Fulya İLHAN, SEVGİ KALKANLI TAŞ, HÜSEYİN ATASEVEN, Nalan MİRZAİ, İ. Halil BAHÇECİOĞLU

Çeşitli kronik karaciğer hastalığı vakalarında T lenfosit subtiplerinin dağılımı

Amaç: Hepatit B erişkinlerde %1-5 oranında kronikleşe- bilen siroz ve hepatosellüler karsinomaya neden olabilen önemli bir enfeksiyon hastalığıdır. Hepatit D ise HBsAg (+) kişilerde gelişen bir enfeksiyondur. Hepatit D virüsü- nün sitopatik etkili olduğu bilinmektedir ancak bu hasta- lığın gelişiminde rol oynayan immün mekanizmalar halen araştırılmaktadır. Bundan dolayı, bu çalışmada çeşitli kro- nik hepatit vakalarında lenfositlerin sayısal değişikliği olup olmadığını araştırmak amaçlandı. Yöntemler: Bu çalışmada, kronik karaciğer hastalığı olan 12’si kadın 10’u erkek toplam 22 hasta değerlendirildi. Bu hastalar 12 kadın 8 erkekten oluşan, 20 kişilik sağlıklı kontrol grubu ile karşılaştırıldı. Hasta ve kontrol grubunun periferik kanlarında flow sitometrik yöntemle CD3, CD4, CD8, CD25, CD56, CD161 ve Vα24 monoklonal antikor- ları kullanılarak T lenfosit alt grupları araştırıldı. Bulgular: Hastaların ve kontrol grubunun yaş ortalama- sı sırasıyla 45.87±11.18 yıl, 41.45±7.23 yıl idi. Hastaların biri hariç tümünde, HBsAg pozitif olarak bulundu.15 has- ta HBsAg yanı sıra Anti Delta pozitifliği de gösterdi. Bu hastaların; 6’sı kronik karaciğer hastalığı, 7’si karaciğer sirozu ve 2’si ise hepatoma tanısı ile izlenmekteydi. Total T lenfosit, CD4+ Th hücre ve CD3+CD56+ NKT hücre- ler ve Vα24+CD161+ NKT hücreler açısından hasta ve kontrol grubu arasında fark saptanmadı. Ancak, CD8+ Tc, CD16+56+ NK hücreler ve CD4+CD25+ regülatör T hücre düzeylerinin, hastaların kanlarında kontrollere göre daha düşük olduğu saptandı. Sonuç: Bu sonuçlar, HBsAg pozitifliğinin sitotoksik yanıttan sorumlu hücrelerde ki azalmaya neden olduğunu ima etmektedir. Ancak kronik hepatitteki immünolojik cevabı açıklayabilmek için ileri çalışmalara ihtiyaç vardır.

The distribution of T lymphocyte subtypes in cases with different chronic liver disease

Objective: Hepatitis B is an important infectious disease, which can cause severe chronic cirrhosis and hepatocellular carcinoma in 1-5 % of adult patients. Whereas, Hepatitis D is a defective virus infection that develops in people with HBsAg (+). It has been known that Hepatitis D virus has a cytopathic effect but the immune mechanisms which play a role in the development of this disease are still under investigation. Therefore, in this study it was aimed to investigate whether lymphocytes numbers change in a variety of patients with chronic hepatitis. Methods: In this study, 22 patients (12 females and 10 males) with chronic liver diseases were examined. These patients were compared to the control group which consists of 20 healthy individuals (12 females, 8 males). A flow cytometry assay was conducted to examine T lymphocyte subgroups using CD3, CD4, CD8, CD25, CD56, CD161 and Vα24 monoclonal antibodies in peripheral blood samples of both patient and control groups. Results: The mean age of patient group and control group were 45.87±11.18 and 41.45±7.23 year respectively. The HbsAg was found to be positive in all patients with the exception of one patient. 15 patients also exhibited Anti Delta Antigen positive as well as HbsAg. Six of these patients have been diagnosed with chronic liver disease, 7 of them have been diagnosed liver chrosis and two of them have been diagnosed with hepathoma. No difference was found between the patients and healthy controls in terms of total T lymphocyte, CD4+Th cells CD3+CD56+ NKT cells and Vα24+CD161+ iNKT cells. However, the levels of CD8+ Tc cells, CD16+56+ NK cells and CD4+CD25+ T lymphocytes were found to be lower in patients bloods as compared to the healthy controls. Conclusions: These results suggest that HbsAg positivity may cause the decreases of the cells which are responsible for cytotoxic response. Nevertheless, further studies are required to explain the immunological response to the chronic hepatitis.

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