[Impaired antiendotoxin immunity in patients with diabetic retinopathy and type 2 diabetes mellitus]

Solid-phase enzyme immunoassay was used to study the serum levels of the antiendoxin IgA, IgM, IgG antibodies and total immunoglobulins of classes A, M, and G in 62 patients (122 eyes) with type 2 diabetes mellitus at different stages of diabetic retinopathy. Patients with diabetic retinopathy concurrent with type 2 diabetes mellitus were found to have a significant imbalance of antiendotoxin immunity. The highest level of anti-lipopolysaccharide (LPS)-IgA was detected in patients with nonproliferative diabetic retinopathy that exhibited macular edema, single or multiple aneurysms, hemorrhages, portions of solid lipid exudate and preproliferative diabetic retinopathy, in addition to vascular changes. Much lower levels of anti-LPS-IgA were found in nonproliferative retinopathy in which only retinal vascular changes and in proliferative diabetic retinopathy were noted. The patients with proliferative diabetic retinopathy complicated by neovascular glaucoma were ascertained to have the lowest levels of antiendotoxin antibodies of all the classes. As compared with the control group, the patients of all groups had the decreased levels of anti-LPS-IgM. The paper presents the results of a correlation analysis of the relationship of the parameters of antiendotoxin immunity to the levels of total immunoglobulins.