Background The link between immune system and type 2 diabetes mellitus (T2DM) pathogenesis attracted attention to demonstrate the role of immune cells and their secreted cytokines in T2DM development and its subsequent foot complications. Objective To investigate the relation between T Natural killer cell (TNK) %, Interleukin 4 (IL4) and Interferon gamma (IFN-γ) and diabetic foot infection (DFI) development in patients with diabetic foot ulcer (DFU). Patients and Methods Ninety patients with diabetes were included in this work, divided as T2DM group (n=30), DFU group (n=30), and DFI group (n=30). TNK% was detected using flow cytometry. Serum IL4 and IFN-γ were measured by ELISA. Diabetes biochemical parameters were also analyzed. Results Significant decrease was detected in TNK% and IFN-γ in DFI group compared to other 2 groups ( P <0.001). Significant decrease was detected in serum levels of IL4 in DFI group compared to T2DM group ( P =0.006). IFN-γ/IL4 was significantly decreased in DFI compared to DFU group ( P =0.020). There was a significant correlation of TNK% with both IL4 and IFN-γ (r=0.385, P <0.001; r=0.534, P <0.001, respectively). Significant negative correlation of TNK% with HbA1c and LDL was revealed (r=−0.631, P <0.001; and r=−0.261, P =0.013, respectively), while a positive correlation was seen with HDL (r=0.287, P =0.006). A significant negative correlation of IL4 with HbA1c  was found (r=−0.514, P <0.001;. As for IFN-γ, a significant negative correlation with HbA1c and LDL was detected (r=−0.369, P < 0.001; r=−0.229, P =0.030). TNK % and IFN-γ level showed negative correlations with disease duration/year (r=−0.546, P < 0.001; r=−0.338, P =0.001,respectively). Conclusion Decline in TNK frequency has essential role in T2DM pathogenesis and subsequent foot complications. Downregulation of TNK% and IFN-γ level have potential roles in predicting infection of diabetic ulcer and are correlated with disease duration.

Background and Aim Deep venous thrombosis (DVT) of the lower extremities is common in Covid-19 patients. Interleukin (IL)-6 and P-selectin were found to be elevated in Covid-19 patients. The current study aimed to evaluate P-selectin and IL6 in Covid-19 patients with DVT and to explore its relation to clinical and laboratory parameters in those patients. Patients and methods The present retrospective study included 150 hospitalized COVID-19 patients diagnosed on the basis of a positive result of reverse-transcriptase polymerase chain reaction (RT-PCR) test. Laboratory assessments were included for IL-6 and P selectin assessments via enzyme-linked immunosorbent assay. The primary outcome of the present study was the development of DVT detected by Doppler ultrasound (DU) evaluation of the lower extremities during the admission. Results The present study included 150 hospitalized Covid-19 patients. DVT was developed in 59 patients (39.3%). DVP patients had significantly higher levels of P selectin [76.0 (63.0–87.0) versus 63.0 (54.3–75.0), p < 0.001] and IL-6 [37.0 (27.0–49.0) versus 18.5 (13.5–31.5), p < 0.001]. ROC curve analysis revealed good performance of P selectin [AUC (95% CI): 0.72 (0.64–0.81)] and IL-6 [AUC (95% CI): 0.79 (0.71–0.86)] in identification of DVT. Logistic regression analysis identified the presence of severe disease [OR (95% CI): 9.016 (3.61–22.49), p < 0.001], elevated P selectin [OR (95% CI): 1.032 (1.005–1.059), p = 0.018] and elevated IL-6 [OR (95% CI): 1.062 (1.033–1.091), p < 0.001] as significant predictors of DVT development in multivariate analysis. Conclusion The present study identified a probable role of elevated P-selectin and IL-6 levels in the DVT development in hospitalized Covid-19 patients.

Background Metabolic syndrome is defined as a group of interrelated biochemical, clinical, and metabolic factors that directly increase the risk of cardiovascular disease, obesity, and type 2 diabetes mellitus. MicroRNA-33a (miR-33a) and MicroRNA-122 (miR-122) play a crucial role in various biological processes by regulating the gene expression level through post-transcriptional mechanisms, and alterations of their levels are associated with lipid and glucose metabolic disorders. In the present study, we aimed to investigate the correlation of miR-33a and miR-122 with obesity indices and glycemic parameters in a cohort of Egyptian patients. Quantitative real-time polymerase chain reaction (RT-PCR) using TaqMan assay was carried out to estimate the expression levels of miR-33a and miR-122 in serum samples of 100 patients diagnosed as having metabolic syndrome and 50 healthy controls. All patients (100%) had type 2 diabetes (by both history and laboratory assessment) and 70% were obese (BMI ≥ 30 kg/m2). Results Compared to controls, patients had significantly higher serum expression level of miR-33a (p value < 0.001) and miR-122 (p value = 0.0016). miR-33a was less expressed (downregulation expression) with 0.8 fold change in the patient group (obese and diabetic) compared to healthy controls, while miR-122 was highly expressed (upregulation expression) in the patient group of patients with 1.9 fold change. Clinical parameters as body mass index (BMI), wrist circumference (Wc), weight (Wt), and height (Ht) (all p < 0.001); total cholesterol (TC) (p = 0.0115); and triglyceride (TG) (p = 0.0286), all were significantly higher in patients compared to the healthy group. Both miRNAs show statistically significant correlations with clinical and biochemical parameters (p < 0.001). Conclusions Circulating miR-33a and miR-122 might be convincing as possible biomarkers for the diagnosis of metabolic syndrome.

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