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Interplay of t helper 1 and 2 cytokines in type 2 dm with and without microvascular complications.

Authors:Alfred Azenabor, Anthonia. O. Ogbera, Chukwuma J. Okafor, Ngozi Adejuwon
Int J Biol Med Res. 2011; 2(4): 917 – 921  |  PDF File


ABSTRACT: Aims: Cytokines represent the major factors involved in the communication between thymus dependent T cells, macrophages and immune cells in the course of an immune response, the way and manner in which cytokines interact with each other could be a crucial factor in the pathogenesis of diabetic complications. The gluco – toxic microenvironment created in diabetes may influence the cell to cell signaling capabilities of cytokines. This study was designed to evaluate the pattern of interaction of T helper 1 and 2 cytokines in various micro vascular complications (MC) in Diabetes Mellitus. We also sought to assess the possibility of using these variables in the prediction of various microvascular complications in uncomplicated T 2 diabetes mellitus patients. Methods: This was a cross sectional study carried out in 200 type2 Diabetes Mellitus (DM) and 100 sex and age matched healthy controls aged between 40 – 75 years. Type 2 DM patients were subdivided on the basis of presence or absence of MC. We determined plasma levels of interferon gamma (T helper 1 cytokine) and interleukin 10 (T helper 2 cytokine) in the study population using standard method. Long term glycaemic control using glycosylated haemoglobin was determined. Statistical analysis used includes student’s t test, analysis of variance and logistic regression analysis. Results: Significant increase in the mean level of interleukin10 was observed in type 2 DM patients when compared with healthy controls (32.54 ± 1.67 pg/ml Vs 12.35 ± 1.60 pg/ml, p = 0.001), the concentration of which was observed to be much higher in DM with MC. The mean level of interferon gamma was significantly reduced in DM patients in comparison with controls (4.36 ± 0.63 pg/ml Vs 6.71 ± 0.43 pg/ml, p = 0.012), this value was lower in DM with MC. The proportion of DM patients who attained good – long term glycaemic control was 68%. Conclusion: Immune response dynamics exhibited by the complex interplay of cytokines may also contribute to the pathogenesis of MC in DM.