Ahmet Selim YURDAKUL, Taci Nevin HOCA, Filiz ÇİMEN, Şükran ATİKCAN, Mustafa BALCI

Kronik obstrüktif akciğer hastalığı olan hastalarda dolaşımdaki adezyon molekülleri

Intravasküler lökositlerin inflamasyon dokusuna göçünde rol alan adezyon moleküllerinin kronik obstrüktif akciğer hastalığı (KOAH) patogenezindeki yeri tartışmalıdır. Bu çalışmadaki amacımız; stabil KOAH'lı hastalar ile sigara içicilerde ve sigara içmeyen sağlıklı kontrol grubunda, hem nötrofil hem de lenfositlerde Mac-1 (CD11b/CD18) ue "Lymphocyte Function Associated Antigen-1 (LFA-1)" ile "Solubl Intracellular Adhesion Molecule-1 (sICAM-1)" düzeylerini incelemek ve hastalığın şiddeti ile ilgili klinik parametrelerle ilişkisini değerlendirmektir. KOAH tanısı alan ue stabil dönemde olan 24 olgu grup l, sigara içen ancak KOAH olmayan 13 olgu grup II ve sigara içmeyen sağlıklı 14 olgu grup III kabul edilerek prospektif olarak çalışmaya dahil edilmiştir. KOAH grubu ise kendi arasında, sigara içen 12 olgu grup IA ve sigara içme öyküsü olmayan ancak biomass maruziyeti olan 12 olgu grup IB olarak incelenmiştir. Tüm olgulardan periferik kan (PK) örneği alınarak; sICAM-1 düzeyi EL1SA yöntemi ile, nötrofil ve lenfositlerde bakılan LFA-1 ve Mac-1 düzeyleri ise flow sitometri yöntemi ile belirlenmiştir, l, II ue III. gruplar arasında PK slCAM-1 ile nötrofil ue lenfositlerde bakılan LFA-1 düzeyleri açısından istatistiksel olarak anlamlı bir fark tespit edilmemiştir. PK nötrofillerinde bakılan Mac-1, grup l'de, grup II ue lll'e göre anlamlı düzeyde düşük bulunmuştur ancak sigara içici grup II ile kontrol grubu olan grup III arasında anlamlı bir fark bulunmamıştır. PK lenfositlerinde bakılan Mac-1 ise, grup I'de, grup II'ye göre istatistiksel olarak anlamlı düzeyde yüksek bulunmuş ancak kontrol grubu ile karşılaştırıldığında anlamlı bir fark bulunmamıştır. Grup IA ile grup IB arasında herhangi bir adezyon molekülünün düzeyi açısından anlamlı bir fark bulunmamıştır. Sonuç olarak; PK nötrofil Mac-1 düzeyinin KOAH hastalığının gelişmesiyle beraber azaldığı, PK lenfosit Mac-1 düzeyinin ise sigara içenlerde azaldığı ancak KOAH meydana geldikten sonra yükseldiği görülmüştür. Ayrıca hem nötrofil hem de lenfositlerdeki LFA-1 ile sICAM-1 düzeyinde sigara içimine ve/veya KOAH'a bağlı herhangi bir değişiklik olduğu saptanmamıştır.

Circulating adhesion molecules in patients with chronic obstructive pulmonary disease

The place of adhesion molecules that have a role in the immigration of intravascular leukocytes to the tissue with inflammation in the pathogenesis of chronic obstructive pulmonary disease (COPD) is controversial Our purpose in this study was to examine the levels of soluble intracellular adhesion molecule-1 (slCAM-1) and Mac-1 (CD11b/CD18), lymphocyte function associated antigen-1 (LFA-l) in both neutrophils and lymphocytes in stable patients with COPD and in the healthy control groups consisting of non-smokers, and in smokers without COPD and also to evaluate the relationship between the parameters related to the severity of the disease. Peripheral venous blood samples of all the individuals were collected, and levels of slCAM-1 was measured quantitatively with ELISA method. Flow cytometry was used forMac-1 and LFA-1 levels. Twenty-four stable patients with COPD (group I), 13 smokers (group II) and 14 healthy non-smokers (group III) were included in this study. In the COPD group, 12 smokers patients were considered as group IA, and 12 patients with non-smokers and biomass exposure were considered as group IB. Ho statistically significant differences were seen in LFA-1 examined in peripheric blood (PB) neutrophils and lymphocytes and sICAM in groups I, II, and III. Mac-1 examined in PB neutrophils was found to be significantly lower in group I when compared to groups II and III, however no difference could be seen in smokers' group of II and the control group III. Mac-1 examined in PB lymphocytes were found to be higher in group I according to group II, however no statistically significant difference was seen between group I and control group. Ho statistically significant differences were seen in all adhesion molecules levels in group IA and group IB. As a result; it was found that Mac-1 levels in PB neutrophils were decreased with the developing of COPD and Mac-1 levels in PB lymphocytes were decreased in smokers, however increased following the development of COPD. Ho differences existed in sICAM and LFA-1 levels dependent on smoking and/or COPD.

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