Circulating leukocyte alterations and the development/progression of diabetic retinopathy in type 1 diabetic patients - a pilot study

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Circulating leukocyte alterations and the development/progression of diabetic retinopathy in type 1 diabetic patients - a pilot study. / Obasanmi, Gideon ; Lois, Noemi; Armstrong, David; Lavery, Nuala Jane; Romero, Jose; Lynch, Aisling; Wright, David; Chen, Mei; Xu, Heping.

In: Current eye research, 30.01.2020.

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Obasanmi, Gideon ; Lois, Noemi ; Armstrong, David ; Lavery, Nuala Jane ; Romero, Jose ; Lynch, Aisling ; Wright, David ; Chen, Mei ; Xu, Heping. / Circulating leukocyte alterations and the development/progression of diabetic retinopathy in type 1 diabetic patients - a pilot study. In: Current eye research. 2020.

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@article{b71cd9dbed824c6a939685b451fb728e,
title = "Circulating leukocyte alterations and the development/progression of diabetic retinopathy in type 1 diabetic patients - a pilot study",
abstract = "Background/Aims: The aim of this study was to investigate the relationship between alterations in circulating leukocytes and the initiation and progression of DR in people with type 1 diabetes (T1D).Methods: Forty-one patients with T1D [13 mild non-proliferative DR (mNPDR), 14 active proliferative DR (aPDR) and 14 inactive PDR (iPDR)], and 13 age- and gender-matched healthy controls were recruited prospectively. Circulating leukocytes, including CD4+ and CD8+ T-cells, CD14+CD16-, CD14-CD16+ and CD14+CD16+ monocytes; CD16+HLA-DR- neutrophils, CD19+ B-cells and CD56+ natural killer cells and their cell surface adhesion molecules and chemokine receptors (HLA-DR, CD62L, CCR2, CCR5, CD66a, CD157 and CD305) were examined by flow cytometry.Results: In DR patients, compared to healthy controls, increased proportions of neutrophils (p = .0152); reduced proportions of lymphocytes (p = .0002), HLA-DR+ leukocytes (p = .0406) and non-classical monocytes (p = .0204); and reduced expression of CD66a (p = .0048) and CD157 (p = .0007) on CD4+ T cells were observed. Compared to healthy controls, CD19+ B cells were reduced at the mNPDR but not aPDR patients. Total lymphocytes, CD4+ T cells and CD8+ T cells progressively decreased whereas neutrophils, the neutrophil/lymphocyte ratio and the neutrophil/CD4+ ratio progressively increased from early to late stages of DR, reaching statistical significance at the aPDR stage. Longer diabetes duration was associated with a reduced proportion of CD8+ T cells (p = .002) and increased neutrophil/CD8+ ratio (p = .033).Conclusions: In this pilot study, DR is associated with increased innate cellular immunity especially neutrophils and reduced adaptive cellular immunity particularly lymphocytes. Impaired B-cell immunity may play a role in the initiation of DR; whereas impaired T-cell immunity with increased neutrophil response may contribute to progression of DR from non-proliferative to proliferative stages in T1D patients. Large multicenter studies are needed to further understand the immune dysregulation in DR initiation and progression.",
keywords = "Type 1 diabetes, diabetic retinopathy, flow cytometry, lymphocytes, neutrophils",
author = "Gideon Obasanmi and Noemi Lois and David Armstrong and Lavery, {Nuala Jane} and Jose Romero and Aisling Lynch and David Wright and Mei Chen and Heping Xu",
year = "2020",
month = jan,
day = "30",
doi = "10.1080/02713683.2020.1718165",
language = "English",
journal = "Current eye research",
issn = "0271-3683",
publisher = "Taylor & Francis",

}

RIS

TY - JOUR

T1 - Circulating leukocyte alterations and the development/progression of diabetic retinopathy in type 1 diabetic patients - a pilot study

AU - Obasanmi, Gideon

AU - Lois, Noemi

AU - Armstrong, David

AU - Lavery, Nuala Jane

AU - Romero, Jose

AU - Lynch, Aisling

AU - Wright, David

AU - Chen, Mei

AU - Xu, Heping

PY - 2020/1/30

Y1 - 2020/1/30

N2 - Background/Aims: The aim of this study was to investigate the relationship between alterations in circulating leukocytes and the initiation and progression of DR in people with type 1 diabetes (T1D).Methods: Forty-one patients with T1D [13 mild non-proliferative DR (mNPDR), 14 active proliferative DR (aPDR) and 14 inactive PDR (iPDR)], and 13 age- and gender-matched healthy controls were recruited prospectively. Circulating leukocytes, including CD4+ and CD8+ T-cells, CD14+CD16-, CD14-CD16+ and CD14+CD16+ monocytes; CD16+HLA-DR- neutrophils, CD19+ B-cells and CD56+ natural killer cells and their cell surface adhesion molecules and chemokine receptors (HLA-DR, CD62L, CCR2, CCR5, CD66a, CD157 and CD305) were examined by flow cytometry.Results: In DR patients, compared to healthy controls, increased proportions of neutrophils (p = .0152); reduced proportions of lymphocytes (p = .0002), HLA-DR+ leukocytes (p = .0406) and non-classical monocytes (p = .0204); and reduced expression of CD66a (p = .0048) and CD157 (p = .0007) on CD4+ T cells were observed. Compared to healthy controls, CD19+ B cells were reduced at the mNPDR but not aPDR patients. Total lymphocytes, CD4+ T cells and CD8+ T cells progressively decreased whereas neutrophils, the neutrophil/lymphocyte ratio and the neutrophil/CD4+ ratio progressively increased from early to late stages of DR, reaching statistical significance at the aPDR stage. Longer diabetes duration was associated with a reduced proportion of CD8+ T cells (p = .002) and increased neutrophil/CD8+ ratio (p = .033).Conclusions: In this pilot study, DR is associated with increased innate cellular immunity especially neutrophils and reduced adaptive cellular immunity particularly lymphocytes. Impaired B-cell immunity may play a role in the initiation of DR; whereas impaired T-cell immunity with increased neutrophil response may contribute to progression of DR from non-proliferative to proliferative stages in T1D patients. Large multicenter studies are needed to further understand the immune dysregulation in DR initiation and progression.

AB - Background/Aims: The aim of this study was to investigate the relationship between alterations in circulating leukocytes and the initiation and progression of DR in people with type 1 diabetes (T1D).Methods: Forty-one patients with T1D [13 mild non-proliferative DR (mNPDR), 14 active proliferative DR (aPDR) and 14 inactive PDR (iPDR)], and 13 age- and gender-matched healthy controls were recruited prospectively. Circulating leukocytes, including CD4+ and CD8+ T-cells, CD14+CD16-, CD14-CD16+ and CD14+CD16+ monocytes; CD16+HLA-DR- neutrophils, CD19+ B-cells and CD56+ natural killer cells and their cell surface adhesion molecules and chemokine receptors (HLA-DR, CD62L, CCR2, CCR5, CD66a, CD157 and CD305) were examined by flow cytometry.Results: In DR patients, compared to healthy controls, increased proportions of neutrophils (p = .0152); reduced proportions of lymphocytes (p = .0002), HLA-DR+ leukocytes (p = .0406) and non-classical monocytes (p = .0204); and reduced expression of CD66a (p = .0048) and CD157 (p = .0007) on CD4+ T cells were observed. Compared to healthy controls, CD19+ B cells were reduced at the mNPDR but not aPDR patients. Total lymphocytes, CD4+ T cells and CD8+ T cells progressively decreased whereas neutrophils, the neutrophil/lymphocyte ratio and the neutrophil/CD4+ ratio progressively increased from early to late stages of DR, reaching statistical significance at the aPDR stage. Longer diabetes duration was associated with a reduced proportion of CD8+ T cells (p = .002) and increased neutrophil/CD8+ ratio (p = .033).Conclusions: In this pilot study, DR is associated with increased innate cellular immunity especially neutrophils and reduced adaptive cellular immunity particularly lymphocytes. Impaired B-cell immunity may play a role in the initiation of DR; whereas impaired T-cell immunity with increased neutrophil response may contribute to progression of DR from non-proliferative to proliferative stages in T1D patients. Large multicenter studies are needed to further understand the immune dysregulation in DR initiation and progression.

KW - Type 1 diabetes

KW - diabetic retinopathy

KW - flow cytometry

KW - lymphocytes

KW - neutrophils

UR - http://www.scopus.com/inward/record.url?scp=85078861025&partnerID=8YFLogxK

U2 - 10.1080/02713683.2020.1718165

DO - 10.1080/02713683.2020.1718165

M3 - Article

JO - Current eye research

JF - Current eye research

SN - 0271-3683

ER -