doi:10.1038/nindia.2016.148 Published online 15 November 2016
A non-protein amino acid homocysteine, alongside high glucose and other key proteins, could hamper the function of immunity-providing white blood cells, leading to complications associated with diabetes, according to new research by scientists at School of Life Sciences, Manipal University1.
White blood cells or neutrophils provide immunity to the body and help fight pathogens during an infection. One interesting way in which these neutrophils work is by expelling their DNA coated with anti-bacterial/fungal proteins to trap and eliminate pathogens. These structures are called Neutrophil Extracellular Traps (NETs) and the process is NETosis which happens in abundance in diabetics due to the higher levels of circulating homocysteine in their blood.
Diabetics are more prone to recurrent infections and macrovascular (heart attack and stroke) or microvascular (nephropathy, neuropathy, and retinopathy) diseases. The researchers had earlier found that higher level of glucose in diabetics along with proteins such as Interleukin-6make for inefficient and increased NETs production, which could lead to many such complications. Neutrophils get pre-activated due to a diabetic microenvironment in the body and during diabetes associated foot ulcers, they fail to combat infections, the researchers have shown.
Higher level of serum homocysteine is known to increase the risk of cardiovascular diseases. Homocysteine induced NETs also activates platelets, which may lead to clot formation and lead to strokes. The researchers say more studies are needed to investigate how vitamin supplementation could lower homocysteine levels and normalise neutrophil function.
1. Joshi et al. Elevated homocysteine levels in type 2 diabetes induce constitutive neutrophil extracellular traps. Sci. Rep. (2016) doi: 10.1038/srep36362