Ö. ÇOĞULU, H. ONAY, C. GÜNDÜZ, A. EKMEKCİ, F. ATLİHAN, F. ÖZKINAY

Evaluation of the polymorphisms of genes affecting thrombosis throughout sepsis in children

Amaç: Sepsisin klinik gidişindeki kişisel farklılıklardan, hastalığın genetik kökeni ve sepsise yatkınlık yarattığı düşünülen genlerde bulunan polimorfizmler sorumlu olabilir. Sepsis ve koagülasyon arasındaki ilişki araştırmacıları koagülasyonda rol oynayan faktörlerin polimorfizmlerini araştırmaya yönledirmiştir. Bu çalışmada sepsisli ve septik şoklu olan çocuk hastalarda Factor V Leiden, Factor V 1299, prothrombin, Factor XIII, beta-fibrinogen, plasminogen activator inhibitor 1, glycoprotein III, MTHFR, Apo E genlerindeki polimorfizmlerin araştırılması hedeflenmiştir. Yöntem ve Gereç: Sepsisli 92 çocuk hasta ve 92 sağlıklı çocuk çalışmaya dahil edilmiştir. Genotiplendirme reverse hibridizasyon yöntemi ile yapılmıştır. Hasta grubunda 20 çocuk septic şoka girmiştir. Bulgular: Sepsis grubunda 16 vakada (%17,4) kan kültürü pozitif saptanmıştır. Kültür pozitif olguların 7' sinde (%43,7) Pseudomonas aeruginosa, 3' ünde (%18,7) Klebsiella pneumoniae, 2' sinde (%12,5) Streptococcus pneumonia, birinde (%6,3) Enterococcus faecalis ve birinde (%6,3) Candida albicans saptanmıştır. Tüm genotipler için kontrol grubu ile sepsis, septik şok ve sepsise bağlı ölüm olan gruplar arasında anlamlı bir fark saptanmamıştır. Sonuç: Çocuklarda sepsis ya da buna bağlı sonuçların sıklığı üzerinde, tromboz sürecini etkileyen araştırılan genlerdeki polimorfizmlerin rolü olmadığı görülmüştür.

Sepsisli çocuklarda trombozu etkileyen genlerdeki polimorfizmlerin değerlendirilmesi

Aim: Since the clinical course of sepsis exhibits individual variance, its genetic background and the polymorphisms found in the genes which may be responsible for the predisposition to sepsis have been investigated. The interaction between coagulation and sepsis has directed researchers to investigate the genetic polymorphisms of those factors. We aimed to determine the polymorphisms of Factor V Leiden, Factor V 1299, prothrombin, Factor XIII, beta-fibrinogen, plasminogen activator inhibitor 1, glycoprotein III, MTHFR, Apo E in children with sepsis and septic shock. Material and Methods: Ninety-two children with sepsis and ninety-two healthy children were included into the study by using a reverse-hybridization assay. Among the study group 20 cases developed septic shock (10 of nonsurvivors was in the septic shock group, 4 in the sepsis group). Results: Among the sepsis group, a total of 16 cases had (17.4 %) positive blood cultures. The microorganisms were Pseudomonas aeruginosa in 7 cases (43.7 %), Klebsiella pneumoniae in 3 (18.7 %), Eschherichia coli in 2 (12.5 %), Streptococcus pneumonia in 2 (12.5 %), Enterococcus faecalis in 1 (6.3 %) and Candida albicans in 1 (6.3 %). No statistically significant difference associated with all the polymorphisms between the groups of sepsis, septic shock and nonsurvivors compared to healthy group was achieved. Conclusion: The polymorphisms investigated in the proteins having a role in the thrombosis process were not found to have a significant effect on the incidence of developing sepsis or outcome of sepsis in children.

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