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Impaired leucocyte functions in diabetic patients
M Delamaire1, D Maugendre, M Moreno
1Centre Régional de Transfusion Sanguine, Centre Hospitalier Universitaire, Rennes, France.
Summary
Diabetic patients exhibit impaired polymorphonuclear neutrophil (PMN) function, affecting adherence, chemotaxis, and bactericidal activity. These neutrophil deficits may increase risks for infections and vascular complications in diabetes.
Area of Science:
- Immunology
- Endocrinology
- Cell Biology
Background:
- Diabetes mellitus is associated with an increased risk of infections and vascular complications.
- Polymorphonuclear neutrophils (PMNs) are critical immune cells involved in pathogen clearance and tissue repair.
- The functional integrity of PMNs is essential for maintaining host defense against microbial invasion.
Purpose of the Study:
- To comprehensively evaluate the functional performance of polymorphonuclear neutrophils (PMNs) in diabetic patients.
- To investigate the impact of metabolic control, diabetes type, disease duration, and vascular complications on PMN function.
- To determine if impaired PMN function contributes to increased susceptibility to infections and vascular issues in diabetes.
Main Methods:
- Assessed PMN adherence, chemotaxis, phagocytosis, and bactericidal activity in 61 diabetic patients (Type 1 and Type 2).
- Utilized tests including adhesion molecule expression (CD 11a, CD 11b, CD 11c), nylon fiber adherence, FMLP-induced chemotaxis, latex bead phagocytosis, chemiluminescence, and nitroblue tetrazolium reduction.
- Analyzed results based on factors like HbA1C, glycaemia, age, diabetes type, disease duration, and vascular complications.
Main Results:
- PMN chemotaxis was significantly reduced in diabetic patients compared to controls, linked to spontaneous adherence and increased CD 11b/CD 11c expression.
- Diabetic PMNs showed increased spontaneous chemiluminescence (free radical production) but reduced response upon stimulation.
- Chemotaxis and chemiluminescence were further impaired in patients with vascular complications and hyperglycemia; other factors showed no significant impact.
Conclusions:
- All functional steps of PMN cells are significantly altered in diabetic patients, irrespective of diabetes type, age, or disease duration.
- Impaired PMN function, characterized by reduced chemotaxis and altered oxidative burst, may underlie the increased susceptibility to infections in diabetes.
- The observed PMN dysfunction, particularly in the presence of vascular complications and hyperglycemia, could contribute to the pathogenesis of diabetic complications.