Cell-mediated immunity in recent-onset type 1 diabetic children

The ability to suppress an immune response makes regulatory T-cells [T-reg] an attractive candidate as a novel therapeutic agent for treating autoimmune diseases. The mechanisms involved in maintenance of peripheral tolerance include a specialized subset of regulatory-T-cells [T-reg] within the T-cell population. The CD4[+] CD25[+] T-cells may be, important in modulating the risk for autoimmunity. Auto-reactive cytotoxic-cells recognize peptide epitopes displayed on the beta cells surface in the context of HLA class] molecules. A population of CD8[+] regulatory T-cells characterized by expression of CD25 and FOXP3 have been identified and induced in the human peripheral blood cells. The regulatory activity of these cells is on autologous, antigen-reactive CD4[+] T-cells in a cell contact-dependent manner. These findings provide an evidence for a new mechanism for induction of immune regulation in human. This study was aiming to assess the cellular immune parameters including the percentage of CD4[+], CD8[+], CD4[+]/CD8[+] ratio,CD4[+]CD25[+], CD8[+] CD25[+] lymphocytes, which may have its application in developing immune therapy based tools for halting disease progression. This study was conducted on 20 children of recent onset type 1 diabetes [disease duration 0.05] between the two groups. A significant inverse correlation was found between CD4[+] CD25[+] T-cells and HbA1c percentage among patients group [p<0.05].Also a significant difference in the percentage of CD4[+] CD25[+] T-cells was found when patients with HbA1c<8%w ere compared to those with HbA1c >/= 8% [the latter group had significantly lower percentage of CD4[+] CD8[+] T-cells]. Type 1 diabetes is characterised at its onset by a lowered percentage of CD8[+] and CD8[+] CD25[+] T-cells in peripheral blood, a normal percentage of CD4[+] and CD4[+] CD25[+] T-cells. There may be an inverse correlation between percentage of CD4[+] CD25[+] T-cells at disease onset and HbA1c level after three months. These data support the hypothesis that a defect in function or deficiency in number of T-regulatory cells may affect the pathogenesis of type 1 diabetes

Porphyromonas gingivalis; prevalence and quantitation by pcr and clinical assessment of periodontal diseases in type I diabetes mellitus

The aim of this study is to assess the prevalence of periodontal diseases as well as dental caries in a group of diabetic children and adolescents and to study the subgingival microflora, Porphyromonas gingivalis [P.gingivalis]. The study was conducted on 70 type I diabetic patients, 20 healthy age-matched children and adolescents were included as a control group. Both patients and controls were subjected to periodontal examination and subgingival plaque samples for detection and quantitation of Porphyromonas gingivalis using PCR technique. Thirty eight among the seventy studied patients [54%] have been diagnosed as gingivitis [inflammation confined to the gingival], 9/70 [13%] as periodontitis [progressive destruction of periodontal ligament and alveolar bone with pocket formation], and the remaining 23 [33%] were periodontally healthy diabetics. A significantly higher percentage of Porphyromonas gingivalis positive PCR and higher DNA copies/ml were detected in periodontitis and gingivitis compared to periodontically healthy diabetics and healthy controls [P<0.05]. On comparing periodontitis and gingivitis groups, a statistically significant difference was detected [P<0.05] while periodontically healthy diabetics did not show any significant difference neither in positive PCR nor in DNA copies/ml compared to healthy controls [P<0.05]. Assessment of caries condition showed higher caries scores among diabetics than controls but this increase was statistically non significant [P>0.05]. A statistically significant difference was detected between age of the patient, disease duration, poor metabolic control and the development of periodontal disease. Periodontal diseases exist in a significant percentage of diabetic children and adolescents; higher age of the patient, longer duration of DM, and poor diabetic control are risk factors for the development of periodontitis and gingivitis; Porphyromonas gingivalis may be implicated in the development of periodontal disease. Detection and Quantitative analysis of this organism is important for the evaluation of periodontai diseases