Abstract
Background : Diabetes is a metabolic disorder characterized by chronic hyperglycemia. Patients of diabetes mellitus are managed by two basic drug regimens. Generally type-I diabetes is managed by insulin therapy, while type-II diabetes is treated by oral hypoglycemic agents. Natural Killer (NK) cells being an important member of innate immunity have protective and pathogenic roles. A study was designed to enumerate NK cells in diabetes mellitus patients being treated with insulin and oral hypoglycemic therapy. Material & Methods : It was a cross sectional study that comprised of 80 patients of diabetes mellitus. They were categorized as group-I (on oral hypoglycemic) and group-II (on insulin); 40 patients in each group. For enumeration of NK cells, blood sample was analyzed by four color FACS caliber, using CD16/CD56 PE, and CD45 PerCP monoclonal antibodies. Result : Mean±SD of percentage of NK cells of patients on oral hypoglycemic agents was high (11.10±5.66) compared to patients on insulin therapy (9.91±5.08) but on comparison it was not statistically significant (p≤0.327). Mean±SD of percentage of NK cells of male diabetic patients was high (12.01±5.84) compared to female diabetic patients (9.48±4.83) and on comparison it was statistically significant (p≤0.039). Conclusion : No significant difference was observed in the percentage of NK cells of diabetes mellitus patients on insulin and oral hypoglycemic agents. However, percentage of NK cells was significantly high in male patients as compared to female patients.
Keywords: NK cells · NKT cells · T cells · Diabetes mellitus · oral hypoglycemic agents
References
- 1.Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Report of a WHO Consultation (1999) WHO/NCD/NCS/99.2
- 2.Qidwai W. and Ashfaq T. Imminent Epidemic of Diabetes Mellitus in Pakistan: Issues and Challenges for Health Care Providers. JLUMHS 2010; 9:112-113
- 3.Farag, S.S. and Caligiuri, M.A. Human natural killer cell development and biology. Blood Rev 2006; 20: 123–137
- 4.Poulsen, T.M. Beta Cell Death and Protection. N Y Acad Sci 2003; 1005:32-42
- 5.Priatel J, Qin H, Lee IF, Wang X, Panagiotopoulos C, Tan R. Natural Killer Cells from Patients with Type 1 Diabetes Exhibit Defective NKG2D Effector Function and Dysregulated NKG2D Ligand Expression. Clinical Immunology. 2009. 131:S45.
- 6.Alba A, Planas R, Clemente X, Carrillo J, Ampudia R, Puertas MC et al. Natural killer cells are required for accelerated type 1 diabetes driven by interferon-beta. Clin Exp Immunol 2008; 151: 467–475
- 7.Gruzov MA, Shliakhovenko VS, Zak KP, Efimov AS, Kalinovskiĭ AK, Mikhaĭlovsksia EV et al. The effect of insulin therapy on the level of natural killer cells of different immunological phenotypes (CD16+, CD56+ and CD57+) in the blood of patients with diabetes mellitus type I. Lik Sprava 1992; 8:60-62
- 8.Rodacki, M., Svoren, B., Butty V., Besse, W., Laffel, L., Benoist, C. and Mathis, D., 2007. Altered natural killer cells in type 1 diabetic patients. Diabetes, 56: 177-185
- 9.Qin H, Lee IF, Panagiotopoulos C, Wang X, Chu AD, Utz PJ et al. Natural killer cells from children with type 1 diabetes have defects in NKG2D-dependant function and signaling. Diabetes 2011; 60: 857-866
- 10.Nunes FB. Immunomodulatory effect of fructose-1, 6-bisphosphate on T-lymphocytes. International Immuno pharmacology 2003; 3:267-272
- 11.Berrou J, Fougeray S, Venot M, Chardiny V, Gautier JF, Dulphy N et al. Natural killer cell function, an important target for infection and tumor protection, is impaired in type 2 diabetes. PloS ONE 2103; 8: e62418
- 12.Mello KF, Lunardelli A, Donadio MVF, Caberlon E, de Oliveira CSA, Bastos CMA et al. Immunomodulatory effects of oral antidiabetic drugs in lymphocyte cultures from patients with type 2 diabetes. J Bras Patol Med Lab 2011; 47:43-48
- 13.Otton R, Soriano FG, Verlengia R, Curi R. Diabetes induces apoptosis in lymphocytes. J Endocrinol 2004; Enumeration of NK cells in Patients of Type-II Diabetes Mellitus, Nadeem Afzal 26 Original Article MAJMAAH JOURNAL OF HEALTH SCIENCE, Vol 2, Issue 2, 2014 182:145–56
- 14.Towler MC, Hardies DG. AMP-activated protein kinase in metabolic control and insulin signaling. Circulation 2007; 100:328-41
- 15.Foss-Freitas MC, Foss NTEA, Donadi EA, Foss MC. Effect of the glycemic control on intracellular cytokine production from peripheral blood mononuclear cells of type 1 and type 2 diabetic patients. Diabetes res clin pr 2008; 82: 329-34
- 16.Salti I, B’enard E, Detournay B, Bianchi-Biscay Monique, Le Brigand, Corinne et al. A Population-Based Study of Diabetes and Its Characteristics during the Fasting Month of Ramadan in 13 Countries. Diabetes Care 2008; 27:2306–2311
- 17.Gim’enez M, Aguilera E, Castell C, De Lara N, Nicolau J, Conget I. Relationship between BMI and age at diagnosis of Type 1 diabetes in a mediterranean area in the period of1990–2004.Diabetes Care 2007; 30:1593-94.
- 18.Daousi C, Casson IF, Gill GV, MacFarlane IA, Wilding JPH, Pinkney JH. Prevalence of obesity in type 2 diabetes in secondary care: association with cardiovascular risk factors. Post grad Med J 2006; 82:280–84
- 19.Chih AH, Jan CF, Shu SG, Lue BH. Self-efficacy Affects Blood Sugar Control among Adolescents with Type I Diabetes Mellitus. J Formos Med Assoc 2010; 109 :503–510
- 20.Timmons BW, Tarnopolsky MA, Bar-Or O. Sex-based effects on the distribution of NK cell subsets in response to exercise and carbohydrate intake in adolescents. J Appl Physiol 2006; 100:1513-151. Enumeration of NK cells in Patients of Type-II Diabetes Mellitus, Nadeem Afzal 27