Association between Type 2 Diabetes, Obesity and Key Immunological Components of IgE-mediated Inflammation.

BACKGROUND: Changes in lifestyle and obesity in recent decades have brought about a dramatic increase in type 2 diabetes mellitus (DM2) and allergic diseases. Clinical and epidemiological studies associate obesity with epidemics of allergic diseases. The link between obesity and DM2 with immunological components of IgE-mediated allergic inflammation is not yet conclusively established. AIM: To examine the key immunological components of IgE-mediated allergic inflammation in patients with DM2 and their relationship with glycemic control and anthropometric indicators. MATERIALS AND METHODS: Fifty-five patients with DM2 and 32 healthy controls with normal weight and body mass index (BMI) of 18-24.9 kg/m2 were included in the study. Th2-cytokine profile (serum levels of IL-4 and IL-5, pg/ml) and total serum IgE IU/ml were assessed in all participants in the study using ELISA. In patients with DM2, levels of glycated hemoglobin (HbA1c%) in the blood were also measured. RESULTS: Serum levels of IL-4 and IL-5 are significantly higher in patients with DM2 compared to the control group. Serum levels of IL-4 and IL-5 positively correlated with BMI as well as serum levels of IL-4 with waist circumference. Total serum IgE positively correlated with HbA1c. CONCLUSION: Obesity and poor glycemic control in patients with DM2 affect key immunological components of IgE-mediated allergic inflammation and possibly alter the immune response to allergens and antigens.

Correlation between CGRP Levels and the Neuropathic and Inflammatory Component of Postoperative Pain.

INTRODUCTION: In surgical procedures, tissue damage results in the release of a number of bioactive substances. Calcitonin gene-related peptide (CGRP) is a peptide released from sensory nerves, which determines its role in pain sensation. Its distribution in tissues deter-mines its role as a primary afferent neurotransmitter. AIM: To determine the effect of CGRP on postoperative pain and reactive inflammatory process after surgical removal of impacted mandibular third molars, as well as the factors that have influence upon the perception of pain. MATERIALS AND METHODS: Forty patients with bilaterally impacted mandibular third molars were included in the study. Venous blood samples were collected before and 24 hours after the surgical procedure in order to test their serum levels of CGRP and procalcitonin. Two weeks later the procedure was repeated. The difficulty of the surgical procedure, its duration and complications were assessed in all patients. RESULTS: The influence of some of the studied factors upon postoperative pain was established. Differences in the sensation of pain between the two sexes were found when comparing pain intensity reported by the patients. Significant difference between pain inten-sity after the 1st and 2nd surgical procedures (6 hours) was found in females (Z=2.63, p=0.009;), whereas in males the difference was observed at 24 hours (Z=1.99; p=0.047). Regarding the existence of sex-related association, а significant, strong positive correlation between CGRP levels after the 1st and 2nd surgical procedures (24 hours) was found in males (rxy=0.78; p=0.004), whereas in females this correlation was also significant, although moderately significant (rxy=0.44; p=0.020). CGRP levels at the first and second extractions were generally similar in males, and not as much in females. We proved significantly moderate positive association between CGRP and pulse levels measured before the second surgery (rxy=0.37, p=0.021). CONCLUSION: The results of our study suggest a significant role of CGRP in reactive (neurogenic) inflammation.