{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:24:35Z","timestamp":1787243075278,"version":"build-2736575974"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Clinical and Translational Science Collaborative of Northern Ohio"},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1TR004528"],"award-info":[{"award-number":["UM1TR004528"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["R01 EB030134"],"award-info":[{"award-number":["R01 EB030134"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["R01 AI163483"],"award-info":[{"award-number":["R01 AI163483"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["U01 CA265719"],"award-info":[{"award-number":["U01 CA265719"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"name":"VA Merit BLR&D Award","award":["I01 BX005707"],"award-info":[{"award-number":["I01 BX005707"]}]},{"name":"VA Merit BLR&D Award","award":["P30 DK120515"],"award-info":[{"award-number":["P30 DK120515"]}]},{"name":"VA Merit BLR&D Award","award":["P30 DK063491"],"award-info":[{"award-number":["P30 DK063491"]}]},{"name":"VA Merit BLR&D Award","award":["UL1 TR001442"],"award-info":[{"award-number":["UL1 TR001442"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thiazolidinediones are peroxisome proliferator-activated receptor-\u03b3 (PPAR-\u03b3) agonists commonly used to treat type 2 diabetes mellitus. In experimental models, epithelial PPAR-\u03b3 signaling contributes to colonization resistance against bacterial enteric pathogens by shaping oxygen and nitrate luminal bioavailability. Whether the use of PPAR-\u03b3 agonists in humans is associated with reduced risk of bacterial enteric infection is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To investigate whether users of thiazolidinediones (PPAR-\u03b3 agonists) have decreased risk of bacterial enteric infection, we performed a retrospective nationwide analysis using the cloud-based TriNetX Analytics Platform which aggregates health records from 117 million patients across 66 US healthcare organizations. We compared the risk of bacterial enteric infection among patients with diabetes prescribed thiazolidinediones, a class of PPAR-\u03b3 agonists, compared with users of other glucose-lowering medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 85 916 thiazolidinedione users categorized as being at low risk for bacterial enteric infection (no prior history of infection) and 1974 persons identified as being at high risk (prior history of bacterial enteric infection), the risk of bacterial enteric infection was reduced by 49% (RR 0.51, 95% confidence interval [CI] .32\u2013.82) and 22% (RR 0.78, 95% CI .69\u2013.88) respectively, compared to users of other glucose-lowering medications. This reduction in risk was consistent among high-risk individuals, regardless of sex or age. Similar results were observed in high-risk patients when thiazolidinedione users were directly compared to those on DPP-4 inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings demonstrate an association between PPAR-\u03b3 agonist use and a reduced risk of bacterial enteric infection and support further clinical investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag457","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T10:07:21Z","timestamp":1784801241000},"source":"Crossref","is-referenced-by-count":0,"title":["Thiazolidinedione Use and Risk of Bacterial Enteric Infection Among Adults With Type 2 Diabetes Mellitus"],"prefix":"10.1093","volume":"13","author":[{"given":"Morgan","family":"Birabaharan","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Global Public Health, University of California, San Diego , La Jolla, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7855-9515","authenticated-orcid":false,"given":"David C","family":"Kaelber","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics, Internal Medicine, Population and Quantitative Health Sciences, Case Western Reserve University and the Center for Clinical Informatics Research and Education, MetroHealth System , Cleveland, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3847-0422","authenticated-orcid":false,"given":"Victor","family":"Nizet","sequence":"additional","affiliation":[{"name":"Division of Host-Microbe Systems and Therapeutics, Department of Pediatrics, UC San Diego School of Medicine , La Jolla, California ,","place":["USA"]},{"name":"Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego , La Jolla, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6423-5982","authenticated-orcid":false,"given":"Amir","family":"Zarrinpar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University of California, San Diego , La Jolla, California ,","place":["USA"]},{"name":"Center for Microbiome Innovation, University of California, San Diego , La Jolla, California ,","place":["USA"]},{"name":"Division of Gastroenterology, Jennifer Moreno Department of Veterans Affairs Medical Center , La Jolla, California ,","place":["USA"]},{"name":"Institute of Diabetes and Metabolic Health, University of California, San Diego , La Jolla, California ,","place":["USA"]},{"name":"Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego , La Jolla, California 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