UMMS Affiliation

Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine

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Document Type



Allergy and Immunology | Bacterial Infections and Mycoses | Endocrine System Diseases | Immunology and Infectious Disease | Infectious Disease | Microbiology | Nutritional and Metabolic Diseases


Objectives: To study the association of Tissue inhibitors of matrix metalloproteinases (TIMP) levels with tuberculosis-diabetes comorbidity (TB-DM) comorbidity at baseline and in response to anti-TB treatment (ATT).

Methods: We examined the levels of TIMP-1, -2, -3 and -4 in pulmonary tuberculosis alone (TB) or TB-DM at baseline and after ATT.

Results: TIMP-1, -3 and -4 were significantly increased in TB-DM compared to TB at baseline and after ATT. ATT resulted in a significant reduction in TIMP-2 and -3 levels and a significant increase in TIMP-1 in both TB and TB-DM. TIMP-1, -3 and -4 were also significantly increased in TB-DM individuals with bilateral, cavitary disease and also exhibited a positive relationship with bacterial burden in TB-DM and HbA1c in all TB individuals. Within the TB-DM group, those known to be diabetic before incident TB (KDM) exhibited higher levels of TIMP-1, -2, -3 and -4 at baseline and TIMP-2 at post-treatment compared to those newly diagnosed with DM (NDM). KDM individuals on metformin treatment exhibited lower levels of TIMP-1, -2 and -4 at baseline and of TIMP-4 at post-treatment.

Conclusions: TIMP levels were elevated in TB-DM, associated with disease severity and bacterial burden, correlated with HbA1c levels and modulated by duration of DM and metformin treatment.


Diabetes mellitus, Mycobacterium tuberculosis, Tissue inhibitors of metalloproteinases

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Copyright © 2021 The Author(s). This is an open access article under the CC BY-NC-ND license (

DOI of Published Version



Kumar NP, Moideen K, Viswanathan V, Sivakumar S, Hissar S, Kornfeld H, Babu S. Effect of anti-tuberculosis treatment on the systemic levels of tissue inhibitors of metalloproteinases in tuberculosis - Diabetes co-morbidity. J Clin Tuberc Other Mycobact Dis. 2021 Apr 22;23:100237. doi: 10.1016/j.jctube.2021.100237. PMID: 33997311; PMCID: PMC8100611. Link to article on publisher's site

Journal/Book/Conference Title

Journal of clinical tuberculosis and other mycobacterial diseases

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Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.