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Abnormalities of In Vitro Lymphocyte Response to Mitogens in Diabetic Children During Acute Ketoacidosis FREE

David P. Speert, MD; Joseph Silva, MD
[+] Author Affiliations

Reprint requests to Department of Pediatrics, Box 296 Mayo, University of Minnesota Medical Center, Minneapolis, MN 55455 (Dr Speert).


Am J Dis Child. 1978;132(10):1014-1017. doi:10.1001/archpedi.1978.02120350078016.
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• Cell-mediated immunity was evaluated in 11 children with diabetes mellitus; six children were evaluated during ketoacidosis and five were evaluated with ketonuria in the absence of acidosis. Five of the six ketoacidotic children had at least one positive delayed-hypersensitivity skin test. Lymphocytes from two ketoacidotic patients were unresponsive to phytohemagglutinin and pokeweed mitogen, and lymphocytes from these two patients plus a third patient were unresponsive to concanavalin A. Lymphocytes from all six patients responded to these three mitogens after one week of therapy.

In the five diabetic children without ketoacidosis, lymphocyte responses were normal to all three mitogens. Similarly, the addition of glucose to normal plasma did not alter the lymphocyte transformations of three healthy nondiabetic controls. These data suggest that cell-mediated immunity may be transiently defective in children with acute diabetic ketoacidosis.

(Am J Dis Child 132:1014-1017, 1978)

REFERENCES

Hong R, Ammann AJ:  Lymphocytes and delayed hypersensitivity , in Stiehm ER, Fulginiti VA (eds): Immunologic Disorders in Infants and Children. Philadelphia, WB Saunders Co, 1973;, pp 67-84.
Sussman KE: Juvenile-Type Diabetes and Its Complications . Springfield, Ill, Charles C Thomas Publisher, 1975;, pp 165-182.
Scheierson SS:  Diabetes and infection . NY State J Med 62:676-680, 1962;.
Thornton GF:  Infections and diabetes . Med Clin North Am 55:931-938, 1971;.
MacCuish AC, Urbaniak SJ, Campbell CJ, et al:  Phytohemagglutinin transformation and circulating lymphocyte subpopulations in insulindependent diabetic patients . Diabetes 23:708-712, 1974;.
Ragab AH, Hazlett B, Cowan DH:  Response of peripheral blood lymphocytes from patients with diabetes mellitus to phytohemagglutinin and Candida albicans antigen . Diabetes 21:906-907, 1972;.
Delespesse G, Duchateau J, Bastenie PA, et al:  Cell-mediated immunity in diabetes mellitus . Clin Exp Immunol 18:461-467, 1974;.
Brody JI, Merlie K:  Metabolic and biosynthetic features of lymphocytes from patients with diabetes mellitus: Similarities to lymphocytes in chronic lymphocytic leukemia . Br J Haematol 19:193-201, 1970;.
MacCuish AC, Irvine NJ:  Autoimmunologic aspects of diabetes mellitus . Clin Endocrinol Metab 4:435-471, 1975;.
Lindgren BW: Statistical Theory , ed 3. New York, The Macmillan Co Publishers, 1976;, pp 505-511.
David JR, David RR:  Dissociation of skin reactivity and lymphocyte function . Prog Allergy 16:416-420, 1972;.
Sharon N, Lis H:  Lectins: Cell-agglutinating and sugar-specific proteins . Science 177:949-959, 1972;.
Weinstein YW, Melmom KL, Bourne HR, et al:  Specific leukocyte receptors for small endogenous hormones . J Clin Invest 52:1349-1361, 1973;.
Cruickshank AH, Payne TPB:  Antipneumococcal powers of the blood in alloxan diabetes in the rabbit . Bull Johns Hopkins Hosp 84:334-345, 1949;.
Dubos RJ:  Effect of ketone bodies and other metabolites on the survival and multiplication of staphylococci and tubercle bacilli . J Exp Med 98:145-155, 1953;.
Perillie PE, Nolan JP, Finch SC:  Studies of the resistance to infection in diabetes mellitus: Local exudative cellular response . J Lab Clin Med 59:1008-1015, 1962;.
Sheldon W, Bauer H:  The development of the acute inflammatory response to experimental cutaneous mucormycosis in normal and diabetic rats . J Exp Med 110:845-852, 1959;.
Hoagland RJ, Sube J, Bishop RH, et al:  Mucormycosis , Am J Med Sci 242:415-422, 1961;.
Abramson E, Wilson D, Arky RA:  Rhinocerebral phycomycosis in association with diabetic ketoacidosis: Report of two cases and a review of clinical and experimental experience with amphotericin B therapy . Ann Intern Med 66:735-742, 1967;.

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References

Hong R, Ammann AJ:  Lymphocytes and delayed hypersensitivity , in Stiehm ER, Fulginiti VA (eds): Immunologic Disorders in Infants and Children. Philadelphia, WB Saunders Co, 1973;, pp 67-84.
Sussman KE: Juvenile-Type Diabetes and Its Complications . Springfield, Ill, Charles C Thomas Publisher, 1975;, pp 165-182.
Scheierson SS:  Diabetes and infection . NY State J Med 62:676-680, 1962;.
Thornton GF:  Infections and diabetes . Med Clin North Am 55:931-938, 1971;.
MacCuish AC, Urbaniak SJ, Campbell CJ, et al:  Phytohemagglutinin transformation and circulating lymphocyte subpopulations in insulindependent diabetic patients . Diabetes 23:708-712, 1974;.
Ragab AH, Hazlett B, Cowan DH:  Response of peripheral blood lymphocytes from patients with diabetes mellitus to phytohemagglutinin and Candida albicans antigen . Diabetes 21:906-907, 1972;.
Delespesse G, Duchateau J, Bastenie PA, et al:  Cell-mediated immunity in diabetes mellitus . Clin Exp Immunol 18:461-467, 1974;.
Brody JI, Merlie K:  Metabolic and biosynthetic features of lymphocytes from patients with diabetes mellitus: Similarities to lymphocytes in chronic lymphocytic leukemia . Br J Haematol 19:193-201, 1970;.
MacCuish AC, Irvine NJ:  Autoimmunologic aspects of diabetes mellitus . Clin Endocrinol Metab 4:435-471, 1975;.
Lindgren BW: Statistical Theory , ed 3. New York, The Macmillan Co Publishers, 1976;, pp 505-511.
David JR, David RR:  Dissociation of skin reactivity and lymphocyte function . Prog Allergy 16:416-420, 1972;.
Sharon N, Lis H:  Lectins: Cell-agglutinating and sugar-specific proteins . Science 177:949-959, 1972;.
Weinstein YW, Melmom KL, Bourne HR, et al:  Specific leukocyte receptors for small endogenous hormones . J Clin Invest 52:1349-1361, 1973;.
Cruickshank AH, Payne TPB:  Antipneumococcal powers of the blood in alloxan diabetes in the rabbit . Bull Johns Hopkins Hosp 84:334-345, 1949;.
Dubos RJ:  Effect of ketone bodies and other metabolites on the survival and multiplication of staphylococci and tubercle bacilli . J Exp Med 98:145-155, 1953;.
Perillie PE, Nolan JP, Finch SC:  Studies of the resistance to infection in diabetes mellitus: Local exudative cellular response . J Lab Clin Med 59:1008-1015, 1962;.
Sheldon W, Bauer H:  The development of the acute inflammatory response to experimental cutaneous mucormycosis in normal and diabetic rats . J Exp Med 110:845-852, 1959;.
Hoagland RJ, Sube J, Bishop RH, et al:  Mucormycosis , Am J Med Sci 242:415-422, 1961;.
Abramson E, Wilson D, Arky RA:  Rhinocerebral phycomycosis in association with diabetic ketoacidosis: Report of two cases and a review of clinical and experimental experience with amphotericin B therapy . Ann Intern Med 66:735-742, 1967;.

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