Evaluation of some immunological aspects in patients with diabetes type ΙΙ

       Type 2 diabetes mellitus (T2DM) is a metabolic disorder of  multiple etiologies   characterized   by  chronic   hyperglycemia   with  disturbances of  fat and protein metabolism resulting from  defects  in  insulin secretion insulin action or both,  and  mediated in large part by the alteration in adaptive immunity and cytokines. The present study was planned to determine the lymphocyte phenotyping by using monoclonal antibodies against CD4+ T cells and CD8+ T cells, serum levels of tumor necrosis factor-alpha (TNF)-α  and interleukins- 12(IL-12), proinsulin hormone ,as well as study the DNA fragmentation.
     Fifty T2DM patients attending the National Diabetes Center for Treatment and Research at Al-Mustansiriya University between December 2012- January 2013 were recruited for this study. For the purpose of comparison, 30 control subjects matched for age, gender and ethnic background were also included. The patients were characterized by family history of diabetes. The patients were also assessed for  the duration of disease; The body mass index (BMI), waist-to-hip (W-H) ratio were measured, also the fasting plasma glucose (FPG), total cholesterol (TC), HDL-cholestrol, LDL-cholesterol, Triglyceride(TG), glycosylated hemoglobin (HbA ) and  proinsulin hormone were measured . The percentage mean of  (CD4 and CD8) T cells were measured by Apogee flow cytometry by adding CD4 and CD8 markers,  both CD4+T cells  (17.19% vs. 66.25%) and CD8+T cells (18.14% vs. 34.92%) was significantly lower in T2DM patients as compared to healthy  control (p≤0.001). The levels of cytokines (TNF-α  and IL-12 ) were determined by ELISA kits, the TNF-α showed a highly significant increased (p≤0.001) in patients compared controls (117.6 vs. 97.06 pg/ml) .Also the IL-12 levels demonstrated a highly significant increase (p≤0.001) in T2DM patients as compared to controls. (58.02 vs. 28.05 pg/ml). Also 20% of patients  revealed DNA damage by analyzed the DNA fragment by gel electrophoresis on 1.8% agarose gel at
24 voltage for 4 hour, this damage might be due to reactive free radicals and may depend  on severity and chronicity of the case. In conclusion this study suggests  that aberrant  glucose concentrations, hyperinsulinaemia,infections or underlying disease can exert enough stress to affect the immune cell population and influence adversely   the  outcome  of disease in patients. This may be reflected in a lowered immunocompetence  and metabolic dysfunction.