Determination of the levels of some immunological parameters in H. Pylori and type 2 diabetes patients living in Baghdad

Background: Diabetes is a worldwide health problem and is one of the leading causes of death in the world. The Type 2 Diabetes melitus (T2DM) is usually found in adults. Helicobacter pylori (H. pylori) infection has a wide spread globally where more than half the world's population are colonized and causes gastrointestinal damage and disorders outside the stomach. It has recently been observed that there is increased prevalence of the bacteria in diabetic patients. Aim the study: So this study aims to Investigation H. pylori in adults with T2DM, determine the level of cytotoxin-associated gene A (CagA)- infected virulant strain, as well as to measure some biochemical parameters such as Hemoglobin A1c (HbA1c) and C-Peptide. And compaired it with immunological markers Interlukine 33 (IL-33) and Interlukine 37 (IL-37) and tumor necrosis factor TNF-α. Methods: The current study included (102) patients with T2DM (46) males and (56) females, aged between 20 to 70 years. Blood collected for the period from December 3, 2022 until February 15, 2023, from the Specialized Center for Endocrinology and Diabetes, as well as the National Center for Diabetes Treatment and Research, and Al Kindi Teaching Hospital. affiliated with the Baghdad Health Department - Al-Rusafa, also (15) samples from apperantly healthy adults used as a control included in the total number for comparison. After the serum collection, demographic data from the patients were taken by a form prepared by the research. The rapid test of the chromatographic immunoassay was then carried out to detect H. pylori using the (OnSite CTK), and afterward Cobas e411 was used for HbA1C and C-Peptide mesurements. H. pylori CagA, IL-33 and IL-37 and TNF-α were done tested by using ELISA. Results: The results showed that the prevalence of H. pylori in adults with T2DM was (70.11%), furthermore, the increase in the level of the CagA positive virulant strain of H. pylori was (93.44%) from all T2DM H. pylori positive cases. There were high significant differences between CagA and Gender groups (P=0.000) and in the level of C-Peptide between the groups Hp+ and Hp- (P=0.001). The results of the study also showed significant differences in levels between the study groups (Hp+, Hp-, and control group) with IL- 33 & IL-37 reached (P=0.028, 0.01) respectively, while there were no significant differences with the level of TNF-α as it reached (P=0.354). The study showed the levels of interleukins IL 33 & IL-37 & TNF-α between the two groups of patients with type 2 diabetes (T2DM) ii and the group of healthy controls indicated apparently highly statistically significant differences with the levels of interleukins IL-33 & IL- 37 reached (P=≤0.001) for both, while there were no significant differences with TNF-α. Our study also showed a strong, statistically significant positive correlation between C-Peptide and the study groups (+HP diabetics, -HP diabetics, and the control group) amounting to (Pearson Correlation= 0.324, P≤0.001). It was also shown using Pearson correlation that there is a very strong positive correlation with statistical significance between IL-33 & IL-37 (Pearson Correlation= 0.939, P≤0.001). It was also shown using Pearson correlation that there is a very strong, statistically significant positive correlation between IL-37 and the study groups (HP+ diabetics, HP- diabetics, and the control group) amounting to (Pearson Correlation= 0.298, P≤0.001). Conclusion: The results of this study were determined the prevalence of H. pylori was high among adults with T2DM, and the high CagA positive percentage reflect the prevalence of virulent strain in these adults, which by itself represents a serious risky condition. The study detected that increase in C-Peptide production is related to the presence of the bacteria. Our study also found that the production of TNF-α increased with the effect of H. pylori infection in adults with T2DM. On the other hand, the decrease in the levels of IL-33 and -37 in patients with T2DM may implicated in the generalized immunosuppression status