Immune mechanisms in type-2 diabetic retinopathy

To enumerate CD4+CD25+ Treg cells and determine serum IL-6 and IL-17 in type 2 diabetes mellitus patients with retinopathy. The case-control study was conducted at the Department of Immunology, University of Health Sciences, Lahore, from November 2009 to January 2012 and comprised diabetic patients and healthy controls who were divided into three groups. Group 1 had controls, while Group 2 had diabetic patients without retinopathy and Group 3 had diabetic patients with retinopathy. Flowcytometre and enzyme-linked immunosorbent assay were used for CD4+CD25+ Tregs and serum IL-6 and IL-17 respectively. SPSS 20 was used for statistical analysis. Of the 212 subjects in the study, 30[14%] were Group 1, 30[14%] in Group 2 and 152[72%] in Group 3. There were 25[83%] women in Group 2 and 101[66%] in Group 3 compared to 9[30%] in Group 1. Higher mean age was in Group 3 [50.88 +/- 8.9 years] and Group 2 [49.46 +/- 9.94 years] compared to Group 1 [34.66 +/- 8.78 years] while longer mean disease duration was in Group 3 [10.51 +/- 5.24 years] than Group 2 [7.76 +/- 4.14 years]. Highest median ratio of IL-6 was in Group 1 [1468.62] [Q1-Q3: 1229.9-1543.35], followed by Group 2 [1455.32] [Q1-Q3:1214.22-158.9] and Group 3 [469.84] [Q1-Q3: 206.53-1231.33] whereas IL-17 was the highest in Group 1 [339.38] [Q1-Q3: 159.89-1174.93], followed by Group 3 [216.60] [Q1-Q3: 141.87-410.25] and Group 2 [174.17] [Q1-Q3: 138.77-458.17]. Higher percentage of Tregs was in Group 2 [3.07 +/- 0.43] followed by Group 1 [2.91 +/- 0.04] and Group 3 [2.88 +/- 0.38]. Significant difference was observed in gender, age, disease duration, level of IL-6 and IL-17 [p<0.05 each], while no difference was found in glycated haemoglobin, CD4+CD25+ and Tregs [p>0.05 each]. Age, gender and duration of diabetes contributed to diabetic retinopathy, while CD4+CD25+ T cells and Treg cells did not. Serum IL-6 and IL-17 were inversely associated with diabetic retinopathy

Negative association of serum IL-6 and IL-17 with type-II diabetes retinopathy

Diabetes mellitus [DM] is a health concern which leads to complications such as retinopathy. Pakistan has 6.9 million people living with DM and this toll will be doubled by 2025. To determine serum IL-6 and IL-17 of type 2 diabetes mellitus [T2DM] patients with retinopathy. In this cross-sectional case- control study, 212 subjects enrolled which were categorized into 3 groups. Group-I included 30 subjects without diabetes, group-II consisted of 30 subjects with T2DM without retinopathy and group-III consisted of 152 subjects with T2DM and retinopathy. Serum IL-6 and IL-17 levels were determined by ELISA. Data was analysed using SPSS 17.0 and one way ANOVA to observe group mean differences. Longer mean duration of disease was detected in group-III than group-II [p=0.007]. Highest IL-6 level was detected in group-II and highest IL-17 level was detected in group-I. For IL-6, significant differences were detected among groups in total, between Group-I and Group-III and between Group-II and Group-III [p<0.0001 each]. Regarding IL-17, significant differences were found among groups in total [p=0.002] and between Group-I and Group-III [p=0.001]. No significant difference in the percentages of HbA1c observed between groups. Age, gender and duration of diabetes contribute to T2DM retinopathy. Serum IL-6 and IL-17 were inversely associated with T2DM retinopathy