Immunological Base Behind the Increased Susceptibility of Diabetic Patients for Infections

Abstract

A 120 middle-aged adults and elderly were enrolled in this case – control study, including 48 type 2 diabetes without foot infection patients, 36 diabetic foot patients and 36 apparently healthy individuals matched as control group. The current study was carried out to evaluate the immunological status displayed by antimicrobial peptide and their role in diabetes mellitus patients and diabetic foot infection patients. The results of demographic data examination among patients with diabetes mellitus in this work revealed that out of all 84 diabetic patients, 78% had their first signs of diabetes during their forties. Otherwise, the most common age interval for acquirement of diabetic foot infection among diabetic patients were in 50s-60s leading to 60% of diabetic foot patients underwent foot amputation at that age interval. Regarding gender as a demographic factor among diabetes patients in this study, the results showed that the gender of females and males were equal in frequency among diabetes patients without foot ulcers. On the other hand, the results demonstrate that the gender of male was found to have susceptibility to get diabetic foot infection more than the female gender (63.89% versus 36.11%). In this study, biochemical test and hematological parameters that affected on foot amputation were random blood sugar (RBS), hemoglobin A1c, neutrophils (high-significant difference between the groups in the study (P=0.0001)) and neutrophil-lymphocyte ratio (high statistical significant difference between the study groups (P>0.003)). Regarding the evaluation of immune parameters reflected by antimicrobial peptides in present study, serum HNP1-3 and DEF-?2 levels were non-significant difference between the study groups (P>0.05). Otherwise, LL-37 level was significant difference between the study groups (p?0.05). These results suggest that although most AMPs are expressed in DFU, this production is not appropriate to promote wound healing and contain secondary infections but present decrease in human LL-37 can be cause in don’t wound healing in diabetic foot patients.