İBRAHİM TAYMUR, Nurper ÖZEN ERBERK, Rıza Cumhur BORATAV, Halil YAMAN

İlaç kullanmayan majör depresif bozukluk ve panik bozukluğu hastalarında idrar neopterin düzeyi

Amaç: Monoamin sentezinde rol alan pterinlerin idrar düzeylerinin majör depresif bozukluk ve panik bozukluğu hastalarında ölçülerek sağlıklı bireylerle karşılaştırılması amaçlanmıştır. Yöntem: Çalışmaya 14 panik bozukluğu, 26 depresif bozukluk hastası ve herhangi bir yakınması olmayan 20 sağlıklı gönüllü alınmıştır. Hastalık şiddetinin değerlendirilmesi amacıyla katılımcılara Beck Depresyon Ölçeği, Beck Anksiyete Ölçeği, Panik Agorafobi Ölçeği, Durumluk ve Süreklilik Kaygı Ölçeği uygulanmıştır. Bulgular: Grupların neopterin düzeyleri değerlendirildiğinde depresif bozukluk grubunda 199.6±90.8, panik bozukluğu grubunda 182.9±68.0 ve kontrol grubunda181.4±202.8 μmol/kreatinin olarak bulunmuştur (p=0.030). Depresif bozuklukta neopterin düzeyi kontrol grubuna göre anlamlı olarak yüksektir (p=0.015). Sonuç: Tetrahidrobiopterin (BH4), serotonin, noradrenalin ve dopaminin, tirozin ve triptofandan sentezinde hız kısıtlayıcı enzim olan tirozin hidroksilaz ve triptofan hidroksilaz için kofaktör olarak görev yapmaktadır. Plazma neopterin düzeyindeki artış, BH4 sentez yolundaki aktivasyona ve monoamin düzeylerindeki düşüklüğe işaret eder. Çalışmamızın sonuçlarına göre, monoaminlerin sentezinde rol alan neopterinler ve BH4 düzeyindeki değişikliklerin, panik bozukluğundan çok, depresif bozukluk oluşumunda etkisi olabilir.

Urinary neopterin levels in patients with major depressive disorder and panic disorder who do not receive pharmacologic treatment

Objective: To measure urinary level of pterine which takes place in synthesis of monoamine in major depressive disorder and panic disorder patiens and compare results with healthy group. Methods: Fourteen patients with panic disorder, 26 patients with major depressive disorder and 20 healthy volunteers were included to the study. Beck Depression İnventory, Beck Anxiety İnventory, Panic-Agoraphobia Scale, State-Trait Anxiety İnventory were applied to patients in order to evaluate severity of disorders. Results: Measurement results of neopterin levels were 199.6±90.8 μmol/creatinine in depressive disorder group, 182.9±68.0 μmol/creatinin panic disorder group and 181.4±202.8 μmol/creatinin in control group (p=0.030). Neopterin level in depressive disorder is significantly higher than control group (p=0.015). Conclusion: Tetrahydrobiopterin (BH4) is cofactor of tyrosine hydroxylase and tryptophan hydroxylase, the rate limiting enzymes in synthesis of serotonin, noradrenaline and dopamine from tyrosine and tryptophan. Rise in plasma levels of neopterine means activation in BH4 synthesis and reduction in monoamine levels. According to the results our study, changes in neopterine and BH4 levels may have

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