IMMUNOLOGICAL FEATURES OF THE DYNAMICS OF THE I DEGREE SEVERETY BACTERIAL KERATITES DEPENDING ON THE PRESENCE OF DIABETES MELLITUS

2021 ◽  
pp. 63-68
Author(s):  
O. V. Zavoloka ◽  
P. A. Bezditko ◽  
L. P. Abramova ◽  
V. O. Vekshyn
Keyword(s):  
Diabetes Mellitus ◽  
Enzyme Linked Immunosorbent Assay ◽  
Observation Data ◽  
Bacterial Keratitis ◽  
Lacrimal Fluid ◽  
Patients With Diabetes ◽  
Contralateral Eye ◽  
Instructions For Use ◽  
Type 1 Dm

Summary. In patients with diabetes mellitus (DM) there are features of the dynamics of the I degree severity bacterial keratitis, leading to prolongation of the disease and worsening of its consequences. The aim was to identify immunological features of the dynamics of the I degree severity bacterial keratitis depending on the presence of type 1 DM. Materials and methods. The level of interleukins (IL) was analyzed, namely IL-1β, IL-6 and IL-10 in the lacrimal fluid of the sick and the contralateral eye of 6 patients with type 1 DM and the I degree severity bacterial keratitis and 6 nondiabetic patients with I degree severity bacterial keratitis on the 1st day, 10-14th day and 24th day of observation. Data from 14 healthy individuals of the appropriate age were used for comparison. The severity of bacterial keratitis was determined according to our scheme at a total score of ≤ 14. All patients were treated with instillations of ofloxacin, antiseptics, antioxidants, reparents, artificial tears, mydriatics, systemic anti-inflammatory therapy. The level of IL in the lacrimal fluid was determined by quantitative colorimetric enzyme-linked immunosorbent assay using ELISA kits by ANOGEN according to the instructions for use. Results and discussion. In patients with I degree severity bacterial keratitis, both DM and nondiabetic, on the 1st day of observation there was an increase in the level of IL-1β and IL-6 in the lacrimal fluid of the sick eye and IL-10 – of the contralateral eye compared to healthy persons, on the 10th-14th day — increase in the level of IL-1β and IL-6 of the sick and the contralateral eye, as well as IL-10 – of the contralateral eye (p<0.05). On the 24th day in nondiabetic patients with I degree severity bacterial keratitis normalization of interleukin levels in the lacrimal fluid of the sick and the contralateral eye was found, but in DM patients remained elevated levels of IL-1β, IL-6, both in the sick and in the contralateral eye (p<0.05). Conclusions. In DM patients there are immunological features of the dynamics of the I degree severity bacterial keratitis, namely a longer increase in the level of proinflammatory cytokines IL-1β, IL-6 in the lacrimal fluid of the sick and the contralateral eye.

scholarly journals Immunological aspects of bacterial keratites in patients with diabetes mellitus

2021 ◽  
Vol 9 (2) ◽  
pp. 6-9
Author(s):  
O.V. Zavoloka ◽  
P.A. Bezditko ◽  
L.P. Abramova ◽  
V.O. Vekshyn
Keyword(s):  
Diabetes Mellitus ◽  
Anterior Segment ◽  
Enzyme Linked Immunosorbent Assay ◽  
Bacterial Keratitis ◽  
Healthy Individuals ◽  
Lacrimal Fluid ◽  
Cytokine Balance ◽  
Patients With Diabetes ◽  
Contralateral Eye ◽  
Type 1 Dm

Background. The purpose was to analyze the cytokine balance of lacrimal fluid in patients with bacterial keratitis and diabetes mellitus (DM) at the first visit and to identify the immunological aspects of the disease. Materials and methods. The analysis of pro- and anti-inflammatory cytokine concentration in the lacrimal fluid was performed in 17 patients with type 1 DM and bacterial keratitis and 15 nondiabetic patients with bacterial keratitis at the first visit. Data from 14 healthy individuals were used for comparison. In addition to standard ones, ophthalmic examination methods included bacteriological examination, fluorescein test, anterior segment optical coherence tomography, non-contact corneal aesthesiometry. The levels of interleukin (IL) 1β, IL-6 and IL-10 in the lacrimal fluid of the sick and the contralateral eye were determined by a quantitative colorimetric enzyme-linked immunosorbent assay using ELISA kits. Results. In DM patients with bacterial keratitis, the concentration of IL-1β and IL-6 in the lacrimal fluid of the sick eye exceeded that in healthy individuals (p < 0.05) and did not differ significantly from nondiabetic patients with bacterial keratitis (p > 0.05). In the lacrimal fluid of the contralateral eye of DM patients with bacterial keratitis, the level of IL-1β and IL-6 exceeded the corresponding indicators of nondiabetic patients with bacterial keratitis and healthy individuals (p < 0.05). The concentration of IL-10 in the lacrimal fluid of the contralateral eye in DM patients with bacterial keratitis exceeded that in healthy individuals (p < 0.05) and did not significantly differ from those in nondiabetic patients with bacterial keratitis (p > 0.05). Conclusions. DM patients with bacterial keratitis have immunological features of the disease.

scholarly journals PECULIARITIES OF THE LACRIMAL FLUID CYTOKIN PROFILE IN PATIENTS WITH BACTERIAL KERATITITIS OF THE II DEGREE SEVERETY AND DIABETES MELLITUS

2021 ◽  
pp. 61-65
Author(s):  
O. V. Zavoloka ◽  
P. A. Bezditko ◽  
L. P. Abramova ◽  
V. O. Vekshyn
Keyword(s):  
Proinflammatory Cytokines ◽  
Cytokine Profile ◽  
Enzyme Linked Immunosorbent Assay ◽  
Bacterial Keratitis ◽  
Lacrimal Fluid ◽  
Anti Inflammatory ◽  
Contralateral Eye ◽  
Type 1 Dm ◽  
Degree Of Severity

Summary. The aim was to identify the features of the lacrimal fluid cytokine profile in patients with bacterial keratitis of the II degree of severity and type 1 DM in the dynamics of observation. Materials and methods. The lacrimal fluid cytokine profile was analyzed in 6 patients with type 1 DM and bacterial keratitis of the II degree of severity and 6 nondiabetic patients with bacterial keratitis of the II degree of severity on the 1st day, 10-14th day and 24th day of observation. Data from 14 healthy individuals of the appropriate age were used for comparison. II degree of severity of bacterial keratitis was determined according to our proposed scheme at a sum of points 15-21. All patients were treated with instillations of ofloxacin, antiseptics, antioxidants, reparents, artificial tears, mydriatics, systemic anti-inflammatory therapy. The concentration of interleukins (IL)-1β, IL-6 and IL-10 in the lacrimal fluid of the sick and the contralateral eye was determined by quantitative colorimetric enzyme-linked immunosorbent assay using ELISA kits. Results and discussion. In patients with bacterial keratitis of the II degree of severity, both with DM and nondiabetic, within 10-14 days of observation invented the expression of proinflammatory cytokines IL-1β and IL-6 in the lacrimal fluid of the sick eye and anti-inflammatory cytokine IL-10 - in lacrimal fluid of the contralateral eye (p<0.05). In DM patients, a longer expression of IL-1β and IL-6 was detected in the lacrimal fluid of the sick and the contralateral eye, which was observed on the 24th day of the study (p<0.05). Conclusions. There are features of the lacrimal fluid cytokine profile in DM patients with bacterial keratitis of the II severity in the dynamics of observation, namely the longer expression of proinflammatory cytokines IL-1β, IL-6 in the sick and the contralateral eye.

scholarly journals A literature review and meta-analysis of safety profiles of SGLT2 inhibitors in Japanese patients with diabetes mellitus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junichi Mukai ◽  
Shinya Kanno ◽  
Rie Kubota
Keyword(s):  
Diabetes Mellitus ◽  
Meta Analysis ◽  
Japanese Patients ◽  
Sglt2 Inhibitors ◽  
Patients With Diabetes ◽  
Language Restriction ◽  
Calculated Risk ◽  
Favorable Safety ◽  
Type 1 Dm

AbstractThe safety profiles of sodium-glucose co-transporter 2 (SGLT2) inhibitors may depend on races/ethnicities. We aimed to assess the safety profiles of SGLT2 inhibitors in Japanese patients with diabetes mellitus (DM). The electronic databases MEDLINE, CENTRAL, and Ichushi-web were searched for studies with no language restriction from their inception to August 2019. Trials were included in the analysis if they were randomized controlled trials (RCTs) comparing the effects of SGLT2 inhibitors with a placebo in Japanese patients with DM > 18 years and reporting HbA1c and at least 1 adverse event. We calculated risk ratios with 95% CIs and used a random-effects model. Of the 22 RCTs included in our review, only 1 included patients with type 1 DM. The durations of RCTs ranged between 4 and 24 weeks. In comparison with a placebo, SGLT2 inhibitors were associated with similar risks of hypoglycemia, urinary tract infection, genital infection, hypovolemia, and fracture. The outcomes of treatment with SGLT2 inhibitors among Japanese patients with DM suggest favorable safety profiles. However, further evidence from studies with a longer duration, involving more diverse populations, such as patients with different types of DM, or including individual SGLT2 inhibitors is needed to resolve the limitations of the present study.

scholarly journals Novel Molecular Evidence Related to COVID-19 in Patients with Diabetes Mellitus

2020 ◽  
Vol 9 (12) ◽  
pp. 3962
Author(s):  
Yu-Huang Liao ◽  
Jing-Quan Zheng ◽  
Cai-Mei Zheng ◽  
Kuo-Cheng Lu ◽  
You-Chen Chao
Keyword(s):  
Diabetes Mellitus ◽  
Viral Entry ◽  
Cell Injury ◽  
Molecular Evidence ◽  
Protective Effects ◽  
Cytosolic Ph ◽  
S Protein ◽  
Patients With Diabetes ◽  
Type 1 Dm

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly evolved into a global pandemic. The hyperglycemia in patients with diabetes mellitus (DM) substantially compromises their innate immune system. SARS-CoV-2 uses human angiotensin-converting enzyme 2 (ACE2) receptors to enter the affected cell. Uncontrolled hyperglycemia-induced glycosylation of ACE2 and the S protein of SARS-CoV-2 could facilitate the binding of S protein to ACE2, enabling viral entry. Downregulation of ACE2 activity secondary to SARS-CoV-2 infection, with consequent accumulation of angiotensin II and metabolites, eventually leads to poor outcomes. The altered binding of ACE2 with SARS-CoV-2 and the compromised innate immunity of patients with DM increase their susceptibility to COVID-19; COVID-19 induces pancreatic β-cell injury and poor glycemic control, which further compromises the immune response and aggravates hyperglycemia and COVID-19 progression, forming a vicious cycle. Sequential cleavage of viral S protein by furin and transmembrane serine protease 2 (TMPRSS2) triggers viral entry to release the viral genome into the target cell. Hence, TMPRSS2 and furin are possible drug targets. As type 1 DM exhibits a Th1-driven autoimmune process, the relatively lower mortality of COVID-19 in type 1 DM compared to type 2 DM might be attributed to an imbalance between Th1 and Th2 immunity. The anti-inflammatory effects of dipeptidyl peptidase-4 inhibitor may benefit patients with DM and COVID-19. The potential protective effects of sodium–glucose cotransporter-2 inhibitor (SGLT2i), including reduction in lactate level, prevention of lowering of cytosolic pH and reduction in pro-inflammatory cytokine levels may justify the provision of SGLT2i to patients with DM and mild or asymptomatic COVID-19. For patients with DM and COVID-19 who require hospitalization, insulin-based treatment is recommended with cessation of metformin and SGLT2i. Further evidence from randomized or case–control clinical trials is necessary to elucidate the effectiveness and pitfalls of different types of medication for DM.

scholarly journals Thyroid dysfunction in patients with diabetes mellitus at Puducherry, India: a retrospective study

2018 ◽  
Vol 5 (4) ◽  
pp. 822
Author(s):  
K. Shaik Anwar Hussain
Keyword(s):  
Diabetes Mellitus ◽  
Retrospective Study ◽  
Thyroid Dysfunction ◽  
Diabetic Patients ◽  
Type Ii ◽  
Patients With Diabetes ◽  
Study Participants ◽  
Type 1 Dm

Background: There is a complex interrelationship in the co-existence of thyroid dysfunction among diabetic patients and may be related to the development of cardiovascular diseases and other complications of long term metabolic derangements. The prevalence of thyroid dysfunction varies from 10 to 24% among diabetic patients. The objective of the present study was to determine the prevalence of thyroid dysfunction among the patients with diabetes mellitus in a tertiary care hospital at Puducherry, India.Methods: This retrospective study was conducted during June 2018 analysing the records of diabetes patients attending to the diabetes OPD, Department of General Medicine in the past one year and their association with thyroid dysfunction was studied.Results: Among the study participants (n=200), 14.5% (n=29) were Type I diabetics and 85.5% (n=171) were type II Diabetes patients. The prevalence of Thyroid Dysfunction (TD) among the study participants was 28.5% (n=57). The proportion of TD was higher among type 1 DM compared to type 2 (p<0.001).  The prevalence of subclinical hypothyroidism was more (n=7, 24.1%) among type 1DM compared to type II DM patients (p=0.05).Conclusions: There was a higher prevalence of TD among the diabetics. TD was more frequent among type 1 DM compared to Type 2 DM patients and the most frequent TD associated with diabetes was subclinical hypothyroidism.

Analysis of the Cytokine Balance in Tear Fluid of Diabetic Patients with Bacterial Keratitis Depending on the Severity of the Disease

2021 ◽  
pp. 18-25
Author(s):  
Olesia V. Zavoloka ◽  
Pavlo A. Bezditko ◽  
Liliya P. Abramova ◽  
Vitaliy O. Vekshyn
Keyword(s):  
Diabetes Mellitus ◽  
Proinflammatory Cytokines ◽  
Tear Fluid ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diabetic Patients ◽  
Bacterial Keratitis ◽  
Cytokine Balance ◽  
Anti Inflammatory ◽  
Contralateral Eye ◽  
Severity Of The Disease

The aim. To analyze the cytokine balance of tear fluid in patients with bacterial keratitis at presentation depending on the severity of the disease and the presence of diabetes mellitus (DM). Materials and methods. The analysis was performed through the comparison of the level of pro- and anti-inflammatory cytokines in the tear fluid of 17 patients with type 1 DM and bacterial keratitis and 15 patients with bacterial keratitis without DM at presentation. Data from 14 healthy individuals of the appropriate age were also used for comparison. The patients with bacterial keratitis were divided into subgroups according to the severity of bacterial keratitis. The levels of IL-1β, IL-6 and IL-10 in the tear fluid of the sick and the contralateral eye were determined by quantitative colorimetric enzyme-linked immunosorbent assay. Results and discussion. At presentation, patients with bacterial keratitis, both with and without DM, showed increased levels of proinflammatory cytokines, namely IL-1β and IL-6, in the tear fluid of the sick eye, which correlated with the severity of the disease, and also increased level of anti-inflammatory cytokine IL-10 in the tear fluid of the contralateral eye. In addition, the concentrations of proinflammatory cytokines IL-1β, IL-6 in the tear fluid of the contralateral eye in DM patients were increased at all degrees of severity of bacterial keratitis. Conclusions. In patients with bacterial keratitis, the cytokine balance of the tear fluid of the sick and the contralateral eye depends on the severity of the disease and the presence of DM. Keywords: diabetes mellitus, bacterial keratitis, severity of keratitis, cytokines, interleukins.

scholarly journals Etiological features of bacterial keratitis in patients with diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. 10-13
Author(s):  
O.V. Zavoloka
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Causative Agent ◽  
Staphylococcus Epidermidis ◽  
Control Group ◽  
Bacterial Keratitis ◽  
Gram Positive ◽  
Patients With Diabetes

Background. The purpose was to study etiological features of bacterial keratitis in patients with type 1 diabetes mellitus. Materials and methods. The analysis was performed on the basis of survey data of 62 patients with bacterial keratitis and type 1 diabetes mellitus and 43 individuals with bacterial keratitis without diabetes mellitus of the corresponding age (control group). In addition to standard ones, ophthalmic methods included fluorescein test, anterior segment optical coherence tomography, non-contact corneal aesthesiometry, bacteriological examination: culture from the conjunctival cavity to dense nutrient media (5% blood agar and me­dium for sterility control), microscopic examination of conjunctival smear with Romanowsky-Giemsa and Pappenheim stain. Results. Etiological features of bacterial keratitis were found in patients with diabetes mellitus: Gram-positive microflora was the causative agent 1.5 times more often, and Gram-negative — 3.1 times less often than in patients without diabetes mellitus from the control group (p < 0.05). In addition, Staphylococcus epidermidis was the causative agent of bacterial keratitis in patients with diabetes mellitus 1.9 times more often, and Pseudomonas aeruginosa — 6.3 times less often than in patients of the control group (p < 0.05). Conclusions. There are etiological features of bacterial keratitis in patients with diabetes mellitus, namely predominance of the Gram-positive microflora among the pathogens due to Staphylococcus epidermidis.

scholarly journals Hepatocellular Glycogen Accumulation in the Setting of Poorly Controlled Type 1 Diabetes Mellitus: Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Atinuke Aluko ◽  
Ikponmwosa Enofe ◽  
Jacob Burch ◽  
Julie Yam ◽  
Nazia Khan
Keyword(s):  
Diabetes Mellitus ◽  
Rare Complication ◽  
Diagnostic Workup ◽  
Review Of Literature ◽  
Glycogen Accumulation ◽  
Control Regimen ◽  
Patients With Diabetes ◽  
History Of ◽  
Type 1 Dm

Glycogenic hepatopathy (GH) is the accumulation of glycogen in the hepatocytes and represents a rare complication in patients with diabetes mellitus (DM), most commonly type 1 DM. We present a case of a 23-year-old woman with a medical history of poorly controlled type 1 DM and gastroesophageal reflux disease (GERD) who presented with progressively worsening right-sided abdominal pain. Diagnostic workup resulted in a liver biopsy with hepatocytes that stained heavily for glycogen with no evidence of fibrosis or steatohepatitis. A diagnosis of glycogenic hepatopathy was made, and an aggressive glucose control regimen was implemented leading to resolution of symptoms and improvement in AST, ALT, and ALP. In addition to presenting this rare case, we offer a review of literature and draw important distinctions between glycogenic hepatopathy and other differential diagnoses with the aim of assisting providers in the diagnostic workup and treatment of glycogenic hepatopathy.

scholarly journals PECULIARITIES OF BACTERIAL KERATITIS IN PATIENTS WITH DIABETES MELLITUS DEPENDING ON THE SEVERETY OF DIABETIC POLINEUROPATHY

2019 ◽  
pp. 46-50
Author(s):  
O.V. Zavoloka
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Bacterial Keratitis ◽  
Corneal Sensitivity ◽  
Conjunctival Hyperemia ◽  
Corneal Opacification ◽  
Corneal Innervation ◽  
Patients With Diabetes

Summery. The dependence of the peculiarities of bacterial keratitis on the severity of DPN was proven with the help of 15 patients with type 1 diabetes mellitus. During all periods of observation, the severity of conjunctival hyperemia, the size of erosion and the threshold of corneal sensitivity at the stage of severe complications exceeded the corresponding indicators of patients with asymptomatic DPN. Normalization of conjunctival color in all patients with severe complications occurred at 8 days, and reepithelialization of the cornea 4 days later than in asymptomatic DPN. On the last 22nd day of observation, the corneal opacification of the peripheral localization remained in 33.3% of patients (2 patients) with the stage of severe complications, whereas in all patients with asymptomatic DPN the cornea was already transparent on the 14th day of observation. The threshold of corneal sensitivity at 22nd day in patients with severe complications was 35.3% higher than with asymptomatic DPN (p <0.05). So, patients with severe complications DPN with bacterial keratitis show a more pronounced violation of corneal innervation, which manifests by decrease of its sensitivity, and leads to prolongation of the duration of the disease.

The influence of para-aminobenzoic acid on the inflammatory process in dry eye disease in patients with diabetes mellitus (clinical and laboratory research)

2021 ◽  
pp. 19-23
Author(s):  
A.A. Ryabtseva ◽  
◽  
G.K. Ali-Zade ◽  
S.I. Akberova ◽  
O.V. Moskalets ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Dry Eye ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Eye Drops ◽  
Patients With Diabetes

Purpose. Study of the effect of 0.007% PABA solution in the form of the drug Aktipol-M on the inflammatory process based on the assessment of the level of sIL-6R and NE in the lacrimal fluid (LF), with dry eye disease (DED) in patients with diabetes mellitus (DM). Material and methods. The study involved 30 patients (60 eyes) with type 1 and 2 diabetes, aged 35 to 70 years, with a diagnosis of DED. Patients received Aktipol-M eye drops for one month. The contents of NE (10 patients, 20 eyes) and sIL-6R (20 patients, 40 eyes) were determined in the LF. The control group consisted of 10 healthy volunteers (20 eyes). Quantitative determination of the content of sIL-6R and NE was carried out by the method of enzyme-linked immunosorbent assay. Thirty patients (60 eyes) with type 1 and 2 diabetes, aged 35 to 70 years, with a diagnosis of DED were examined. The patients received Aktipol-M eye drops for one month. The content of NE (10 patients, 20 eyes) and sIL-6R (20 patients, 40 eyes) was determined in the LF. The control group consisted of 10 healthy volunteers (20 eyes). The quantitative determination of the content of sIL-6R and NE was carried out by the method of enzyme-linked immunosorbent assay. Results. The patients showed a higher content of sIL-6R (10974.8±1228.5 pkg/ml) and NE (3.85 ± 0.13 ng / ml) compared with the control group (4.6 ± 0.7 pkg / ml and 0.22 ± 0.08 ng/ml, respectively). After 1 month after the start of treatment, a significant decrease in these parameters was observed in all patients and in both eyes: on average, the content of sIL-6R by 80.5% and the NE content by 58.7%. Conclusion. PABA 0.007% in the dosage form of eye drops Aktipol-M has an anti-inflammatory effect, suppressing the production of sIL-6R and NE in the LF in DED in patients with diabetes. Key words: para-aminobenzoic acid, dry eye disease, diabetes mellitus, inflammation, neutrophilic elastase, soluble interleukin-6 receptor.

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