Cell-mediated immunity in diabetes mellitus.
Cell-mediated immunity was evaluated in patients with diabetes mellitus by delayed hypersensitivity skin tests and in vitro lymphocyte transformations. Only 44% of diabetic patients had skin test reactivity to Candida antigen, compared with 88% of normal controls (P < 0.001). Insulin-dependent diabetic (IDD) patients had abnormally low lymphocyte transformation responses to phytohemagglutinin, concanavalin A, and streptokinase-streptodornase (P < 0.05). This defect was not corrected by culturing the cells in nondiabetic plasma. IDD patients with persistent hyperglycemia (fasting serum glucose level, >200 mg/dl) had lower levels of transformation than did IDD patients with fasting serum glucose levels less than 150 mg/dl. Lymphocytes from two IDD patients with poor lymphocyte transformation responses had marked improvement in response to phytohemagglutinin when the lymphocytes were cultured after a preincubation period designed to deplete cultures of suppressor activity. Seven IDD patients were studied serially over 12 months. Lymphocyte transformation responses in four of these patients improved coincidentally with a change in the level of fasting hyperglycemia from >200 to <150 mg/dl. The other three IDD patients with consistent fasting serum glucose levels of >200 mg/dl had poor lymphocyte transformation responses. Diabetic patients have demonstrable defects in lymphocyte function which improved in a small number of patients with reduction in the level of fasting hyperglycemia.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002478:Cells, Cultured; D003208:Concanavalin A / Q000494:pharmacology; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007328:Insulin / Q000627:therapeutic use; D008137:Longitudinal Studies; D008213:Lymphocyte Activation; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010835:Phytohemagglutinins / Q000494:pharmacology; D012882:Skin Tests; D013299:Streptodornase and Streptokinase / Q000494:pharmacology; D013601:T-Lymphocytes / Q000276:immunology
D007328:Insulin; D010835:Phytohemagglutinins; D003208:Concanavalin A; D013299:Streptodornase and Streptokinase