Associations of cells from both innate and adaptive immunity with lower nerve conduction velocity: the Maastricht Study

Introduction Distal sensorimotor polyneuropathy (DSPN) is common in people with diabetes but is also found in pre-diabetes. Peripheral nerve myelin damage, which can be assessed by reduced nerve conduction velocity (NCV), is an essential feature of DSPN. Emerging evidence indicates that the developm...

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Main Authors: Dan Ziegler, Michael Roden, Christian Herder, Haifa Maalmi, Kristiaan Wouters, Jeroen H P M van der Velde, Jos P H Reulen, Werner Mess, Casper G Schalkwijk, Nicolaas C Schaper
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/9/1/e001698.full
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author Dan Ziegler
Michael Roden
Christian Herder
Haifa Maalmi
Kristiaan Wouters
Jeroen H P M van der Velde
Jos P H Reulen
Werner Mess
Casper G Schalkwijk
Nicolaas C Schaper
author_facet Dan Ziegler
Michael Roden
Christian Herder
Haifa Maalmi
Kristiaan Wouters
Jeroen H P M van der Velde
Jos P H Reulen
Werner Mess
Casper G Schalkwijk
Nicolaas C Schaper
author_sort Dan Ziegler
collection DOAJ
description Introduction Distal sensorimotor polyneuropathy (DSPN) is common in people with diabetes but is also found in pre-diabetes. Peripheral nerve myelin damage, which can be assessed by reduced nerve conduction velocity (NCV), is an essential feature of DSPN. Emerging evidence indicates that the development of DSPN may involve the activation of the immune system. However, available studies have mainly investigated circulating immune mediators, whereas the role of immune cells remains unclear. Therefore, we aimed to test whether leukocyte subsets are associated with NCV.Research design and methods This cross-sectional study analyzed data from 850 individuals (of whom 252 and 118 had type 2 diabetes and pre-diabetes, respectively) of the Maastricht Study. NCV was measured in the peroneal and tibial motor nerves and the sural sensory nerve and summed to calculate a standardized NCV sum score. Associations between percentages of leukocyte subsets and NCV sum scores were estimated using linear regression models adjusted for demographic, lifestyle, metabolic and clinical covariates.Results After adjustment for covariates, higher percentages of basophils and CD4+ T cells were associated with lower NCV (p=0.014 and p=0.005, respectively). The percentage of CD8+ T cells was positively associated with NCV (p=0.022). These associations were not modified by glucose metabolism status (all pinteraction >0.05). No associations were found for monocytes, eosinophils, neutrophils, lymphocytes, total T cells, Treg cells and B cells.Conclusions The associations of basophils, CD4+ and CD8+ T cells with NCV suggest that cell types from both innate and adaptive immunity may be implicated in the development of DSPN.
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spelling doaj-art-c3d15e07a8534201b9a431309aba48572024-12-12T08:10:08ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972021-03-019110.1136/bmjdrc-2020-001698Associations of cells from both innate and adaptive immunity with lower nerve conduction velocity: the Maastricht StudyDan Ziegler0Michael Roden1Christian Herder2Haifa Maalmi3Kristiaan Wouters4Jeroen H P M van der Velde5Jos P H Reulen6Werner Mess7Casper G Schalkwijk8Nicolaas C Schaper9Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, GermanyDivision of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, GermanyInstitute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, GermanyGerman Center for Diabetes Research, Düsseldorf, GermanyDepartment of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, The NetherlandsDepartment of Nutrition and Movement Sciences, Maastricht University, Maastricht, The NetherlandsDepartment of Clinical Neurophysiology, Maastricht University Medical Center+, Maastricht, The NetherlandsDepartment of Clinical Neurophysiology, Maastricht University Medical Center+, Maastricht, The NetherlandsDepartment of Internal Medicine, Maastricht University Medical Centre, Maastricht, The NetherlandsDepartment of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, The NetherlandsIntroduction Distal sensorimotor polyneuropathy (DSPN) is common in people with diabetes but is also found in pre-diabetes. Peripheral nerve myelin damage, which can be assessed by reduced nerve conduction velocity (NCV), is an essential feature of DSPN. Emerging evidence indicates that the development of DSPN may involve the activation of the immune system. However, available studies have mainly investigated circulating immune mediators, whereas the role of immune cells remains unclear. Therefore, we aimed to test whether leukocyte subsets are associated with NCV.Research design and methods This cross-sectional study analyzed data from 850 individuals (of whom 252 and 118 had type 2 diabetes and pre-diabetes, respectively) of the Maastricht Study. NCV was measured in the peroneal and tibial motor nerves and the sural sensory nerve and summed to calculate a standardized NCV sum score. Associations between percentages of leukocyte subsets and NCV sum scores were estimated using linear regression models adjusted for demographic, lifestyle, metabolic and clinical covariates.Results After adjustment for covariates, higher percentages of basophils and CD4+ T cells were associated with lower NCV (p=0.014 and p=0.005, respectively). The percentage of CD8+ T cells was positively associated with NCV (p=0.022). These associations were not modified by glucose metabolism status (all pinteraction >0.05). No associations were found for monocytes, eosinophils, neutrophils, lymphocytes, total T cells, Treg cells and B cells.Conclusions The associations of basophils, CD4+ and CD8+ T cells with NCV suggest that cell types from both innate and adaptive immunity may be implicated in the development of DSPN.https://drc.bmj.com/content/9/1/e001698.full
spellingShingle Dan Ziegler
Michael Roden
Christian Herder
Haifa Maalmi
Kristiaan Wouters
Jeroen H P M van der Velde
Jos P H Reulen
Werner Mess
Casper G Schalkwijk
Nicolaas C Schaper
Associations of cells from both innate and adaptive immunity with lower nerve conduction velocity: the Maastricht Study
BMJ Open Diabetes Research & Care
title Associations of cells from both innate and adaptive immunity with lower nerve conduction velocity: the Maastricht Study
title_full Associations of cells from both innate and adaptive immunity with lower nerve conduction velocity: the Maastricht Study
title_fullStr Associations of cells from both innate and adaptive immunity with lower nerve conduction velocity: the Maastricht Study
title_full_unstemmed Associations of cells from both innate and adaptive immunity with lower nerve conduction velocity: the Maastricht Study
title_short Associations of cells from both innate and adaptive immunity with lower nerve conduction velocity: the Maastricht Study
title_sort associations of cells from both innate and adaptive immunity with lower nerve conduction velocity the maastricht study
url https://drc.bmj.com/content/9/1/e001698.full
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