Serum immunoglobulin levels in the course of post- burn hypertrophic scar development with specific reference to immunoglobulin E

Amaç. Yanıklı hastalarda hipertrofik skar gelişimi ile immunoglobulin düzeyleri arasındakiilişkinin IgE düzeyleri ön planda dikkate alınarak incelenmesi. Yöntemler. Bu çalışma yanıknedeni ile kliniğimize yatırılmış 20 hastayı kapsamaktadır. İmmunglobulin A, G, M, E düzeyleriiçin kan örnekleri hastalardan ilk 48 saatte, 10. günde ve 90. günde alınmıştır. Hipertrofik skardeğerlendirmesi Vankouver skar skalası esas alınarak yapılmıştır. Hipertrofik skar ve serumimmunoglobulin düzeyleri ilişki incelenmiştir. Bulgular. Erken dönemde serum IgA, M ve Gdüzeyleri düşmüş ve daha sonar tekrar normale dönmüştür. Serum IgE düzeylerinde ise ciddifarklılıklar söz konusudur. Serum IgE düzeyleri bazı hastalarda normal düzeylerde seyrederken,bazılarında yükselmiş, bazılarında da düşmüştür. Sonuç. Hipertrofik skar gelişimi ile IgA, G ve Marasında herhangi bir ilişki saptanmamıştır. Aynı durum IgE ile hipertrofik skar gelişimi arasındada söz konusu olmakla birlikte IgE düzeylerindeki farklılıklar ilginç olup yazıda tartışma konusuyapılmıştır.

Yanık sonrası hip ertrof ik skar gelişiminde serum immunglobulin E ile diğer immunglobulin düzeylerinin incelenmesi

Aim. The relation between the occurrence of the hypertrophic scar and serum immunoglobulinlevels with specific reference to IgE was investigated in burn patients. Methods. This studyincluded 20 burn patients hospitalized in our clinic. Serum levels of immunoglobulin A, G, M andE were measured in the first 48 hours, on the 10th day and on the 90th day during the treatment.Evaluation of the hypertrophic scar was made using Vankouver scar scale. The relation betweenthe hypertrophic scar and serum levels of each immunoglobulins were analyzed. Results. Serumlevels of immunoglobulin A, G and M decreased in the early postburn period, and they returned tonormal in the following period. There were serious variations in the levels of IgE. In some patientsthe levels stayed within normal ranges, in some of them increased and in some of them decreased.Conclusion. There were no relation among the hypertrophic scar formation and levels ofimmunoglobulins A, G and M. We were unable to find a significant relation between the IgElevels and formation of hypertrophic scars; however, there were some peculiarities which wediscussed.

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1. Niessen FB, Spauwen PHM, Schalwijk J, Kon M. On the nature of hypertrophic scars and keloids: a review. Plast Reconstr Surg 1999; 104: 1435-58.
2. Matheson JD, Clayton CN, Muller MJ. The reduction of itch during burn wound healing. J Burn Care Rehabil 2001; 22: 76-81.
3. Kazeem AA. The immunological aspect of keloid tumor formation. J Surg Oncol 1988; 38: 16-8.
4. Bloch EF, Hall MG Jr, Denson MJ, Slay-Solomon V. General immune reactivity in keloid patients. Plast Reconstr Surg 1984; 73: 448-51.
5. Janssen de Limpens AM, Cormane RH. Studies on the immunologic aspects of hypertrophic scars. Arc Dermatol Res 1982; 274: 259-66.
6. Kischer WC, Shetlar MR, Shetlar CL, Chvapil M. Immunoglobulins in hypertrophic scars and keloids. Plast Reconstr Surg 1983; 71: 821-5.
7. Polacek V, Jira M, Strejcek J, Konigova R. Immunoglobulin E (IgE) in patients with severe burns. Burns Incl Therm Inj 1987; 13: 458-61.
8. Smith CJ, Payne VM, Scott SM, Luterman A. Immunoglobulin E levels and anticollagen antibodies in patients with postburn hypertrophic scars. J Burn Care Rehabil 1997; 18: 411-6.
9. Deitch EA, Wheelahan TM, Rose MP, Clothier J, Cotter J. Hypertrophic burn scars: analysis of variables. J Trauma 1983; 23: 895-8.
10. Larson DL, Abston S, Evans EB, Dobrkovsky M, Linares HA. Techniques for decreasing scar formation and contractures in the burned patient. J Trauma 1971; 11: 807-23.
11. Barlow Y. Tlymphocytes and immunosuppression in the burned patients: a review. Burns 1994; 20: 487-90.
12. Molina V, Blank M, Shoenfeld Y. Intravenous immunoglobulin and fibrosis. Clin Rev Allergy Immunol 2005; 29: 321-6.