Gönül TEZEL, Osman ÖZTEKİN, Salih KALAY, Mehmet AKDAĞ, Murat TURHAN, Nuray ERİN, Mustafa AKÇAKUŞ, Nihal OYGUR

Adrenokortikotropin hormon ve kortizolün doğum şekline göre epitelyal sodyum kanalları üzerine etkisi

Amaç: Adrenokortikotropin hormon ACTH ve kortizolün etkilediği epitelyal sodium kanalı (ENAC) immatüritesinin Yenidoğanın takipnesinin altta yatan başlıca nedeni olduğuna inanılmaktadır. Bu çalışmanın amacı doğum şekline göre ACTH, kortizol düzeylerinin ve bebeklerin akciğer ENaC alfa subünit ekspresyonunun ilişkisinin araştırılmasıdır.Yöntemler: Çalışmamız prospektif kohort çalışma olarak planlandı. Hastanemizde elektif sezaryen(C/S ) planlanan 18 gebe ve normal spontan doğum(NSD) için başvuran 15 gebe ve onların miad 33 yenidoğan bebekleri çalışmaya dahil edildi. ACTH ve kortizol için kan örnekleri annelerden doğumdan önce ve bebeklerinden doğumdan 1 saat sonra alındı. Bebeklerin ENaC α subunit değerlendirmesi için burun mukoza örnekleri alındı.Bulgular: Sezaryen olan annelerin ACTH ve kortizol düzeyleri NSD yapan annelerin ACTH ve kortizol düzeylerinde daha düşüktü (p<0,001). Sezaryen ile doğan bebeklerin ACTH düzeyleri NSD ile doğan bebeklerin ACTH düzeylerinden anlamlı derecede yüksek (p<0,001) olmasına rağmen kortizol (p=0,078) ve ENaC α subunit düzeyleri arasında fark saptanmadı (p=0,671).Sonuç: Çalışmamızın sonuçları yenidoğan bebeklerde hormonal mekanizmaların annelerinden bağımsız olduğunu göstermektedir. Miad bebeklerde doğum şeklinin ENaC α subünit ekspresyonunu etkileyen ana faktör olmadığını göstermektedir.

Anahtar Kelimeler:

Adrenokortikotropin hormon, Kortizol, Epitelyal sodium kanalı, Doğum yolu

Effect of adrenocorticotropin hormone and cortisol on epithelial sodium channels according to delivery route

Aim: Immaturity of epithelial sodium channels (ENaC), which are affected by adrenocorticotropin hormone (ACTH) and cortisol, is believed to be the major underlying cause of transient tachypnea of the newborn. The aim of this study is to investigate the differences in ACTH and cortisol levels and the expression of lung ENaC α subunit of the babies in relation to mode of delivery.Methods: The study was planned as prospective cohort study. Eighteen women who underwent elective caesarean section (C/S) and fifteen women who admitted to hospital for normal spontaneous delivery (NSD) and their term 33 newborn infants were included in the study. Blood samples for ACTH and cortisol levels were collected from the mothers prior to birth and the newborn infants 1 hour after birth. Nasal mucosa species of the infants were performed to assess ENaC α subunit levels. Results: The ACTH and cortisol levels of mothers of C/S group were lower than the ACTH and cortisol levels of mothers of NSD group (p<0.001). Although the ACTH levels of infants delivered by C/S were significantly higher than the ACTH levels of infants delivered by NSD (p=0.001), no significant difference was identified between them with regards to the levels of cortisol (p=0.078) and ENaC α subunits (p:0.671). Conclusion: Our results suggest that hormonal mechanisms in newborn infants function independently from their mothers. In term babies mode of delivery is not the major factor affecting the expression of ENaC α subunit.

Keywords:

Adrenocorticotropin hormone, Cortisol, Epithelial sodium channels, Delivery route,

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