Role of alteration in Treg/Th17 cells’ balance in nephropathic patients with Type 2 diabetes mellitus

Authors

  • Sameh Abouzeid MD, lecturer of Nephrology, Nephrology Department, Theodor Bilharz Research Institute, Cairo, Egypt

Keywords:

Type 2 diabetes mellitus, Treg/Th17 cells, diabetic nephropathy

Abstract

Introduction: In type 2 diabetes mellitus, the adaptive immune system drives systemic inflammation, promoting insulin resistance and related complications, such as diabetic nephropathy. Increased infiltration of activated T lymphocytes has been found in patients with diabetic nephropathy. T-cell influx and accumulation are the factors that aggravate diabetic nephropathy and link with glomerular filtration surface and albumin excretion. An appropriate balance between pro-inflammatory (T helper 17: Th17, and T helper 1: Th1) and anti-inflammatory (regulatory T cells: Tregs) subsets of T cells is critical to maintain homeostasis and avoid inflammatory disease. The aim of this study was to determine the balance between T helper 17 and regulatory T cells in type 2 diabetic patients who have diabetic nephropathy.

Methods:  This case control study was conducted between December 2013 and June 2014 in Theodor Bilharz Research Institute in Egypt. Forty patients and 20 healthy volunteers were recruited in the study, and three groups were formed, i.e. two groups of cases with 20 patients in each group and one group of 20 controls) The groups were 1) 20 type 2 diabetic patients with nephropathy (group A); 2) 20 type 2 diabetic patients without nephropathy (group B); and 3) 20 healthy individuals (control group). Evaluation of T cells was done by standard 2-color flow cytometry.

Results: The study found higher mean of Th17 counts and Th17/Treg ratio among type 2 diabetic nephropathy patients compared to other groups; but a lower mean of Treg count was identified among type 2 diabetic nephropathy patients than in the other groups (p-value = 0.001).

Conclusion: The important role for regulatory T cells in the protection against nephropathy in type 2 diabetic patients was demonstrated, and also it was observed that T helper 17 cells were associated with renal affection.

 

References

Kornete M, Mason E and Piccirillo C. Immune regulation inT1D andT2D: prospective role of Foxp3 Treg

cells in disease pathogenesis and treatment. Front Endocrinol (Lausanne)2013; 4(76): 8. doi:

3389/fendo.2013.00076, PMCID: PMC3691561

Navarro J, Mora C. Diabetes, Inflammation, Proinflammatory Cytokines, and Diabetic Nephropathy.

ScientificWorldJournal. 2006; 6: 908-17, doi: 10.1100/tsw.2006.179, PMID: 16906324

Galkina E, Ley K. (2006): Leukocyte Recruitment and Vascular Injury in Diabetic Nephropathy. J Am Soc

Nephrol. 2006; 17: 368–77. doi: 10.1681/ASN.2005080859, PMID: 16394109

Bogdan M, McDonnell M, Shin H , Rehman Q, Hasturk H, Apovian C, et al. (2011). Elevated

Proinflammatory Cytokine Production by a Skewed T Cell Compartment Requires Monocytes and

Promotes Inflammation in Type 2 Diabetes. J Immunol. 2011; 186(2): 1162–72. doi:

4049/jimmunol.1002615, PMID: 21169542, PMCID: PMC3089774

National Kidney Foundation. KDOQI Clinical Practice Guideline for Diabetes and CKD: 2012 Update.

Am. J. Kidney Dis. 2012; 60(5): 850-86, PMID: 23067652

Ryba M, Myśliwska J. [CD4+CD25+Foxp3+ T lymphocytes: naturally occuring regulatory T cells]. Pediatr

Endocrinol Diabetes Metab. 2010; 16(4): 289-94. PMID: 21447271

Chalan P, Kroesen B, van der Geest K, Huitema M, Abdulahad W, Bijzet J, et al. Circulating

CD4+CD161+ T Lymphocytes Are Increased in Seropositive Arthralgia Patients but Decreased in Patients

with Newly Diagnosed Rheumatoid Arthritis. Journal pone. 2013; 8: 234-51. doi:

1371/journal.pone.0079370

Duran-Salgado M, Rubio-Guerr AF. Diabetic nephropathy and inflammation. World J Diabetes.2014; 5(3):

-8. doi: 10.4239/wjd.v5.i3.393, PMID: 24936261, PMCID: PMC4058744

Lim A, Tesch G. Inflammation in Diabetic Nephropathy. Mediators of inflammation. 2012; 20: 122-31, doi:

1155/2012/146154

Wu C, Sytwu H, Lu K, Lin Y. Role of T Cells in Type 2 Diabetic Nephropathy. Experimental Diabetes

Research. 2011; 11: 9. doi: 10.1155/2011/514738

Yousefidaredor H, Zare-Bidaki M, Hakimi H, Assar S, Bagheri V.Arababadi M. IL-17A plays an important

role in induction of type 2 diabetes and its complications. Asian Pac J Trop Dis. 2014; 4(5): 412-5. doi:

1016/S2222-1808(14)60598-3

Viswanathan V, Tilak P, Kumpatla S. Risk factors associated with the development of overt nephropathy in

type 2 diabetes patients: A 12- year- observational study. Indian J Med Res. 2012; 136: 46-53. PMID:

Zhang C, Xiao C, Wang P, Xu W, Zhang A, Li Q and Xu X (2014): The alteration of Th1/Th2/Th17/Treg

paradigm in patients with type 2 diabetes mellitus: Relationship with diabetic nephropathy. ELSEVIER

Journal. Hum Immunol. 2014; 75: 289-96. doi: 10.1016/j.humimm.2014.02.007, PMID: 24530745

Published

2022-03-08