Original paper
Pro-atherogenic alterations in NKT cell counts in peripheral blood of patients with pre-diabetes

Introduction and aim : The incidence of atherosclerosis and cardiovascular disease is elevated long before the clinical diagnosis of diabetes, and is even observed in pre-diabetes. It was noted that NKT cells, the unique population of T lymphocytes expressing both CD3+ and CD16+56+ antigens, may play an essential role at the very early stages of atherosclerotic plaque development. There are currently no data concerning alterations in NKT cell subsets in the peripheral blood of patients with overt diabetes type 2 and in subjects with pre-diabetes. The present study was undertaken to assess whether the prevalence of NKT cells in peripheral blood undergoes modification in patients at different dysglycaemia levels.

Methods and results : Twenty-five patients with type 2 diabetes, 15 patients with pre-diabetes and 14 healthy individuals were included in the study. Measurements were made of fasting glucose levels, HbA1c, lipid profile and lymphocyte receptor expression (CD45+, CD3+, CD16+56+). The mean counts of CD3+CD16+56+ cells were significantly higher in patients with pre-diabetes compared to both patients with diabetes and to healthy controls. These differences between the groups were related predominantly to glycaemic status. A negative correlation was found between HbA1c and CD3+CD16+56+ cells.

Conclusions : These results suggest that an increased number of NKT cells in peripheral blood in association with the pre-diabetic state could be related to the initiation of atherosclerosis. Therefore the development of NKT cell-based therapy in the future might be an option to reduce atherosclerosis-dependent cardiovascular risk in patients with mild forms of dysglycaemia.