Mustafa MEN, Ceyhan KUTLU, Demet ILHAN ALGIN, Zafer GÜLBAŞ

Multipl Skleroz’un Değişik Klinik Tiplerinde ve Farkli Evrelerinde Cd4(+) Cd25(+) Regülatuar T Hücre Profili ve Foxp3 Ekspresyonu

Multipl Skleroz patogenezinde otoimmunitenin ortaya çıkışında periferik immun toleransın bozulması önemli rol oynamaktadır. İmmun toleransın sağlıklı işleyişinde regülatuvar T hücreleri ise anahtar rol oynamaktadır. FoxP3 ise regülatuvar T hücreler yeterli ekpresyonu için transkripsiyon faktörü olarak görev almaktadır. Biz bu çalışmayla Mc Donald’s kriterlerine göre klinik olarak kesin MS tanısı almış 12 RRMS (relapsing Remitting Multipl skleroz), 11 SRMS ( Sekonder Relapsing Multipl skleroz), 8 atak RRMS hastası olmak üzere toplam 31 hasta ile 12 sağlıklı kontrol gurubunun regülatuvar T hücre alt tipleri hematoloji laboratuarında akım sitometrisi ile analiz ederek total CD4(+) T lenfosit içerisindeki yüzdeleri ve FoxP3 ekspresyonunu karşılaştırdık. Ataklı 8 RRMS hastasının ise 7 tanesi 1000 mg/ gün İVMP tedavisinden önce ve tedaviden sonra kendi içinde karşılaştırıldı. Sonuçlar istatiksel olarak değerlendirildi. Regülatuvar T hücre profili CD4(+) CD25(+), CD4(+) foxP3(+), CD4(+) CD25(+) foxP3(+),CD4(+) CD25(+) foxP3(-), ve CD4(+) CD25(-) foxP3(+) karşılaştırıldı, hastalar ve kontrol grubu arasında anlamlı fark bulunmadı (p>0.005). Atak öncesi ve atak sonrası IVMP tedavisi sonrası 7 hastanın regülatör hücre profilleri ve foxP3 ekspresyonu arasında anlamlı fark saptanmadı (p>0.05). Ancak, yüksek doz intravenöz metilprednizolon (IVMP) tedavisinin regülatör hücre alt tipleri içinde hafif bir sayısal artış neden olduğu gözlenmiştir. Regülatuvar T hücrelerin MS imunopatogenezinde sayısal yeterliliği yanında işlevsel özelliklerinin önemli rol oynadığı düşünüldü.

Anahtar Kelimeler:

MS, foxP3, immun toleransı, regülatuvar hücre

The Cd4(+) Cd25(+) Regulatory T Cell Profile and Foxp3 Expression and Clinic Associations of in Various Stage and Types of Multiple Sclerosis

In the pathogenesis of MS, impairment of peripheric immune tolerance plays an important critical role in the emergence of autoimmunity. The regulatory T cells play a crucial role in the healthy function of immune tolerance. FoxP3 is a transcription factor which assignment for enough regulatory T cell expression. We compared the total percentage CD4(+) and FoxP3 expression in T lymphocytes in 31 cases including 12 RRMS, 11 SRMS and eight attack which has a definite MS regarding Mc Donald's criteria 12 healthy subjects for regulatory T cell subtypes with analysis flow cytometry in haematology laboratory. Also, we compared 7 cases in a group of 8 RRMS with an attack for before and after 1000 mg/day IVMP. The results have assesment as statistical. The regulatory cell profiles CD4(+) CD25(+), CD4(+) foxP3(+), CD4(+) CD25(+) foxP3(+),CD4(+) CD25(+) foxP3(-), and CD4(+) CD25(-) foxP3(+)of all patients were compared with the healthy control group.No significant differences existed between the groups (p>0.005). The results of regulatory cell profiles and foxP3 expression of 7 patients with attacks before treatment and after IVMP treatment were not significant (p>0.05). However, high-dose intravenous methylprednisolone therapy (IVMP) treatment was observed to cause a slight numerical increase in regulatory cell subtypes. As a consequence, we thought that the regulatory T cells play an important role in the immunopathogenesis of MS as well as its numerical sufficiency.

Keywords:

MS, immune tolerance, foxP3,

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