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Üveitli olgularda sitokin profilinin karşılaştırılması

Comparison of the cytokine profile in patients with uveitis

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Abstract (2. Language): 
We aimed to measure serum cytokine levels in patients with uveitis in this study. Serum levels of interleukin (IL)-2 and interferone (INF)-γ, produced by T helper (Th)1 cells; IL-4 and IL-10 produced by Th2 cells; IL-8 produced by endothelial cells and tumor necrosis factor (TNF-α) produced by monocytes and macrophages were measured. Forty-one patients with active uveitis, 20 patients with inactive uveitis in remission and 18 control subjects were included in the study. Patients with any systemic or ocular infections were excluded from the study. Patients were evaluated in three categories as active and inactive uveitis; Behçet uveitis and Non-Behçet uveitis and according to their clinical characteristics (number of the eyes affected, disease period, number of recurrences, degree of vision loss, localization of uveitis, level of cellular activity and activity of systemic disease). No significant differences were observed between serum IL-2, IL-4, IL-10, INF-γ and TNF-α levels, and uveitis activity. Serum IL-8 levels in patients with active uveitis were higher than those of the control group (p=0.025). There was a significant negative correlation between the activity of systemic disease and serum IL-4 levels in patients with active uveitis (r=-0.507, p=0.003). There was a significant positive corelation between serum TNF-α levels and severity of vision loss (r=0.483, p=0.004). In conclusion we found a Th1 immune response in response to systemic disease activity in patients with active uveitis. IL-8 can be used as an uveitis marker, and TNF- α can be used as a prognostic indicator in patients with uveitis.
Abstract (Original Language): 
Çalışmamızda üveitli hastaların serumlarındaki sitokin düzeylerinin belirlenmesi planlanmıştır. Bu amaçla yardımcı T1 (Th1) hücrelerden salınan interlökin (İL)-2 ve interferon gamma (İNF-γ), yardımcı T2 (Th2) hücrelerinden salınan İL-4 ve İL-10, endotel hücrelerinden salınan İL-8 ile monosit, makrofaj, nötrofilerden salınan tümör nekrozis faktör alfa (TNF-α) düzeyleri araştırıldı. Çalışma kapsamına aktif üveit tanısı konulan 41 hasta, remisyonda olduğu tespit edilen 20 hasta ile 18 kontrol olgusu alındı. Sistemik veya oküler herhangi bir enfeksiyonu bulunan hastalar çalışma kapsamına alınmadı. Hastalar aktif ve inaktif üveitler, Behçet üveit ve Behçet dışı üveitler (BDÜ) ile klinik özelliklerine göre (tutulan göz sayısı, hastalık süresi, atak sıklığı, görme kaybı düzeyi, üveit lokalizasyonu, hücresel inflamasyon düzeyi ve sistemik hastalık aktivitesi) üç ayrı şekilde değerlendirildi. Üveit aktivitesi ile serum İL-2, İL-4, İL-10, İNF- γ ve TNF-α düzeyleri arasında anlamlı bir farklılık tespit edilmedi. Serum İL-8 düzeyi aktif üveitli hastalarda kontrol grubundan yüksek bulundu (p=0.025). Sistemik hastalık aktivitesi bulunan aktif üveitli olgular ile serum İL-4 düzeyi arasında negatif ilişki bulundu (r=-0.507, p=0.003). Ağır görme kaybı ile serum TNF-α düzeyi arasında pozitif ilişki bulundu (r=0.483, p=0.004). Sonuç olarak çalışmamızda aktif üveitli olgularda sistemik hastalık aktivitesi ile birlikte Th1 ağırlıklı bağışıklık yanıtının oluştuğu belirlendi. Bununla birlikte serum İL-8 düzeyinin üveit belirteci olarak, TNF-α düzeyinin ise prognostik belirteç olarak kullanılabileceği düşünülmektedir.
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