Hiper-IgE sendromunda Th17 farklılaşması; IL-17 salınımı ve ROR?t gösterimi

Amaç: Hiper-IgE sendromu (HIES), enfeksiyona duyarlılık ve düşük sayıdaki Th17 hücreleri ile karakterize edilir. Th17 hücreleri fungal ve hücre dışı bakteriyel enfeksiyonların eliminasyonunda önemli rol oynarlar. Bu çalışmada amacımız, HIES hastaları ve sağlıklı kontroller arasında interlökin 17 (IL-17) salgılanması ve ……. (ROR?t) ekspresyonunun ölçülmesi ile Th17 hücrelerinin farklılaşmasını araştırmaktır.Yöntem: Çalışmaya 3 adet HIES tanısı almış çocuk ve 4 adet sağlıklı kontrol alındı. HIES skorları değerlendirildi ve hastaların klinik verileri hastane kayıtlarından toplandı. Th17 farklılaşması, ELİSA yöntemi ile IL-17 üretiminin ve gerçek zamanlı PZR yöntemi ile ROR-?t ekpresyonunun ölçülmesiyle değerlendirildi.Bulgular: HIES hastalarında, peripheral kan mononükleer hücreler (PKMH) ve CD45+RA naif T hücreler Th17 farklılaştırma koşullarında kültüre edildiğinde, IL-17 sitokin seviyesinde sağlıklı bireylere göre önemli derecede azalma gözlendi. Buna ek olarak, sağlıklı kontrollerin IL-17 seviyeleri forbol 12-miristat 13-asetat (FMA) ve iyonomisin uyarımlı durumda uyarımsız duruma göre daha yüksek bulundu. Ayrıca PKMH kültürlerinde IL-17 seviyesi FMA ve iyonomisin uyarımlı durumda, HIES hastaları ve sağlıklı kontroller için uyarımsız koşullarla karşılaştırıldığı zaman önemli derecede yüksek gözlendi. HIES hastasında uyarılmış PKMH’lerdeki ROR?t ekspresyon seviyesi, sağlıklı kontrolün yarı düzeyinde olarak tespit edildi.Sonuç: IL-17 salgılanması ve ROR-?t ifadesinin değerlendirilmesi mutasyon analizleri için aday olan hastaları belirlemek için yapılmalıdır. Ülkemizde bu adımların uygulanması ve bilinen mutasyonları olmayan HIES hastalarının seçimi, yeni genetik bozuklukların keşfedilmesine ve böylece yeni tedavi yaklaşımlarına olanak sağlayacaktır.

Th17 Differentiation in Hyper-IgE Syndrome; IL-17 Secretion and ROR?t Expression

Objective: Hyper-IgE syndrome (HIES) is characterized by susceptibility to infection and low number of Th17 cells. Th17 is believed to be critical in the clearance of fungal and extracellular bacterial infections. Present study investigates the differentiation of Th17 cells by evaluation of interleukin 17 (IL-17) secretion and ….. (ROR?t) expression in HIES compared with healthy subjects.Method: Three children diagnosed with HIES and 4 healthy subjects were enrolled in the study. HIES scores were evaluated and clinical data of patients were collected from their hospital records. At Th17 polarizing conditions, Th17 differentiation was assessed by the secretion of IL-17 with ELISA and the expression of ROR-?t with real time PCR.Results: HIES (n=3) patients showed significantly lower levels of IL-17 secretion compared to the healthy subjects (n=4) regarding the peripheral blood mononuclear cells (PBMCs) and CD45+RA naive T cells cultured in Th17 differentiating conditions. In addition, phorbol 12-myristate 13-acetate (PMA) and ionomycin stimulated IL-17 levels of healthy group were significantly higher than unstimulated conditions. Moreover, PMA and ionomycin stimulated IL-17 levels of PBMC cultures were significantly higher when compared to unstimulated conditions for both HIES patients and healthy subjects. ROR-?t expression level of stimulated PBMCs for HIES patient was detected nearly half of that of the healthy subject. Conclusion: Evaluation of IL-17 secretion and ROR-?t expression should be performed to determine the patients who are candidates for mutation analyses. Performing these steps and selection of HIES patients without known mutations in our country would provide an opportunity to discover new genetic defects and so new therapeutic approaches in HIES.

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