Role of alteration in Treg/Th17 cells’ balance in nephropathic patients with Type 2 diabetes mellitus

摘要

Introduction: In type 2 diabetes mellitus, the adaptive immune system drives systemic inflammation, promotinginsulin resistance and related complications, such as diabetic nephropathy. Increased infiltration of activated Tlymphocytes has been found in patients with diabetic nephropathy. T-cell influx and accumulation are the factorsthat aggravate diabetic nephropathy and link with glomerular filtration surface and albumin excretion. Anappropriate balance between pro-inflammatory (T helper 17: Th17, and T helper 1: Th1) and anti-inflammatory(regulatory T cells: Tregs) subsets of T cells is critical to maintain homeostasis and avoid inflammatory disease.The aim of this study was to determine the balance between T helper 17 and regulatory T cells in type 2 diabeticpatients who have diabetic nephropathy.Methods: This case control study was conducted between December 2013 and June 2014 in Theodor BilharzResearch Institute in Egypt. Forty patients and 20 healthy volunteers were recruited in the study, and three groupswere formed, i.e. two groups of cases with 20 patients in each group and one group of 20 controls) The groupswere 1) 20 type 2 diabetic patients with nephropathy (group A); 2) 20 type 2 diabetic patients withoutnephropathy (group B); and 3) 20 healthy individuals (control group). Evaluation of T cells was done by standard2-color flow cytometry.Results: The study found higher mean of Th17 counts and Th17/Treg ratio among type 2 diabetic nephropathypatients compared to other groups; but a lower mean of Treg count was identified among type 2 diabeticnephropathy patients than in the other groups (p-value = 0.001).Conclusion: The important role for regulatory T cells in the protection against nephropathy in type 2 diabeticpatients was demonstrated, and also it was observed that T helper 17 cells were associated with renal affection.