Efeito do controle metabólico na proliferação in vitro de células mononucleares de sangue periférico de pacientes diabéticos tipo 1 e 2
Palavras-chave:
Cultura de células, Ativação linfocítica, Diabetes mellitus tipo I, Diabetes mellitus tipo II, Hiperglicemia, InfecçãoResumo
CONTEXTO E OBJETIVO: Diabetes mellitus é uma síndrome clínica que freqüentemente leva ao desenvolvimento de complicações crônicas, e também, alta susceptibilidade a infecções, provavelmente devido a um defeito na defesa imunológica, que pode ser relacionada ao controle metabólico da doença. Neste estudo, propomos avaliar o efeito do controle metabólico no comportamento imunocelular de pacientes diabéticos tipo 1 e 2 através da proliferação in vitro de células mononucleares de sangue periférico (PBMC) em pacientes com controle metabólico inadequado e adequado. TIPO DE ESTUDO E LOCAL: Estudo experimental e laboratorial, realizado em hospital universitário. MÉTODOS: Estudamos 11 diabéticos do tipo 1 e 13 do tipo 2 além de 21 controles saudáveis, divididos em dois grupos (11/10), pareados para sexo e idade aos diabéticos tipo 1 e 2. Usamos culturas de PBMCs estimuladas com concanavalina (Con-A) para medir a incorporação de 3H-timidina após 72 horas de cultura de células. As culturas foram realizadas no primeiro dia de internação para os pacientes em controle metabólico inadequado, e repetidas após o controle metabólico adequado. RESULTADOS: O índice de estimulação das culturas estimuladas com Con-A nos diabéticos tipo 1 foi significantemente maior que na cultura de indivíduos saudáveis e diabéticos tipo 2, independentemente do controle metabólico. Além disso, foi observada uma correlação negativa entre o índice de proliferação e o índice de massa corporal e níveis de proteína-C. CONCLUSÃO: O aumento na capacidade de proliferação de linfócitos de diabéticos tipo 1 não é causado por hiperglicemia e/ou insulinopenia relacionada a controle inadequado.
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