title: Effect of acute hyperglycaemia and/or hyperinsulinaemia on proinflammatory gene expression, cytokine production and neutrophil function in humans.
abstract: OBJECTIVE
  Type 2 diabetes is frequently associated with infectious complications. Swift activation of leucocytes is important for an adequate immune response. We determined the selective effects of hyperglycaemia and hyperinsulinaemia on lipopolysaccharide (LPS)-induced proinflammatory gene expression and cytokine production in leucocytes and on neutrophil functions.
  
  
  METHODS
  Six healthy humans were studied on four occasions for 6 h during: (i) lower insulinaemic euglycaemic clamp, (ii) lower insulinaemic hyperglycaemic clamp, (iii) hyperinsulinaemic euglycaemic clamp, and (iv) hyperinsulinaemic hyperglycaemic clamp. Target levels of plasma glucose were 12.0 mmol/l (hyperglycaemic clamps) or 5.0 mmol/l (euglycaemic clamps). Target plasma insulin levels were 400 pmol/l (hyperinsulinaemic clamps) or 100 pmol/l (lower insulinaemic clamps).
  
  
  RESULTS
  Hyperglycaemia reduced LPS-induced mRNA expression of nuclear factor of kappa light polypeptide gene enhancer in B cells inhibitor alpha (NFKBIA), interleukin-1 alpha (IL1A) and chemokine (C-C motif) ligand 3 (CCL3), whereas during hyperinsulinaemia enhanced mRNA levels occurred in six out of eight measured inflammation-related genes, irrespective of plasma glucose levels. Combined hyperglycaemia and hyperinsulinaemia led to enhanced IL1A, interleukin-1 beta (IL1B) and CCL3 mRNA levels upon LPS stimulation. Neither hyperglycaemia nor hyperinsulinaemia altered cytokine protein production, neutrophil migration, phagocytic capacity or oxidative burst activity.
  
  
  CONCLUSIONS
  These results suggest that short-term hyperglycaemia and hyperinsulinaemia influence the expression of several inflammatory genes in an opposite direction, that the acute effects of hyperinsulinaemia on inflammatory mRNA levels may be stronger than those of hyperglycaemia, and that the effects of insulin, in particular, may be relevant in the concurrent presence of hyperglycaemia.
authors.affiliation: Centre for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands. m.e.stegenga@amc.uva.nl
authors.forename: M E
authors.initials: ME
authors.lastname: Stegenga
authors.forename: S N
authors.initials: SN
authors.lastname: van der Crabben
authors.forename: M C
authors.initials: MC
authors.lastname: Dessing
authors.forename: J M
authors.initials: JM
authors.lastname: Pater
authors.forename: P S
authors.initials: PS
authors.lastname: van den Pangaart
authors.forename: A F
authors.initials: AF
authors.lastname: de Vos
authors.forename: M W
authors.initials: MW
authors.lastname: Tanck
authors.forename: D
authors.initials: D
authors.lastname: Roos
authors.forename: H P
authors.initials: HP
authors.lastname: Sauerwein
authors.forename: T
authors.initials: T
authors.lastname: van der Poll
mesh_terms: D000328:Adult; D004268:DNA-Binding Proteins / Q000235:genetics / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D015870:Gene Expression / Q000235:genetics; D015309:Glucose Clamp Technique; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism*; D006946:Hyperinsulinism / Q000378:metabolism*; D020672:I-kappa B Proteins; D053582:Interleukin-1alpha / Q000235:genetics / Q000378:metabolism; D008297:Male; D000072000:NF-KappaB Inhibitor alpha; D009504:Neutrophils / Q000378:metabolism*; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism*
chemical_list: D004268:DNA-Binding Proteins; D020672:I-kappa B Proteins; C508584:IL1A protein, human; D053582:Interleukin-1alpha; C000606204:NFKBIA protein, human; D012333:RNA, Messenger; D000072000:NF-KappaB Inhibitor alpha