{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:39Z","timestamp":1772168919450,"version":"3.50.1"},"reference-count":54,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Abstract The comorbidity due to pulmonary tuberculosis (TB) and diabetes mellitus (DM) is a global health problem, but its mechanism remains unclear. It is suspected that hyperglycemic alteration of the immune response to TB and the composition of the lung microbiota play an important role. This scoping review aimed to contribute to the understanding of the mechanisms by mapping evidence on the effect of hyperglycemia on physical health indicators, immune cell counts, cytokine levels, and the composition of lung microbiota in patients with the DM-TB comorbidity. A systematic search for research articles about the relationship between hyperglycemia and physical health, immune cells, and cytokine levels in humans was conducted in MEDLINE, Scopus, and CINAHL Plus. Then, articles on the interactions between the immune cells, cytokines, and lung microbiota were identified through Google Scholar and Google search engines. Characteristics of the studies focusing on effects of hyperglycemia, the findings of the articles relevant to the research objectives, and strengths and weaknesses of the selected articles were charted in a data extraction tool. Twenty-one articles on the effects of hyperglycemia on immune mediators and health outcomes of patients with DM-TB were included. The evidence showed hyperglycemia to be associated with unfavorable treatment outcomes; altered counts and functioning of dendritic cells, monocytes, and CD4+ T cells; and changes in cytokine levels (mainly INF-\u03b3, IL-17, IL-1\u03b2, IL-2, IL-6, IL-10, and TNF-\u03b1) in patients with DM-TB. The composition of the lung microbiota changed in correlation with changes in physical health outcomes, counts of immune cells, and cytokine levels. Thus, hyperglycemia, immune responses, and dysbiosis of the lung microbiota are integral in the pathogenesis of DM-TB and TB treatment outcomes. A prospective cohort study, especially in individuals with newly diagnosed DM versus known DM and concomitant latent TB versus active TB, is recommended to define causal relationships.<\/ns3:p>","DOI":"10.12688\/f1000research.159555.1","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T06:45:08Z","timestamp":1734677108000},"page":"1543","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of hyperglycemia on lung microbiota and treatment outcome in pulmonary tuberculosis: A scoping review"],"prefix":"10.12688","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7523-2784","authenticated-orcid":false,"given":"Victor Moses","family":"Musyoki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Mureithi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamari","family":"Heikinheimo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Maleche-Obimbo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5924-7970","authenticated-orcid":false,"given":"Dennis","family":"Kithinji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Musau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kariuki","family":"Njaanake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omu","family":"Anzala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1186\/s12879-019-3892-8","article-title":"Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: A systematic review and meta-analysis of observational studies.","volume":"19","author":"A Alebel","year":"2019","journal-title":"BMC Infect. 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There are spelling mistakes at more than 4 places. Plz. correct these.<\/b> We have proofread the manuscript repeatedly but we could not see the spelling mistakes, perhaps due to familiarity blindness. We request you highlighting the spelling mistakes and we will gladly correct them.  2.&nbsp;\n<b>First of all, the authors need to adopt a uniform style of writing. The entire manuscript should be written in Times New Roman, Font 12 with double spacing. The present one is Times New Roman, Font 12 with 1.5 paragraph spacing.<\/b> We submitted the manuscript uniformly written in Times New Roman, Font 12 with double spacing. Copyediting and typesetting are done by the journal\u2019s editorial team in the production stage.  \n<b>3.&nbsp;Abstract:&nbsp;<\/b>\n<b>Include the place of study in Keywords.&nbsp;It is important.<\/b> The study is a scoping review that included studies conducted globally, hence it does not have a specific place of study.  \n<b>4.&nbsp;The methodology, i.e., selection criteria of studies included, excluded, screened, assessed for eligibility, etc. in the review need to be represented in a figure.<\/b> Figure 1 presents a PRISMA flow diagram showing the selection of sources of evidence for the relationship between TB and hyperglycemia.","URL":"https:\/\/f1000research.com\/articles\/13-1543\/v1#referee-comment-13637","order":2,"name":"referee-comment-13637","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.175303.r362451, Sonal Sekhar Miraj, Manipal Academy of High Education, Manipal, 19 Feb 2025, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/13-1543\/v1#referee-response-362451","order":3,"name":"referee-response-362451","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Victor Musyoki<\/b>; \n<i>Posted: 26 Mar 2025<\/i>; \n<b>1. In the abstract, the authors mention, &quot;The composition of the lung microbiota changed in correlation with changes in physical health outcomes, counts of immune cells, and cytokine levels.&quot; What way composition of microbiota should be mention (phylum levels, genes level or microbial diversity)<\/b> The changes in the microbial diversity could best be summarized as in the abstract since they are diverse, but the details are in the main text.  \n<b>2. Effect of the hyperglycemia on lung microbiota, the readers will expect changes in the microbial diversity and richness. These points are not discussed in the manuscript<\/b> We have discussed variations in the microbial composition of the lung microbiota based on TB disease status and levels of immunological markers because that is the closest information we could find. Our search could not identify any study that directly addressed the effect of hyperglycemia on lung microbiota in TB patients; that is why we did not discuss those details. We recommended further research to study the relationship.&nbsp;  \n<b>3.&nbsp;&nbsp;How can you ensure the dysbiosis in the lung microbiota is due to hyperglycemia alone, because TB and its ATT drugs itself can cause the dysbiosis.<\/b> That is our argument in this scoping review; it is the reason we have recommended a prospective study where other factors can be controlled to determine whether hyperglycemia causes lung dysbiosis in TB patients. &nbsp; \n<b>4. In conclusion, authors mention &quot;hyperglycemia and lung microbiota are involved in the pathogenesis of DM-TB, ..........&quot; Is it pathogenesis of DM-TB? this is not clear<\/b> Yes, it is pathogenesis (cellular events, reactions, and other mechanisms) that occur when a patient has the DM-TB comorbidity. The scoping review revealed that poor TB outcomes and immunological markers of TB progression co-occur with hyperglycemia and lung dysbiosis, hence the conclusion that they are involved in the DM-TB pathogenesis.","URL":"https:\/\/f1000research.com\/articles\/13-1543\/v1#referee-comment-13638","order":4,"name":"referee-comment-13638","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}