A Study of Pain Threshold, Interleukins and NLR in Diabetic Polyneuropathy in a Selected Nigerian Population
Parole chiave:
Diabetes, inflammation, interleukins, pain threshold, polyneuropathyAbstract
Summary: Pain serves a protective function and is often lost in chronic conditions such as painful diabetic neuropathy (PDN). This has been reported to be associated with ongoing inflammation. This study aims to investigate an association between body immune responses, neutrophil-lymphocyte ratio (NLR) and pain perception in DPN patients. Sixty volunteers were recruited for the study. 30 control and 30 diagnosed DPN patients (used Biothesiometer). All subjects were trained and informed consents were obtained. The pain threshold was significantly (p<0.05) lower in DPN (23.48±1.19 sec) compared to control group (30.38±1.9 sec), there was significant lower NLR in DPN (1.27±0.09) compared to control group (1.93±0.1) and the serum level of IL6 (15.31±0.85 pg/ml) in DPN was significantly higher compared to control group (11.9±0.15 pg/ml), likewise the serum level of IL10 (13.26±2.78 pg/ml) in DPN is significantly higher compared to control group (6.59±1.07 pg/ml). This study showed that hyperalgesia seen in patients with DPN was independent of increased NLR, and increased IL6 & IL10 seen in this group of patients indicates need to further explore the role of immunological response in the pathogenesis and progression of DPN.
Riferimenti bibliografici
Arikawa E. (2007). Effects of insulin replace-ments, inhibitors of angiotensin, and PKC beta's actions to normalize cardiac gene expression and fuel metabolism in diabetic rats. Diabetes, 56(5):1410-1420.
Azab B, Daoud J, Naeem FB, Nasr R, Ross J, Ghimire P, Siddiqui A, Azzi N, Rihana N, Abdallah M. (2012). Neutrophil-to-lymphocyte ratio as a predictor of worsening renal function in diabetic patients (3-year follow-up study). Renal Failure, 34: 571–576.
Azab B, Chainani V, Shah N McGinn JT. (2013). Neutrophil–lymphocyte ratio as a predictor of major adverse cardiac events among diabetic population: a 4-year follow-up study. Angiology, 64: 456–465.
Bishnoi M, Bosgraaf CA, Abooj M, Zhong L, Premkumar LS. (2001). Streptozotocin-induced early thermal hyperalgesia is independent of glycemic state of rats: role of transient receptor potential vanilloid 1(TRPV1) and inflammatory mediators. Mol Pain. 7, 52.
Boulton AJ, Malik RA, Arezzo JC, Sosenko JM. (2004). Diabetes somatic neuropathies. Diabetes Care, 27:1458-1486
Boulton AJ, Vileikyte L, Ragnarson-Tennvall G. (2005) The global burden of diabetic foot disease. Lancet 2005; 366: 1719–1724.
Cancelliere PA. (2016). Review of the Pathophysiology and Clinical Sequelae of Diabetic Polyneuropathy in the Feet. J Diabetes J Diabetes Metab Disord Control. 2016;3(2):21‒24.
Czyzyk A. (1987). Pathophysiology and diabetes clinic (Polish). PZWL, Warszawa. 146–147.
D’Andrea A, Aste-Amezaga M, Valiante NM, Ma X. (1993). Interleukin 10 (IL-10) inhibits human lymphocyte interferon gamma-production by suppressing natural killer cell stimulatory factor/IL-12 synthesis in accessory cells. J. Exp. Med. 178: 1041-1048.
Dacie and Lewis (2011). Practical haematology. 11th ed. Livingstone Elsevier: 11-24.
Dai Z, Turtle CJ, Booth GC, Riddell SR, Gooley TA. (2009). Normally occurring NKG2D+CD4+ T cells are immunosuppressive and inversely correlated with disease activity in juvenile-onset lupus. J Exp Med. 206: 793-805.
Dyck PJ, Albers JW, Andersen H (2011); Toronto Expert panel on Diabetic Neuropathy. Diabetic polyneuropathies: update on research definition, diagnostic criteria and estimation of severity. Diabetes Metab Res Rev.27(7):620-628.
Farmer K, Li C, and Dobrowsky RT. (2012). Dia-betic Peripheral Neuropathy: Should a Chaperone Accompany Our Therapeutic Approach. Pharmacol Rev. 64: 880-900.
Guiliani F, Hader W, Young VW. (2005). Minocycline attenuates T cell and microglia activity to impair cytokine production in T cell- microglia interaction. J. Leukoc. Biol. 78(1):135-43.
Guo X, Zhang S, Zhang Q, Liu L, Wu H, Du H, Shi H, Wang C, Xia Y, Liu X, Li C, Sun S, Wang X, Zhou M, Huang G, Jia Q, Zhao H, Song K, Niu K. (2015). Neutrophil:lymphocyte ratio is positively related to type 2 diabetes in a large-scale adult population: a Tianjin Chronic Low-Grade Systemic Inflammation and Health cohort study. European Journal of Endocrinology, 173: 217–225.
Hayashino Y, Mashitani T, Tsujii S, Ishii H. (2014). Diabetes Distress and Care Registry at Tenri Study Group.Serum high-sensitivity C-reactive protein levels are associated with high risk of development, not progression, of diabetic nephropathy among Japanese type 2 diabetic patients: a prospective cohort study (Diabetes Distress and Care Registry at Tenri [DDCRT7]).Diabetic Care, 11:2947-2952.
Hewapathirana N and Page S. (2012). Diabetic microvascular complications – screening, diagnoses, and prevention. Clinical Focus Primary Care. 6(3):177-191.
Hirota H, Kiyama H, Kishmoto T, Taga T. (1996). Accelerated nerve regeneration in mice by upregulated expression of interleukin (IL) 6 and IL-6 receptor after trauma. J Exp Med. 1: 2627–2634.
Holzer SE, Camerota A, Martens L. (1998). Costs and duration of care for lower extremity ulcers in patients with diabetes. Clin Ther, 20:169 –1 81.
Jeppsson JO, Jerntorp P, Sundkvist G, Englund H, Nylund V. (1986). Measurement of hemoglobin A1c by a new liquid-chromatographic assay: methodology, clinical utility, and relation to glucose tolerance evaluated. Clin Chem. 32(10):1867-1872.
Jie C, Qiwen D and Yuqin P. (2015). Prognostic value of neutrophil-to-lymphocyte ratio in breast cancer FEBS Open Bio. 5: 502–07.
Kolb H, Kicscel U, Kroncke KD, Kolb- Bechofen V. (1991). Suppression of low-dose steptozotozin induced diabetes in mice by administration of nitric oxide synthase inhibitor. Life Sci. 49: L213-L217.
Langenkamp A, Messi M, Lanzavecchia A, Sallusto F. (2000). Kinectics of dendritic cell activation: impact on priming of TH1, TH2 and non-polarized T cells. Nat. Immunol. 19: 683-765.
Lee YY, Choi CH, Kim HJ, Kim TJ, Lee JW. (2012). Pre-treatment neutrophil:lymphocyte ratio as a prognostic factor in cervical carcinoma. Anticancer Res. 32: 1555-1561.
Lopez-Parra V, Mallavia B, Egido, J, Gomez-Guerrero C. (2012). Immunoinflammation in Diabetic Nephropathy: Molecular Mechanisms and Therapeutic Options. Diabetic Nephropathy, edited by John S. D. Chan JSD, 166: ISBN 978-953-51-0543-5.
Marcio C, Oliveira B, Sakata RK, Machado A, Gerola LR, Salomão R. (2011). Cytokines and Pain : Rev Bras Anestesiol, 61(2): 255-265.
Muller S, Matins S, Koenig W, Moghaddam H, Rathmann W, Haastert B. (2002). Impaired glucose tolerance is associated with increased serum concentrations of Interleukin 6 and co-regulated acute-phase proteins but not TNF-α or its receptors. Diabetologia, 45: 805-812.
Oliveira C.M, Sakata R.K, Issy A.M, Gerola L.R, Salomão R. (2011). Cytokines and Pain. Revista Brasileira de Anestesiologia. 61: 2: 255-265.
Pabreja K, Dua K, Sharma S, Padi SS, Kulkarni SK. (2011). Minocycline attenuates the development of diabetic neuropathic pain: possible anti-inflammatory and anti-oxidant mechanisms. Eur J Pharmacol. 661: 15–21.
Plesan A, Sollevi A, Segerdahl M. (2000). The N-methyl-D-aspartate-receptor antagonist dextromethorphan lacks analgesic effect in a human experimental ischemic pain model. Acta Anaesthesiol Scand. 44: 924–928.
Rojewska E, Popiolek-Barczyk K, Jurga AM, Makuch W, Przewlocka B, Joanna Mika J. (2014). Involvement of pro- and antinociceptive factors inminocycline analgesia in rat neuropathic pain model J. Neuroimmunol, 277: 57–66.
Saraiva M, O’Garra A. (2010). The regulation of IL-10 production by immune cells. Nat Rev Immunol. 10: 170-181.
Schalkwijk CG, Poland DC, van Dijk W. (1999). Plasma concentration of C-reactive protein is increased in type I diabetic patients without clinical macroangiopathy and correlates with markers of endothelial dysfunction: evidence for chronic inflammation. Diabetologia, 42:351–357.
Shaw JE, Sicree RA, Zimmet PZ. (2010). Diabetes Atlas; Global estimates of the prevalence of
diabetes for 2010 and 2030: diabetes research and clinical practice, 87: 4-14.
Sukhija R, Aronow WS, Sorbera C, Peterson SJ, Frishman WH, Cohen M. (2007). Mortality, left ventricular ejection fraction, and prevalence of new left ventricular wall motion abnormality at long-term follow-up in patients with implantable cardioverter defibrillators treated with biventricular pacing versus right ventricular pacing. American Journal of Therapeutics, 14: 328–330.
Vinik A, Mehrabyan A. (2004). Diabetic neuropathies. Med Clin North Am, 88:947–99.
Vinik A, Ullal J, Parson HK. (2006). Diabetic neuropathies: clinical manifestations and current treatment options. Nat Clin Pract Endocrinol Metab, 2:269 – 281.
Voorhis and Morgan (2007). Understanding power and rules of thumb for determining sample sizes. Tutorials in Quantitative Methods for Psychology 3 (2); 43-50.
Ulu SM, Dogan M, Ahsen A, Altug A, Demir K, Acarturk G, Inan S. (2013). Neutrophil-to-lymphocyte ratio as a quick and reliable predictive marker to diagnose the severity of diabetic retinopathy. Diabetes Technology &Therapeutics, 15: 942–947.
Uthamalingam S, Patvardhan EA, Subramanian S, Ahmed W, Martin W. (2011). Utility of the neutrophil to lymphocyte ratio in predicting long-term outcomes in acute decompensated heart failure. Am J Cardiol. 107: 433-438.
WHO (2014). Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia; report of a WHO/IDF consultation: ISBN 92 4 159493 4
Zahorec R. (2001). Ratio of neutrophil to lymphocyte counts – rapid and simple parameter of systemic inflammation and stress in critically ill. Bratislavske Lekarske Listy, 102(1):5–14. Zeng L, Alongkronrusmee D, van Rijn RM. (2017). An integrated perspective on diabetic, alcoholic, and drug-induced neuropathy, etiology, and treatment in the US. J Pain Res. 10:219-228.
Dowloads
Pubblicato
Fascicolo
Sezione
Licenza

Questo volume è pubblicato con la licenza Creative Commons Attribuzione - Non commerciale - Non opere derivate 4.0 Internazionale.