Why are people with diabetes more prone to infection? Here’s a pathway.

A decreased glutathione ratio in monocytes results in reduced IL-12 production. IL-12 induces the production of IFNγ from natural killer (NK) and T cells. IFNγ is necessary to activate the infected monocytes to become bactericidal for killing of intracellular B. pseudomallei (B. p.) and M. tuberculosis (M. tb.). The IL-12 response from monocytes infected with B. p. is dependent on TRIF and MyD88 adaptors, yet these signaling pathways do not seem to be affected by the GSH ratio [20]. Perhaps another signaling pathway mediated by an intracellular pattern recognition receptor (PRR) is also necessary for IL-12 induction, and this pathway is modulated by GSH. The effect of GSH on diabetic NK cell and neutrophil function in response to B. p. is currently under investigation. In tuberculosis, indirect evidence where GSH was added to healthy NK cells and neutrophils in vitro shows increased cellular control of M. tb. [33].