Role of Th1/Th2 Balance in the Pathogenesis of Diabetes Mellitus Complicating Chronic Hepatitis C
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- Category: Vol. 77, June 2009
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Role of Th1/Th2 Balance in the Pathogenesis of Diabetes Mellitus Complicating Chronic Hepatitis C,GHADA MAHMOUD, SHERIF MONIER, AMAL SHAWKY and HALA MAHMOUD
Abstract
Background and Aim: Hepatitis C virus (HCV) infection is a major cause of morbidity and mortality worldwide. HCV mainly affects the liver, but also several other tissues outside the liver have been reported to be involved, resulting in a wide spectrum of extra hepatic manifestations. The association between HCV and type 2 diabetes mellitus has been described. Although the specific mechanisms involved in the pathogenesis of diabetes associated with HCV remain to be elucidated, High levels of proinflammatory cytokines have been found in HCV-infected patients and, thereby, they could be involved in the pathogenesis of insulin resistance associated with HCV.
The aim of present work was to study the role of Th1/Th2 balance (by assessing the levels of IL-2 IL-10) in the patho-genesis of DM in patients with chronic HCV infection.
Methods: Twenty diabetic patients with HCV and 20 non diabetic patients with HCV were studied in addition to 15 healthy control subjects after full history taking and clinical examination, IL-2 and IL-10 were assayed for the all studied groups.
Results: Both HCV groups had higher IL-10 and lower IL-2 in comparison to control group. Diabetic patients showed significantly lower IL-2 levels compared to non diabetic patients (2.81±0.67 versus 3.69±0.92 pg/ml, p<0.05). On the other hand, IL-10 levels were found to be significantly higher in diabetics compared to non diabetic patients (10.11±2.90 versus 7.85±1.94pg/ml, p<0.05). the correlation between IL-2 and different variables in the different studied groups showed that IL-2 correlated positively to serum albumin and negatively to ALT, AST, serum bilirubin (total and direct), FBS and IL-10. On the other hand, The correlation between IL-10 and different variables in the different studied groups showed that IL-10 correlated positively with ALT, AST, S.bilirubin (total and direct), FBS and negatively to serum albumin and IL-2.
Conclusion: It was concluded that Th1/Th2 (i.e. IL2/IL10) imbalance in favor of Th2 is present in chronic HCV infected patients and these changes are much more apparent in those who developed DM. This may open a gate for trials to treat chronic HCV infection and prevent the occurrence of DM in patients with HCV infection by restoring the disturbed Th1/Th2 balance. Therapy with IL-2 cytokines that elevateTh1 response may be tried to prevent the development of DM in HCV infected patients.