medigraphic.com

2020, Number 2

<< Back Next >>

Revista Cubana de Angiología y Cirugía Vascular 2020; 21 (2)

Characterization of the immunometabolic status of patients with diagnosis of diabetic foot

Álvarez HRJ, Escalante PO, Álvarez EG

Language: Spanish
References: 23
Page: 1-13
PDF size: 209.97 Kb.


ABSTRACT

Introduction: Diabetic foot is a clinic alteration induced by persistent hyperglycemias, with or without ischemia and previous trauma, lesion and/or ulceration of the foot. Hyperglycemia favours infections, but it does not increase the bacterial growth which suggests the participation of the immune system in this sensitivity.
Objective: To characterize the immunometabolic status of patients with diagnosis of diabetic foot.
Methods: It was carried out a descriptive, cross-sectional study in 25 patients hospitalized with diagnosis of diabetic foot among September and December, 2018 in “Manuel Ascunce Domenech” University Hospital. The studied variables were: age, sex, clinical forms of diabetic foot, complement 3 and 4, G and A, immunoglobulins and glycosylated hemoglobine. It was used descriptive statistic for data analysis.
Results: Females represented the 60% and patients older than 70 years were the 40%. Seric G immunoglobulin was found as decreased in 28% of the patients with diabetic foot and increased in the 28%. Glycosylated hemoglobine presented unbalanced in 48% of the cases. From the patients with metabolic decontrol, 8 (32%) showed alterations of G immunoglobulin and 2 in the component C3.
Conclusions: There was a group of patients with diabetic foot who presented variable immunological alterations and/or metabolic decontrol. Those patients can benefit with an integral management using immunotherapy and the prevention of infectious complications of the diabetic foot.


REFERENCES

  1. Beneit Montesinos JV. El Síndrome del “Pie Diabético”: El Modelo de la Clínica Podológica de la Universidad Complutense de Madrid. Madrid: Universidad Complutense de Madrid; 2010 [acceso 20/06/2019]. Disponible en: https://www.ucm.es/data/cont/docs/35-2019-02-04-3-2013-10-09- Lección%20Inaugural%202010-2011%20(Beneit)65.pdf

  2. Jafar N, Edriss H, Nugent K. The effect of short term hyperglycemia on the innate immune system. Am J Med Sci. 2016 [acceso 20/06/2019];351(2). Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1- s2.0S0002962915000270.pdf?locale=es_ES&searchIndex=

  3. Reichhardt MP, Meri S. Intracellular complement activation. An alarm raising mechanism? Sem Immunol. 2018 Apr [acceso 20/06/2019];38. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0- S1044532318300022.pdf?locale=es_ES&searchIndex=

  4. Ferretti C, La Cava A. Adaptive immune regulation in autoimmune diabetes. Autoimmunity Reviews. 2016 [acceso 20/06/2019];15(3). Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0- S1568997215002396.pdf?locale=es_ES&searchIndex=

  5. Fuentes Pérez JM, Jiménez Polvo EN, Espinosa Padilla SE. Inmunodeficiencias del complemento. Revisión de la literatura Parte I. Generalidades y deficiencias de la vía clásica. Alerg Asma Inmunol Pediatr. 2016 Sep-Dic [acceso 20/06/2019];25(3). Disponible en: https://www.medigraphic.com/pdfs/alergia/al-2016/al163c.pdf

  6. Moura J, Rodrigues J, Gonçalves M, Amaral C, Lima M, Carvalho E. Impaired T cell differentiation in diabetic foot ulceration. Cell Mol Biol. 2017 [acceso 20/06/2019];14. Disponible en: https://www.nature.com/articles/cmi2015116.pdf

  7. Boada Valmaseda A. Atención al paciente con diabetes y neumonía en Atención Primaria. Diab Práct. 2017 [acceso 20/06/2019];8(1). Disponible en: https://www.diabetespractica.com/files/1495108237.04_casos_dp_8-1.pdf

  8. Toniolo A, Cassani G, Puggioni A, Rossi A, Colombo A, Onodera T, et al. The diabetes pandemic and associated infections: suggestions for clinical microbiology. Rev Med Microbiol. 2019 [acceso 20/06/2019];30(1). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319590/

  9. Devaraj S. Increased monocytic activity and biomarkers of inflammation in patients with type 1 diabetes. Diabetes. 2006 [acceso 20/06/2019];55(3). Disponible en: https://www.researchgate.net/profile/Nicole_Glaser/publication/7272917_Increased_M onocytic_Activity_and_Biomarkers_of_Inflammation_in_Patients_With_Type_1_Diab etes/links/5604370f08aea25fce30bdd3/Increased-Monocytic-Activity-and-Biomarkersof- Inflammation-in-Patients-With-Type-1-Diabetes.pdf

  10. Moura J, Madureira P, Leal EC, Fonseca AC, Carvalho E. Immune aging in diabetes and its implications in wound healing. Clin Immunol. 2019 Feb [acceso 20/06/2019];200. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0- S1521661619300014.pdf?locales_ES&searchIndex

  11. Mirza RE, Koh TJ. Contributions of cell subsets to cytokine production during normal and impaired wound healing. Cytokine. 2015 [acceso 20/06/2019];71(2). Disponible en: https://www.sciencedirect.com/science/article/pii/S104346661400533X

  12. Akbari M, Hassan-Zadeh V. Hyperglycemia affects the expression of inflammatory genes in peripheral blood mononuclear cells of patients with type 2 diabetes. Immunol Invest. 2018 [acceso 20/06/2019];47(7). Disponible en: https://www.tandfonline.com/doi/full/10.1080/08820139.2018.1480031

  13. Lee HM, Jwa-Jin K, Hyun Jin K, Minho Shong, Bon Jeong K, Eun Kyeong J. Up regulated NLRP3 in flamma some activation in patients with type 2 diabetes. Diabetes. 2013 [acceso 20/06/2019];62(1). Disponible en: https://diabetes.diabetesjournals.org/content/62/1/194.full-text.pdf

  14. McCook J. Hacia una clasificación etiopatogénica del llamado pie diabético. Angiología. 1979;31(1):7-11.

  15. Lepedda AJ, Lobina O, Rocchiccioli S, Nieddu G, Ucciferri N, De Muro P, et al. Identification of differentially expressed plasma proteins in atherosclerotic patients with type 2 diabetes. J Diabetes Complications. 2016 Mar [acceso 20/06/2019];30(5). Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0- S1056872716300447.pdf?locales_ES&searchIndex

  16. Hostetter MK. Handicaps to host defense. Effects of hyperglycemia on C3 and Candida albicans. Diabetes. 1990 [acceso 20/06/2019];39. Disponible en: https://www.researchgate.net/publication/20747689_Handicaps_to_Host_Defense_Effe cts_of_Hyperglycemia_on_C3_and_Candida_albicans/link/566495e408ae4931cd6097d 2/download

  17. Ahrén B, Havel PJ, Pacini G, Cianflone K. Acylation stimulating protein stimulates insulin secretion. Int J Obes Relat Metab Disord. 2003 [acceso 20/06/2019];27(9). Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/12917708

  18. Sá Fernandes K, Glick M, Sérgio de Souza M, Kokron CM, Gallottini M. Association between immunologic parameters, glycemic control, and post-extraction complications in patients with type 2 diabetes. JADA. 2015 Ago [acceso 20/06/2019];146(8). Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1s2.0S0002817715003451. pdf?locales_ES&searchIndex

  19. Llorente L, de la Fuente H, Richaud Patin Y, Alvarado de la Barrera C, Díaz Borjón A, López Ponce A, et al. Innate immune response mechanisms in non insulin dependent diabetes mellitus patients assessed by flow cyto-enzymology. Immunol Lett. 2000 [acceso 20/06/2019];74(3). Disponible en: https://www.sciencedirect.com/science/article/pii/S0165247800002558?via%3Dihub

  20. Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes Metab Res Rev 2007 [acceso 20/06/2019];23(1):3-13. Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1002/dmrr.682

  21. Hu R, Xia CQ, Butfiloski E, Clare-Salzler M. Effect of high glucose on cytokine production by human peripheral blood immune cells and type I interferon signaling in monocytes: Implications for the role of hyperglycemia in the diabetes inflammatory process and host defense against infection. Clin Immunol. 2018 [acceso 20/06/2019];195:139-48. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119493/pdf/nihms976014.pdf

  22. Roshanzamir N, Hassan-Zadeh V. Methylation of specific CpG sites in IL-1β and IL1R1 genes is affected by hyperglycaemia in type 2 diabetic patients. Immunol Invest. 2019 [acceso 20/06/2019]:1-12. Disponible en: https://www.tandfonline.com/doi/full/10.1080/08820139.2019.1656227

  23. Chang CH, Wang JL, Wu LC, Chuang LM, Lin HH. Diabetes, glycemic control, and risk of infection morbidity and mortality: A cohort study. Open Forum Infect Dis. 2019 [acceso 20/06/2019];6(10):358. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6765350/




2020     |     www.medigraphic.com