Abstract
Diabetes mellitus is a clinical syndrome that frequently leads to the development of chronic complications and high susceptibility to infections. It is probably due to defective immunological defense, which may be related to metabolic control of the disease. The aim of this study was to evaluate the effect of metabolic control on immune-cell behavior in type 1 and type 2 diabetic patients. For this, the in vitro proliferation of peripheral blood mononuclear cells (PBMC) was analyzed in patients with inadequate and adequate metabolic control. Experimental/laboratory study at a university hospital. Eleven type 1 and thirteen type 2 diabetic patients were studied, together with 21 healthy individuals divided in two groups (11/10), who were matched by sex and age with those diabetic patients. PBMC cultures stimulated with concanavalin-A (Con-A) were used to measure 3H-thymidine incorporation after 72 hours of cell culturing. For patients with inadequate metabolic control, culturing was performed on the first day of patient hospitalization and again after intensive treatment to achieve adequate control. The proliferation index for Con-A-stimulated cultures from type 1 diabetic patients was significantly greater than that for cultures from healthy individuals and type 2 diabetic patients, independent of metabolic control. A negative correlation between the proliferation cell index and body mass index and serum C-reactive protein levels was also observed. The increase in the proliferation capacity of type 1 diabetic T lymphocytes was probably not caused by hyperglycemia and/or insulinopenia related to inadequate metabolic control.
Highlights
Diabetes mellitus is a chronic clinical syndrome caused by insulin deficiency that causes a set of metabolic abnormalities involving the metabolism of glucose, lipids, protein and other substances
Impairment of polymorphonuclear leukocyte phagocytosis and reduction in granulocyte phagocytic capacity have been reported with increased plasma glucose concentration in diabetic patients, and these abnormalities are reversed after insulin therapy.[11,12,13,14,15,16]
Considering the importance of the immune system in the development of diabetic complications such as higher susceptibility to infections in diabetic patients, we proposed to study the in vitro proliferation of peripheral blood mononuclear cells (PBMCs) from type 1 and type 2 diabetic patients, and to correlate this with inadequate and adequate metabolic control, as measured by the glycemic parameters associated with body mass index (BMI), and with the peripheral inflammatory response assessed by C-reactive protein levels
Summary
Diabetes mellitus is a chronic clinical syndrome caused by insulin deficiency (defects of insulin secretion and/or action) that causes a set of metabolic abnormalities involving the metabolism of glucose, lipids, protein and other substances. Impairment of polymorphonuclear leukocyte phagocytosis and reduction in granulocyte phagocytic capacity have been reported with increased plasma glucose concentration in diabetic patients, and these abnormalities are reversed after insulin therapy.[11,12,13,14,15,16] The most dramatic defect that occurs in diabetes mellitus is related to abnormalities of T cell function.[17,18] The reason for these alterations in the immune cell behavior of diabetic patients is still undefined, with few studies of lymphocyte proliferation and none regarding the influence of metabolic control in diabetic patients
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