Neslihan YILDIRIM SARAL, Cemil AKGÜL, Pervin VURAL

PREEKLAMPSİDE PLAZMA PRO-İNFLAMATUAR VE ANTİ-İNFLAMATUAR SİTOKİN DÜZEYLERİ

Amaç: Sitokinler normal gebeliğin sürdürülmesi ve patolojik durumların ortaya çıkmasında önemli rol oynar. Bu çalışmada preeklampside plazma sitokin paternini incelemek ve hastalığın seyri ile bir ilişkisi olup olmadığını değerlendirmek hedeflenmiştir. Gereç ve yöntem: 25’i sağlıklı ve gebe olmayan (NP), 20’si normotensif gebe (NTP), ve 20’si preeklamptik gebe (PEP) olmak üzere toplam 65 kadının plazma örneklerinde TNFα, IL-1β, IL-12, IL-4 ve IL-10 konsantrasyonları tayin edildi. İstatistiksel değerlendirme Student’s t-, Kruskal-Wallis, Mann-Whitney U- ve Spearman korelasyon testleri ile gerçekleştirildi. Bulgular: NP kadınlara kıyasla, PEP’de pro-inflamatuar ve Th1 sitokinleri olan TNFα, IL-1β, IL-12 artışı ile birlikte anti-inflamatuar ve Th2 sitokinleri olan IL-4 ve IL-10 de artmaktadır. Bununla birlikte, NTP’ye kıyasla PEP’de anti-inflamatuar IL-4 ve IL-10 düzeyleri artmaktadır. Preeklampsi grubunda IL-1β/ IL-10; TNFα/IL-12 arasında pozitif; IL-4/sistolik kan basıncı ve IL-4/LDH arasında ise negatif korelasyon bulundu. Sonuçlar: Anti-inflamatuar sitokin artışı pro-inflamatuar sitokinlerin neden olduğu endotel disfonksiyonuna karşı koyan bir kompensatuar mekanizma olabilir. Anti-inflamatuar sitokinler ile kan basıncı veya bazı karaciğer enzimleri arasında bulunan negatif korelasyon, plazma sitokin düzeyleri ve hastalığın seyri arasında bir ilişki olabileceğini ortaya koymaktadır. Bununla birlikte, preeklampside anne plazmasında IL-4 ve IL-10 konsantrasyonlarının artışının, Th1/Th2 sitokin dengesini etkileyerek, maternal imünorejeksiyondan korumaya çalışan bir cevap olduğunu söyleyebiliriz.

Anahtar Kelimeler:

Preeklampsi, Th1/Th2 sitokinleri, endotel hasarı

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