Diphtheria Antitoxin Antibodies in Type II Diabetes Mellitus with Toxin Neutralization Method

Öz

Objective: The study was conducted on 310 volunteer diabetes mellitus patients admitted to the outpatient clinic and 200 controls in
Kirikkale University School of Medicine. Patients and controls were given standard questionnaires including demographic data and
vaccination history.
Research Design and Methods: Sera samples were kept at -20 0
Results: The susceptibility rates, basic protection rates and full protection rates in patient and control groups were 18.1%, 42.5%, 81.9%
and 16.5%, 36.5%, 83.5%, respectively. Results were not significantly different for patient and control groups at all titer intervals
(x
C until used. Toxin neutralization (TN) method was applied to measure
the diphtheria antibody levels in the sera samples. By the TN test < 0.01 IU/ml levels were assessed as susceptible; ≥ 0.01 - < 0.1 IU/ml
levels as basic protection; and ≥ 0.1 IU/ml levels as full protection status. The statistical analysis was done by using SPSS 8.0 program.
2
=2.966, p=0.227). A tendency of difference in only older age patients was noted in the patient group although it was not statistically
significant (x2
=20.923, p=0.052). No significant difference was found in the control group (x2
Conclusions: There was not a statistically significant difference between those groups. For this reason, people whose antitoxin levels were
susceptible had to be determined and vaccinated.
=15.908, p=0.196). A statistical difference
was not identified between the groups in terms of mean titer, educational level, age and gender.

Anahtar Kelimeler

• diabetes mellitus,diphtheria antitoxin level,toxin neutralization test

Diphtheria Antitoxin Antibodies in Type II Diabetes Mellitus with Toxin Neutralization Method

Öz

Amaç: Bu araştırma Kırıkkale Üniversitesi Tıp Fakültesi hastanesine ayaktan başvuran 310 gönüllü diyabetes mellitus hastası ile 200 sağlıklı kontrol grubunda yapıldı. Hastalar ve kontrol grubuna demografik bilgileri ve aşılama hikâyesini de içeren standart anket uygulandı. Araştırma Dizaynı ve Metot: Serum örnekleri alınarak -20 0C ‘de saklandı. Toksin nötralizasyon (TN) metodu ile serum örneklerinde difteri antikor düzeyleri ölçüldü. Bu metotla, < 0.01 IU/ml düzeyler hassa; ≥ 0.01 - < 0.1 IU/ml düzeyler temel koruyucu ve ≥ 0.1 IU/ml seviyeler tam koruyucu düzeyler olarak değerlendirildi. İstatistiksel analiz SPSS 8.0 programı kullanılarak yapıldı. Sonuçlar: Hassasiyet, temel koruyucu ve tam koruyucu düzeyler hasta ve kontrol grubunda sırasıyla %18.1, %42.5, %81.9 ve %16.5, %36.5, %83.5 olarak ölçüldü. Sonuçlar tüm titre aralığuında incelendiğinde hasta ve kontrol grubu arasında fark bulunmadı (x2=2.966, p=0.227). Sadece daha yaşlı hasta bireyler arasında, istatistiksel olarak anlamlı fark olmasa da farka eğilim tespit edildi (x2=20.923, p=0.052). Kontrol grubunda da ise aynı yaş grubunda anlamlı fark yoktu (x2=15.908, p=0.196). İstatistiksel farklılık her iki grupta eğitim düzeyi, yaş ve cinsiyet üzerinde de bulunmadı. Tartışma: Her iki grup arasında istatistiksel olarak anlamlı bir fark bulunmadı. Bu nedenle, antitoksin düzeyi hassas olan kişiler tespit edilip aşılanmalıdır

Anahtar Kelimeler

• diyabetes mellitus, difteri antitoksin düzeyleri, toksin nötralizasyon testi

Kaynakça

1. 1. Marlovits S, Stocker R, Efstratiou A, et al. Seroprevalence of diphtheria immunity among injured adults in Austria. Vaccine 2000; 19 (9- 10): 1061-67.
2. 2. Galazka AM, Robertson SE. Immunization against diphtheria with special emphasis on immunization of adults. Vaccine 1996; 14 (9): 845-57.
3. 3. Liorente L, De La Fuente H, Patin YR, et al. Innate immune response mechanisms in noninsulin dependent diabetes mellitus patients assessed by flow cytoenzymology. Immunol Letters 2000; 74: 239-244.
4. 4. Alexiewicz JM, Kumar D, Smorgorzewski M, Massry SG. Elevated cytosolic calcium and impaired proliferation of B lymphoctes in type II diabetes mellitus. Am J Kidney Dis 1997; 30: 98-104.
5. 5. Walory J, Grzesiowski P, Hryniewicz W. Comparison of four serological methods for the detection of diphtheria anti-toxin antibody. J Immunological Methods 2000; 245: 55-65.
6. 6. Maple PA, Jones CS, Wall EC, et al. Immunity to diphtheria and tetanus in England and Wales. Vaccine 2000; 19 (2-3): 167-173.
7. 7. Marlovits S, Stocker R, Efstratiou A, et al. Effect on Diphtheria Immunity of Combined Tetanus and Diphtheria Booster Vaccination in Adults. Eur J Clin Microbiol Infect Dis 2000; 19 (7): 506-13.
8. 8. CDC. Immunization of adolescents: recommendations of the Advisory Committee on immunization Practices. The American Academy of Pediatrics, the American Academy of Family Physicians, and the American Medical Association. MMWR 1996; 45: 1-16.

9. 9. Brennan M, Vitek C, Strebel P, et al. How many doses of diphtheria toxoid are required for protection in adults? Results of a casecontrol study among 40- to 49-year-old adults in the Russian Federation. J Infect Dis 2000; 181 (Suppl 1): S193-6.
10. 10. Anonymous: Expanded programmed on immunization: diphtheria epidemic in the Newly lndependent States of the former USSR. 1990-1994. Weekly Epidemiol Record 1995; 70: 141-44.
11. 11. Vitek CR, Wharton M. Diphtheria in the former Soviet Union: reemergence of a pandemic disease. Emerg Infect Dis 1998; 4: 539-50.
12. 12. Rakhmanova AG, Lumio J, Groundstroem K, et al. Diphtheria outbreak in St. Petersburg: clinical characteristics of 1860 adult patients. Scand J Infect Dis 1996; 28 (1): 37-40.
13. 13. Maple PA, Efstratiou A, George RC, Andrews NJ, Sesardic D. Diphtheria immunity in UK blood donors. Lancet 1995; 345: 963-65.
14. 14. Comodo N, Bonanni P, Lo Nostro A, Tiscione E, Mannelli F, Tomei A. Low prevalence of diphtheria immunity in the population of Florence, Italy. European J Epidemiol 1996; 12: 351-55.
15. 15. Gupta RK, Griffin P, Xu J, Rivera R, Thompson C. Siber GR. Diphtheria antitoxin levels in US blood and plasma donors. J Infect Dis 1996; 173: 1493-97.
16. 16. Hasselhorn HM, Nubling M, Tiller FW, Hofmann F. Factors influencing immunity against diphtheria in adults. Vaccine 1998; 16: 70-75.