Integral Hematologic Indices in the Evaluation of the Immunologic Reactivity of the Organism in a Patient With Complication of Type 1 Diabetes Mellitus: A Case of Diabetic Retinopathy After Autologous Mesenchymal Stem Cell Transplant

The search continues for pathogenetically effective measures in autoimmune processes for a number of complications of type 1 diabetes mellitus, in particular, diabetic retinopathy. However, there are few studies of the prognostic and therapeutic values of the systemic autoimmune response in this pathology after transplant of autologous mesenchymal stem cells. Here, we present a 40-year-old patient with complications of type 1 diabetes mellitus (diabetic retinopathy) after mesenchymal stem cell transplant. Based on peripheral blood results, we were able to calculate integral hematologic parameters, allowing us to indirectly assess the patient's immune system after autologous mesenchymal stem cell transplant. One month after autologous mesenchymal stem cell transplant, we observed a positive immune response, with a 40% decrease in leukocyte intoxication index and a 22% increase from the initial lymphocyte and eosinophil ratio index values, which indicated the formation of a delayed-type hypersensitivity reaction. Two months after transplant, stem cell leukocyte intoxication index, in contrast, increased by 10%, indicating a possible metabolic shift. At the same time, changes were observed in the lymphocyte stimulation index value, which increased by 11%.This observation indicated negative immunologic reactivity, namely, poor function of factors of nonspecific resistance due to autointoxication of the organism. However, 3 months after transplant, the hematologic parameters of this patient returned to levels before treatment.The use of integral hematologic parameters can indirectly interpret parallels between immunologic reactivity and metabolic disorders in type 1 diabetes mellitus complications (diabetic retinopathy) after autologous mesenchymal stem cell transplant. These parameters could become a diagnostic indicator in the correction of pathogenetic therapy.