Immunity status of patients with type 1 and 2 diabetes mellitus and pyelonephritis

Abstract

Aim. To elucidate changes in the immunity status of patients with type 1 and 2 diabetes mellitus (DM) and pyelonephritis (PN). Materials and methods. The study included 48 patients with type 1 and 2 diabetes mellitus and acute pyelonephritis and 15 ones with pyelonephritiswithout DM. Bacteriological study of urine in the acute phase of the disease was supplemented by evaluation of phagocytic activity, NBT test, measurementof circulating immune complexes, T and B-lymphocyte populations and subpopulations (CD3, CD4, CD8, CD16, CD19, CD95), HLA-DR,determination of lymphocyte immunoregulatory index and serum IgA, G, M, E levels. All patients were given identical antibacterial, anti-inflammatory,and detoxication treatment. Results. Patients with DM and PN suffered more pronounced disturbances of phagocytosis, humoral and cellular immunity than those with PN withoutDM. Immunity changes in DM1 and DM2 patients were similar, but the former had smaller phagocytic reserve and lower CD8, CD19, IgM, and IgElevels than the latter. Immunity status in DM1 and DM2 patients with PN was related to the duration of diabetes. Conclusion. Greater changes in the immune system of DM (especially DM1) patients with PN account for the enhanced frequency of upper urinarytract diseases.

Keywords

• pyelonephritis
• immunity
• diabetes mellitus