estrogen restores the protective function of bladder cells in humans and mice and thereby helps to regulate the immune response to a UTI. The researchers, therefore, tested how estrogen treatment affects infected cells exposed to high glucose concentrations. They found that the treatment boosted levels of psoriasin and reduced bacterial populations, indicating that the treatment may have an effect also among patients with diabetes.

“We now plan to probe deeper into the underlying mechanisms of infections in individuals with diabetes,” says the study’s lead author Soumitra Mohanty. He is a researcher in the same department at Karolinska Institute. “The ultimate goal is to reduce the risk of infection in this growing patient group.”

Reference: “Diabetes downregulates the antimicrobial peptide psoriasin and increases E. coli burden in the urinary bladder” by Soumitra Mohanty, Witchuda Kamolvit, Andrea Scheffschick, Anneli Björklund, Jonas Tovi, Alexander Espinosa, Kerstin Brismar, Thomas Nyström, Jens M. Schröder, Claes-Göran Östenson, Pontus Aspenström, Hanna Brauner and Annelie Brauner, 20 September 2022, Nature Communications.
DOI: 10.1038/s41467-022-32636-y

The study was conducted in collaboration with the Karolinska University Hospital, Region Stockholm, Capio and Uppsala University in Sweden, and Universitätsklinikum Schleswig-Holstein in Germany. It was largely financed by the Olle Engkvist Foundation, Region Stockholm (ALF funding), the KI Research Foundation, the Swedish Society of Medicine, the Swedish Society for Medical Research (SSMF), the Clas Groschinsky Memorial Foundation, the Åke Wiberg Foundation and the Magnus Bergvall Foundation. There are no reported conflicts of interest.

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