Frequency of Circulating B1a and B2 B-cell Subsets in Egyptian Patients with Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) is a growing health problem in Egypt. T2DM is recognized as chronic inflammatory disease with involvement of immune cells including B cells. We aimed to determine the frequency of antibody secreting B1a and B2 B cells in T2DM patients, their correlation with diabetes metabolic parameters and whether they play a role in diabetic foot infection (DFI) development. This study included 56 participants, recruited from Al-Zahraa hospital, Al-Azhar University, Egypt. Of these, 36 patients were diagnosed with T2DM, divided to two groups; (1) DM group (n=19) recently diagnosed, without foot complication; (2) DFI group (n=17); in addition to a Control group (n=20). The study assessed the frequency of circulating B1a (CD19+CD23-CD5+), and B2 (CD19+CD23+CD5-) cells by flow cytometry in diabetic patients. Comparison of the 3 studied groups revealed significant differences in frequency of studied total B cells (P=0.011), B1a (P < 0.001) and B2 subsets (P < 0.001). Comparison of B cell subsets between DFI, DM groups showed significant decrease in B1a in DFI group (P < 0.001). B1a cells % showed inverse correlation with HgA1c (r=-0.47, P < 0.001), LDL (r=-0.64, P < 0.001), and TG (r=-0.67, P < 0.001) but showed positive correlation with HDL (r=0.61, P < 0.001), while B2 cells showed opposite correlations. We concluded that imbalance of B cell subsets is seen in T2DM subjects. Beneficial role of B1a cells was spotted as they correlated inversely with glycemia and lipidemia in contrary to B2 cells. Decrease in B1a cells may predispose to DFI development.

The Effect of Low Molecular Weight Heparin in Recurrent Pregnancy Loss: Changes in Radial Uterine Artery Blood Flow and Peripheral Blood NK Cell Fraction.

Immunological alteration has been suggested as a cause of unexplained early recurrent pregnancy loss (RPL). Natural killers (NKs) have been reported to play a role in vascular remodeling of decidual vessels. We aimed to find out if there is a relationship between peripheral blood NKs (pbNKs) and uterine radial artery (uRA) blood flow, and if low molecular weight heparin (LMWH) is effective in improving uRA blood flow in RPL cases and pregnancy outcome. The study was conducted on 30 pregnant women (5-7 weeks gestation) with ≥ 2 RPL and control group including 30 healthy pregnant women. The frequency of pbNKs (CD3 negative/CD56+CD16 positive) was measured using flow cytometry. Uterine color-pulsed doppler ultrasound was performed to evaluate uterine radial artery resistance index (uRA-RI). LMWH was administered daily in RPL cases with elevated uRA-RI (≥0.5) and uRA-RI was reassessed one week later. Comparison between cases and controls revealed that uRA-RI was significantly higher in RPL cases than controls (P =0.023), while pbNK frequency showed no significant difference between both groups. Post LMWH treatment, uRA-RI was significantly decreased when compared to pretreatment uRA-RI with mean±SD= (0.48+0.08) and (0.68±0.09) respectively (P=0.007). There was significant correlation of uRA-RI with number of abortions. There was no significant correlation of pbNK% with URa-RI (r=0.125 P=0.509) in RPL group. We concluded that LMWH treatment carries potentiality of improving pregnancy outcome in cases of RPLs with elevated uRA-RI. No significant correlation of NK% with uRA-RI, which denies the association of pbNK and RPL and raises questions about impact of pbNK cell testing in RPL.