Regional differences in cell-mediated immunity in people with diabetic peripheral neuropathy

K Pickwell, M Geerts, D van Moorsel, D Hilkman, M Kars, N C Schaper, K Pickwell, M Geerts, D van Moorsel, D Hilkman, M Kars, N C Schaper

Abstract

Aim: To study cell-mediated immunity in the feet of people with type 2 diabetes with polyneuropathy.

Methods: In a cohort comprising people with type 2 diabetes with polyneuropathy (n = 17) and without polyneuropathy (n = 12) and a healthy control group (n = 12) indurations due to delayed-type hypersensitivity responses to intracutaneous Candida albicans antigen were determined in the foot and compared with those in the arm (an area relatively spared in diabetic polyneuropathy). The sizes of indurations on the foot were correlated with electromyographic measurements in the participants with diabetes.

Results: No differences were observed in the median size of indurations between the foot and arm in healthy controls and participants without polyneuropathy; in participants with polyneuropathy, induration sizes on the foot were smaller than on the arm: 0 (95% CI 0 to 1) vs 5 (95% CI 2 to 6) mm (P < 0.01). In participants with diabetes, larger indurations correlated with better nerve function (Spearman's rho 0.35 to 0.39).

Conclusion: Our findings suggest that diabetic peripheral polyneuropathy negatively affects cell-mediated immunity in the foot. (Clinical Trials registry no.: NCT01370837).

© 2019 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

Figures

Figure 1
Figure 1
Median induration (mm) in response to intracutaneous Candida albicans antigen in the arm and foot. DM, diabetes without diabetic peripheral neuropathy; DMDPN, diabetes with diabetic peripheral neuropathy; HC, healthy controls. Error bars represent 95% CIs.

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