Cytokines in the blood of patients with type 2 diabetes mellitus depending on the level of overweight/obesity (literature review and own data)

Abstract

The paper analyzes the current literature data and the results of our own researches concerning the state of the cytokine network: pro- and anti-inflammatory cytokines (interleukin (IL) 1α, IL-1β, IL-4, IL-6, IL-10, IL-17 and tumor necrosis factor (TNF) α), α- and β-chemokines, including IL-8 and IL-16, as well as adipokines (leptin and adiponectin) in the peripheral blood of patients with type 2 diabetes (T2D) with normal and increased body weight/obesity. It has been shown that patients with T2D are cha­racterized by an increased content of proinflammatory cytokines (IL-1, IL-6, IL-17, TNFα), α- and β-chemokines in the peripheral blood, including IL-8 and IL-16, as well as leptin with a decrease in adiponectin content. In lean patients (with body mass index (BMI) < 25.5 kg/m2) compared to lean normoglycemic individuals from the control group (BMI < 25.5 kg/m2), there is a small but significant increase in IL-1β, IL-6, IL-17, TNFα and leptin, which, as BMI increases, significantly increases in severe obesity (BMI > 30.0 kg/m2), especially in obese women (BMI > 35.0 kg/m2). Similarly, an increase in proinflammatory cytokines is observed in normoglycemic people, but not as signifi­cant as in T2D. Less clear data were obtained when during determination of the anti-inflammatory cytokines IL-4 and IL-10, which is explained by a significant polymorphism of their genes, and both protective and compensatory effects on pro-inflammatory cytokine rise. In T2D patients, especially those with obesity, there is an increase in the leptin level and a decrease in the adiponectin content. The severity of the course and the percentage of mortality are closely associated with the BMI of patients. The effectiveness of the fight against an increase in the incidence of T2D should be primarily aimed at preventing obesity, and in case of already developed T2D — at reducing concomitant obesity. The analysis of the data presented also suggests that a sharp increase in the content of pro-inflammatory cytokines (so called cytokine storm) observed in patients with T2D and obesity infected with COVID-19, is a consequence of the summation and potentiation of already existing inflammatory process.

Content and ultrastructure of natural killer cells in the blood of patients with newly diagnosed type 2 diabetes mellitus

“…As is known, a huge number of review publications are devoted to such an important problem as the interdependence (correlation) between obesity and T2DM [39]. Howe ver, unfortunately, only a few publications are devoted to studying the role of NK cells in obesity, especially in patients with T2DM [5,14,20,35,40]. At the same time, there is evidence that obese people without diabetes, like patients with diabetes, experience similar but less pronounced changes in natural immunity.…”

“…In T2DM patients, vacuoles with residues of AZ granules were also more common. In this regard, it is important to emphasize that in recent years it has been discovered that AZ granules in NK cells are one of the producers of many vital cytokines and chemokines involved in the pathogenesis of IR and T2DM [28,35]. There are several publications that show a significant association between increased levels of pro-inflammatory cytokines (IL-1β, IL-6, IL-17, TNFα) and CD56+ cells in the PB of patients with prediabetes and T2DM [5,12,26,27,36].…”

Удосконалені Методи Лікування Хворих На Ожиріння На Основі Вивчення Деяких Патогенетичних Чинників Цього Захворювання

“…Преадипоцити по ходять із мультипотентної стовбурової кліти ни мезодермального походження, і потенціал генерувати нові жирові клітини зберігається протягом усього життя людини. Кількість ма крофагів позитивно корелює з масою тіла, роз міром адипоцитів і експресією прозапальних цитокінів [14,15].…”

Immunological mechanisms of increased susceptibility to COVID-19 disease and its severe course in patients with diabetes mellitus type 2 and obesity

“…Thus, most of the classic inflammatory biomarkers were found in patients with T2D, namely: leukocytosis, neutrophilia, monocytosis, increased level of C-reactive protein, NLR index, ferritin, D-dimer [33][34][35], as well as high levels of proinflammatory cytokines (IL-1β, IL-6, IL-17, TNFα, etc.) [14,34,[36][37][38][39][40][41][42][43].…”

“…For many years, we have studied natural and T-cell immunity in newly diagnosed untreated T2D patients with a range of body weights [11][12][13][14][15][16]. The present work summarizes and analyzes these numerous studies, as well as current literature data on the immunity of individuals with prediabetes (HbA1c ≥ 5.7-6.4%) and T2D (HbA1c > 6.5%) in comparison with the results of published studies in patients with COVID-19 of varying severity [17][18][19][20][21][22][23][24][25][26][27][28], which could be important for understanding the causes and immune mechanisms that make COVID -19 more severe in T2D patients as well as for developing more targeted treatments.…”