Résumé
Background: Type II diabetes mellitus [T2D] is one of the most common chronic metabolic diseases. It is associated with a state of chronic inflammation resulting in both microvascular and macrovascular complications. The adinosinergic axis plays an important anti-inflammatory protective role through conversion of ATP [produced as a result of inflammation] into adenosine [a potent anti-inflammatory mediator] through CD39 and CD73. Various peripheral blood leucocytes hold CD39 and CD73 with different degrees
Objective: To determine the expression of CD73 and CD39 on different peripheral blood leukocytes including Treg cells to uncover their inflammatory modulation role in T2D subjects in comparison to normal control ones. The level of their expression will be correlated with various anthropometric and biochemical parameters in diabetic patients
Materials and Methods: Venous blood was collected on EDTA anticoagulated tubes from 45 T2D patients; 15 with early T2D and 30 with complicated T2D with both microvascular and macrovascular complications. Twenty-five normal subjects, with no family history of T2D, were included. Immunophenotyping of the samples were performed on Navios Flow cytometer [Coulter Electronics, USA], using phycoerythrin [PE]- labelled CD39 antibodies, fluorescein isothiocyanate [FITC]-labelled CD4 antibodies, peridinin-chlorophyllprotein complex: CY5.5 conjugate [PerCP-CY5.5]-labelled CD73 and allophycocyanin conjugate [APC]- labelled CD25
Results: CD39 expression was highest in early cases of T2D in comparison to least expression in complicated T2D on peripheral blood total lymphocytes, CD4+ lymphocytes and CD4+CD25+ lymphocytes
Conclusions: The increased expression of CD39 in early non-complicated cases of T2D indicates a state of low-level chronic inflammation owing to their role in production of adenosine; a potent anti-inflammatory mediator. This is reversed when CD39 expression in peripheral blood leucocytes is assessed in complicated T2D patients, which emphasise their role in protecting the patients from diabetic complications
Résumé
Background: Bone profile parameters are affected by decreased estimated GFR within chronic kidney disease stage 3. We aimed to investigate if bone profile parameters response to vitamin D3 supplementation , within this stage , became affected by the presence or absence of diabetic state
Materials and methods: 30 patients having chronic kidney disease [stage 3] were enrolled in the study. 19 patients constituted non - diabetic group I and 11 patients constituted diabetic group II . All of them have received vitamin D3 1000 IU daily for 3 months . For all patients the following measurements were performed before and after vitamin D3 use :CBC , ESR1 and ESR2 , blood urea , serum creatinine , estimated GFR , complete urine analysis , serum Na , protein / creatinine ratio , serum calcium , serum phosphorus , calcium - phosphorus product , serum albumin , serum alkaline phosphatase , and intact serum parathyroid hormone
Results: Serum calcium levels have increased, while intact parathyroid hormone has decreased within both groups , with a more obvious response within the diabetic group . Serum alkaline phosphatase , serum phosphorus , and calcium - phosphorus product did not show any significant change, they were within their level after vitamin d3 use .ESR 1 and ESR 2 levels were higher from the start of the study within the diabetic group. Their mean level values have significantly decreased in a highly significant way within this group . Kidney function parameters and proteinuria have been deteriorated within the two groups , being worse within the diabetic group
Conclusion: Vitamin D3 use within stage 3 chronic renal disease patients is effective for patients support against bone mineral disturbances occurring within this disease