Pongcharoen Sutatip, Chansantor Wuttichote, Supalap Kwansuda, Jienmongkol Poj, Niumsup Pannika Ritvirool
Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand.
Southeast Asian J Trop Med Public Health. 2011 Sep;42(5):1197-203.
Diabetic patients with poorly controlled blood glucose have frequent and persistent bacterial infections particularly those infecting the skin, such as Staphylococcus aureus and S. epidermidis. The function of phagocytes of diabetic patients is believed to be impaired due to hyperglycemia, leading to suboptimal immune response to clear acute infection. The present study investigated interleukin (IL)-1beta expression by diabetic patients' monocytes (n = 22) experimentally infected with S. aureus compared with that from healthy subjects (n = 30). In addition, the in vitro effect of hyperglycemia on IL-1beta expression by monocytes from normal subjects (n = 18) stimulated with S. aureus and S. epidermidis was investigated. Monocytes from diabetic patients, stimulated or not with S. aureus, express significantly lower levels of IL-1beta than those from healthy subjects. In vitro hyperglycemia did not affect IL-1beta expression by unstimulated monocytes. However, at the same levels of glucose normal monocytes stimulated with S. aureus produce significantly higher IL-1beta than those stimulated with S. epidermidis. These findings suggest that diabetic patients have abnormally lower IL-1beta expression and hyperglycemia is related to abnormal expression of IL-1beta by monocytes, which could lead to enhanced susceptibility to infection by the more virulent bacteria.
血糖控制不佳的糖尿病患者频繁且持续发生细菌感染,尤其是那些感染皮肤的细菌,如金黄色葡萄球菌和表皮葡萄球菌。由于高血糖,糖尿病患者吞噬细胞的功能被认为受损,导致清除急性感染的免疫反应欠佳。本研究调查了实验性感染金黄色葡萄球菌的糖尿病患者单核细胞(n = 22)与健康受试者(n = 30)相比白细胞介素(IL)-1β的表达情况。此外,还研究了高血糖对用金黄色葡萄球菌和表皮葡萄球菌刺激的正常受试者(n = 18)单核细胞IL-1β表达的体外影响。糖尿病患者的单核细胞,无论是否用金黄色葡萄球菌刺激,其IL-1β表达水平均显著低于健康受试者。体外高血糖对未刺激的单核细胞IL-1β表达无影响。然而,在相同葡萄糖水平下,用金黄色葡萄球菌刺激的正常单核细胞产生的IL-1β显著高于用表皮葡萄球菌刺激的单核细胞。这些发现表明,糖尿病患者IL-1β表达异常降低,高血糖与单核细胞IL-1β异常表达有关,这可能导致对毒性更强细菌的感染易感性增加。