Adnan ORHAN, Mehmet Aral ATALAY, Mehpare TÜFEKÇİ, İşıl KASAPOĞLU, Orhan GÖRÜKMEZ

Preeklamptik Hastalarda Adenozin Deaminaz Gen Polimorfizmi

Preeklampsi; hipertansiyon, proteinüri ve birçok klinik manifestasyon ile karakterize multisistem bir hastalıktır. Etyopatogenezi henüz tam olarak anlaşılamasa da azalmış plasental perfüzyonun genetik, immünolojik ve inflamatuar faktörlerden etkilendiği bilinmektedir. Preeklampside artan hücresel immünitenin temel mediatörlerinden adenozin deaminaz (ADA), pürin nükleotidlerinin yıkımında yer alan ve Adenozin’in İnozin’e çevrimini katalizleyen bir enzimdir. Preeklampside hücresel immünitenin artmasına bağlı olarak ADA seviyelerindeki artış saptanmıştır. Bu çalışmanın amacı preeklamptik hastalarda ADA gen polimorfizmini değerlendirmektir. Çalışmaya 45 asemptomatik normal gebe ile 43 preeklampsili gebe alındı. Olgulardan alınan maternal plazma örneklerinden PCR-RFLP (Polymerase Chain Reaction- Restriction fragment lenght polymorphism) tekniği ile 20. kromozom uzun kolu üzerinde bulunan ADA geninin 8. kodon kısmındaki 22. nükleotidinin G (Guanin)’den A (Adenin)’e dönmesi ile karakterize gen polimorfizmi incelendi. Her iki gruptan elde edilen verilerin istatistiksel analizi Fisher exact test ve Ki-kare testleri ile yapıldı. Her iki grup arasında psikososyokültürel ve demografik özellikler açısından fark saptanmadı. Kontrol grubundaki adenozin deaminaz gen polimorfizmi oranı %8,9 iken, preeklampsi grubundaki ADA gen polimorfizmi oranı %4,5 olarak saptandı. Preeklampsi grubu ile kontrol grubu arasında istatistiksel olarak anlamlı fark izlenmedi (p>0.05, Odds ratio: 0.9 [%95 confidence interval:0.485-1.693]). Çalışmanın sonucunda preeklamptik hastalardaki immünolojik patogenetik süreçlerin bir mediatörü olarak düşünülen ve pürin metabolizmasının en önemli enzimi olan adenozin deaminazı üreten ADA genindeki polimorfizmin, preeklamptik hastalarda farklı olmadığı görülmüştür. Maternal plazma ADA düzeyleri ile ilgili yapılan birçok çalışma olmasına rağmen, literatürde preeklamptik hastalarda ADA gen polimorfizmini ilk defa araştıran bu çalışma ile, preeklampsinin patogenezini için yapılacak ileri dönem araştırmalara bir katkı sağlayabileceğimizi ümit ediyoruz.

Anahtar Kelimeler:

Adenozin deaminaz, Preeklampsi, Gen polimorfizmi

Adenosine Deaminase Gene Polymorphism in Preeclampsia

Preeclampsia is a severe pregnancy complication characterized by high blood pressure and signs of damage to another organ system. Although the etiopathogenesis of the preeclampsia has not been fully understood, decreased placental perfusion resulting genetic, immunological and inflammatory factors is known to be the main cause. Increased cellular immunity in preeclampsia is a well-known immune response. One of the essential mediators in the cellular immune system is Adenosine deaminase (ADA). This enzyme involves in purine metabolism and catalyzes the irreversible deamination of adenosine and 2’-deoxyadenosine to inosine and 2’-deoxyinosine, respectively. Depending on the increase of cellular immunity in preeclampsia, earlier studies found increased levels of adenosine deaminase. This study aimed to evaluate the ADA gene polymorphism in preeclamptic women. 45 asymptomatic pregnant and 43 preeclamptic patients were included in the study. We investigated the ADA gene -located on the long arm of chromosome 20- codon 8, G22A polymorphism (Asp8Asn). There were no demographic differences between the two groups. The ADA gene polymorphism rate in the control group was 8.9%, while it was 4.5% in the preeclampsia group. Although this difference was not statistically significant and further studies are needed, ADA gene polymorphism in preeclamptic women has been investigated for the first time with this study in the medical literature.

Keywords:

Adenosine deaminase, Preeclampsia, Gene Polymorphism,

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