"Unveiling cellular immunity: A study on diabetes mellitus patients with gangrene wounds"
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Apr 19, 2024
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Abstract
Diabetes mellitus experiences disruptions in the immune system, particularly in cellular components. Cells crucial in inflammatory conditions are represented by granulocytes and lymphocytes. However, further explanation is needed regarding the quantities of these cells, especially in diabetes mellitus with gangrene. The research method employed is a quantitative descriptive cross-sectional approach. The research population consists of diabetes mellitus patients with gangrene wounds. The sample size contributing to the study is 14 individuals, representing the total population. Exclusion criteria include patients with other systemic infections. The research findings reveal the frequency distribution of the average granulocyte cell count to be 65.47%, with a standard deviation (SD) of 8.52, a minimum value of 53.3%, and a maximum value of 83.4%. The average lymphocyte cell count is 25.7%, with an SD of 7.97, a minimum value of 10.8%, and a maximum value of 38.7%. In conclusion, the study indicates an increased granulocyte count in 4 individuals or 26.6%, while 10 individuals or 71.4% exhibit normal counts. Conversely, the normal lymphocyte count is observed in 11 individuals or 78.6%, whereas 3 individuals or 21.4% exhibit low counts.
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How to Cite
Meri, M., Meisya F, L. and Liswanti, Y. (2024) “"Unveiling cellular immunity: A study on diabetes mellitus patients with gangrene wounds"”, Science Midwifery, 12(1), pp. 313-321. doi: 10.35335/midwifery.v12i1.1471.
References
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Arıcan, G., Kahraman, H. Ç., Özmeriç, A., İltar, S., & Alemdaroğlu, K. B. (2020). Monitoring the Prognosis of Diabetic Foot Ulcers: Predictive Value of Neutrophil-to-Lymphocyte Ratio and Red Blood Cell Distribution Width. International Journal of Lower Extremity Wounds, 19(4), 369–376. https://doi.org/10.1177/1534734620904819
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Peiseler, M., & Kubes, P. (2019). More friend than foe: The emerging role of neutrophils in tissue repair. Journal of Clinical Investigation, 129(7), 2629–2639. https://doi.org/10.1172/JCI124616
Petrie, J. R., Guzik, T. J., & Touyz, R. M. (2018). Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. Canadian Journal of Cardiology, 34(5), 575–584. https://doi.org/10.1016/j.cjca.2017.12.005
Phillipson, M., & Kubes, P. (2019). The Healing Power of Neutrophils. Trends in Immunology, 40(7), 635–647. https://doi.org/10.1016/j.it.2019.05.001
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Rehak, L., Giurato, L., Meloni, M., Panunzi, A., Manti, G. M., & Uccioli, L. (2022). The Immune-Centric Revolution in the Diabetic Foot: Monocytes and Lymphocytes Role in Wound Healing and Tissue Regeneration—A Narrative Review. Journal of Clinical Medicine, 11(3). https://doi.org/10.3390/jcm11030889
Rodrigues, M., Kosaric, N., Bonham, C. A., & Gurtner, G. C. (2019). Wound healing: A cellular perspective. Physiological Reviews, 99(1), 665–706. https://doi.org/10.1152/physrev.00067.2017
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Ulandari, R., Kurniawan, L. B., Nurahmi, N., & Muhadi, D. (2023). Analysis of NLR in Type 2 Diabetes Mellitus with and without Diabetic Foot Ulcer. Indonesian Journal of Clinical Pathology and Medical Laboratory, 29(2), 185–188. https://doi.org/10.24293/ijcpml.v29i2.1971
Wang, J. (2018). Neutrophils in tissue injury and repair. Cell and Tissue Research, 371(3), 531–539. https://doi.org/10.1007/s00441-017-2785-7
Wilkinson, H. N., Hardman, M. J., & Wilkinson, H. N. (2020). Wound healing : cellular mechanisms and pathological outcomes. Open Biology, 10, 1–14. https://doi.org/http://dx.doi.org/10.1098/rsob.200223
Zhang, K., Ding, S., Lyu, X., Tan, Q., & Wang, Z. (2021). Clinical Laboratory Analysis - 2021 - Zhang - Correlation between the platelet‐to‐lymphocyte ratio and diabetic foot ulcer.pdf. J Clin Lab Anal., 1–6. https://doi.org/https://doi.org/10.1002/jcla.23719 wileyonlinelibrary.com/journal/jcla
Zhu, S., Yu, Y., Ren, Y., Xu, L., Wang, H., Ling, X., Jin, L., Hu, Y., Zhang, H., Miao, C., & Guo, K. (2021). The emerging roles of neutrophil extracellular traps in wound healing. Cell Death and Disease, 12(11), 1–9. https://doi.org/10.1038/s41419-021-04294-3
Arıcan, G., Kahraman, H. Ç., Özmeriç, A., İltar, S., & Alemdaroğlu, K. B. (2020). Monitoring the Prognosis of Diabetic Foot Ulcers: Predictive Value of Neutrophil-to-Lymphocyte Ratio and Red Blood Cell Distribution Width. International Journal of Lower Extremity Wounds, 19(4), 369–376. https://doi.org/10.1177/1534734620904819
Berbudi, A., Rahmadika, N., Tjahjadi, A. I., & Ruslami, R. (2019). Type 2 Diabetes and its Impact on the Immune System. Current Diabetes Reviews, 16(5), 442–449. https://doi.org/10.2174/1573399815666191024085838
Chapple, I. L. C., Hirschfeld, J., Kantarci, A., Wilensky, A., & Shapira, L. (2023). The role of the host—Neutrophil biology. Periodontology 2000, April, 1–47. https://doi.org/10.1111/prd.12490
Chen, L., Deng, H., Cui, H., Fang, J., Zuo, Z., Deng, J., Li, Y., Wang, X., & Zhao, L. (2018). IChen, L., Deng, H., Cui, H., Fang, J., Zuo, Z., Deng, J., Li, Y., Wang, X., & Zhao, L. (2018). Inflammatory responses and inflammation-associated diseases in organs. Oncotarget, 9(6), 7204–7218. https://doi.org/10.18632/oncotarget.23208nflammatory respon. Oncotarget, 9(6), 7204–7218.
Chen, W., & Chen, K. (2021). Neutrophiltolymphocyte-ratio-and-platelettolymphocyte-ratio-predict-mortality-in-patients-with-diabetic-foot-ulcers-undergoing-amputationsDiabetes-Metabolic-Syndrome-and-Obesity.pdf. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 821–829.
Daryabor, G., Atashzar, M. R., Kabelitz, D., Meri, S., & Kalantar, K. (2020). The Effects of Type 2 Diabetes Mellitus on Organ Metabolism and the Immune System. Frontiers in Immunology, 11(July). https://doi.org/10.3389/fimmu.2020.01582
David G. Armstrong, Theresa A. Perales, Randall T. Murff, Gary W. Edelson, & John G. Welchon. (1996). Value of White Blood Cell Count With Differential in the Acute Diabetic Foot Infection. Journal of the American Podiatric Medical Association, 86, 224–227.
Duman, T. T., Aktas, G., Atak, B. M., Kocak, M. Z., Erkus, E., & Savli, H. (2019). Neutrophil to lymphocyte ratio as an indicative of diabetic control level in type 2 diabetes mellitus. African Health Sciences, 19(1), 1602–1606. https://doi.org/10.4314/ahs.v19i1.35
Ead, J. K., & Armstrong, D. G. (2023). Granulocyte-macrophage colony-stimulating factor: Conductor of the wound healing orchestra? International Wound Journal, 20(4), 1229–1234. https://doi.org/10.1111/iwj.13919
Galkowska, H., Wojewodzka, U., & Olszewski, W. L. (2005). Original Research Articles – Basic Science Low recruitment of immune cells with increased expression of endothelial adhesion molecules in margins of the chronic diabetic foot ulcers. Wound Repair and Regeneration, 13(3), 248–254. https://doi.org/https://doi.org/10.1111/j.1067-1927.2005.130306.x
Geng, K., Ma, X., Jiang, Z., Huang, W., Gao, C., Pu, Y., Luo, L., Xu, Y., & Xu, Y. (2021). Innate Immunity in Diabetic Wound Healing: Focus on the Mastermind Hidden in Chronic Inflammatory. Frontiers in Pharmacology, 12(April), 1–19. https://doi.org/10.3389/fphar.2021.653940
George-Gay, B., & Parker, K. (2003). Understanding the complete blood count with differential. Journal of Perianesthesia Nursing, 18(2), 96–117. https://doi.org/10.1053/jpan.2003.50013
Lisco, G., Giagulli, V. A., De Pergola, G., Guastamacchia, E., Jirillo, E., & Triggiani, V. (2021). Hyperglycemia-Induced Immune System Disorders in Diabetes Mellitus and the Concept of Hyperglycemic Memory of Innate Immune Cells: A Perspective. Endocrine, Metabolic & Immune Disorders - Drug Targets, 22(4), 367–370. https://doi.org/10.2174/1871530321666210924124336
Nguyen, A. V., & Soulika, A. M. (2019). The dynamics of the skin’s immune system. International Journal of Molecular Sciences, 20(8), 1–53. https://doi.org/10.3390/ijms20081811
Oliver, T. I., Mutluoglu., M., & Author. (2023). Diabetic foot ulcer. NCBI Bookshelf. A Service of the National Library of Medicine, National Institutes of Health., 1–7. https://doi.org/10.12968/jowc.2020.29.Sup10a.S17
Peiseler, M., & Kubes, P. (2019). More friend than foe: The emerging role of neutrophils in tissue repair. Journal of Clinical Investigation, 129(7), 2629–2639. https://doi.org/10.1172/JCI124616
Petrie, J. R., Guzik, T. J., & Touyz, R. M. (2018). Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. Canadian Journal of Cardiology, 34(5), 575–584. https://doi.org/10.1016/j.cjca.2017.12.005
Phillipson, M., & Kubes, P. (2019). The Healing Power of Neutrophils. Trends in Immunology, 40(7), 635–647. https://doi.org/10.1016/j.it.2019.05.001
Raziyeva, K. (2021). Immunology of acute and chronic wound healing. In Biomolecules (Vol. 11, Issue 5). https://doi.org/10.3390/biom11050700
Rehak, L., Giurato, L., Meloni, M., Panunzi, A., Manti, G. M., & Uccioli, L. (2022). The Immune-Centric Revolution in the Diabetic Foot: Monocytes and Lymphocytes Role in Wound Healing and Tissue Regeneration—A Narrative Review. Journal of Clinical Medicine, 11(3). https://doi.org/10.3390/jcm11030889
Rodrigues, M., Kosaric, N., Bonham, C. A., & Gurtner, G. C. (2019). Wound healing: A cellular perspective. Physiological Reviews, 99(1), 665–706. https://doi.org/10.1152/physrev.00067.2017
Sapra, D. A., & Bhandari, P. (2023). Diabetes. In NCBI (pp. 1–10). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559263/
Short, W. D., Wang, X., & Keswani, S. G. (2022). The Role of T Lymphocytes in Cutaneous Scarring. Advances in Wound Care, 11(3), 121–131. https://doi.org/10.1089/wound.2021.0059
Ulandari, R., Kurniawan, L. B., Nurahmi, N., & Muhadi, D. (2023). Analysis of NLR in Type 2 Diabetes Mellitus with and without Diabetic Foot Ulcer. Indonesian Journal of Clinical Pathology and Medical Laboratory, 29(2), 185–188. https://doi.org/10.24293/ijcpml.v29i2.1971
Wang, J. (2018). Neutrophils in tissue injury and repair. Cell and Tissue Research, 371(3), 531–539. https://doi.org/10.1007/s00441-017-2785-7
Wilkinson, H. N., Hardman, M. J., & Wilkinson, H. N. (2020). Wound healing : cellular mechanisms and pathological outcomes. Open Biology, 10, 1–14. https://doi.org/http://dx.doi.org/10.1098/rsob.200223
Zhang, K., Ding, S., Lyu, X., Tan, Q., & Wang, Z. (2021). Clinical Laboratory Analysis - 2021 - Zhang - Correlation between the platelet‐to‐lymphocyte ratio and diabetic foot ulcer.pdf. J Clin Lab Anal., 1–6. https://doi.org/https://doi.org/10.1002/jcla.23719 wileyonlinelibrary.com/journal/jcla
Zhu, S., Yu, Y., Ren, Y., Xu, L., Wang, H., Ling, X., Jin, L., Hu, Y., Zhang, H., Miao, C., & Guo, K. (2021). The emerging roles of neutrophil extracellular traps in wound healing. Cell Death and Disease, 12(11), 1–9. https://doi.org/10.1038/s41419-021-04294-3