Prof swanathan Diabetes Research Center

Chennai, India

Prof swanathan Diabetes Research Center

Chennai, India

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Kumar N.P.,National Institutes of Health International Center for Excellence in Research | Moideen K.,National Institutes of Health International Center for Excellence in Research | Viswanathan V.,Prof swanathan Diabetes Research Center | Kornfeld H.,University of Massachusetts Medical School | And 2 more authors.
Immunology | Year: 2016

Perturbations in CD4+ and CD8+ T-cell phenotype and function are hallmarks of tuberculosis–diabetes co-morbidity. However, their contribution to the pathogenesis of this co-morbidity and the effect of anti-tuberculosis treatment on the phenotype of the T-cell subsets is poorly understood. In this study, we examined the frequency of different T-cell subsets in individuals with pulmonary tuberculosis (PTB) with diabetes mellitus (DM) or without coincident diabetes mellitus (NDM) before, during and after completion of anti-tuberculosis chemotherapy. PTB-DM is characterized by heightened frequencies of central memory CD4+ and CD8+ T cells and diminished frequencies of naive, effector memory and/or effector CD4+ and CD8+ T cells at baseline and after 2 months of treatment but not following treatment completion in comparison with PTB-NDM. Central memory CD4+ and CD8+ T-cell frequencies exhibited a positive correlation with fasting blood glucose and glycated haemoglobin A1c levels, whereas the frequencies of naive and effector memory or effector CD4+ and CD8+ T cells exhibited a negative correlation. However, the frequencies of CD4+ and CD8+ T-cell subsets in individuals with PTB exhibited no significant relationship with bacterial burdens. Finally, although minor alterations in the T-cell subset compartment were observed at 2 months of treatment, significantly decreased frequencies of central memory and significantly enhanced frequencies of naive CD4+ and CD8+ T cells were observed at the completion of treatment. Our data reveal a profound effect of coexistent diabetes on the altered frequencies of central memory, effector memory and naive T cells and its normalization following therapy. © 2016 John Wiley & Sons Ltd


Kumpatla S.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Michael C.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Viswanathan V.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Viswanathan V.,Prof swanathan Diabetes Research Center
International Journal of Diabetes in Developing Countries | Year: 2015

This study was designed to evaluate the effect of yogasanas on glycaemic control, haemodynamic and lipid profile in newly diagnosed subjects with type 2 diabetes prescribed with oral hypoglycaemic agents (OHA). Three hundred and three (M:F 199:104) subjects were recruited in this prospective study and were divided into two groups. Group 1 (N = 149) were prescribed OHA alone, while group 2 subjects (N = 154) were prescribed OHA and received training individually once for regular yoga practice for 30 min daily. Baseline data on anthropometric, haemodynamic and biochemical details were collected, and subjects were asked to report for review after 3 months. All investigations were repeated after 3 months. A total of 241 subjects were available for follow-up. Diabetes treatment regimen was unchanged in both the groups during the study period. Both the groups were matched with respect to body mass index (BMI), glycaemic level, lipid profile and diet calorie consumption at baseline. BMI did not differ significantly at follow-up in both the groups. Glucose levels and HbA1c % showed greater reduction in group 2 practising yoga. Total and low-density lipoprotein (LDL) cholesterol alone improved in group 1, whereas improvement was seen in all lipid parameters in group 2. High-density lipoprotein (HDL) cholesterol was not statistically significant in both groups. Group 1 showed improvement in systolic blood pressure (P = 0.027), whereas group 2 subjects showed improvement in both systolic and diastolic blood pressures (P < 0.0001). In conclusion, regular practice of yoga along with conventional medicines could be beneficial for better control of diabetes. © 2015, Research Society for Study of Diabetes in India.


Kornfeld H.,University of Massachusetts Medical School | West K.,University of Massachusetts Medical School | Kane K.,University of Massachusetts Medical School | Kumpatla S.,Prof swanathan Diabetes Research Center | And 4 more authors.
Chest | Year: 2016

Background Previous studies reported an association of diabetes mellitus (DM) with TB susceptibility. Many studies were retrospective, had weak diagnostic criteria for DM, and did not assess other comorbidities. The Effects of Diabetes on Tuberculosis Severity (EDOTS) study is addressing these limitations with a longitudinal comparison of patients with TB who are classified as diabetic or normoglycemic according to World Health Organization criteria. We report interim findings after enrolling 159 of a planned 300 subjects. Methods A cohort study of patients with TB in South India with DM or normoglycemia defined by oral glucose tolerance test (OGTT) and fasting glucose. Glycohemoglobin (HbA1c), serum creatinine, lipids, and 25-hydroxyvitamin D were measured at enrollment. Patients were monitored monthly during TB treatment, and HbA1c measurement was repeated after 3 months. Results Of 209 eligible patients, 113 (54.1%) were classified as diabetic, 44 (21.0%) with impaired glucose tolerance, and 52 (24.9%) as normoglycemic. More patients with diabetes were detected by OGTT than by HbA1c. Diabetes was a newly received diagnosis for 37 (32.7%) in the DM group, and their median HbA1c (6.8%) was significantly lower than in those with previously diagnosed DM (HbA1c, 10.4%). Among 129 patients monitored for 3 months, HbA1c declined in all groups, with the greatest difference in patients with a newly received diagnosis of DM. Conclusions Early EDOTS study results reveal a strikingly high prevalence of glycemic disorders in South Indian patients with pulmonary TB and unexpected heterogeneity within the patient population with diabetes and TB. This glycemic control heterogeneity has implications for the TB-DM interaction and the interpretation of TB studies relying exclusively on HbA1c to define diabetic status. © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.


PubMed | Prof swanathan Diabetes Research Center, University of Massachusetts Medical School, National Institutes of Health International Center for Excellence in Research, U.S. National Institutes of Health and National Institute for Research in Tuberculosis
Type: | Journal: Tuberculosis (Edinburgh, Scotland) | Year: 2016

Type 2 diabetes mellitus (DM) is a major risk factor for the development of active pulmonary tuberculosis (PTB), with development of DM pandemic in countries where tuberculosis (TB) is also endemic. However, the effect of anti-TB treatment on the changes in dentritic cell (DC) and monocyte subset phenotype in TB-DM co-morbidity is not well understood. In this study, we characterized the frequency of DC and monocyte subsets in individuals with PTB with (PTB-DM) or without coincident diabetes mellitus (PTB-NDM) before, during and after completion of anti-TB treatment. PTB-DM is characterized by diminished frequencies of plasmacytoid and myeloid DCs and classical and intermediate monocytes at baseline and 2 months of anti-TB treatment but not following 6 months of treatment completion in comparison to PTB-NDM. DC and monocyte subsets exhibit significant but borderline correlation with fasting blood glucose and glycated hemoglobin levels. Finally, while minor changes in the DC and monocyte compartment were observed at 2 months of treatment, significantly increased frequencies of plasmacytoid and myeloid DCs and classical and intermediate monocytes were observed at the successful completion of anti-TB treatment. Our data show that coincident diabetes alters the frequencies of innate subset distribution of DC and monocytes in TB-DM co-morbidity and suggests that most of these changes are reversible following anti-TB therapy.


PubMed | Prof swanathan Diabetes Research Center, University of Massachusetts Medical School and National Institutes of Health International Center for Excellence in Research
Type: Journal Article | Journal: Immunology | Year: 2016

Perturbations in CD4(+) and CD8(+) T-cell phenotype and function are hallmarks of tuberculosis-diabetes co-morbidity. However, their contribution to the pathogenesis of this co-morbidity and the effect of anti-tuberculosis treatment on the phenotype of the T-cell subsets is poorly understood. In this study, we examined the frequency of different T-cell subsets in individuals with pulmonary tuberculosis (PTB) with diabetes mellitus (DM) or without coincident diabetes mellitus (NDM) before, during and after completion of anti-tuberculosis chemotherapy. PTB-DM is characterized by heightened frequencies of central memory CD4(+) and CD8(+) T cells and diminished frequencies of naive, effector memory and/or effector CD4(+) and CD8(+) T cells at baseline and after 2months of treatment but not following treatment completion in comparison with PTB-NDM. Central memory CD4(+) and CD8(+) T-cell frequencies exhibited a positive correlation with fasting blood glucose and glycated haemoglobin A1c levels, whereas the frequencies of naive and effector memory or effector CD4(+) and CD8(+) T cells exhibited a negative correlation. However, the frequencies of CD4(+) and CD8(+) T-cell subsets in individuals with PTB exhibited no significant relationship with bacterial burdens. Finally, although minor alterations in the T-cell subset compartment were observed at 2months of treatment, significantly decreased frequencies of central memory and significantly enhanced frequencies of naive CD4(+) and CD8(+) T cells were observed at the completion of treatment. Our data reveal a profound effect of coexistent diabetes on the altered frequencies of central memory, effector memory and naive T cells and its normalization following therapy.


PubMed | Prof swanathan Diabetes Research Center, University of Massachusetts Medical School, National Institutes of Health International Center for Excellence in Research and U.S. National Institutes of Health
Type: | Journal: The Journal of infection | Year: 2016

Tuberculosis-diabetes co-morbidity (TB-DM) is characterized by increased inflammation with elevated circulating levels of inflammatory cytokines and other factors. Circulating angiogenic factors are intricately involved in the angiogenesis-inflammation nexus.To study the association of angiogenic factors with TB-DM, we examined the systemic levels of VEGF-A, VEGF-C, VEGF-D, VEGF-R1, VEGF-R2, VEGF-R3 in individuals with either TB-DM (n=44) or TB alone (n=44).Circulating levels of VEGF-A, C, D, R1, R2 and R3 were significantly higher in TB-DM compared to TB individuals. Moreover, the levels of VEGF-A, C, R2 and/or R3 were significantly higher in TB-DM with bilateral or cavitary disease or with hemoptysis, suggesting an association with both disease severity and adverse clinical presentation. The levels of these factors also exhibited a significant positive relationship with bacterial burdens and HbA1c levels. In addition, VEGF-A, C and R2 levels were significantly higher (at 2 months of treatment) in culture positive compared to culture negative TB-DM individuals. Finally, the circulating levels of VEGF-A, C, D, R1, R2 and R3 were significantly reduced following successful chemotherapy at 6 months.Our data demonstrate that TB-DM is associated with heightened levels of circulating angiogenic factors, possibly reflecting both dysregulated angiogenesis and exaggerated inflammation.

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