2205. A Change in Paradigm: Diabetes Exacerbates Infection Severity by Hyperinflammation, Not Immunosuppression
Session: Poster Abstract Session: Host-Pathogen Interactions
Saturday, October 29, 2016
Room: Poster Hall
  • IDWeek 2016 - Poster 2205 (Travis Nielsen).pdf (1.4 MB)
  • Background: Diabetes mellitus has long been believed to be immunosuppressive due to defective phagocytic clearance of microbes.

    Methods:We measured inflammatory biomarkers, blood bacterial density, and survival in diet-induced obesity (DIO) diabetic wild-type and congenic knockout mice infected with Gram-negative bacteria.

    Results: We confirmed that diabetic mice were hyper-susceptible to bacteremia caused by Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli.However, despite excess mortality, bacterial burden was not significantly higher in diabetic mice, indicating that phagocytic clearance of bacteria was not impaired. Rather, diabetic mice exhibited dramatically increased pro-inflammatory cytokines compared to non-diabetic mice. Furthermore, immunosuppressing diabetic mice with dexamethasone reversed their hypersusceptibility to lethal infection. Disruption of Toll-like receptor 4 (TLR4), the receptor for advanced glycation end-products (RAGE), or their common pro-inflammatory signal transducer MyD88 also protected mice from lethal infection.

    Conclusion: We thus define a molecular mechanism by which diabetic mice are more susceptible to bacterial infections. Rather than immunosuppression, the primary driver of diabetes-associated susceptibility to Gram-negative bacterial infections is increased inflammation, induced by MyD88 signaling through RAGE and TLR4.

    Travis B. Nielsen, BA1, Paul Pantapalangkoor, MS1, Brian Luna, PhD1, Ken Dekitani, BS1, Kevin Bruhn, PhD1, Brandon Tan, MS1, Justin Junus, BS2, Robert A. Bonomo, MD3, Ann Marie Schmidt, MD4, Terrence M. Doherty, BS2, Lin Lin, MD, PhD2 and Brad Spellberg, MD1, (1)Medicine and Molecular Microbiology & Immunology, University of Southern California, Los Angeles, CA, (2)Los Angeles Biomedical Research Institute, Torrance, CA, (3)Department of Pharmacology, Case Western Reserve University School of Medicine, Cleveland, OH, (4)New York University, New York, NY


    T. B. Nielsen, None

    P. Pantapalangkoor, None

    B. Luna, None

    K. Dekitani, None

    K. Bruhn, None

    B. Tan, None

    J. Junus, None

    R. A. Bonomo, None

    A. M. Schmidt, None

    T. M. Doherty, None

    L. Lin, None

    B. Spellberg, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.