What question did this study set out to answer?

To evaluate vascular complications in pediatric patients with long-standing type 1 diabetes and examine their association with circulating cytokine and chemokine profiles.

January 26, 2024International Journal of Molecular SciencesOpen Access

The Complex Network of Cytokines and Chemokines in Pediatric Patients with Long-Standing Type 1 Diabetes

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Why the study?

Type 1 diabetes causes microangiopathies and macroangiopathies involving numerous cytokines and chemokines, prompting assessment of complications in long-standing disease and their relationship with serum biomarkers.

Do serum cytokine and chemokine concentrations correlate with early microvascular and macrovascular complications in pediatric patients with long-standing Type 1 Diabetes?

Key Points

To evaluate vascular complications in pediatric patients with long-standing type 1 diabetes and examine their association with circulating cytokine and chemokine profiles.
Assessed 52 pediatric patients with type 1 diabetes (disease duration ≥4 years) stratified by disease duration (<7 vs. ≥7 years) and metabolic control (HbA1c <8% vs. ≥8%), alongside 39 healthy controls.
Quantified serum biomarker panels via Luminex technology, evaluated microalbuminuria using 24-hour urine collection, identified retinopathic changes via optical coherence tomography, and measured subclinical atherosclerosis via carotid intima-media thickness.
Patients with type 1 diabetes exhibited markedly higher serum concentrations of EGF, eotaxin/CCL11, MDC/CCL22, sCD40L, TGF-α, and TNF-α compared to healthy controls.
Circulating cytokine concentrations correlated significantly with carotid intima-media thickness, with overall biomarker expression shifting in response to disease duration, glycemic control, and subclinical vascular changes.

Structured PICO

Do serum cytokine and chemokine concentrations correlate with early microvascular and macrovascular complications in pediatric patients with long-standing Type 1 Diabetes?

Population

52 pediatric subjects with Type 1 Diabetes (disease duration ≥4 years) and 39 healthy controls.

Comparator

39 healthy controls

Outcome

Serum biomarker concentrations (cytokines and chemokines) and their relationship with complications (albuminuria, retinopathic changes, subclinical atherosclerosis assessed by IMT)surrogate

Implication

May support biomarker monitoring in long-standing T1D; hypothesis-generating for complication prediction, requiring prospective validation.

Abstract

Type 1 diabetes (T1D) is a progressive disorder leading to the development of microangiopathies and macroangiopathies. Numerous cytokines and chemokines are involved in the pathogenesis of T1D complications. The study aimed to assess the presence of complications in patients with long-standing T1D and its relationship with serum biomarker concentrations. We examined 52 T1D subjects, with a disease duration ≥4 years and 39 healthy controls. The group of T1D patients was further divided into subgroups based on the duration of the disease (<7 years and ≥7 years) and the metabolic control assessed by the HbAlc level (<8% and ≥8%). We used Luminex Technology to assess a wide range of biomarker concentrations. A 24 h urine test was done to evaluate the rate of albuminuria. Optical coherence tomography (OCT) was conducted to detect early retinopathic changes. Subclinical atherosclerosis was assessed by measuring the carotid intima-media thickness (IMT). T1D patients showed remarkably higher concentrations of EGF, eotaxin/CCL11, MDC/CCL22, sCD40L, TGF-α, and TNF-α. Moreover, we reported statistically significant correlations between cytokines and IMT. Biomarker concentrations depend on numerous factors such as disease duration, metabolic control, and the presence of complications. Although the majority of pediatric T1D patients do not present signs of overt complications, it is indispensable to conduct the screening for angiopathies already in childhood, as its early recognition may attenuate the further progression of complications.