Inhibition of lipopolysaccharide-induced inflammation via the protective role of T regulatory cells in the fetal liver in a late-pregnancy preterm mouse model

OBJECTIVES: This study intended to explore the effect of T regulatory cells (Tregs) in the perinatal liver against LPS-induced inflammation in a preterm birth mouse model. Moreover, the role of adoptive Tregs on the inflammatory response induced by LPS was also studied. METHODS: Female BALB/C mice were injected intraperitoneally (IP) with LPS dissolved in normal saline solution at a dose of 50 µg/kg. Spleens from pregnant mice were used to obtain Tregs. The expression of Forkhead family transcription factor-3 (Foxp3), Interleukin-6 (IL-6), Toll-like receptor-4 (TLR-4), and Heme oxygenase-1 (HO-1) were assessed from fetal liver tissues by polymerase chain reaction and western blotting. RESULTS: LPS administered to mice induced an inflammatory response in the perinatal liver, and this inflammatory response was negatively regulated by Tregs in the experimental group. Maternal-fetal tolerance was maintained by Tregs. Transmission of Tregs was estimated in different experimental groups based on the mRNA expression of TLR-4, IL-6, HO-1, and Foxp3. CONCLUSIONS: After analysis of the experimental data, it was determined that Tregs exhibited regulatory potential against LPS-induced inflammatory response. Further, it was concluded that the transmission of Tregs improved the mother's immune tolerance against LPS-induced inflammation in the fetal liver.

Obstructive Sleep Apnea (OSA) in Patients with Type 2 Diabetes: A Prospective Study

Background:The incidence of obstructive sleep apnea (OSA) is more in type II diabetis patients as compared to healthy individuals. One of the links between OSA and type 2 diabetes is obesity and increased Body mass index is found to be associated with increased risk of metabolic syndrome, diabetes and OSA. OSA is found to have an adverse effect on overall glycemic control in type 2 diabetes and diabetics who have OSA have found to have relatively higher levels of HbA1c indicating poor long-term glycemic controls. As the diagnosis of OSA is usually delayed due to non-specific symptomatology any patient having disturbed sleep and daytime somnolence must be investigated for OSA. It is important from the perspective of treating physician to diagnose OSA in diabetics so as to optimally manage long term glycemic control. We conducted this study to find out the incidence of OSA in type 2 diabetics and its effect on long term glycemic control. Methods: This was a prospective observational study conducted in a tertiary care hospital in which 50 diagnosed cases of type 2 diabetes and suspected to be having Obstructive sleep apnea and came for evaluation were included on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and thorough clinical examination was done. OSA was diagnosed on the basis of polysomnography. The diagnosis of OSA was done on the basis ofpolysomnography OSA was defined as apnea-hypopnea index (AHI) > 5 per hour sleep. The incidence of OSA in diabetics and its effect on long term glycemic control was studied. Data was analyzed using SSPE 17.0 software. P value less than 0.05 was taken as significant for statistical purposes. Results: Out of 50 studied cases there were 32 (64%) were males and 18 (36%) were females with a M:F ratio of 1:0.56. Mean age of the studied cases was found to be 46.16+/- 8.53 years. 32 patients were obese (BMI =/> 30) and 10 patients were overweight (BMI=\> 25 but < 30). Common co-morbidities seen were hypertension (36%), hypertriglyceridemia (68%) and low HDL levels (44%). 24 (48%) patients were found to be having obstructive sleep apnea on the basis of polysomnography and history of associated symptoms. Raised BMI and Fasting blood sugar levels were found to be higher in patients with OSD (P<0.0001). There was a statistically significant difference in glycosylated Hemoglobin levels in patients with and without OSA. Patients with OSA were found to have higher HbA1c levels indicating poor glycemic control. Conclusion: Patients with Type 2 Diabetes are more at risk of developing OSA which is usually diagnosed late due to non-specific symptomatology. OSA is associated with poor long-term glycemic control in these patients. It is important from the perspective of treating physician to diagnose and treat OSA in diabetics for optimum management.