Cellular İmmune Responses in Adult-Onset Diabetes Mellitus: Prospective study

Yıl 2018, Cilt: 4 Sayı: 2, 808 - 821, 15.08.2018

Güzin Özden , Nurullah Yekta Akçam

https://doi.org/10.30569/adiyamansaglik.434583

Öz

Introduction:
T-helper-1 and T-helper-2 cells are reported to be effective in
cellular/autoimmune and humoral/allergic responses, respectively, and
controlled each other interactively. This is proposed as a mechabism of
tolerance.  Decreased resistance to
infections with diabetic patients have been reported by several investigators.

The
aim of study was to investigate cellular immune responses in patients with type
two diabetes mellitus; by using Mantoux test which had been accepted as a
measure of cellular immunity and skin prick test in relation to T-helper-2
responses.

Material
and method: Montoux test and skin prick test results of 77 type-2-diabetic
patients and 71 gender –and- age matched healthy individuals were evaluated

Results:
Number of subjects with a negative Mantoux test was found to be 23 among
diabetic group and 7 among control group; frequency of subjects with 1-5 mm Montoux test result was
19 and 10, respectively. That of subjects with more than 10 mm were 12 and 25 in the same order. There
was a negative correlation between Mantoux test results with fasting serum
glucose levels (r=-0.285, p=0.012) and HbA1c (r= -0.353,
p=0.002) levels of diabetic subjects

 Conclusion: type-2 diabetic patients have
significantly decreased cellular immune responses, and this is not related to
skin test results (Th2 responses).

Anahtar Kelimeler

Atopi, adult-onset Diabetes mellitus, Phadiatop, Prick test

Erişkin tip diabette hücresel immun yanıt: Prospektif çalışma

Öz

Giriş:
T-helper 1 ve T-helper 2 effektör hücrelerin sırasıyla hücresel/otoimmün ve
hümoral/alerjik yanıtlarında etkili olduğu ve karşılıklı olarak birbirini
kontrol ettiği bildirilmiştir. Bu durum toleransın mekanizması olarak ileri sürülmüştür.
Diabetli hastalarda infeksiyonlara karşı direncin azaldığı bazı araştırmacılar
tarafından bildirilmiştir.

Bu
çalışmanın amacı, hücresel immünitenin ölçütü olarak kabul edilen Mantoux testi
ve Th2 yanıtları ile ilişkisi bildirilen deri prick testlerini kullanarak tip 2
diabeti olan hastalarda hücresel immün yanıtları araştırmaktır.

 Materyal ve metot:Yaş ve cins uyumluluğu
gösteren 77 tip 2 diabetli hasta ve 71 sağlıklı kontrolün Mantoux testi ve deri
prick testi sonuçları beraber değerlendirildi.

Bulgular:
Diabet grubunda Mantoux testi negatif denek sayısı 23, kontrol grubunda 7
bulundu; Mantoux testi 1-5 mm
arasında olanların frekansı sırasıyla 19 ve 10 idi. On mm'nin üzerinde olanlar
ise sırasıyla 12 ve 25 idi. Yapılan korreleasyon analizinde Diabetli hastalarda
Mantoux testi sonuçları açlık kan şekeri (r=-0.285, p=0.012) ve HbA1c (r=-0.353, p=0.002)
düzeyleri ile yakın bir negatif korrelasyon gösteriyordu.

Sonuç:
Tip 2 diabetli hastalarda hücresel immün yanıtlarda önemli düzeyde azalma
olduğuna; bunun deri testleri ile (Th2 yanıtları) ilişkili olmadığına
ulaşılmaktadır.

Anahtar Kelimeler

Atopi, erişkin tipi diabet, Phadiatop, Prick test

Kaynakça

• Shah BR ve ark. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care. 2003;26(2):510-3.
• Geerlings SE ve ark. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol. 1999;26(3-4):259-65.
• Tanaka Y. [Immunosuppressive mechanisms in diabetes mellitus]. Nihon Rinsho. 2008;66(12):2233-7.
• Viardot A ve ark. Potential antiinflammatory role of insulin via the preferential polarization of effector T cells toward a T helper 2 phenotype. Endocrinology. 2007;148(1):346-53.
• MacCuish AC ve ark. Phytohemagglutinin transformation and circulating lymphocyte subpopulations in insulin-dependent diabetic patients. Diabetes. 1974;23(8):708-12.
• Pozzilli P ve ark. In vivo determination of cell mediated immune response in diabetic patients using a multiple intradermal antigen dispenser. Diabetes Res. 1987;6(1):5-8.
• Peleg AY ve ark. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes Metab Res Rev. 2007;23(1):3-13.
• Ragab AH ve ark. Response of peripheral blood lymphocytes from patients with diabetes mellitus to phytohemagglutinin and Candida albicans antigen. Diabetes. 1972;21(8):906-7.
• Delespesse G ve ark. Cell-mediated immunity in diabetes mellitus. Clin Exp Immunol. 1974;18(4):461-7.
• Plouffe JF ve ark. Cell-mediated immunity in diabetes mellitus. Infect Immun. 1978;21(2):425-9.
• Leung CC ve ark. Tuberculosis in older people: a retrospective and comparative study from Hong Kong. J Am Geriatr Soc. 2002;50(7):1219-26.
• Shirakawa T ve ark. The inverse association between tuberculin responses and atopic disorder. Science. 1997;275(5296):77-9.
• Gruber C ve ark. Delayed hypersensitivity to tuberculin, total immunoglobulin E, specific sensitization, and atopic manifestation in longitudinally followed early Bacille Calmette-Guerin-vaccinated and nonvaccinated children. Pediatrics. 2001;107(3):E36.
• Strannegard IL ve ark. Prevalence of allergy in children in relation to prior BCG vaccination and infection with atypical mycobacteria. Allergy. 1998;53(3):249-54.
• Omenaas E ve ark. Absence of relationship between tuberculin reactivity and atopy in BCG vaccinated young adults. Thorax. 2000;55(6):454-8.
• Kroger L ve ark. Development of tuberculin reactivity and sensitization to M. scrofulaceum and M. fortuitum in children BCG-vaccinated at birth. Eur Respir J. 2000;15(2):382-7.
• Tezcan D ve ark. Retrospective evaluation of epidermal skin prick tests in patients living in Aegean region. Allergol Immunopathol (Madr). 2003;31(4):226-30.
• Merrett J ve ark. Phadiatop--a novel IgE antibody screening test. Clin Allergy. 1987;17(5):409-16.
• Vidal C ve ark. Evaluation of the phadiatop test in the diagnosis of allergic sensitization in a general adult population. J Investig Allergol Clin Immunol. 2005;15(2):124-30.
• Garcia-Marcos L ve ark. Phadiatop compared to skin-prick test as a tool for diagnosing atopy in epidemiological studies in schoolchildren. Pediatr Allergy Immunol. 2007;18(3):240-4.
• Perez-Guzman C ve ark. Does aging modify pulmonary tuberculosis?: A meta-analytical review. Chest. 1999;116(4):961-7.