Nihayet BAYRAKTAR, Ataman GÖNEL, İsmail KOYUNCU, Oruç ASLAN, Mehmet ENEŞ, Ahmet UYANIKOĞLU, Mehmet Tevfik BAYRAKTAR, Hamza ERDOĞDU

Akut Pankreatitli Hastalarda Plazma Amino Asit Profilinin İncelenmesi

Amaç: Akut pankreatit (AP), pankreasın kendi enzimlerinin parankim içerisine sızması ve aktive olması ile glandin sindirimi sonucu gelişen, bakteriyel olmayan akut inflamasyonudur. Aminoasitler organizmalarının süreçlerinde metabolik ara maddeler olarak deprotein bloklarının oluşturulmasında önemli rol oynamakta ve metabolomik analizlerin önemli bir parçasını oluşturmaktadır. Amino asidopatiler; AP’li hastalar, akut metabolik dekompansasyonun, bulantı, kusma ve gastroözofageal ve karın ağrısı gibi beslenmede gastrointestinal fonksiyon bozukluğu gösterir. Bu amaçla, plazma aminoasit profilinin akut pankreatitli hastalarda bağlantılı varyasyonu için bir marker olarak rolü alabileceğine dair bu çalışma yapmayı ve akut pankreatit tanısında aminoasit profilinin rolünü değerlendirmektir. Materyal ve Metod : Çalışmaya 65 akut pankreatatli hasta, Çalışılan hastalar da tipik karın ağrısı, serum amilaz ve lipazı üst sınırın 3-5 kat artışı ile konuldu. Sağlıklı kontrol grubunda 50 kişi mevcut hastalık öyküsü ve patolojik durumu olmayanlar seçildi. Plazmada aminoasit profili ölçümü 8045 LC-MS/MS cihazında çalışıldı. Bulgular: Yaptığımız çalışmada akut pankreatitli hastaların serum amino asit profilineki amino asitlerin 1- metil histidine, 2-aminoadipik asit, 2-minobutrik asit, 3-metil histidine, aspartat, sitrulin, glutamin metiyonin ve valine amino asitlerinin anlamlı olarak arttığı; ancak 5-hidroksilizin, alanin, sistine, tirozin ve izolösin seviyeleri nin sağlıklı kontrol grubu ile karşılaştırıldığında anlamlı olarak düştüğü saptandı (p<0.01). Sonuç: Fizyolojik aminoasit konsantrasyonları organların işlevlerine bağlıdır ve patolojik koşullar metabolizmasında değişiklik yapabilir. Son yıllarda, aminoasit profillemesi tıp biliminde metabolik hastalıklar, bazı bilim adamları, akut pankratit hastalarda bir potansiyel belirteç olarak kullanıldığı, diyet proteinleri ve aminoasitler pankreas fonksiyonunu düzenleyebildiğini ileri sürmüşlerdir. Ayrıca pankreatik enflamasyonun oluşmasında pankreasın proteolitik enzimleri rol oynadığı bilinse de inaktif formdaki bu enzimlerin pankreas dokusu içinde hangi mekanizmalarla aktive oldukları halen tartışma konusudur. Aminoasit olan arginin arginaz enzimiyle üre ve ornitine metabolize olmaktadır. Metiyonin ve ornitin amino asitlerinden ise poliaminler olan spermidin, spermin ve pütressinler bileşimleri elde edilir. Poliaminler hücrelerde nükleotid ve protein sentezini uyararak hücre proliferasyonunda önemli görevlerde yer alır. Plazma aminoasitlerinin seviyeleri vücuttaki aminoasitlerin akışına tesir eden tüm faktörlerin net tesirini gösterdi. Enfeksiyonun varlığında oluşan değişikliklerin bu hastaların plazmalarındaki aminoasitler tarafından iletiliyor olabileceği düşünülmektedir. Akut pankreatit enfeksiyonu hastalarda yapacak olduğumuz çalışma sonucunda bazı aminoasitlerin akut pankreatit enfeksiyonlu hastalarda bulunması, bu aminoasitlerin enfeksiyonun gelişimi yönünde önemli bir role sahip olduğunu göstermek ve hekimlere bu konu hakkında karar verirken yardımcı olabilmektir.

Anahtar Kelimeler:

Akut Pankreatit, Serbest Aminoasit profili, LC-MS/MS

Investigation of Plasma Amino Acid Profile in Patients with Acute Pancreatitis

Background: Acute pancreatitis (AP) is a non-bacterial acute inflammation of the pancreas that develops as a result of glandin digestion, with its enzymes leaking and activating into the parenchyma. It plays an important role in the formation of deprotein blocks as metabolic intermediates in the processes of amino acids organisms and forms an important part of metabolomic analysis. Amino acidopathies; Patients with AP show gastrointestinal dysfunction in nutrition such as acute metabolic decompensation, nausea, vomiting and gastroesophageal and abdominal pain. For this purpose, this study is to evaluate the role of the amino acid profile in the diagnosis of acute pancreatitis and that the plasma amino acid profile may play a role as a marker for its associated variation in patients with acute pancreatitis. Materials and Methods: Approximately 65 patients with acute pancreatitis were included in the study. Patients studied were included with typical abdominal pain, a 3-5-fold increase in serum amylase and lipase upper limit. In the healthy control group, 50 people were selected who had no existing disease history and pathological status.Amino acid profile measurement in plasma was examined by 8045 LC-MS / MS device. Results: In our study, the amino acids in the serum amino acid profile of patients with acute pancreatitis significantly increased the amino acids 1- methyl histidine, 2-aminoadipic acid, 2minobutric acid, 3-methyl histidine, aspartate, citrulline, glutamine methionine and valine amino acids; however, 5-hydroxyline, alanine, cysteine, tyrosine and isoleucine levels were found to be significantly decreased compared to the healthy control group (P <0.01). Keywords: Acute Pancreatitis, Free Amino acid profile, LC-MS/MS Conclusion: Physiological amino acid concentrations depend on the functions of organs and pathological conditions can alter metabolism. In recent years, amino acid profiling has been suggested in medicine as a potential marker in metabolic diseases, some scientists, acute pancratitis patients, diet proteins and amino acids have been able to regulate pancreatic function. In addition, although the proteolytic enzymes of the pancreas play a role in the formation of pancreatic inflammation, the mechanisms by which these enzymes in inactive form are activated within the pancreatic tissue are still controversial. Arginine, which is an amino acid, is metabolised to urea and ornithine with the enzyme arginase. Among the amino acids of methionine and ornithine, the combinations of polyamines, spermidine, spermin and butressins are obtained. Polyamines play an important role in cell proliferation by stimulating nucleotide and protein synthesis in cells. Levels of plasma amino acids showed the net effect of all factors affecting the flow of amino acids in the body. It is thought that the changes occurring in the presence of the infection may be transmitted by the amino acids in the plasma of these patients. As a result of our study in patients with acute pancreatitis infection, the presence of some amino acids in patients with acute pancreatitis infection is to show that these amino acids have an important role in the development of the infection and to assist physicians in deciding on this issue.

Keywords:

Acute Pancreatitis, Free Amino acid profile, LC-MS / MS,

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