Highlights
- •Diabetic populations are susceptible to viral infections.
- •The cessation of smallpox vaccination resulted in increased monkeypox outbreaks.
- •High glucose levels are associated with impaired function of viral sensors.
- •Most countries should be more cautious regarding their diabetic populations.
- •Hypoglycemic agents are key to control glucose and improve antiviral mechanisms.
Abstract
Background and aims
Methods
Results
Conclusions
Keywords
1. Introduction
2. Monkeypox infection
3. Pathophysiology of Monkeypox infection
4. Immunopathogenesis related to Monkeypox infection
5. Immune mechanisms associated to protect from Poxvirus protection
6. T2D and infections
7. T2D and immune dysfunction
8. T2D and antiviral mechanism
9. Hypoglycemiants as protective drugs against viral infections
DRUG | ACTION MECHANISM | EFFECT | REFERENCE |
---|---|---|---|
Glyburide | Inhibits ATP-sensitive K+ channels, ASC ensemble, and NLRP3 inflammasome. | Reduces inflammatory mediators production, such as IL-1b, which is associated with severe manifestation during viral infection. | 61 |
Angiotensin 1–7, NorLeu3-A | Induce activation of Mas receptor, vasodilation, and reduce of oxidative stress. | Promote oxidative stress and may accelerate immunity. Oxidative stress is also linked to inflammation and damage. | 62 |
Evogliptin and sitagliptin | Inhibits dipeptidyl peptidase 4 (DDP4) activity. | Control the activation and proliferation of T cells. A key cell population during viral infection. | 64 |
Thiazolidinedione | Inhibit peroxisome proliferator-activated receptor γ (PPAR γ), a regulator of glucose metabolism. | Inhibits T cell apoptosis. During viral infection, T cells are induced to apoptosis as a mechanism of immune evasion. | 66,67 |
Metformin | Inhibits mitochondrial complex I, ATP production, fructose-1,6-bisphosphatase, and gluconeogenesis. | Promotes p38MPAK pathway activation and B-cell activity. Therefore, metformin enhances innate immune response and antibody production, respectively. | 71,72 |
Sodium-glucose cotransporter type 2 | Inhibits empagliflozin. | Reduces the production of TNF-α, PCR, and IL-6, which prevents exacerbated inflammation associated with viral infections. | 73 |

9.1 Glyburide, and angiotensin 1–7 and NorLeu3-A
9.2 Evogliptin
9.3 Thiazolidinedione
9.4 Metformin
9.5 Sodium-glucose cotransporter type 2
10. Conclusions
11. Summary
Funding
Conflict interest
Acknowledgments
References
〈https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html〉.
〈https://www.cdc.gov/poxvirus/monkeypox/considerations-for-monkeypox-vaccination.html〉.
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