Depression of Cell-Mediated Immunity in Diabetes

Eliashiv, Avinoam; Olumide, F; Norton, Lawrence W.; Eiseman, Ben

doi:10.1001/archsurg.1978.01370220066011

Cited by 46 publications

(19 citation statements)

References 12 publications

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“…Our observations that both uninfected spleen weights and cell counts are significantly greater in the +m/+m control mice than in the db+/db+ restricted mice are consistent with the report that the spleen of the C57BL/KsJ ob/ob diabetic mouse is also significantly smaller than normal [Chandra, 19801, as well as the studies reporting that in humans the number of peripheral lymphocytes are diminished in the diabetic condition [Cattaneo et al, 1976;Eliashiv et al, 1978;Chandra, 1980;Muller et al, 19801.…”

Section: Discussionsupporting

confidence: 90%

Humoral immune response in hereditary and overt diabetes mellitus

Montgomery

Loria

1986

Journal of Medical Virology

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The inbred diabetic mutant mouse, C57BL/KsJ db +/db + (db +/db +), spontaneously develops diabetes mellitus when allowed food ad libitum. However, restriction of food intake prevents the expression of this genetic predisposition for diabetes. This experimental design has been used previously to demonstrate a deficient neutralizing antibody response to coxsackievirus B4 (CB4) in mutants with the genetic predisposition only. These observations demonstrate that in the genetically predisposed diabetic mutant, deficient humoral immunity extends further to a general impairment in both total IgM and IgG production after CB4 infection. Furthermore, these mice are unable to produce a virus-specific IgG response but do show a high level of nonspecific antibody suggesting a polyclonal activation following CB4 challenge. In addition, we observed an increase in the number of spleen IgM antibody-forming cells to sheep erythrocytes (SRBC) in the overtly diabetic animal following CB4 infection with little change apparent in the genetically predisposed animal after infection. These results were identical to the changes seen in total spleen cell numbers. Our animal model provides an opportunity to distinguish between the genetic predisposition to diabetes and the overt disease and suggests that some of the immune impairment found prior to diabetes onset may be partially diminished afterwards.

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Section: Discussionsupporting

confidence: 90%

Humoral immune response in hereditary and overt diabetes mellitus

Montgomery

Loria

1986

Journal of Medical Virology

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“…Consequently, DM increases the frequency and severity of various types of bacterial infections, including abscesses. 4,5 Several reports have demonstrated underlying diabetes as a predisposing factor for pancreatic abscesses secondary to Klebsiella pneumonia, similar to these two cases. The treatment of pancreatic abscesses is complicated.…”

Section: Discussionsupporting

confidence: 63%

Isolated Pyogenic Pancreatic Abscess Successfully Treated via Endoscopic Ultrasound-guided Drainage

Lee

Kim

Chon

2017

Korean J Gastroenterol

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An isolated pyogenic pancreatic abscess (IPPA) without pancreatitis is extremely rare but can occur in patients with uncontrolled diabetes. This pathologic condition poses a clinical challenge in diagnosis and management because it can be confused easily with a malignancy. Endoscopic ultrasound (EUS) may be a useful diagnostic modality for indeterminate pancreatic lesions and IPPA. Here, we report two cases with elevated carbohydrate antigen 19-9 levels and pancreatic masses on cross sectional imaging. The patients were subsequently diagnosed with IPPA by EUS. EUS-guided drainage was performed successfully and the patients' clinical symptoms and radiologic findings improved. In our experience, EUS and EUS-guided drainage are crucial steps for the diagnosis and management of patients with an indeterminate pancreatic lesion. In addition, EUS-guided drainage has excellent technical and clinical outcomes for the treatment of IPPA. (Korean J Gastroenterol 2017;69:321-324)

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“…Diabetes is also associated with an increased susceptibility to infection, largely due to macrophage dysfunction and inhibition of cell-mediated immunity [214]. Anaemia may also have significant effects on the immune system.…”

Section: Anaemia Wound Healing and Infectionmentioning

confidence: 99%

Anaemia in Diabetes: An Emerging Complication of Microvascular Disease

Thomas

Tsalamandris

MacIsaac

et al. 2005

CDR

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Diabetes as the dominant cause of ESRD is also the major cause of renal anaemia. However, most patients with diabetic kidney disease will succumb to co-morbid vascular disease or heart failure before developing severe renal impairment. In these patients, anaemia is also common finding, with a 2-3 times greater prevalence and earlier onset than in patients with renal impairment from other causes. We have recently shown that at least one in five outpatients with type 1 or type 2 diabetes in tertiary referral clinics have anaemia, in whom it constitutes a significant additional burden. Impaired renal erythropoietin release in response to declining haemoglobin levels appears to be the major contributor to anaemia in diabetes. This may be due to the predominance of damage to cells and vascular architecture of the renal tubulointerstitium associated with diabetic nephropathy that may be apparent, like albuminuria, before demonstrable changes in renal function. In addition, systemic inflammation, autonomic neuropathy and reduce red cell survival may also compound anaemia in diabetes. While anaemia may be considered a marker of diabetic kidney disease, reduced haemoglobin levels, even within the normal range, identify diabetic patients with an increased risk of hospitalisation and mortality. Anaemia may also be significant in determining the outcome of heart failure and hypoxia-induced organ damage in patients with diabetes. Upcoming studies will determine whether correction of anaemia in diabetes will lead to improved outcomes in these patients.

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Depression of Cell-Mediated Immunity in Diabetes

Cited by 46 publications

References 12 publications

Humoral immune response in hereditary and overt diabetes mellitus

Humoral immune response in hereditary and overt diabetes mellitus

Isolated Pyogenic Pancreatic Abscess Successfully Treated via Endoscopic Ultrasound-guided Drainage

Anaemia in Diabetes: An Emerging Complication of Microvascular Disease

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