Delamaire M, Maugendre D, Moreno M, Le Goff M C, Allannic H, Genetet B
Centre Régional de Transfusion Sanguine, Centre Hospitalier Universitaire, Rennes, France.
Diabet Med. 1997 Jan;14(1):29-34. doi: 10.1002/(SICI)1096-9136(199701)14:1<29::AID-DIA300>3.0.CO;2-V.
This study evaluates polymorphonuclear neutrophil (PMN) cell performance in 61 diabetic patients free of infection (40 Type 1, 21 Type 2), using tests that explore all the functional steps of PMN: (1) adherence: expression of adhesion molecules, CD 11a, CD 11b, CD 11c; nylon fiber adherence test; (2) chemotaxis under agarose towards the bacterial oligopeptide FMLP and complement fractions, used as attracting agents; (3) phagocytosis of opsonized latex microbeads; (4) bactericidal activity: chemiluminescence assessment of the oxidative killing potential before and after stimulation by opsonized zymosan and PMA; nitroblue tetrazolium reduction test. Results were analysed according to potentially influential factors: metabolic control (HbA1C, glycaemia), age of patient, type of diabetes, disease duration, and existence of vascular complications. PMN chemotaxis was significantly lower in patients than in healthy controls (p < 0.001) and associated with spontaneous adherence and increased expression of adhesion molecules (CD 11b, CD 11c). The increased response to chemiluminescence reflects spontaneous activation of PMN cells and increased free radical production; after stimulation, response was lower than in controls. The type of diabetes, the age of patients, HbA1C level and disease duration did not affect the responses. Chemotaxis and chemiluminescence were further reduced in patients with vascular complications and hyperglycaemia. We conclude that all steps of PMN functioning are altered in diabetic patients, which may increase the risk of vascular complications and infectious episodes.
本研究评估了61例无感染的糖尿病患者（40例1型糖尿病，21例2型糖尿病）的多形核中性粒细胞（PMN）细胞功能，采用了探索PMN所有功能步骤的检测方法：（1）黏附：黏附分子CD 11a、CD 11b、CD 11c的表达；尼龙纤维黏附试验；（2）在琼脂糖下对用作吸引剂的细菌寡肽FMLP和补体片段的趋化作用；（3）调理素化乳胶微珠的吞噬作用；（4）杀菌活性：用调理素化酵母聚糖和佛波酯刺激前后，通过化学发光评估氧化杀伤潜力；硝基蓝四氮唑还原试验。根据潜在影响因素分析结果：代谢控制（糖化血红蛋白、血糖）、患者年龄、糖尿病类型、病程以及血管并发症的存在情况。患者的PMN趋化作用显著低于健康对照组（p < 0.001），且与自发黏附及黏附分子（CD 11b、CD 11c）表达增加相关。对化学发光的反应增强反映了PMN细胞的自发激活及自由基产生增加；刺激后，反应低于对照组。糖尿病类型、患者年龄、糖化血红蛋白水平和病程并未影响这些反应。血管并发症和高血糖患者的趋化作用和化学发光进一步降低。我们得出结论，糖尿病患者PMN功能的所有步骤均发生改变，这可能会增加血管并发症和感染发作的风险。
