IMMUNE DYSFUNCTION IN ADOLESCENTS WITH DIABETES MELLITUS TYPE 1 AND MICROANGIOPATHY
The article presents new data on the role of the immune system in the formation of vascular complications in diabetes in adolescents. Objective: to determine the role of the factors of congenital and adaptive immunity in the formation of microangiopathy in CD1. 140 patients with type 1 diabetes mellitus (DM1) and 36 somatically healthy adolescents (control group) were examined. Patients with DM1 were divided into two groups: group I – patients with poor glycemic control of DM1 (n=65); group II-with optimal and suboptimal glycemic control (n=75). The groups were divided into subgroups: Ia (n=50), IIa (n=38) – with microvascular complications; Ib (n=15), IIb (n=37) – without microangiopathy. The determination of the population and subpopulation composition of lymphocytes and peripheral blood monocytes, the level of expression of Toll receptors (TLR-2, TLR-4) was performed by single- and double-parameter phenotyping using reagents from Immunotex (France), Caltag (USA), FITC (isothiocyanate fluorescein) - labeled CD3 +, CD4 +, CD8 +, CD16 +, CD19 +, CD282 +, CD284 +, HLADR + and PE (phycoerythrin) - labeled CD14 +. It was revealed that imbalance of immunoregulatory subpopulations, activation of components of innate immunity are associated with the risk of development of microangiopathies. Conclusion: An increase in the number of NK cells, monocytes expressing TLR-2, TLR-4, can be considered as early markers for the development of microangiopathy, and further study of immune mechanisms will allow detection of preclinical signs of vascular lesions and timely use of appropriate therapeutic measures.