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Poor Glycemic Control Is Associated With Lower Interleukin-2 (IL-2) Levels and Low Macrophage Viability in Chronic
Tuhina Banerjee1, Shailendra Rai2, Aradhana Singh1
1Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Abstract:
Low macrophage viability in chronic diabetic foot ulcers (DFUs) may lead to inadequate interleukin (IL) expression and the persistence of infection. This study evaluates the association between macrophage function, IL-2 expression, and wound microflora in chronic DFUs. Diabetic patients with DFUs (group 1, n = 40) and without DFUs (group 2, n = 40) were compared for macrophage function in serum by viability testing. Immunological response was measured by serum IL-1β, IL-2β, and IL-10 levels. The aerobic and anaerobic microflora of the DFUs were assessed by culture and molecular methods. Demographic, clinical, and biochemical factors were statistically analyzed by χ2 test and Student t test. Multiple correspondence analysis (MCA) was used to detect the pattern of association between glycosylated hemoglobin (hemoglobin A1c), serum IL-2 levels, and macrophage viability. Of the total DFU cases, 22 (55%) showed the presence of polymicrobial microflora. Low macrophage viability with predominant Gram-negative flora was seen in 10 (25%) cases in group 1. Serum IL-2 levels were significantly lower (P = .004) in patients in group 1 along with elevated levels of hemoglobin A1c (P = .038). MCA showed an association between low viability of macrophages and lower IL-2 levels and elevated hemoglobin A1c levels with lower serum IL-2 levels. As compared to group 2, the low viability of macrophages was significantly associated (P = .007) with lower IL-2 levels in group 1. Elevated hemoglobin A1c levels are strongly associated with lower IL-2 levels and low macrophage viability. This might be a contributing factor to the persistence of infections in chronic DFUs.
Insights
Low macrophage viability and reduced interleukin-2 (IL-2) expression in diabetic foot ulcers (DFUs) are linked to poor wound healing. Elevated hemoglobin A1c levels correlate with these factors, potentially worsening chronic DFU infections.
Area of Science:
- Immunology
- Diabetology
- Microbiology
Background:
- Chronic diabetic foot ulcers (DFUs) are often complicated by persistent infections.
- Macrophage dysfunction and altered cytokine profiles may contribute to DFU non-healing.
- Understanding the interplay between immune cells, inflammatory markers, and microbial load is crucial for DFU management.
Purpose of the Study:
- To investigate the association between macrophage viability, interleukin-2 (IL-2) expression, and wound microflora in chronic diabetic foot ulcers.
- To determine the relationship between glycemic control (hemoglobin A1c) and these factors in DFU patients.
Main Methods:
- Compared macrophage viability and serum levels of IL-1β, IL-2, and IL-10 in DFU patients (n=40) versus controls (n=40).
- Assessed aerobic and anaerobic microflora in DFUs using culture and molecular methods.
- Employed statistical analyses including chi-squared, Student's t-test, and Multiple Correspondence Analysis (MCA) to identify associations.
Main Results:
- Polymicrobial infections were present in 55% of DFUs.
- Low macrophage viability, often with Gram-negative flora, was observed in 25% of DFU cases.
- DFU patients exhibited significantly lower serum IL-2 levels (P=.004) and elevated hemoglobin A1c (P=.038) compared to controls.
- MCA revealed a strong association between low macrophage viability, low IL-2 levels, and elevated hemoglobin A1c.
Conclusions:
- Elevated hemoglobin A1c levels are significantly associated with reduced IL-2 levels and impaired macrophage viability in chronic DFUs.
- These immune dysfunctions may be key factors contributing to the persistence of infection and delayed healing in diabetic foot ulcers.
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