EXPLORATION OF THE VARIOUS STEPS OF POLYM ORPHONUCLEAR NEUTROPHIL FUNCTIONS IN DIABETIC-PATIENTS

Vascular complications in diabetic patients is a complex, probably mul tifactorial phenomena involving cellular phagocytosis. The aim of this study was to evaluate polymorphonuclear performance in 61 infection f ree diabetic patients based on tests of the different cell functions: 1) adhesion: adhesion molecule expression CD 11a, CD11b, CD11c; adhesi on test on nylon fibers. 2) chemotaxis : chemotaxis under aragose to F MLP (bacteria oligopeptide) and complement, fractions. 3) Phagocytosis : latex beads. 4) Bacteriocial power : chemoluminescence photometric o xidative potential before and after stimulation with opsonized zymosan and PMA; reduction of tetrazolium nitroblue. Results were analyzed ac cording to type of diabeties, glucose control, duration of the disease , history of infection and presence of vascular complications. Results : compared with a group of 30 controls, the diabetic patients had a si gnificant impaired polynuclear chemotaxis function (p < 0.001) with bo th spontaneous adhesion and increased expression of adhesion molecules (CD 11b, CD 11c). The chemoluminescence test was increased a the base line level due to spontaneous polynuclear adhesion and increased produ ction of free radicals. This response decreased after stimulation comp ared with controls. The type of diabetes, Hb Ale level and history of infection did not appear to have an effect. Inversely, changes in chem otaxis and chemoluminescence were greater in patients with vascular co mplications. In summary, all the functions of polynuclear neutrophils tested were altered in diabetic patients and could favor vascular comp lications and infections episodes