Aims: This chapter aims to present the results of studies on
intestinal microbiota, innate and acquired immune responses, and tissue
regenerative capacity in hemodialysis patients with T2DM.
Study Design: It is a quantitative study that used two types
of biological samples: blood and faeces.
Place and Duration of Study: Institute of Virology and
University Research Institute laboratories, between January and June 2024.
Methodology: The study was conducted on 60 patients divided
into two groups: the test group (patients with ESRD and T2DM) and the control
group (ESRD only). The intestinal microbiota was investigated using a genetic
study. As markers for innate immunity (inflammation), the IL-6, sIL-6R, IL-1β,
TNFα, IL-10, and NGAL serum levels (ELISA kits). As a cellular immunity marker,
TNFβ/LTα was investigated. Regenerative capacity was studied using NT-3 (this
is the first study to do so) and VEGFβ (another marker that is scarcely found
in this patient category) (ELISA kits).
Results: The results proved a marked polarisation. IL-6 and
sIL-6R presented significant increases in both groups, especially in diabetics.
IL-6 generates trans-signalling through sIL-6R, with proinflammatory and
anti-regenerative effects, confirmed through a significant reduction in NT-3
and VEGF-β. Statistical analysis has allowed us to conclude that the high level
of IL-6 significantly influences IL-1β, TNF-β, NT-3, VEGF-β and IL-10
behaviour. But we were very surprised to find unexpected immunological changes
and tissue regenerative capacity in an 82-year-old female patient, diagnosed
with insulin-requiring T2DM, with multiple complications, including ESRD.
Conclusions: Although this research is in its early stages,
it generates important conclusions and directions for further research.
Regarding the particular case presented, we support the following causal
hypotheses: genetically conditioned IL-6 overproduction (possibly acquired
post-infection), together with its predominant anti-inflammatory and
pro-regenerative signalling through IL-6R membrane receptors; the possibility
that the extremely high levels of growth factors predict severe decompensation
of the two associated diseases.
Author(s) Details
Mihaela Gheorghiu
Pathophysiology and Immunology Department, “Carol Davila” University of
Medicine and Pharmacy, Bucharest, Romania.
Maria-Florina
Trandafir
Pathophysiology and Immunology Department, “Carol Davila” University of
Medicine and Pharmacy, Bucharest, Romania.
Coralia Bleotu
“Stefan S. Nicolau” Institute of Virology, Bucharest, Romania.
Octavian Savu
“N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic
Diseases, Bucharest, Romania and
Doctoral School of “Carol Davila”, University of Medicine and Pharmacy,
Bucharest, Romania.
Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/7002
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