Neutrophil and Lymphocyte Function in Patients with Diabetes Mellitus

Valerius, Niels Henrik; Eff, C.; Hansen, Niels Ebbe; Karle, Hans; Nerup, J.; Söeberg, B; Sørensen, Søren Freiesleben

doi:10.1111/j.0954-6820.1982.tb01983.x

Cited by 96 publications

(70 citation statements)

References 24 publications

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“…For example, polymorphonuclear leukocyte function is depressed, particularly when acidosis is present. Leukocyte adherence, chemotaxis and phagocytosis may also be affected (27).…”

Section: Discussionmentioning

confidence: 99%

Mycotic Pseudoaneurysm of the Femoral Artery in a Patient with Psoriasis

2012

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Mycotic aneurysms of the common femoral artery are rare and usually occur in intravenous drug abusers who use the femoral vessels for injection. We herein describe a case of mycotic aneurysm of the common femoral artery caused by methicillin-sensitive Staphylococcus aureus seeding of an atherosclerotic plaque in which the bacteria possibly originated from psoriatic skin lesions. A 67-year-old Caucasian man was admitted to the hospital after experiencing chest pain for two days. He was known to have psoriasis and coronary artery disease with a history of coronary artery bypass grafting surgery three years earlier. He was found to have methicillin-sensitive Staphylococcus aureus bacteremia and later developed a mycotic aneurysm of the femoral artery opposite to the site of catheterization access. Mycotic aneurysms are rare clinical conditions associated with significant morbidity and mortality. In patients with psoriasis, a high prevalence of Staphylococcus aureus colonization of the skin makes possible bacterial seeding of existing atherosclerotic plaques. Therefore, the risk of mycotic pseudoaneurysm formation in these patients should be considered.

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“…For example, polymorphonuclear leukocyte function is depressed, particularly when acidosis is present. Leukocyte adherence, chemotaxis and phagocytosis may also be affected (27).…”

Section: Discussionmentioning

confidence: 99%

Mycotic Pseudoaneurysm of the Femoral Artery in a Patient with Psoriasis

2012

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“…Adherence, chemotaxis, phagocytosis and microbicidal IL-18 resistance, obesity and diabetes GRC Zilverschoon et al activity of leukocytes have all been proposed to be impaired in patients with diabetes, as is T-cell-dependent cellular immunity. [19][20][21][22] Interestingly, all cellular immune processes that are defective in diabetes are under the control of proinflammatory cytokines, with special emphasis on IFNg.…”

Section: Discussionmentioning

confidence: 99%

“…17,18 Several explanations have been proposed for the increased susceptibility to infections in these patients, such as the facilitation of bacterial growth by hyperglycemia, negative effects of ketoacidosis on the function of the leukocytes, and also a disturbed activation of cellular and/or humoral immunity due to impaired production of proinflammatory cytokines. [19][20][21][22] The latter has been supported by multiple studies reporting a defective production of proinflammatory Th1-type cytokines, such as IFNg. IFNg activates phagocytosis, stimulates the release of oxygen and nitrogen radicals by neutrophils and macrophages and increases intracellular bacterial killing, 23 and these mechanisms have been suggested to be affected in patients with obesity or diabetes.…”

Section: Introductionmentioning

confidence: 98%

Interleukin-18 resistance in patients with obesity and type 2 diabetes mellitus

et al. 2008

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Objective: Interleukin-18 (IL-18) has been recently demonstrated to improve experimental hyperphagia and insulin resistance. Paradoxically, concentrations of circulating IL-18 in obese subjects and in patients with type 2 diabetes are increased. The objective of this study is to provide an explanation for this paradox. Design: We have hypothesized that cells from obese individuals or from patients with type 2 diabetes mellitus have a diminished response to stimulation with IL-18. IL-18 responsiveness was tested by stimulating blood monocytes of obese or diabetes patients with rIL-18 or microbial components. Results: Obese individuals and patients with type 2 diabetes mellitus exhibit increased circulating concentrations of IL-18. More importantly, leukocytes isolated from obese or type 2 diabetes patients respond poorly after stimulation with IL-18, as reflected by defective interferon-g (IFNg) production. The defective response to IL-18 stimulation was accompanied by a 50% reduction in the expression of IL-18R a and b chains. In addition, cells of patients with obesity and diabetes displayed an impaired release of IFNg after challenge with bacterial or fungal pathogens, which was due to defective IL-18-mediated signaling. Conclusion: Patients with obesity or type 2 diabetes mellitus are characterized by lower responses after stimulation with IL-18. This IL-18 resistance explains the association of obesity and diabetes with high IL-18 circulating concentrations, similar to hyperinsulinemia and hyperleptinemia. IL-18 resistance may represent an important mechanism of the increased susceptibility of these patients to a number of infections.

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“…These include chemotaxis, adherence, phagocytosis and the ability to kill the phagocytosed microorganism. Reduction in intracellular killing of microbes with free radicals superoxides and hydrogen peroxide called the respiratory burst are also impaired 6 . Disturbances in acquired immunity also occur in diabetic patients 7, 8 .…”

Section: Introductionmentioning

confidence: 99%

Community acquired pneumonia in diabetic and non-diabetic hospitalized patients: presentation, causative pathogens and outcome

Saibal

Rahman

Nishat

et al. 2013

Bangladesh Med Res Counc Bull

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Both community acquired pneumonia and diabetes mellitus are common in Bangladesh. Though hospitalization of diabetic patients with CAP is increasing, data regarding their clinical presentation, microbial characteristics, antimicrobial susceptibility and outcome are lacking. This study was aimed at finding any difference in clinical presentation, bacterial causes, antimicrobial susceptibility pattern of isolated bacteria and outcome in diabetic and non-diabetic hospitalized patients with CAP. In this study total 47 diabetic and 43 non-diabetic adult hospitalized patients with CAP were enrolled. Clinical presentation of CAP differed in diabetics and non-diabetics. Frequency of atypical presentation and CURB-65 score were significantly higher in diabetics. Pleural effusion with multilobar infiltration was also common feature for CAP in diabetic patients. Klebsiella pneumoniae was the most frequent causative pathogen for CAP in diabetic patients, whereas Streptococcus pneumoniae was the most frequent causative agent for non-diabetic patients. Bacteria isolated from sputum sample of diabetic patients with CAP were resistant to almost all recommended antibiotics used for CAP but 100% of isolates were sensitive to Carbapenems. Pulmonary complications were relatively more in diabetics than in non-diabetics. Hospitalized diabetics with CAP required referral to intensive care unit more than that of non-diabetics. So, diabetic patients with CAP need extra attention.

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Neutrophil and Lymphocyte Function in Patients with Diabetes Mellitus

Cited by 96 publications

References 24 publications

Mycotic Pseudoaneurysm of the Femoral Artery in a Patient with Psoriasis

Mycotic Pseudoaneurysm of the Femoral Artery in a Patient with Psoriasis

Interleukin-18 resistance in patients with obesity and type 2 diabetes mellitus

Community acquired pneumonia in diabetic and non-diabetic hospitalized patients: presentation, causative pathogens and outcome

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