Nazal polipozis ile nitrik oksit sentetaz II gen polimorfizmi arasındaki ilişkinin vaka-kontrol çalışması ile incelenmesi.
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Dosyalar
Tarih
2010
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hastaların yaşam kalitesi üzerinde önemli bir etkiye sahip olan nazal polip (NP), nazal mukozanın kronik inflamatuar bir hastalığıdır. Genel toplumdaki görülme sıklığı %0,2?4,3'tür. Sinonazal polipozisin etyopatogenezi tam olarak aydınlatılamamakla birlikte, L-Arginin'den Nitrik Oksit Sentetaz(NOS) ile sentezlenen NO'in, nazal polip gelişiminde rol oynadığı düşünülmektedir. Yapılan çalışmalarda NOS enzimlerinden uyarılabilen (İnducible) nitrik oksit sentetaz (İNOS) enziminin, nazal polip dokusunda arttığı immunohistokimyasal olarak gösterilmiştir.İNOS enzimini kodlayan gen (NOS2A) 17. kromozomun q11.2 bölgesine lokalizedir. Bu çalışmamızda yaygın ve nüks nazal polipozisli hastalarda İNOS gen polimorfizminin değerlendirilmesi amaçlanmıştır. NP'li hastaların %29 `unda astım ve aspirin intoleransı ,%28 `inde yalnızca astım mevcutken ,%43'ünde herhangi bir ek hastalık bulunmamıştır.100 nazal polipozisli hastanın şikayetleri sorgulanmış, endoskopik skorlama ile fizik muayeneleri yapılmıştır. Paranazal sinus BT'leri Lund mackay yöntemiyle evrelendirilmiştir. Hastaların ve 50 sağlıklı kontrolün serum Total IgE ve Eozinofil değerlerine bakılmış, prick testleri yapılmış ve venöz kan örnekleri alınarak DNA izolasyonu, PZR ve jel elektroforez yöntemiyle İNOS gen polimorfizmleri değerlendirilmiş ve karşılaştırılmıştır. NP'li hastaların %45'inde (n=45) serum total IgE değerleri normal değerden yüksek bulunurken %27 sinde (n=27) serum eozinofil değerleri yüksek bulundu. Kontrol grubunun %30'unda (n=15) serum total IgE değerleri normal değerden yüksek bulunurken %12'sinde (n=6) serum eozinofil değerleri normal değerden yüksek idi. Hastaların %42'sinde (n=42) kontrol grubunun %22'sinde (n=11) prick testi pozitif bulundu. İNOS gen polimorfizmi için iki farklı polimorfik bölgede tek nükleotid polimorfizmine bakıldı. Rs2279249 bölgesinde hasta grubunda 22 kişide homozigot mutasyon görülürken, Rs2297518 polimorfik bölgesinde 10 kişide homozigot mutasyon görüldü.Serum eozinofil değerlerinin ve prick testi pozitifliğinin nazal polipozisli hastalarda, kontrol grubuna oranla daha yüksek bulunması, nazal polipozisin etiyopatogenezinde alerjinin major bir faktör olduğunu göstermiştir. İNOS gen polimorfizmi açısından hasta ve kontrol grupları arasında istatistiksel olarak anlamlı bir fark bulunmadı. Her iki polimorfik bölgede hasta grubunda heterozigot ve homozigot mutasyon kontrol grubuna oranla yüksek bulunurken aradaki fark istatistiksel olarak anlamlı değildi.İNOS gen polimorfizminin nazal polipozis etyopatogenezindeki olası rolünü ortaya koymak için daha geniş çalışma grubuna ihtiyaç duyulmaktadır.
Nasal polyp is a chronic inflammation of nasal mucosa which has considerable effect on life quality of the patients. The incidence of Nasal polyp in population is about %0, 2 ? 4, 3. Without elucidating etiopathogenesis of Sinonasal polyposis, it is assumed that NO being synthesized on L-Arginine with Nitric Oxide Synthetase (NOS) has a role on developing of nasal polyp. İmmunohistochemistry researches show that inducible Nitric Oxide Synthetase (INOS) increases on nasal polyp tissue.The gene (NOS2A) coding INOS enzyme is localized on q11.2 of chromosome 17. By this study it is aimed to evaluate INOS gene polymorphism on common and recurrent nasal polyposis patients. While 29% of all NP patients have asthma and aspirin intolerance and 28% only have asthma, 43% have no other disease. 100 nasal polyposis patients were examined and were included in endoscopic scoring and physical examination. Paranasal sinuses BT?s were staged by Lund Mackay. Patients and the control group?s (consist of 50 healthy person) total IgE serum and eosinophil values were examined and prick tests were completed. INOS gene polymorphism of these were evaluated and compared by taking venous blood samples and using DNA isolation, PZR and gel electrophoresis methods. While serum total IgE values of 45% (n=45) of NP patients were higher than the accepted value, serum eosinophil values of 27% (n=27) of the patients were higher than the accepted values. As serum total IgE values of 30% (n=15) of control group were higher than the accepted value, serum eosinophil values of 12% (n=6) of them were higher than accepted value. Prick test results were positive on 42% (n=42) of the patients and 22% (n=11) of the control group. To determine INOS gene polymorphism, single nucleotide polymorphism was examined on two different polymorphic regions. On Rs 2297518 polymorphic region, homozygote mutation was observed on 10 patients meanwhile it was 22 patients having homozygote mutation on RS 2279249.Higher serum eosinophil values and positive prick test results of the patients of nasal polyposis shows that allergy is a major factor on etiopathogenesis of nasal polyposis. Heterozygote and homozygote mutation was found in our patient group higher than control group at both of the polymorphic region, but the difference was no reliable statistical result between patients (evaluation) group and control group about INOS gene polymorphism.It is needed to have a larger work group to prove the potential effects of INOS gene polymorphism on nasal polyposis etiopathogenesis.
Nasal polyp is a chronic inflammation of nasal mucosa which has considerable effect on life quality of the patients. The incidence of Nasal polyp in population is about %0, 2 ? 4, 3. Without elucidating etiopathogenesis of Sinonasal polyposis, it is assumed that NO being synthesized on L-Arginine with Nitric Oxide Synthetase (NOS) has a role on developing of nasal polyp. İmmunohistochemistry researches show that inducible Nitric Oxide Synthetase (INOS) increases on nasal polyp tissue.The gene (NOS2A) coding INOS enzyme is localized on q11.2 of chromosome 17. By this study it is aimed to evaluate INOS gene polymorphism on common and recurrent nasal polyposis patients. While 29% of all NP patients have asthma and aspirin intolerance and 28% only have asthma, 43% have no other disease. 100 nasal polyposis patients were examined and were included in endoscopic scoring and physical examination. Paranasal sinuses BT?s were staged by Lund Mackay. Patients and the control group?s (consist of 50 healthy person) total IgE serum and eosinophil values were examined and prick tests were completed. INOS gene polymorphism of these were evaluated and compared by taking venous blood samples and using DNA isolation, PZR and gel electrophoresis methods. While serum total IgE values of 45% (n=45) of NP patients were higher than the accepted value, serum eosinophil values of 27% (n=27) of the patients were higher than the accepted values. As serum total IgE values of 30% (n=15) of control group were higher than the accepted value, serum eosinophil values of 12% (n=6) of them were higher than accepted value. Prick test results were positive on 42% (n=42) of the patients and 22% (n=11) of the control group. To determine INOS gene polymorphism, single nucleotide polymorphism was examined on two different polymorphic regions. On Rs 2297518 polymorphic region, homozygote mutation was observed on 10 patients meanwhile it was 22 patients having homozygote mutation on RS 2279249.Higher serum eosinophil values and positive prick test results of the patients of nasal polyposis shows that allergy is a major factor on etiopathogenesis of nasal polyposis. Heterozygote and homozygote mutation was found in our patient group higher than control group at both of the polymorphic region, but the difference was no reliable statistical result between patients (evaluation) group and control group about INOS gene polymorphism.It is needed to have a larger work group to prove the potential effects of INOS gene polymorphism on nasal polyposis etiopathogenesis.
Açıklama
Anahtar Kelimeler
Nazal polipler., Nasal polyps., Nitrik oksit., Nitric oxide.
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kurnaz, G. (2010). Nazal polipozis ile nitrik oksit sentetaz II gen polimorfizmi arasındaki ilişkinin vaka-kontrol çalışması ile incelenmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Kulak Burun Boğaz Anabilim Dalı, Konya.
