Document Type : New and original researches in the field of Microbiology.
Authors
1
Microbiology and Immunology Department, Faculty of Pharmacy, Horus University, Egypt; College of Pharmacy, Uruk University, Baghdad, Iraq
2
Internal Medicine Department, Faculty of Medicine, Horus University, Egypt
3
Mansoura Central Laboratories, Clinical Pathology Department, Ministry of Health, Egypt
4
Mansoura Manchester Medical Program, Faculty of Medicine, Mansoura University, Egypt
5
Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Egypt
6
Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Egypt; Medical Microbiology and Immunology Department, Faculty of Medicine, Northern Border University, Saudi Arabia
7
Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt; Basic Medical Sciences Department, College of Medicine, Al-Maarefa University, P.O.Box71666, Riyadh 11597, Saudi Arabia
Abstract
Background: There is increasing evidence that type 2 diabetes mellitus (T2D) patient has higher risk for hypervirulent Klebsiella pneumoniae (hvKP) infections. Neutrophils achieve different immunological functions such as phagocytosis, and neutrophil extracellular trap (NETs) formation to arrest and eradicate microbes such as hvKp. Physicians have restricted curative approach for treatment of infection due to these superbugs. This necessitates to more understand innate immune arm included in these infections. Objective: This study aimed to investigate in vitro interaction of human NETs (as one of innate immune components) with hvKp in T2D. Methodology: Twenty patients with T2D and twenty age and sex matched healthy persons as healthy controls (HCs) were included in this study. By using clinical-derived hvKp strains, NETs complex testing by immunofluorescence, phagocytosis detection and NETs killing analysis were performed. Results: Direct killing of diabetic patients NETs against hvKp strain significantly decreased compared to NETs of HCs despite NETosis induction was significantly higher in neutrophils of T2D patients, compared to neutrophils of HCs. HvKp showed significantly lower level of phagocytosis compared to the control strain (14.65% vs. 96.43%). However, insignificant difference in the level of phagocytosis was detected between T2D and HCs neutrophils. Conclusion: Our study suggests that impaired NETs bactericidal ability makes diabetic patient more susceptible to develop hvKp invasive infection. This will shed light on a novel NETs dependant therapeutic approach and improved therapeutic plan against hvKP infection in T2D patient.
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