[Polimorphonuclear leukocytes and diabetes mellitus]
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1Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Semeiotica e Metodologia Medica, Università di Palermo, Palermo, Italy. euhopps@libero.it
Abstract:
Diabetic subjects have a higher infective risk than healthy people, with more frequent and severe infections. This predisposition to infections is determined by hyperglycemia, microangiopathy and altered immune system. In particular, there is a polymorphonuclear leukocytes disfunction including chemotaxis, phagocytosis, bacterial killing and cellular activation by infective stimulus. These alterations are due to abnormal properties of polymorphonuclear leukocytes (PMN) in diabetic patients. Several parameters like phagocytosis of bacterial cells, chemiluminescence during oxidative burst and cell membrane deformability are related to glycaemia and glycated hemoglobin. Recent acquisitions show an altered integrin pattern on diabetics PMN, at baseline and after in vitro stimulation with soluble stimulus like fMLP or PMA. This could influence the interactions between PMN and endothelial cells and the diapedesis. Receptorial alterations on PMN surface may be ascribed to the abnormalities of the cytoscheleton, of the endocytosis and of the transduction mechanism, due to hyperglycemia.
Insights
Diabetic patients experience increased infection risk due to impaired polymorphonuclear leukocytes (PMN) function. Hyperglycemia and related conditions disrupt PMN
Area of Science:
- Immunology
- Endocrinology
- Cell Biology
Context:
- Diabetic individuals exhibit heightened susceptibility to infections, characterized by increased frequency and severity.
- Underlying factors include hyperglycemia, microangiopathy, and a compromised immune system.
- Specific immune cell dysfunction involves polymorphonuclear leukocytes (PMN).
Purpose:
- To investigate the functional alterations in polymorphonuclear leukocytes (PMN) of diabetic patients.
- To explore the relationship between glycemic control and PMN functional parameters.
- To examine the impact of hyperglycemia on PMN surface receptors and interactions.
Summary:
- Diabetic patients present with polymorphonuclear leukocyte (PMN) dysfunction, affecting chemotaxis, phagocytosis, and bacterial killing.
- Parameters such as bacterial phagocytosis, oxidative burst chemiluminescence, and cell deformability correlate with glycemic levels and HbA1c.
- Altered integrin expression and surface receptor abnormalities on diabetic PMNs, linked to cytoskeletal and signal transduction defects, may impair endothelial cell interactions and diapedesis.
Impact:
- Understanding PMN dysfunction in diabetes can lead to targeted strategies for infection prevention.
- This research highlights the critical role of glycemic control in maintaining immune competence.
- Findings may inform the development of novel therapeutic approaches to mitigate infection risk in diabetic populations.
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