Glycemic Variability in Diabetes Increases the Severity of Influenza

Rebecca J Marshall; Pornthida Armart; Katina D Hulme; Keng Yih Chew; Alexandra C Brown; Philip M Hansbro; Conor J Bloxham; Melanie Flint; Katharina Ronacher; Helle Bielefeldt-Ohmann; Linda A Gallo; Kirsty R Short

doi:10.1128/mBio.02841-19

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Glycemic Variability in Diabetes Increases the Severity of Influenza

Journal article

Open access

Peer reviewed

Glycemic Variability in Diabetes Increases the Severity of Influenza

Rebecca J Marshall, Pornthida Armart, Katina D Hulme, Keng Yih Chew, Alexandra C Brown, Philip M Hansbro, Conor J Bloxham, Melanie Flint, Katharina Ronacher, Helle Bielefeldt-Ohmann, …

mBio, Vol.11(2), pp.1-15

2020

DOI: https://doi.org/10.1128/mBio.02841-19

PMCID: PMC7157527

PMID: 32209691

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Abstract

blood

glucose

diabetes

influenza

People with diabetes are two times more likely to die from influenza than people with no underlying medical condition. The mechanisms underlying this susceptibility are poorly understood. In healthy individuals, small and short-lived postprandial peaks in blood glucose levels occur. In diabetes mellitus, these fluctuations become greater and more frequent. This glycemic variability is associated with oxidative stress and hyperinflammation. However, the contribution of glycemic variability to the pathogenesis of influenza A virus (IAV) has not been explored. Here, we used an in vitro model of the pulmonary epithelial-endothelial barrier and novel murine models to investigate the role of glycemic variability in influenza severity. In vitro, a history of glycemic variability significantly increased influenza-driven cell death and destruction of the epithelial-endothelial barrier. In vitro, influenza virus-infected mice with a history of glycemic variability lost significantly more body weight than mice with constant blood glucose levels. This increased disease severity was associated with markers of oxidative stress and hyperinflammation both in vitro and in vivo. Together, these results provide the first indication that glycemic variability may help drive the increased risk of severe influenza in people with diabetes mellitus.

Details

Title: Glycemic Variability in Diabetes Increases the Severity of Influenza
Authors: Rebecca J Marshall (Author) - The University of Queensland
Pornthida Armart (Author) - The University of Queensland
Katina D Hulme (Author) - The University of Queensland
Keng Yih Chew (Author) - The University of Queensland
Alexandra C Brown (Author) - University of Newcastle Australia
Philip M Hansbro (Author) - University of Technology Sydney, Faculty of Science, Ultimo, NSW, Australia
Conor J Bloxham (Author) - The University of Queensland
Melanie Flint (Author) - The University of Queensland
Katharina Ronacher (Author) - The University of Queensland
Helle Bielefeldt-Ohmann (Author) - The University of Queensland
Linda A Gallo (Author) - The University of Queensland
Kirsty R Short (Author) - The University of Queensland
Publication details: mBio, Vol.11(2), pp.1-15
Publisher: American Society for Microbiology
Date published: 2020
DOI: 10.1128/mBio.02841-19
ISSN: 2150-7511; 2161-2129
PMID: 32209691; PMC7157527
Organisation Unit: School of Health - Biomedicine; University of the Sunshine Coast, Queensland; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99620607902621
Output Type: Journal article

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Collaboration types: Domestic collaboration
Web Of Science research areas: Microbiology

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