Ahmet Hakan GEDİK, Fatih DİLEK, Özkaya EMİN, Mebrure YAZICI, Erkan ÇAKIR, Bilge GÜLTEPE

Alerjik rinitli çocuklarda nazal sıvı β-defensin 2 düzeylerinin incelenmesi

Amaç: Son yıllarda doğal immün sistemin alerjik hastalıkların patogenezindeki rolü konusunda bilgi birikimi artmaktadır. Antimikrobiyal peptidlerden olan defensinler doğal immün sistemin önemli bileşenlerindendir. Defensinler bakteri, virüs ve mantar enfeksiyonlarına kar- şı güçlü etkinlik gösterirler. Ayrıca; antitümoral immünite, kemotaksi, enflamasyon ve yara iyileşmesi gibi birçok fizyolojik süreçte düzenleyici işlevleri vardır. Bu çalışmamızda alerjik rinitli çocukların nazal sıvılarındaki ?-defensin 2 düzeylerini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışma ve kontrol grupları; 28 yeni tanı konulmuş, hiç tedavi almamış alerjik rinit tanılı hasta ve 23 sağlıklı çocuktan oluşturuldu. Alerjik rinit tanılı hastalara alerjenlerle deri testleri yapıldı ve hastalığın şiddeti toplam belirti puanı kullanılarak değerlendirildi. Hasta ve kontrol grubunun nazal sıvıları değiştirilmiş bir poliüretan sünger absorbsiyon yöntemi ile toplandı ve ?-defensin 2 düzeyleri ELISA yöntemi ile ölçüldü. Bulgular: Alerjik rinit tanılı hastaların nazal sıvı ?-defensin 2 düzeylerinin ortanca değeri 173,8 pg/mL (çeyrekler aralığı; 54,8-205,9) iken kontrol grubunun ortanca ?-defensin 2 değeri 241,6 pg/mL (163,5- 315,2) idi. Gruplar arasında istatistiksel olarak anlamlı farklılık vardı (p=0,01). Ayrıca, nazal sıvı ?-defensin 2 düzeyleri ve toplam belirti puanı arasında anlamlı bir negatif korelasyon izlendi (rho:-0,78, p

Evaluation of nasal fluid β-defensin 2 levels in children with allergic rhinitis

Aim: Knowledge about the role of the innate immune system in thepathogenesis of allergic diseases has been expanding in recent years.Defensins are antimicrobial peptides that are components of the innateimmune system. Defensins have strong efficacy against bacterial,viral, and fungal infections. Moreover, they have regulatory functions inmany physiologic processes such as antitumoral immunity, chemotaxis,inflammation, and wound healing. In this study, we aimed to investigateβ-defensin 2 levels in the nasal fluids of children with allergic rhinitis.Material and Methods: Study and control groups consisted of 28 patientswith newly diagnosed allergic rhinitis who were not taking anymedication, and 23 healthy children. Skin prick tests were performedon patients with allergic rhinitis and disease severity was assessed usingthe total symptom score. Nasal fluid samples were obtained usinga modified polyurethane sponge absorption method from patientsand control subjects. Nasal fluid β-defensin 2 levels were determinedusing an enzyme-linked immunosorbent assay (ELISA).Results: The median value of nasal fluid β-defensin 2 levels were173.8 pg/mL (interquartile range; 54.8-205.9 pg/mL) in allergic rhinitisgroup and 241.6 pg/mL (163.5-315.2 pg/mL) in the control group.There was a statistically significant difference between the two groups(p=0.01). Moreover, nasal fluid β-defensin 2 levels showed a significantnegative correlation with total symptom scores (rho= -0.78, p

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1. Tuncer A, Yuksel H, editors. Allerjik rinit tanı ve tedavi rehberi 2012. Ankara: Bilimsel Tıp Yayınevi; 2012.
2. Mallol J, Crane J, von Mutius E, Odhiambo J, Keil U, Stewart A; ISAAC Phase Three Study Group. The international study of asthma and allergies in childhood [ISAAC] Phase Three: a global synthesis. Allergol Immunopathol (Madr) 2013; 41: 73-85. [CrossRef ]
3. Kurt E, Metintas S, Basyigit I, et al. Prevalence and risk factors of allergies in Turkey: Results of a multicentric cross-sectional study in children. Pediatr Allergy Immunol 2007; 18: 566-74. [CrossRef ]
4. Melvin TA, Ramanathan M Jr. Role of innate immunity in the pathogenesis of allergic rhinitis. Curr Opin Otolaryngol Head Neck Surg 2012; 20: 194-8. [CrossRef ]
5. Auvynet C, Rosenstein Y. Multifunctional host defense peptides: Antimicrobial peptides, the small yet big players in innate and adaptive immunity. FEBS Journal 2009; 276: 6497–508. [CrossRef ]
6. Wang G. Human antimicrobial peptides and proteins. Pharmaceuticals 2014; 7: 545-94. [CrossRef ]
7. Mattar EH, Almehdar HA, Yacoub HA, Uversky VN, Redwan EM. Antimicrobial potentials and structural disorder of human and animal defensins. Cytokine Growth Factor Rev 2016; 28: 95-111. [CrossRef ]
8. Bogefors J, Kvarnhammar AM, Höckerfelt U, Cardell LO. Reduced tonsillar expression of human β-defensin 1, 2 and 3 in allergic rhinitis. FEMS Immunol Med Microbiol 2012; 65: 431-8. [CrossRef ]
9. Bogefors J, Kvarnhammar AM, Cardell LO. Upregulated levels of human β-defensins in patients with seasonal allergic rhinitis after allergen-specific immunotherapy treatment. Int Forum Allergy Rhinol 2013; 3: 99-103. [CrossRef ]
10. Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63: 8-160. [CrossRef ]
11. Ertugrul AS, Sahin H, Dikilitas A, Alpaslan NZ, Bozoğlan A, Tekin Y. Gingival crevicular fluid levels of human betadefensin-2 and cathelicidin in smoker and non-smoker patients: a cross-sectional study. J Periodont Res 2014; 49: 282-9. [CrossRef ]
12. Kim BJ, Rho YK, Lee HI, et al. The effect of calcipotriol on the expression of human beta defensin-2 and LL-37 in cultured human keratinocytes. Clin Dev Immunol 2009; 2009: 645898. [CrossRef ]
13. Bousquet J, Heinzerling L, Bachert C, et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy 2012; 67: 18-24. [CrossRef ]
14. Ellis AK, Zhu Y, Steacy LM, Walker T, Day JH. A four-way, double-blind, randomized, placebo controlled study to determine the efficacy and speed of azelastine nasal spray, versus loratadine, and cetirizine in adult subjects with allergen-induced seasonal allergic rhinitis. Allergy Asthma Clin Immunol 2013; 9: 16. [CrossRef ]
15. Lü FX, Esch RE. Novel nasal secretion collection method for the analysis of allergen specific antibodies and inflammatory biomarkers. J Immunol Methods 2010; 356: 6-17. [CrossRef ]
16. Kalfa VC, Spector SL, Ganz T, Cole AM. Lysozyme levels in the nasal secretions of patients with perennial allergic rhinitis and recurrent sinusitis. Ann Allergy Asthma Immunol 2004; 93: 288-92. [CrossRef ]
17. Dilek F, Gultepe B, Ozkaya E, Yazici M, Gedik AH, Cakir E. Beyond anti-microbial properties: The role of cathelicidin in allergic rhinitis. Allergol Immunopathol 2016; 44: 297-302. [CrossRef ]
18. Choi IJ, Rhee CS, Lee CH, Kim DY. Effect of allergic rhinitis on the expression of human β-defensin 2 in tonsils. Ann Allergy Asthma Immunol 2013; 110: 178-83. [CrossRef ]
19. Harder J, Meyer-Hoffert U, Teran LM, et al. Mucoid Pseudomonas aeruginosa, TNF-alpha, and IL-1beta, but not IL-6, induce human beta-defensin-2 in respiratory epithelia. Am J Respir Cell Mol Biol 2000; 22: 714-21. [CrossRef ]
20. Hiratsuka T, Nakazato M, Date Y, et al. Identification of human beta-defensin-2 in respiratory tract and plasma and its increase in bacterial pneumonia. Biochem Biophys Res Commun 1998; 249: 943-7. [CrossRef ]
21. Cakir E, Torun E, Gedik AH, et al. Cathelicidin and human β-defensin 2 in bronchoalveolar lavage fluid of children with pulmonary tuberculosis. Int J Tuberc Lung Dis 2014; 18: 671-5. [CrossRef ]
22. Kennedy VE, Todd JL, Palmer SM. Bronchoalveolar lavage as a tool to predict, diagnose and understand bronchiolitis obliterans syndrome. Am J Transplant 2013; 13: 552-61. [CrossRef ]
23. Beisswenger C, Kandler K, Hess C, et al. Allergic airway inflammation inhibits pulmonary antibacterial host defense. J Immunol 2006; 177: 1833-7. [CrossRef ]
24. Nomura I, Goleva E, Howell MD, et al. Cytokine milieu of atopic dermatitis, as compared to psoriasis, skin prevents induction of innate immune response genes. J Immunol 2003; 171: 3262-9. [CrossRef ]
25. Ong PY, Ohtake T, Brandt C, et al. Endogenous antimicrobial peptides and skin infections in atopic dermatitis. N Engl J Med 2002; 347: 1151-60. [CrossRef ]
26. Ohmori Y, Hamilton TA. Interleukin-4/STAT6 represses STAT1 and NF-kappa B-dependent transcription through distinct mechanisms. J Biol Chem 2000; 275: 38095- 103. [CrossRef ]
27. Ozdemir C, Kucuksezer UC, Akdis M, Akdis CA. Mechanisms of Aeroallergen Immunotherapy: Subcutaneous Immunotherapy and Sublingual Immunotherapy. Immunol Allergy Clin North Am 2016; 36: 71-86. [CrossRef ]
28. Oyer SL, Mulligan JK, Psaltis AJ, Henriquez OA, Schlosser RJ. Cytokine correlation between sinus tissue and nasal secretions among chronic rhinosinusitis and controls. Laryngoscope 2013; 123: 72-8. [CrossRef ]
29. Riechelmann H, Deutschle T, Rozsasi A, Keck T, Polzehl D, Bürner H. Nasal biomarker profiles in acute and chronic rhinosinusitis. Clin Exp Allergy 2005; 35: 1186-91. [CrossRef ]
30. Riechelmann H, Deutschle T, Friemel E, Gross HJ, Bachem M. Biological markers in nasal secretions. Eur Respir J 2003; 21: 600-5. [CrossRef ]
31. Diamant Z, Boot JD, Mantzouranis E, Flohr R, Sterk PJ, Gerth van Wijk R. Biomarkers in asthma and allergic rhinitis. Pulm Pharmacol Ther 2010; 23: 468-81. [CrossRef ]
32. Easton DM, Nijnik A, Mayer ML, Hancock RE. Potential of immunomodulatory host defense peptides as novel anti-infectives. Trends Biotechnol 2009; 27: 582-90. [CrossRef ]