IMPAIRED LEUKOCYTE FUNCTIONS IN DIABETIC-PATIENTS

This study evaluates polymorphonuclear neutrophil (PMN) cell performan ce in 61 diabetic patients free of infection (40 Type 1, 21 Type 2), u sing tests that explore all the functional steps of PMN: (1) adherence : expression of adhesion molecules, CD11a, CD11b, CD11c; nylon fiber a dherence test; (2) chemotaxis under agarose towards the bacterial olig opeptide FMLP and complement fractions, used as attracting agents; (3) phagocytosis of opsonized latex microbeads; (4) bactericidal activity : chemiluminescence assessment of the oxidative killing potential befo re and after stimulation by opsonized zymosan and PMA; nitroblue tetra zolium reduction test. Results were analysed according to potentially influential factors: metabolic control (HbA(1C), glycaemia), age of pa tient, type of diabetes, disease duration, and existence of vascular c omplications. PMN chemotaxis was significantly lower in patients than in healthy controls (p < 0.001) and associated with spontaneous adhere nce and increased expression of adhesion molecules (CD11b, CD11c). The increased response to chemiluminescence reflects spontaneous activati on of PMN cells and increased free radical production; after stimulati on, response was lower than in controls. The type of diabetes, the age of patients, HbA(1C) level and disease duration did not affect the re sponses. Chemotaxis and chemiluminescence were further reduced in pati ents with vascular complications and hyperglycaemia. We conclude that all steps of PMN functioning are altered in diabetic patients, which m ay increase the risk of vascular complications and infectious episodes .