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ESANSÎYEL AMÎNOASÎT UYGULAMASININ KRONİK HEMODİYALİZ HASTALARININ HÜCRESEL VE HUMORAL BAĞIŞIKLIĞI ÜZERİNDEKİ ETKİLERİ

THE EFFECTS OF INTRAVENOUS ESSENTIAL AMINOACID ADMINISTRATION ON CELLULAR AND HUMORAL IMMUNITIES OF CHRONIC HEMODIALYSIS PATIENTS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
One of the factors responsible for suppression of cellular and humoral immune system is essential aminoacid (EAA) deficiency in the patients with end-stage renal disease (ESRD) . It has been reported that the functions of the immune system are improved by administering EAA solutions intravenously to the patients in each dialysis session. The immune system of 15 healthy persons (8M, 7F) whose ages between 19-49 (mean age: 32±8) , 28 chronic hemodialysis patients (18M, lOF) whose ages between 21-82 (mean age: 56±13) and the alterations occured in the immune responses of the patients after EAA replacement were investigated by determining the levels of serum total protein and albumin, the counts of serum total leukocytes, granulucytes, lymphocytes, monocytes and peripheral blood mononuclear cell subpopulations (CD3, CD4, CD8, CD 14, CD16I CD56, CD19, CD25, CD38, CD45) and CD4/ CD8 ratio. When compared to healthy control group , the levels of serum total protein and albumin decreased , cellular and humoral immune responses were suppressed in chronic hemodialysis patients. The solutions of EAA, administered to chronic hemodialysis patients in a month, did not cause significant alterations on serum total protein levels , increased serum albumin levels, improved the cellular immune response suppressed previously and did not cause any positive effect upon humoral immune response. When compared to control group, in chronic hemodialysis patients to whom administered parenteral EAA , total protein and albumin levels continued to be low , the counts of total T lymphocytes and T-helper inducer cells attained to the physiological limits and the other paremeters remained subnormal. Our study demonstrated that EAA administration improved immune system relatively in chronic hemodialysis patients.
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Abstract (Original Language): 
Son dönem böbrek yetmezliği (SDBY) olan hastaların hücresel ve humoral bağışıklık sistemlerinin baskılanmasından sorumlu tutulan faktörlerden birisi de esansiyel aminoasit (EAA) eksikliğidir. Bu hastalara her diyaliz seansında EAA solüsyonlarının intravenöz uygulanması ile bağışıklık sistemi işlevlerinde düzelmeler olduğu bildirilmektedir. Bu çalışmada yaşları 19-49 arasında (ort.yaş: 32 ± 8) olan 15sağlıklı kişi (8E, 7K) ile yaşları 21-82 arasında (ort.yaş: 56 ± 13) olan 28 kronik hemodiyaliz hastasının (18E.10K) bağışıklık sistemleri ve hastaların EAA replasman tedavisi sonrasında bağışık yanıtlarında ortaya çıkan değişiklikler serum total protein, albumin, total lökosit, granülosit, lenfosit, monosit sayıları ile periferik kan mononükleer hücre alt gruplarının sayılarının belirlenmesi (CD3, CD4, CD8, CD14, CD16/CD56, CD 19, CD25, CD38, CD45) ve CD4/ CD8 oranının saptanmasıyla araştırılmıştır. Kontrol grubu ile karşılaştırıldığında, kronik hemodiyaliz hastalarının total protein ve albumin düzeylerinin azaldığı, hücresel ve humoral bağışık yanıtlarının baskı/andığı belirlenmiştir. Kronik hemodiyaliz hastalarına bir ay süreyle uygulanan EAA solüsyonlarının total protein düzeylerinde anlamlı bir değişikliğe neden olmadığı, albumin düzeylerini arttırdığı ve önceden baskılanmış olduğu belirlenen hücresel bağışıklık yanıtını düzeltirken, humoral bağışıklık yanıtı üzerine olumlu bir etki oluşturmadığı gözlenmiştir. Kontrol grubu ile karşılaştırıldığında, parenteral olarak EAA uygulanmış olan kronik hemodiyaliz hastalarının total protein ve albumin düzeylerinin düşük kalmaya devam ettiği, total T lenfosit ve T-helper inducer hücre sayılarının fizyolojik sınırlara geldiği, diğer parametrelerin subnormal değerlerde kaldığı saptanmıştır. Araştırmamız EAA uygulamasının kronik hemodiyaliz hastalarında bağışıklık sistemini göreceli olarak düzeltebildiğim ortaya koymuştur.
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  • 1
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  • Turkish

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