IMMUNOLOGICAL FEATURES OF THE DYNAMICS OF THE I DEGREE SEVERETY BACTERIAL KERATITES DEPENDING ON THE PRESENCE OF DIABETES MELLITUS

Abstract

Summary. In patients with diabetes mellitus (DM) there are features of the dynamics of the I degree severity bacterial keratitis, leading to prolongation of the disease and worsening of its consequences.
 The aim was to identify immunological features of the dynamics of the I degree severity bacterial keratitis depending on the presence of type 1 DM.
 Materials and methods. The level of interleukins (IL) was analyzed, namely IL-1β, IL-6 and IL-10 in the lacrimal fluid of the sick and the contralateral eye of 6 patients with type 1 DM and the I degree severity bacterial keratitis and 6 nondiabetic patients with I degree severity bacterial keratitis on the 1st day, 10-14th day and 24th day of observation. Data from 14 healthy individuals of the appropriate age were used for comparison. The severity of bacterial keratitis was determined according to our scheme at a total score of ≤ 14. All patients were treated with instillations of ofloxacin, antiseptics, antioxidants, reparents, artificial tears, mydriatics, systemic anti-inflammatory therapy. The level of IL in the lacrimal fluid was determined by quantitative colorimetric enzyme-linked immunosorbent assay using ELISA kits by ANOGEN according to the instructions for use.
 Results and discussion. In patients with I degree severity bacterial keratitis, both DM and nondiabetic, on the 1st day of observation there was an increase in the level of IL-1β and IL-6 in the lacrimal fluid of the sick eye and IL-10 – of the contralateral eye compared to healthy persons, on the 10th-14th day — increase in the level of IL-1β and IL-6 of the sick and the contralateral eye, as well as IL-10 – of the contralateral eye (p<0.05). On the 24th day in nondiabetic patients with I degree severity bacterial keratitis normalization of interleukin levels in the lacrimal fluid of the sick and the contralateral eye was found, but in DM patients remained elevated levels of IL-1β, IL-6, both in the sick and in the contralateral eye (p<0.05).
 Conclusions. In DM patients there are immunological features of the dynamics of the I degree severity bacterial keratitis, namely a longer increase in the level of proinflammatory cytokines IL-1β, IL-6 in the lacrimal fluid of the sick and the contralateral eye.