Role of Complements and Immunoglobulins in Type 1 Diabetes Mellitus
Keywords:
Diabetes Mellitus, Immunoglobulin, Complement.
Abstract
Background: The aim of the present study was to determine the role of complements and immunoglobulins in normal healthy population and patients having Type 1 diabetes mellitus (T1DM).Methods: A total of 26 patients with T1DM and 20 healthy controls were included in the study. The sample was collected from OPD of Department of Endocrinology, SS Hospital, IMS, BHU, Varanasi. Immunoglobulins and complements estimation was done by turbidometry method. Result: A total of 26 patients with T1DM between 8 yrs to 33 yrs age were studied. Out of 26 cases, 19.2% cases had low C4 and 3.9% had elevated serum C4 value. Mean value of serum C4 was significantly reduced in T1DM. The patients having low C4 value belonged to the age group less than 18 years. About 23.1% DM patient had increased serum IgM levels and 7.7% had increased serum IgA levels. But only rise of IgM was statistically significant. C3 and IgG in DM patients were within normal range. There was significant positive correlation of serum C4 with increase BMI. IgA was significantly correlated with rising of BMI and low age of onset of T1DM.Conclusion: Our study concludes that C4 deficiency associated with Type I DM. The study also showed that increased IgM which may be due to recent infection.References
REFERENCE:
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6. Vreugdenhil GR, Schloot NC, Hoorens A et al. Acute onset of type I diabetes mellitus after severe echovirus 9 infection: putative pathogenic pathways. Clin Infect Dis. 2000; 31: 1025– 1031.
7. Yoon JW, Austin M, Onodera T, Notkins AL. Virusinduced diabetes mellitus. N Engl J Med. 1979; 300:1173–1179.
8. Jun HS, Yoon JW. The role of viruses in type I diabetes: two distinct cellular and molecular pathogenic mechanisms of virus-induced diabetes in animals. Diabetologia.2001; 44:271–285.
9. Imagawa A, Hanafusa T, Makino H, Miyagawa J I and Juto P. High titres of IgA antibodies to enterovirus in fulminant type-1 Diabetes. Diabetologia. 2005; 48: 290–293.
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11. Gillani S W, Sulaiman SAS, Sundram S, Sari YO, Baig M, and Iqbal MS. Factors associated with infections in diabetic population. African Journal of Pharmacy and Pharmacology, 2011; 5(11): 1414-1421.
12. Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol. 1999; 26:259-65.
13. Moutschen MP, Scheen AJ, Lefebvre PJ. Impaired immune responses in diabetes mellitus: analysis of the factors and mechanisms involved. Relevance to the increased susceptibility of diabetic patients to specific infections. Diabete Metab. 1992;18: 187-201.
14. Dunkelberger JR, Song WC. Complement and its role in innate and adaptive immune responses. Cell Res. 2010; 20(1):34-50.
15. Ballanti E, Perricone C, Greco E, Ballanti M, Di Muzio G, Chimenti MS, Et Al. Complement And Autoimmunity. Immunol Res. 2013; 56(2-3):477-91.
16. Mcmillan DE. Elevation Of Complement Components In Diabetes Mellitus. Diabete Metab. 1980; 6(4):265-70.
17. Barnett AH, Mijovic C, Fletcher J, Chesner I, Kulkuska-Langlands BM, Holder R et al. Low plasma C4 concentrations: association with microangiopathy ill insulin-dependent diabetes. Br Med J. 1984; 289 : 943-945.
18. Bertrams J, Hintzen U, Schlicht V, Schoeps S. C41 another marker for type I diabetes. Lancet. 1982; I : 41.
19. Cooper ME, Duff R, Buchanan R, McPherson J, Jerums G. Low serum C4 concentrations and microangiopathy in type I and type II diabetes. Br Med J. 1986; 292 : 801.
20. Chiarelli F, Verrotti A, La Penna G, Morgese G. Low serum C4 concentrations in type-1 diabetes mellitus. Eur J Pediatr. 1988; 147(2):197-8.
21. Flyvbjerg, Allan. Diabetic angiopathy, the complement system and the tumor necrosis factor superfamily. Nature Reviews Endocrinology. 2010; 6: 94-101.
22. Gorus FK, Vandewalle CL, Winnock F, Lebleu F, Keymeulen BV, et al. Increased prevalence of abnormal immunoglobulin M, G, and A concentrations at clinical onset of insulin-dependent diabetes mellitus: A registry-based study. The Belgian Diabetes Registry. Pancreas. 1998; 16:50–9.
23. Cser A, Ambrus M, Bajtai G, Heim T, Varga F. Juvenile diabetes mellitus and selective IgA deficiency. Ovr Heti. 1974; 1115:803-806.
24. Penny R, Thompson RG, Polmar SM, Schultz RB. Pancreatic malabsorption and IgA deficiency in a child with diabetes. Pediatrics.1971; 78:512-516
25. Silver HKB, Shuster J, Gold P, Hawkins D, Freedman SO. Endocrinopathy and IgA deficiency. Clin Immunol Immunopath. 1973; 1 : 212-219.
26. Svensson J, Eising S, Mortensen HB, Christiansen M, Laursen I, Lernmark A et al. High levels of immunoglobulin E and a continuous increase in immunoglobulin G and immunoglobulin M by age in children with newly diagnosed type 1 diabetes. 2012; 73(1):17–25.
27. Eguchi K, Yagame M, Suzuki D, et al. Significance of high levels of serum IgA and IgA-class circulating immune complexes (IgA-CIC) in patients with noninsulin- dependent diabetes mellitus. J DiabetComplications. 1995; 9: 42–48.
28. Rodriguez-Segade S, Camina MF, Carnero A, et al. High serum IgA concentrations in patients with diabetes mellitus: agewise distribution and relation to chronic complications. Clin Chem. 1996; 42: 1064– 1067.
29. Islam Laila N, Mahmud Hossain and M. Shamim H. Zahid. Complement mediated bactericidal activity and humoral immune response in type 2 diabetes mellitus. Int J Diabetes Metab. 2006; 14: 92-97.
30. Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes Metab Res Rev. 2007; 23:3-13.
1. International Diabetes Federation; IDF Diabetes Atlas; 6th edn.; International Diabetes Federation; 2013; http://www.idf.org/diabetesatlas ISBN: 2-930229-85-3.
2. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998; 15:539–553.
3. Maahs DM, West NA, Lawrence JM and Mayer-Davis EJ. Epidemiology of type 1 diabetes. Endocrinol Metab Clin North Am. 2010; 39: 481–97.
4. International Diabetes Federation. IDF Diabetes Atlas. 6th ed. International Diabetes Federation. 2013.
5. Graves PM, Norris JM, Pallansch MA, Gerling IC, Rewers M. The role of enteroviral infections in the development of IDDM: limitations of current approaches. Diabetes. 1997; 46:161–168.
6. Vreugdenhil GR, Schloot NC, Hoorens A et al. Acute onset of type I diabetes mellitus after severe echovirus 9 infection: putative pathogenic pathways. Clin Infect Dis. 2000; 31: 1025– 1031.
7. Yoon JW, Austin M, Onodera T, Notkins AL. Virusinduced diabetes mellitus. N Engl J Med. 1979; 300:1173–1179.
8. Jun HS, Yoon JW. The role of viruses in type I diabetes: two distinct cellular and molecular pathogenic mechanisms of virus-induced diabetes in animals. Diabetologia.2001; 44:271–285.
9. Imagawa A, Hanafusa T, Makino H, Miyagawa J I and Juto P. High titres of IgA antibodies to enterovirus in fulminant type-1 Diabetes. Diabetologia. 2005; 48: 290–293.
10. Deresinski S. Infections in the diabetic patient: Strategies for the clinician. Infect. Dis. Rep., 1995; 1: 1-12.
11. Gillani S W, Sulaiman SAS, Sundram S, Sari YO, Baig M, and Iqbal MS. Factors associated with infections in diabetic population. African Journal of Pharmacy and Pharmacology, 2011; 5(11): 1414-1421.
12. Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol. 1999; 26:259-65.
13. Moutschen MP, Scheen AJ, Lefebvre PJ. Impaired immune responses in diabetes mellitus: analysis of the factors and mechanisms involved. Relevance to the increased susceptibility of diabetic patients to specific infections. Diabete Metab. 1992;18: 187-201.
14. Dunkelberger JR, Song WC. Complement and its role in innate and adaptive immune responses. Cell Res. 2010; 20(1):34-50.
15. Ballanti E, Perricone C, Greco E, Ballanti M, Di Muzio G, Chimenti MS, Et Al. Complement And Autoimmunity. Immunol Res. 2013; 56(2-3):477-91.
16. Mcmillan DE. Elevation Of Complement Components In Diabetes Mellitus. Diabete Metab. 1980; 6(4):265-70.
17. Barnett AH, Mijovic C, Fletcher J, Chesner I, Kulkuska-Langlands BM, Holder R et al. Low plasma C4 concentrations: association with microangiopathy ill insulin-dependent diabetes. Br Med J. 1984; 289 : 943-945.
18. Bertrams J, Hintzen U, Schlicht V, Schoeps S. C41 another marker for type I diabetes. Lancet. 1982; I : 41.
19. Cooper ME, Duff R, Buchanan R, McPherson J, Jerums G. Low serum C4 concentrations and microangiopathy in type I and type II diabetes. Br Med J. 1986; 292 : 801.
20. Chiarelli F, Verrotti A, La Penna G, Morgese G. Low serum C4 concentrations in type-1 diabetes mellitus. Eur J Pediatr. 1988; 147(2):197-8.
21. Flyvbjerg, Allan. Diabetic angiopathy, the complement system and the tumor necrosis factor superfamily. Nature Reviews Endocrinology. 2010; 6: 94-101.
22. Gorus FK, Vandewalle CL, Winnock F, Lebleu F, Keymeulen BV, et al. Increased prevalence of abnormal immunoglobulin M, G, and A concentrations at clinical onset of insulin-dependent diabetes mellitus: A registry-based study. The Belgian Diabetes Registry. Pancreas. 1998; 16:50–9.
23. Cser A, Ambrus M, Bajtai G, Heim T, Varga F. Juvenile diabetes mellitus and selective IgA deficiency. Ovr Heti. 1974; 1115:803-806.
24. Penny R, Thompson RG, Polmar SM, Schultz RB. Pancreatic malabsorption and IgA deficiency in a child with diabetes. Pediatrics.1971; 78:512-516
25. Silver HKB, Shuster J, Gold P, Hawkins D, Freedman SO. Endocrinopathy and IgA deficiency. Clin Immunol Immunopath. 1973; 1 : 212-219.
26. Svensson J, Eising S, Mortensen HB, Christiansen M, Laursen I, Lernmark A et al. High levels of immunoglobulin E and a continuous increase in immunoglobulin G and immunoglobulin M by age in children with newly diagnosed type 1 diabetes. 2012; 73(1):17–25.
27. Eguchi K, Yagame M, Suzuki D, et al. Significance of high levels of serum IgA and IgA-class circulating immune complexes (IgA-CIC) in patients with noninsulin- dependent diabetes mellitus. J DiabetComplications. 1995; 9: 42–48.
28. Rodriguez-Segade S, Camina MF, Carnero A, et al. High serum IgA concentrations in patients with diabetes mellitus: agewise distribution and relation to chronic complications. Clin Chem. 1996; 42: 1064– 1067.
29. Islam Laila N, Mahmud Hossain and M. Shamim H. Zahid. Complement mediated bactericidal activity and humoral immune response in type 2 diabetes mellitus. Int J Diabetes Metab. 2006; 14: 92-97.
30. Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes Metab Res Rev. 2007; 23:3-13.
Published
2016-02-13
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