New study explains link between diabetes and urinary tract infections – ScienceDaily

Decreased immunity and frequent infections are common in type 1 and type 2 diabetes. Researchers at Karolinska Institutet in Sweden have now shown that the immune system of people with diabetes has lower levels of the antimicrobial peptide psoriasis, which damages the urinary bladder cell barrier, increasing the risk Urinary tract infection. The study was published in Nature Communications.

Diabetes results from a lack of insulin and/or a decreased action of insulin. Insulin is a hormone that regulates glucose (sugar) and therefore energy for cells. In type 1 diabetes, the body stops producing insulin, while in type 2 diabetes, cells become less sensitive to insulin, which contributes to higher blood sugar levels. Diabetes is a common disease that affects health in many ways.

One effect is that it harms the innate immune system, leaving many people with an increased susceptibility to regular infections, such as urinary tract infections (UTIs) caused by coli bacteria bacteria. In people with diabetes, it is more likely to lead to general septicemia, sepsis, which originates in the urinary tract.

internal antibiotic

Researchers at Karolinska Institutet have now investigated whether glucose levels in people with diabetes (type 1, type 2, or pre-diabetes) are related to psoriasis, an endogenous antibiotic that is part of the innate immune system.

Using urine, urinary bladder cells and blood serum samples from patients, the researchers analyzed levels of psoriasis and other peptides needed to ensure the bladder mucosa remains healthy and protects against infection. The results were then verified in mice and infected and non-infected urinary bladder cells.

“We found that higher glucose concentrations reduce psoriasis antimicrobial peptide levels, while insulin has no effect,” says Annelie Brauner, a professor in the Karolinska Institutet’s Department of Microbiology, Oncology and Cell who led the study. “People with diabetes have lower levels of psoriasis, which impairs the protective function of the cells’ barrier and increases the risk of bladder infections.”

Estrogen therapy reduced the number of bacteria

Professor Browner’s research group has previously shown that estrogen therapy restores the protective function of bladder cells in humans and mice, thus helping to regulate the immune response to UTIs. So the researchers tested how estrogen treatment affects infected cells exposed to high concentrations of glucose. They found that the treatment boosted psoriasis levels and reduced bacteria numbers, suggesting that the treatment may also have an effect among people with diabetes.

“We now plan to investigate more deeply the mechanisms underlying infection in individuals with diabetes,” says study lead author Sumitra Mohanty, a researcher in the same department at Karolinska Institutet. “The ultimate goal is to reduce the risk of infection in this growing group of patients.”

The study was conducted in collaboration with Karolinska University Hospital in Stockholm and Cabello, Uppsala University in Sweden and Schleswig-Holstein Clinic in Germany. It is funded largely by the Olle Engkvist Foundation, Stockholm Region (funded by ALF), KI Research, Swedish Society of Medicine, Swedish Society for Medical Research (SSMF), Clas Groschinsky Memorial Foundation, Åke Wiberg Foundation, and Magnus Bergwald Foundation. No conflict of interest has been reported.

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