Cytokines in Egyptian Children with Type 1 Diabetes

Type 1 diabetes mellitus (TIDM) is an autoimmune disease characterized by progressive destruction of pancreatic beta cells by genetic and environmental factors which leads to an absolute dependence of insulin for survival and maintenance of health. Objective: To investigate the role of serum IL-1β, IL-2, IL-6, and TNF-a in children with type 1 diabetes mellitus (TIDM) and diabetic ketoacidosis (DKA). Design: Case-control study. Patients and Methods: The study population consisted of 45 children with (TIDM) and 15 healthy controls. Children with TIDM were divided into three subgroups: (1) previously diagnosed patients (long standing TIDM) (n:15), (2) newly diagnosed patients with diabetic ketoacidosis (before treatment) (n:15), and (3) newly diagnosed patients with diabetic ketoacidosis (after treatment by 2 weeks) (n:15). Serum IL-1β, IL- 2, IL-6, and TNF-a levels were measured in all subjects by enzyme linked immunosorbent assay. Results: In comparison to control group, significant higher levels of IL-1β, IL-2, IL-6 and TNF-a were detected in all diabetic groups especially in newly diagnosed diabetics with diabetic ketoacidosis before treatment (group Ill). Conclusion: Our data about elevated serum IL-1β, IL-2, IL-6, and TNF-a levels in newly diagnosed TIDM patients with DKA in comparison with longer standing cases supports an activation of systemic inflammatory process during early phases of TIDM which may be indicative of an ongoing β-cell destruction. Trials of anti cytokines might be tried in the management of newly diagnosed TIDM patients aiming to decrease β-cell destruction.