Wilson R M, Reeves W G
Clin Exp Immunol. 1986 Feb;63(2):478-84.
Neutrophil phagocytosis and killing of Candida albicans were examined using a radiometric assay in 25 patients with insulin-dependent diabetes and 17 controls under various in vitro metabolic conditions. Glucose was present at 5, 10 and 50 mM, beta-hydroxybutyrate at 1, 5 and 20 mM and glucose with beta-hydroxybutyrate in combinations of 10 with 5 and 50 with 20 mM, respectively. Phagocytosis occurred at similar levels in diabetics and controls at all the glucose and beta-hydroxybutyrate concentrations used. The ability to neutrophils from diabetics to kill candida was inhibited by increased concentrations of glucose and beta-hydroxybutyrate, both independently and in combination. Candida killing (mean +/- s.e.) was 20 +/- 2.4, 19 +/- 2.3 and 13 +/- 2.7% at glucose concentrations of 5, 10 and 50 mM; and 20 +/- 3.4, 20 +/- 3 and 13 +/- 3% at beta-hydroxybutyrate concentrations of 1, 5 and 20 mM, respectively, and in glucose and beta-hydroxybutyrate combinations of 10 with 5 and 50 with 20 mM was 20 +/- 2.8 and 10 +/- 2.8%, respectively. Inhibition was not observed with control neutrophils. These data indicate that although phagocytosis occurs at similar levels in diabetics and controls, killing of candida by the diabetic neutrophil is impaired under conditions of hyperglycaemia and ketosis. The biochemical basis for this effect is discussed.
在25名胰岛素依赖型糖尿病患者和17名对照者中，利用放射性测定法在各种体外代谢条件下检测了中性粒细胞对白色念珠菌的吞噬和杀伤作用。葡萄糖浓度分别为5、10和50 mM，β-羟基丁酸浓度分别为1、5和20 mM，葡萄糖与β-羟基丁酸的组合分别为10与5 mM以及50与20 mM。在所有使用的葡萄糖和β-羟基丁酸浓度下，糖尿病患者和对照者的吞噬作用水平相似。糖尿病患者中性粒细胞杀伤念珠菌的能力受到葡萄糖和β-羟基丁酸浓度升高的抑制，二者单独作用及联合作用时均如此。在葡萄糖浓度为5、10和50 mM时，念珠菌杀伤率（平均值±标准误）分别为20±2.4%、19±2.3%和13±2.7%；在β-羟基丁酸浓度为1、5和20 mM时，念珠菌杀伤率分别为20±3.4%、20±3%和13±3%，在葡萄糖与β-羟基丁酸组合为10与5 mM以及50与20 mM时，念珠菌杀伤率分别为20±2.8%和10±2.8%。对照中性粒细胞未观察到抑制现象。这些数据表明，尽管糖尿病患者和对照者的吞噬作用水平相似，但在高血糖和酮症状态下，糖尿病患者中性粒细胞对念珠菌的杀伤能力受损。文中讨论了这种效应的生化基础。
