Bacterial Phagocytosis and Intracellular Killing by Alveolar Macrophages in BB Rats

Abstract

Diabetic patients and animals show an increased susceptibility to bacterial infections due to impaired bactericidal function of various host-defense mechanisms. In our study, we examined the ability of alveolar macrophages (AMs) of the diabetic BB rat to phagocytize and kill Staphylococcus aureus bacteria. Groups of spontaneously diabetic BB rats with variable severity of diabetes were used and compared with non-diabetes-prone BB rats. AMs obtained from diabetic insulin-deficient BB rats showed a markedly decreased capacity to phagocytize and kill bacteria, a defect that was partially corrected after a period of aggressive insulin treatment. Glucose-intolerant BB rats and diabetes-prone BB rats who did not develop diabetes showed a normal AM function compared to non-diabetes-prone BB rats. The impaired phagocytotic and bactericidal functions of AMs appeared to be caused by a cellular abnormality associated with the degree of insulin deficiency.

Predisposing factors for surgical site infection of spinal instrumentation surgery for diabetes patients

“…These include abnormalities in granulocyte adherence [11], impaired phagocytosis [12], delayed chemotaxis [13], and depressed bactericidal capacity [12]. Furthermore, dysfunction of opsonization and immunoglobulin are reported to be induced by hyperglycemia [14].…”

“…The association between perioperative blood glucose range and the incidence of postoperative infection remains unclear in the majority of surgical patients due to lack of evidence [6]. Leukocyte deficiencies and wound healing impairment appear to be reversible and to improve with tight glycemic control [12,13,22]. On the other hand, severe vascular compromise developed from endothelial dysfunction caused by long term hyperglycemia is not reversible even following glycemic control [18,23].…”

Preoperative glucose as a screening tool in patients without diabetes

“…4,[10][11][12] Possible mechanisms linking hyperglycemia with worse outcomes (besides an undiagnosed illness causing physiologic stress) include derangements in leukocyte function, glycosylation and inactivation of immunoglobulins (leading to immune dysfunction), and collagen glycosylation (leading to poor healing from wounds and organ damage). [13][14][15][16] However, since there are likely many confounding factors contributing to the relationship between pre-operative hyperglycemia and post-operative complications, we sought to assess preoperative glucose as a marker, not as a causal determinant, of post-operative complications.…”

Gelatin Sheet Incorporating Basic Fibroblast Growth Factor Enhances Healing of Devascularized Sternum in Diabetic Rats

“…Intensive diabetic therapy with improved blood glucose control has been shown to prevent impairment of the ability of the white blood cells to phagocytose and effectively kill bacteria. 20,21 Our diabetic rats did not receive any treatment during the perioperative period, and their elevated blood glucose level remained Ͼ400 mg/dL postoperatively. We believe that our method can prevent DSWC more effectively when used in combination with perioperative glucose control.…”