Why are people with diabetes more prone to urinary tract infections?

by time news

It was already known that people with type 1 and 2 diabetes have a higher risk of urinary tract infections, but now researchers from the Karolinska Institute in Sweden have shown that the link between the two pathologies has to do with the fact that the immune system of people with diabetes has lower levels of the antimicrobial peptide psoriasin, which compromises the cellular barrier of the urinary bladder, increasing the risk of urinary tract infection. The results of the study are published in the journal ‘Nature Communications’.

The insulin It is a hormone that regulates the glucose (sugar) that reaches the cells. In type 1 diabetes, the body stops producing insulin, while in type 2 diabetes, cells become less sensitive to this hormone, which contributes to high blood glucose levels.

This pathology compromises health in many ways. Among others, it affects the innate immune systemleaving many people more susceptible to everyday infections, such as urine infections, caused by E. coli bacteria.

The Karolinska researchers analyzed whether glucose levels in people with diabetes (type 1, type 2 or prediabetes) are related to psoriasin, a endogenous antibiotic which is part of the innate immune system.

Using urine, urinary bladder cells and blood serum samples from the patients, the researchers assessed the levels of psoriasin and other peptides needed to ensure that the bladder mucosa remains intact and protects against infection. The findings were then verified in mice and urinary bladder cells with and without infection.

“We found that high glucose concentrations reduce levels of the antimicrobial peptide psoriasin, while insulin has no effect,” explains Annelie Brauner, Professor in the Karolinska Institutet’s Department of Microbiology, Tumor and Cell Biology, who led the study. “People with diabetes have lower levels of psoriasin, which weakens the cells’ protective barrier function and increases the risk of bladder infection,” she adds.

Professor Brauner’s research group has previously shown that the estrogen treatment restores the protective function of bladder cells in humans and mice and thus helps regulate the immune response to a urinary tract infection.

The researchers tested how estrogen treatment affects infected cells exposed to high concentrations of glucose. They found that this increased psoriasin levels and reduced bacterial populations, indicating that the treatment may also have an effect among patients with diabetes.

“Now we plan to delve into the underlying mechanisms of infections in people with diabetes. The ultimate goal is to reduce the risk of infection in this growing group of patients,” says study lead author Soumitra Mohanty, a researcher in the same department at the Karolinska Institute.

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