دراسة مناعية وبكتريولوجية للنساء الحوامل التي تعاني من السكري واخماج المسالك البولية

Immunological and Bacteriological Study of Pregnant Diabetes Femals with Urinary Tract Infections

ABSTRACT

The function of the immune system is to distinguish between self and non-self in order to eliminate toxins, allergens, and potential pathogens without harming the host’s tissues.
Autoimmune diseases are a diverse group of conditions characterized by reactivity (abnormal B cells, T cells, and normal components of the host).
Diabetes is a disorder in which there is insufficient production of insulin or decreased sensitivity to it. Blood sugar levels rise and excess sugar is excreted in the urine. Symptoms include increased urine production, thirst, weight loss, and weakness. It includes two basic types:
Type 1 or insulin-dependent diabetes is an autoimmune disease in which insulin is not produced. It must be treated with insulin injections.
Type 2, or non-insulin-dependent diabetes, where tissues do not respond to insulin, is linked to genetics and obesity and can be controlled by diet.
Gestational diabetes is high blood sugar in a pregnant woman who had not previously been diagnosed with diabetes before pregnancy. The study aims to determine the frequency of infection with microorganisms and its relationship to some immune indicators in pregnant women with type 1 and type 2 diabetes. This will be done through the effect of some immune markers in pregnant women with both types of diabetes (CD4, CD19, CD28, CD86, TLR-4) on the recurrence of infection.
This study was conducted in Karbala Governorate. This study included 90 samples and was divided into six groups: A1 pregnant women with type 1 diabetes with a bacterial infection 10, A2 pregnant women with type 1 diabetes without a bacterial infection 14, and B1 pregnant women with type 2 diabetes with an infection. . . Bacterial B2, 16 Pregnant women with type 2 diabetes without bacterial infection, 18 C1 Healthy pregnant women without diabetes and without bacterial infection, C2, 17 Non-pregnant women without diabetes and without bacterial infection, 15 Age range of women (19 – 40) Years. Samples were collected. From the Obstetrics and Gynecology Hospital in Karbala and the Al-Hassan Center for Endocrinology and Diabetes in Karbala during the period from November 2022 to January 2023, and immunological tests were conducted in the research laboratory of the College of Medicine, Al-Nahrain University, and the rest of the tests included DNA extraction and the use of polymerase chain reaction technology to determine the presence of the CsgA gene.
The results were the appearance of bacterial isolates such as Escherichia coli, Klebsiella pneumonia, Staphylococcus haemolyticus, Staphylococcus epidermidis, and Enterobacter cloacae with a probability of 85%, 85%, 98%, 95% and 85%, respectively (Appendix II). It was noted in the study that 55.1% of these patients were infected with a urinary tract infection, which was distributed in the form of Escherichia coli bacteria (46.9%), 25% were infected with K. pneumoniae bacteria, and 6.3% were infected with K. pneumoniae bacteria. Intestinal bacteria. cloacal bacteria. Bacteria, and 9.3% were infected with K. pneumoniae bacteria. They were infected with staph. Skin, and 12.5% suffer from urinary tract infections. Information obtained from patients included age, smoking, blood pressure, duration of diabetes, type of treatment, weight measurement, and other diabetes-related diseases in the targeted samples. Bacterial infections (UTI) in pregnant women with diabetes affect levels of CD4+ T cells and CD19+ B cells. The CsgA gene found in Gram-negative bacteria plays a role in bacterial virulence.
There were also statistically significant differences in CD4 + T cell levels at P < 0.0001 (CD19 + B cell levels, CD86, CD28, and TLR-4) due to the effect of bacterial infection. T1DM and T2DM, there was no difference in the levels of red blood cells and platelets, and there were no significant differences in red blood cells and platelets in pregnant women with type 1 or type 2 diabetes, with or without bacteria, as We noticed the role of the pregnancy factor and its effect on immune markers by increasing or decreasing the immune response, thus weakening immunity and microorganisms overpowering the immune system, leading to recurrence of bacterial infections or vice versa. We also noticed a decrease in T cells in pregnant women with type 2 diabetes. The first, with or without infection. We observed a decreased number of B cells in pregnant women with type 2 diabetes in the presence of bacterial infection, and this may indicate their relationship and impact on the development of type 2 diabetes.
It can be concluded that bacterial infection in diabetic patients causing urinary tract infections, especially bacteria that express the CsgA gene, led to the activation of the adaptive immune response represented by B and T cells.