Abstract
Background: Patients with diabetes mellitus (DM) have infections more frequently than those without DM. The progress of the infections is also more complex in this patients group.
Objective: This work provides an evidence of the systemic immunological aspect among diabetic patients suffer from odontogenic infection. Our study considered study of systemic immune parameters among odontogenic infection patients suffering from diabetes mellitus. The immune parameters include antibodies such as serum IgG, IgM and IgA and cytokines such as the proinflamatory cytokine IFN?, IL-6 which represent as regulatory cytokine act as both pro-inflammatory and anti-inflamatory cytokine, cellular immunity represented by CD4
Tcells and CD8 T cells in each of DM patients, DM-odontogenic infection patients and normal control subjects as well as odontogenic infected DM free patients.
Methods
Systemic immune parameters were measured using using radial immunodiffusion plates for IgM, IgG & IgA and enzyme-linked immunosorbent assay (ELISA) for IFN-?, IL-6, CD-4 AND CD-8 T-cell receptores.
Results: The result shows that the patients with DM recorded significantly higher IgG level (884.74 ±244.15) ng\ml than in control group (443.04±171.18) ng\ml, (P?0.05).)
DM patients with dental infection record higher IgM (126.91±34.83) ng\ml than in control group (37.51±16.62) ng\ml, (P?0.05).
The result recorded non significant differences in IgA antibodies concentrations among normal control versus DM control subjects (59.26±25.86 ng\ml, 83.06±36.94
ng\ml) respectively, odontogenic infection cause significant elevation in serum IgA concentration in each of both DM patients and DM free patients (200.66±68.03 ng\ml, 129.2±64.54 ng\ml) respectively (P?0.05).
The level of IL-6 cytokine was significantly higher in DM control patients versus normal control subjects (38.115±23.80 pg/ml, 10.68±5.06 pg/ml) respectively (P?0.05). Odontogenic infection cause significant elevation in Il-6 concentration in each of DM patients and DM free patients (66.99±33.256 pg/ml, 41.94±18.85 pg/ml) (P?0.05).
Odontogenic infection cause significant elevation in IFN-? concentration both in DM free and in DM patients (84.17±41.73 pg/ml , 82.07±43.07 pg/ml)
in compare with control groups in DM free and in DM patients (18.59±9.22 pg/ml, 32.36 pg/ml ±17.24) respectively.
The elevation in IFN? in odontogenic DM free infected patients and in odontogenic DM patients was almost approximately similar.
CD-4 T-Cell concentration in each of odontogenic infected, DM control and odontogenic DM patients (4.64±2.12 ng/ml, 4.22±1.21 ng/ml, 4.49±1.79 ng/ml) were significantly higher than control group (2.11±1.37 ng/ml) (p? 0.05).
CD-8 T-Cell concentration in each of odontogenic infected and DM control and odontogenic DM patients (2.57±1.1 ng/ml, 1.88±0.9 ng/ml, 2.8±1.13 ng/ml) were significantly higher than control group (0.72±0.28 ng/ml) (p? 0.05).
Conclusion: IgM antibodies which represent as part of innate immunity do not depressed in DM patients.
Other humoral immune response parameters represented by IgG, and IgA were high in diabetic patients with odontogenic infection as in patients without DM, this result reflect that the class switching mechanism was not depressed in DM patients.
Further study for specificities and avidity determination of these antibodies in DM odontogenic infested patients required.
Our result recorded significant elevation in CD-4 T cells in DM control patients in comparing with normal control subjects control group, this result indicate there were stimulation and induction in producing such types of cells. This may cause depletion in the deposit of naïve T-cell and may lead to affect the number of antigen specific T-cells.
Similar results recorded for cellular immunity represented by CD-4 & CD-8 T-cells, the elevation number of T-cells may combined disturbance in function and cytokine production.
As we recorded as high IL-6 which represent as both proinflamatory and anti-inflamatory cytokine in the same time and non significant elevation in the level of proinflamatory cytokine IFN? in diabetic patients, and the elevation in IFN? in odontogenic infected patients and in odontogenic DM patients was almost approximately similar.
Keywords: Odontogenic infection, Diabetes mellitus , immune Response, cytokine, antibodies and CD4 & CD-8 T-cells.