Sinem GÜRCÜ, Göknur YORULMAZ, Evin KOCATÜRK, Hatice HAMARAT, Melisa ŞAHİN TEKİN, Yeşim KAYA YAŞAR, İ. Özkan ALATAŞ

Graves hastalığında serum neopterin düzeylerinin değerlendirilmesi

Amaç: Graves hastalığı tiroid bezinden tiroid hormonunun sentez ve salınımının arttığı otoimmün temelleri olan bir hastalıktır. Aktive edilmiş T lenfositlerinden salınaninterferon-gamma ( IFN-γ), makrofajların neopterin (NPT) üretmesine ve bunun serum ve diğer vücut sıvılarındaki konsantrasyonunu artırmasına neden olur. NPT ile bu hücrelerin serbest oksijen radikalleri üretmesi arasında bir ilişki vardır. Bu çalışmada Graves hastalığı olan bireylerde serum NPT düzeylerinin ölçülmesi amaçlandı. Gereç ve Yöntem: Çalışmaya, 13 yeni tanı almış Graves hastası (ilk tanı anında ve tedavinin 3. ayında neopterin düzeyi bakıldı) ve endokrinoloji polikliniklerinde en az bir yıldır takip edilen 16 Graves hastası dahil edildi. Herhangi bir hastalığı olmayan 23 sağlıklı bireyin NPT düzeyleri bakılarak kontrol grubu olarak alındı. Katılımcıların kan örneklerinde serbest triiyodotironin (T3), serbest tiroksin (T4), tiroglobulin ve tiroid uyarıcı hormon (TSH) düzeyleri ölçüldü. Bulgular: Serum NPT seviyeleri Graves hastalarında kontrol grubuna göre daha yüksek bulundu (sırasıyla yeni tanı alanlarda 6,66 nmol/L:,tedavinin 3. Ayındaki hastalarda 9,24 nmol/L:, bir yıl ve üzeri süredir takip edilen hastalarda 10,68 nmol/L, kontrol grubunda 1,44 nmol/L , p <0,05,). Sonuç: Serum ve diğer vücut sıvılarında NPT seviyelerinin izlenmesi, otoimmün hastalıkların tanısını, prognozunu ve tedavi etkinliğini değerlendirmede kullanılabilir. Ayrıca NPT, Graves hastalığının tanısının yanı sıra hastalık evresini, tedavi etkinliğini ve immünolojik remisyon durumunu belirlemek için potansiyel bir biyobelirteç olarak öne sürülebilir.

Anahtar Kelimeler:

Neopterin, Graves hastalığı, Hipertiroidizm, Hücresel bağışıklık, Yardımcı T hücreleri.

Evaluation of serum neopterin levels in patients with Graves disease

Aim: Graves' disease is a disease with an autoimmune basis in which the synthesis and release of thyroid hormone from the thyroid gland increases. Interferon-gamma (IFN-γ) released from activated T lymphocytes causes macrophages to produce neopterin (NPT), increasing its concentration in serum and other body fluids. There is a relationship between NPT and the production of free oxygen radicals by these cells. In this study, it was aimed to measure serum NPT levels in individuals with Graves' disease. Material and Method: The study included 13 newly diagnosed Graves' patients (neopterin levels were measured at the time of first diagnosis and at the 3rd month of treatment) and 16 Graves' patients who were followed up in endocrinology outpatient clinics for at least one year. NPT levels of 23 healthy individuals without any disease were taken as the control group. Free triiodothyronine (T3), free thyroxine (T4), thyroglobulin, and thyroid stimulating hormone (TSH) levels were measured in the blood samples of the participants. Results: Serum NPT levels were found to be higher in Graves' patients compared to the control group (6.66 nmol/L in newly diagnosed patients, 9.24 nmol/L in patients at the 3rd month of treatment, 10.68 nmol/L in patients followed for one year or more, 1.44 nmol/L in the control group, respectively, p <0.05). Conclusion: Monitoring NPT levels in serum and other body fluids can be used to evaluate the diagnosis, prognosis, and treatment efficacy of autoimmune diseases. In addition, NPT can be suggested as a potential biomarker to determine disease stage, treatment efficacy, and immunological remission status, as well as the diagnosis of Graves' disease.

Keywords:

Neopterin, Graves disease, Hyperthyroidism, Cellular immunity, T helper cells.,

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