Bahriye ATMIŞ, Yurdanur KILINÇ, Mustafa YILMAZ, Anıl ATMIŞ, Barbaros Şahin KARAGÜN, Hatice İlgen ŞAŞMAZ

Orak hücreli anemisi olan çocuklarda T helper, T sitotoksik ve doğal öldürücü hücre profili ve klinik prognozla ilişkisi

Amaç: Orak hücreli anemide iskemik atakların T hücre profiline, immun fonksiyonlara ve klinik prognoza etkisinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Bu çalışmaya 29 orak hücreli anemi hastası çocuklar çalışmaya dahil edildi. Çalışma grubu vazo-oklüzif kriz ve kriz dışı döneminde olan hastalardan oluşmaktaydı. Kontrol grubu olarak aynı yaş grubunda 24 sağlam çocuk alındı. Tüm çocuklardan tam kan sayımı, hemoglobin elektroforezi, kan biyokimyası çalışıldı. T hücre profilini belirlemek için akım sitometri yöntemi kullanıldı.Bulgular: Orak hücre anemili hastaların kriz dönemlerinde bakılan HbS ortalaması %83.8±6.6 bulundu. Orak hücre anemili hastaların kriz dönemlerinde bakılan CD3 değerleri (%62.31±7.79) aynı hastaların stabil dönemlerinde bakılan CD3 değerlerine (% 65,53±5,72) ve kontrol grubunda bakılan CD3 değerlerine (% 69,09±9,18) göre anlamlı olarak daha düşük bulundu. Orak hücre anemili hastaların kriz dönemlerinde bakılan doğal öldürücü T hücre değeri (%13.07±7.67) kontrol grubuna (%8.11±4.67) göre anlamlı olarak daha yüksek bulundu. Sonuç: Çalışma sonucunda kronik hemoliz ve doku hipoksisi ile seyreden orak hücre anemili hastalarda toplam T hücre sayısını gösteren CD3 değerleri vazo-oklüzif kriz döneminde kontrol grubuna göre daha düşük saptandı.. Doğal öldürücü T hücre seviyeleri çalışma grubunda kontrol grubuna göre yüksek bulundu.

Anahtar Kelimeler:

çocukluk çağı, doğal ödürücü T hücre, orak hücreli anemi, T hücre profili, vazo-oklüzif kriz

T helper, cytotoxic T, and natural killer T cell profiles and their association with clinical prognosis in children with sickle cell anemia

Purpose: Our aim was to determine the effects of ischemic attacks on T cell profiles, immune functions and clinical prognosis in patients with sickle cell anemia.Materials and Methods: The study group consisted of 29 sickle cell anemia patients who were either in vaso-occlusive crisis or in steady state. Twenty-four age-matched healthy children served as the control group. All patients underwent complete blood cell count, hemoglobin electrophoresis, and blood chemistry analysis. Flow-cytometry was used to assess the T-cell profiles.Results: The mean HbS in sickle cell anemia patients during vaso-occlusive crisis was 83±6.6%. The CD3 levels of patients in vaso-occlusive crisis (62.31±7.79%) were lower compared to steady state (65.53±5.72 %) and healthy controls (69.09±9.18%). The NK T cell percentages of patients in vaso-occlusive crisis (13.07±7.67%) were higher than the control group (8.11±4.67%). Conclusion: Total T lymphocyte levels were found to be significantly lower in sickle cell anemia patients during vaso-occlusive crisis compared to healthy controls. NK T cell levels of the study group were higher than that of the control group.

Keywords:

children, natural killer t cells, sickle cell anemia, T cell profile, vaso-occlusive crises,

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