Ailesel Akdeniz Atesi olan hastalarda lenfosit alt gruplari ve serum adenozin deaminaz düzeyleri
Serum adenosine deaminase levels and lymphocyte subgroups in familial mediterranean fever
- Ana Sayfa
- Sayılar
- Ailesel Akdeniz Atesi olan hastalarda lenfosit alt gruplari ve serum adenozin deaminaz düzeyleri...
Özet
Giris ve amaç: Ailesel Akdeniz Atesi (AAA) tekrarlayici poliserozit ataklari ile karakterize en sik görülen periyodik sendromdur. AAA olan hastalarda T ve B lenfosit sayilarinda ve bazi sitokinlerin saliniminda anormallikler oldugu bildirilmistir. Bu çalismada; AAA’li hastalarda serum adenozin deaminaz (ADA) düzeylerini ve periferik kan lenfosit alt gruplari yüzdesini tayin etmek ve ADA’nin bu hastalik için bir aktivasyon kriteri olup olmadigini arastirmak amaçlandi. Gereç ve yöntem: Çalismaya AAA olan 17 erkek hasta ile yas ve cinsiyet uyumlu 17 sagli kli birey dahil edildi. AAA klinik tanisi Tel-Hashomer kriterlerine göre kondu. Serum ADA aktivitesi Giusti ve Galanti’nin tanimladigi sekilde kolorimetrik metot ile saptandi. Periferik kan lenfosit alt gruplarinin (CD3+, CD4+, CD8+, CD19+, CD3-CD16+CD56+, aktive T lenfosit) yüzdesini saptamak için ise akim sitometri kullanildi. Bulgular: AAA’li hastalarin remisyon ve atak dönemlerindeki serum ADA düzeyleri arasi nda anlamli farklilik tespit edilmedi. Hasta ve kontrol grubu arasinda da serum ADA düzeyleri açisindan anlamli farklilik yoktu. Lenfosit alt gruplari açisindan remisyon ve atak dönemleri arasinda anlamli bir farkli lik saptanmadi. Ancak remisyon dönemindeki CD4+ T lenfosit (T helper) orani kontrol grubuna göre anlamli yüksek, remisyon ve atak dönemindeki CD8+ T lenfosit (T supressör/sitotoksik) orani ise kontrol grubuna göre anlamli düsük saptandi. CD4/CD8 yüzde oranlari karsilastirildi ginda ise, gerek hasta ve kontrol grubu arasinda, gerekse remisyon ve atak dönemi arasinda istatistiksel olarak anlamli bir farklilik tespit edilmedi. Sonuç: AAA olan hastalarda remisyon ve atak esnasinda serum ADA düzeylerinde anlamli bir degisiklik saptanmamasi, ADA’nin aktivasyon kriteri olarak degerli olmadigini ortaya koymustur. Remisyon ve atak dönemlerinde CD4+ ve CD8+ T lenfosit oranlarinda tespit edilen farkliliklar normal kabul edilen sinirlar içerisinde oldugundan lenfosit alt gruplarinin farkliligindan kaynaklanan anormallikler hastalik patogenezinde rol oynamamaktadir.
Abstract
Background/aim: Familial Mediterranean fever (FMF) is the most frequent periodic syndrome characterized by recurrent attacks of polyserositis. Studies showing the existence of some immunologic abnormalities including changes in T and B cell numbers and cytokines in FMF patients have been reported. In the present study, we aimed to investigate the percentage of peripheral blood lymphocyte subsets and the levels of serum adenosine deaminase (ADA) in patients with FMF and to determine if ADA is an activation criterion for this disease. Materials and methods: Seventeen male patients with FMF and 17 sex- and age-matched healthy volunteers were enrolled into the study. The clinical diagnosis of FMF was based on the Tel-Hashomer criteria. Serum ADA activity was determined by colorimetric method as described by Giusti and Galanti. Flow cytometry was used to determine the percentage of peripheral blood lymphocyte subgroups (CD3+, CD4+, CD8+, CD19+, CD3- CD16+CD56+, active T lymphocyte). Results: No significant difference was found between the acute phase and the remission period of FMF patients when serum ADA levels were considered. Furthermore, no significant difference was found in serum ADA levels between patients and control subjects. When lymphocyte subgroups were compared, there was no significant difference between the acute phase and the remission period of FMF patients. However, the percentages of CD4+ T lymphocytes (T helper) were significantly higher in patients in remission period than those of control subjects, and the percentages of CD8+ T lymphocytes (T suppressor/cytotoxic) were significantly lower in both acute attacks and remission periods than those of control subjects. There were no statistical differences for CD4/CD8 ratios between the study and control groups both at the acute phase and the remission period. Conclusion: There was no statistically meaningful change in ADA levels in the acute phase and the remission period in FMF patients. Because the differences determined in CD4+ and CD8+ T lymphocytes were in normal ranges, the differences arising from lymphocyte subgroup do not play a role in the pathogenesis of FMF.
