Expansion of CD14+CD16+ monocytes producing TNF-α in complication-free diabetes type 1 juvenile onset patients

We concentrated on the complication-free phase of juvenile onset type 1 diabetes mellitus (T1DM) searching for associations between concentration of inflammatory factors TNF-α, CRP and VEGF and two monocyte subsets the CD14++CD16− and CD14+CD16+. We analysed a randomly selected group of 150 patients without complications (disease duration 2.74 ± 2.51 years) at the start of the project and 5 years later. They were compared with 24 patients with retinopathy (6.53 ± 3.39 years of disease) and 30 healthy volunteers. Our results indicate that in the complication-free period the concentration of TNF-α significantly increased and continued to increase after retinopathy was established. After 5 years the percentage and absolute number of CD14+CD16+ monocytes doubled in complication-free patients. Our study indicates that the size of CD14+CD16+ monocyte subset may be used alternatively to CRP values as an indicator of inflammation grade. Our results imply the necessity of trials using anti-TNF-α therapy in the complication-free phase of the disease.

► Young patients in complication-free phase of type 1 diabetes mellitus were evaluated. ► During 5-year complication-free T1DM CD14+CD16+ monocytes and TNF-α increased. ► During 5-year complication-free T1DM CD14++CD16− monocytes decreased. ► In complication-free T1DM CD14+CD16+ monocytes indicate grade of inflammation.