Pınar YILDIZ, Füsun ŞAHİN, Esra YAZAR ERTAN, Gülden PAŞAOĞLU

Erişkin astımlılarda atopik durum ile tüberkülin yanıtı arasındaki ters ilişki

Giriş: Bu çalışmada tüberküloz infeksiyonu ile atopik ve nonatopik astım arasındaki ilişkinin araştırılması amaçlanmıştir. Materyal ve Metod: Seksen altı astımlı hasta çalışmaya alındı. Hastalar atopi varlığına göre iki gruba ayrıldı. Bunlardan allerji öyküsü ile birlikte standart inhalan allerjenlerle yapılan prick testinde en az bir allerjene pozitif olan 71 hasta atopik astım grubu, allerji öyküsü olmayan ve prick testi negatif bulunan 15 hasta nonatopik astım grubu olarak ayrıldı. Her iki hasta grubu için yaş ve cinsiyet bakımından benzer iki farklı kontrol grubu oluşturuldu. Tüberkülin deri testi yapıldı. Bulgular: Bu çalışmada diğer birçok çalışmadan farklı olarak atopik astımlı grubun yanı sıra nonatopik astımlı bir hasta grubu alındı. Atopik astımlılarda pürifiye protein derivesi değeri kontrol grubuna göre anlamlı olarak düşüktü (p< 0.001). Nonatopik astımlılarda ise pürifiye protein derivesi değeri kontrol grubuna göre daha düşük olmakla birlikte istatistiksel olarak anlamlı değildi. Tüm hasta ve kontroller alındığında, pürifiye protein derivesi ortalama değeri ile total IgE düzeyleri arasında negatif korelasyon mevcuttu. Sonuç: Pürifiye protein derivesi yanıtı atopik astımlılarda belirgin olarak baskılanmış olarak saptanırken nonatopiklerde baskılanma daha hafifti. Mikobakteri infeksiyonu veya BCG aşılamasının, yaşamın erken yıllarında ortaya çıkan atopik astım gelişim riski üzerinde baskılayıcı etkisi olabilecekken, daha ileri yaşlarda ortaya çıkan nonatopik astım gelişimi üze- rinde aynı etkiyi göstermemesinin bu sonuca neden olmuş olabileceği düşünüldü.

Inverse relation between atopic status and tuberculin response in adult asthmatics

Introduction: We aimed to examine the relation between tuberculosis infection and both atopic and nonatopic asthma. Materials and Methods: Eighty six patients with asthma were included. These patients were divided into two groups ac- cording to atopic status. Seventy one patients with positive prick tests to at least one aeroallergen together with history of allergy were named as atopic asthma group, and the other 15 patients with negative prick tests, who do not have any his- tory of allergy were named as nonatopic asthma group. Two different control groups similar in terms of age and gender we- re taken for each group. Tuberculin skin test was done. Results: As a different from most of the previous studies, we included nonatopic asthmatics besides atopic asthma group. PPD value in atopic asthma group was significantly lower (p< 0.001) than the control group. In nonatopic asthmatics, PPD value was also lower than the control group, but it wasn’t statistically significant. When we take all patients and controls, negative correlation was seen between mean PPD value and total IgE levels. Conclusion: PPD reactivity has been detected as remarkably suppressed in atopic asthma group while mildly suppressed in nonatopic asthmatics. The results may be affected by the fact that mycobacterium infection or BCG vaccination may ha- ve suppressive effect on atopic asthma development which comes out in early ages, but they don’t have the same effect on nonatopic asthma development which comes out in elder ages.

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