DAMAGE TO SPLEEN AND IMMUNE SYSTEM IN GENERAL IN DIABETES MELLITUS (LITERATURE REVIEW).
DOI:
https://doi.org/10.21856/j-PEP.2024.2.10Keywords:
diabetes mellitus, oxidative stress, immune system, immune system damage, reviewAbstract
Diabetes mellitus is an important medical problem that leads to a large number of complications. As is widely known, the immune system is highly susceptible in cases of diabetes, resulting in diverse infectious complications. The study of changes in the immune system in diabetes mellitus is important for understanding their pathogenesis and developing effective methods of treatment and prevention of this disease.
Aim. To establish the patterns of morphological and functional changes in the immune system in diabetes mellitus according to the literature.
Material and Methods. Study and generalization of original and foreign literature, results of meta-analyses and randomized trials.
Results. A study of the literature shows that the main mechanisms of diabetic damage to the immune system are the result of oxidative stress and the development of chronic inflammation in tissues. Additionally as pro-inflammatory cytokines, adhesion molecules, and chemokines, result in endoplasmic reticulum impairment and mitochondrial stress, ultimately initiating cellular programmed cell death and contributing to tissue damage and immune system disruption. With the progression of the disease, characteristic histopathological changes were observed in the spleen, namely: atrophy of the white pulp, fibrous changes in the capsule and trabecular expansion, and increased apoptosis of the splenocytes themselves. At the cellular level, one of the key roles in maintaining chronic inflammation is played by an imbalance of Treg and Th17 cells, decreased natural killer (NK) cell activity, and changes in the M1/M2 ratio, which shifts towards pro-inflammatory macrophages.
Conclusions. Significant progress has been made in the study of changes in the immune system in diabetes over the past decade. It has been established that the effect of oxidative stress on the immune system in diabetes occurs at all levels from cellular to organ, with all cells of the body being affected. Oxidative stress affects the immune system by causing chronic inflammation, which is one of the factors that cause the development of various complications in tissues. It is the disruption of the regulatory mechanisms of the immune system that leads to chronic inflammation in tissues and cellular apoptosis.
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