Cytokine response to diabetic ketoacidosis (DKA) in children with type 1 diabetes (T1DM)

CXCL1/CXCL8 (GROα/IL-8) in human diabetic ketoacidosis plasma facilitates leukocyte recruitment to cerebrovascular endothelium in vitro

“…CXC chemokines, including CXCL1 (GRO␣) and CXCL8, (IL-8) are critical for leukocyte recruitment (28). Circulating levels of CXCL1 were increased significantly in adult type 1 diabetes (47), and CXCL8 is elevated in children with type 1 diabetes (10) and severe/moderate DKA (20,27). We have shown that CXCL1 and CXCL8 were elevated in children with DKA compared with controlled type 1 diabetes patients and that these two chemokines mediated leukocyte adhesion to hCMEC/D3 via CXCR1/CXCR2.…”

“…DKA is an inflammatory state with acute systemic elevations in heat shock proteins (35), complement (25), activated lymphocytes (22), and cytokines (20,27). Acute inflammation from other pathologies (i.e., infection, ischemia, or trauma) activates both endothelial cells and leukocytes, resulting in increased endothelial-leukocyte adhesion (7).…”

General immune dampening is associated with disturbed metabolism at diagnosis of type 1 diabetes

“…However, it was recently shown that in children with moderate or severe diabetic ketoacidosis at diagnosis, secretion of IL-6 and IL-10 was elevated (26)(27)(28). High-sensitive C-reactive protein was also shown to be correlated to the increase in IL-6 secretion indicating an ongoing inflammation (27). This observation is in line with the present finding, showing a higher ratio of spontaneously secreted IL-10/ IFN-γ in children suffering from ketoacidosis at diagnosis.…”

“…This observation is in line with the present finding, showing a higher ratio of spontaneously secreted IL-10/ IFN-γ in children suffering from ketoacidosis at diagnosis. It has been speculated that these changes may be responsible for increased capillary perturbation, which could subsequently lead to the development of acute ketoacidosis complications (27).…”

Diabetic Ketoacidosis

“…Karavanaki et al studied plasma levels of cytokines IL-1β, interleukin-2 (IL-2), IL-6, IL-8, and interleukin-10 (IL-10), TNF-α and also white blood cell count (WBC), high sensitivity C-reactive protein (hs-CRP), growth hormone (GH) and cortisol in 38 newly diagnosed T1DM children with DKA (mean age 7.68±3.07 years), prior to, during and 120 hours after DKA management, with the aim to monitor their levels at different time-points and in different degrees of DKA severity. Prior to DKA management the levels of IL-6, IL-8, IL-10,WBC and cortisol were elevated, but all parameters were reduced within 120 hours after DKA management [43]. …”