Melissa TATLIDİL AKAL, Burak ÖNAL, Deniz ÖZEN, Bülent DEMİR, Ahmet Gökhan AKKAN, Sibel ÖZYAZGAN

Kardiyak Sendrom X Hastalarında CYP2J2 Polimorfizminin Belirlenmesi

ÖZET Amaç: Tipik anjinaya sahip, invaziv olmayan testlerde iskemi bulgusuna rastlanan ve koroner anjiyografide normal epikardiyal koroner arterlere sahip olan hasta popülasyonu Kardiyak Sendrom X (KSX) olarak tanımlanmaktadır. KSX hastalarında CRP ve diğer inflamatuvar belirteçlerin düzeylerinin artması, hastalığın inflamasyon aracılı bir patogeneze sahip olduğunu gösterir niteliktedir. Sitokrom P450 enzimi olan CYP2J2, koroner arter endoteli, düz kas hücreleri ve kardiyomiyositlerde yüksek düzeylerde eksprese edilen bir hem protein ailesi üyesidir. CYP2J2’nin başlıca görevi, araşidonik asidin; 5,6- 8,9- 11,12- 14,15- olmak üzere 4 farklı çeşit epoksieikozatrienoik asitlere (EET) dönüşümünü sağlamaktır. Bu EET’ler, TNF-α ile uyarılan VCAM-1’in, endotelyal ekspresyonunu azaltarak inflamatuvar yanıt oluşumunu baskılamakta ve NF-κB’yi de inhibe ederek vasküler duvara lökosit adezyonunu azaltmaktadır. CYP2J2 geni -76G>T polimorfizmi, hücre içerisinde CYP2J2 ve metabolitlerinin ekspresyonunda düşüşe neden olmaktadır. Biz bu çalışmamızda, patofizyolojisinde inflamatuvar süreçlerin etkili olduğu düşünülen KSX hastalığı ile inflamatuvar yolakta rol aldığı bilinen CYP2J2 geni -76G>T polimorfizmi arasındaki bağlantıyı incelemeyi amaçladık. Materyal ve Metot: Ardışık 125 KSX hastası ve 125 sağlıklı bireyden oluşan kontrol grubunu, CYP2J2 geni -76G>T polimorfizmi açısından karşılaştırdık. DNA örneklerinden CYP2J2 geni -76G>T polimorfizminin genotiplemesi gerçek zamanlı PCR metodu kullanılarak yapılmıştır. Bulgular: Hasta ve kontrol gruplarında görülen TT, GT ve GG genotipleri incelendiğinde, istatistiksel olarak anlamlı bir fark gözlenmemiştir (p>0,05). Sonuç: Bu durum KSX hastalığının patogenezinde, inflamasyon artışına neden olan CYP2J2 geni -76G>T polimorfizminin önemli bir rolü olmadığını düşündürmektedir.

Anahtar Kelimeler:

kardiyak sendrom X; inflamasyon; CYP2J2; polimorfizm; mikrovasküler disfonksiyon

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