title: Regulatory T cells with CD62L or TNFR2 expression in young type 1 diabetic patients: relation to inflammation, glycemic control and micro-vascular complications.
abstract: BACKGROUND
  Alteration of regulatory T cells (Tregs) may contribute to ineffective suppression of proinflammatory cytokines in type 1 diabetes.
  
  
  OBJECTIVE
  We determined the percentage of Tregs expressing CD62L or tumor necrosis factor receptor type 2 (TNFR2) in 70 young type 1 diabetic patients compared with 30 controls and assessed their relation to inflammation, glycemic control and micro-vascular complications.
  
  
  METHODS
  High-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c), tumor necrosis factor alpha (TNF-α) and interleukin-10 (IL-10) were assessed with flow cytometric analysis of Tregs, Tregs expressing CD62L or TNFR2.
  
  
  RESULTS
  The percentage of CD4(+)CD25(high) T cells and CD4(+)CD25(high)CD62L(high) cells were significantly decreased while CD4(+)CD25(high)TNFR2(+) T cells were elevated in patients with micro-vascular complications than those without and controls (p<0.001). ROC curve revealed that the cutoff values of Tregs, Tregs expressing CD62L and Tregs expressing TNFR2 (7.46%, 24.2% and 91.9%, respectively) could detect micro-vascular complications. Significant negative correlations were observed between Tregs expressing CD62L and disease duration, FBG, HbA1c, urinary albumin excretion and hs-CRP, whereas, positive correlations were found between Tregs expressing TNFR2 and these variables (p<0.05). TNF-α was significantly increased while IL-10 was decreased among patients with micro-vascular complications than those without (p<0.05).
  
  
  CONCLUSIONS
  Alteration in the frequency of Tregs and Tregs expressing CD62L or TNFR2 in type 1 diabetes is associated with increased inflammation, poor glycemic control and risk of micro-vascular complications.
authors.affiliation: Pediatrics Department, Faculty of Medicine, Ain Shams University.
authors.forename: Mona H
authors.initials: MH
authors.lastname: El-Samahy
authors.affiliation: Pediatrics Department, Faculty of Medicine, Ain Shams University.
authors.forename: Amira A M
authors.initials: AA
authors.lastname: Adly
authors.affiliation: Clinical Pathology Department, Faculty of Medicine, Ain Shams University. Electronic address: eman.ismail_70@yahoo.com.
authors.forename: Eman A
authors.initials: EA
authors.lastname: Ismail
authors.affiliation: Pediatrics Department, Faculty of Medicine, Ain Shams University.
authors.forename: Nouran Yousef
authors.initials: NY
authors.lastname: Salah
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000503:physiopathology; D016753:Interleukin-10 / Q000097:blood; D019041:L-Selectin / Q000097:blood*; D008297:Male; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D047889:Receptors, Tumor Necrosis Factor, Type II; D019041:L-Selectin; D016753:Interleukin-10
keywords: CD62L; Micro-vascular complications; TNFR2; Tregs; Type 1 diabetes