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Immunological disturbances in T2DM have an association with CMI and an inappropriate immune response may result from the defects in the action of insulin that is required for Tlymphocyte function. ADA, an enzyme distributed in human tissues, is considered a good marker of CMI as well as a marker for insulin function. Dipeptidyl peptidase - 4 (DPP- 4) also known as adenosine deaminase binding protein (ADABP) binds with ADA to activate T lymphocytes. DPP4 inhibitors are currently regarded as potential oral drugs for the treatment of T2DM and have shown improved efficacy over time. This study was conducted in order to make a contribution to the understanding of the effect of DPP-4 inhibitors on the ongoing immune disturbances in T2DM by analysing their serum ADA level and comparing the effect of other commonly prescribed oral anti-diabetic drugs on the activity of this enzyme. A group of 96 newly diagnosed T2DM patients on oral hypoglycemic medication and 46 healthy non-diabetics were enrolled as cases and controls, respectively. 50 subjects were taking a combination drug comprising of SU +Met (Group 1) and 46 were taking an add on DPP-4 inhibitor (Group 2). Serum ADA activity was investigated in the whole study group. It was found to be significantly decreased in group 2 as compared to group 1. A positive correlation between the enzyme activity and HbA1c levels was observed in these patients (Group 2) as well, when compared to cases on other oral anti-diabetic drugs (Group 1) indicating the ability of DPP-4 inhibitors to significantly alter the immune status along with the glycemic status in T2DM.
Type 2 Diabetes Mellitus (T2DM), Cell mediated immunity (CMI), Adenosine Deaminase (ADA), Dipeptidyl peptidase – IV(DPPIV) Inhibitors, Sulfonylurea (SU), Metformin (Met).