Epstein-Barr Virüs (EBV) enfeksiyonlarının tanısında Polimeraz Zincir Reaksiyonunun (PCR) yeri
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Date
2011
Authors
Geçgel, Sanem Karadağ
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Publisher
Uludağ Üniversitesi
Abstract
Bu çalışma Epstein-Barr Virus (EBV) enfeksiyonlarının tanı ve takibinde EBV-DNA'nın önemini belirlemek amacıyla yapılmıştır.Çalışmamızda 62 erişkin renal transplant ve 37 çocuk onkoloji hastasından tedavi öncesinde bir, tedavi sonrasında üç olmak üzere toplam dört kez; immünsüprese olmayan çocuk ve erişkinlerden oluşan 50 kontrol hastasından bir kez alınan serum örneklerinde Paul-Bunnel ve immünblot ile EBV serolojisi belirlendi. ELISA ile Viral Kapsid Antijen (VCA)-IgG avidite ve Real Time Polymerase Chain Reaction (RT-PCR) ile EBV-DNA testleri çalışıldı.Renal transplant grubundaki hastaların üçünde (%4,8) EBV-DNA pozitif bulundu. Bu hastalarda CD4/CD8 oranları transplantasyon öncesi değerlerine göre transplantasyon sonrası birinci hafta ve üçüncü ayda anlamlı olarak düşük bulunmakla birlikte EBV enfeksiyonu ile ilişkili organ reddi gelişmedi.Çocuk onkoloji grubundaki hastaların üçünde (%8,1) EBV-DNA pozitif saptandı. EBV-DNA pozitifliği Hodgkin lenfoma tanısıyla takip edilen iki çocukta hastalık, diğerinde ise reaktivasyon ile ilişkilendirildi.Kontrol grubunda yer alan hastaların 10'unda (%20) EBV-DNA pozitif bulundu. İmmünblot sonuçları akut enfeksiyon serolojisi ile uyumlu olan erişkin kontrol hastalarında EBV-DNA pozitifliği, Paul-Bunnel pozitifliği ve düşük avidite sonuçları arasındaki uyum istatistiksel olarak anlamlı idi. Çocuk kontrol grubunda ise bu serolojik profil ile sadece düşük avidite arasındaki uyum anlamlı bulundu.Çalışmamız renal transplant hastalarında EBV reaktivasyonunun saptanması; çocuk onkoloji hastalarında EBV ilişkili kanserlerin tanısı ve prognozunun değerlendirilmesi; immünkompetan erişkin ve çocuk hastalarda akut enfeksiyonun tanı ve takibinde Paul-Bunnel ve spesifik antikor testleri ile birlikte doğrulama amacıyla VCA-IgG avidite ve EBV-DNA testlerinin yararını ortaya koymuştur.
The aim of this study was to evaluate the importance of Epstein-Barr Virus (EBV) DNA in the diagnosis and monitoring of EBV infections.EBV serology was determined from the serum of 62 renal transplant and 37 pediatric oncology patients and 50 non-immunocompromised adult and pediatric controls by using Paul-Bunnel and Immunoblotting tests. Serum specimens were collected four times (once before treatment and three times after treatment) from the renal transplant and pediatric oncology patients, whereas once from the control group. ELISA and Real Time Polymerase Chain Reaction (RT-PCR) tests were used for the evaluation of Viral Capsid Antigen (VCA)-IgG avidity and EBV-DNA respectively.EBV-DNA was found positive in three (4.8%) of renal transplant patients. In these patients, CD4/CD8 ratios were found significantly lower one week and three months after transplantation comparing with pre-transplantation period but there was no organ rejection associated with EBV infections.EBV-DNA was found positive in three (8.1%) of pediatric oncology patients. The positivity of EBV-DNA was considered associated with Hodgkin's lymphoma disease in two patients and reactivation in the other patient.EBV-DNA was found positive in 10 (20%) of the control group. At acute infections, immunoblot serology were found significantly compatible with Paul-Bunnel, EBV-DNA positivity and low avidity in adult controls but only low avidity were significantly found compatible in pediatric controls.In this study, the usefulness of EBV-DNA was shown; in determining the reactivation in renal transplant patients; in evaluation of the diagnosis and prognosis of EBV associated cancers in pediatric oncology patients and the diagnosis and monitoring of acute infections associated with Paul-Bunnel, immunblotting and VCA-IgG avidity at the adult and pediatric immunocompetant control patients.
The aim of this study was to evaluate the importance of Epstein-Barr Virus (EBV) DNA in the diagnosis and monitoring of EBV infections.EBV serology was determined from the serum of 62 renal transplant and 37 pediatric oncology patients and 50 non-immunocompromised adult and pediatric controls by using Paul-Bunnel and Immunoblotting tests. Serum specimens were collected four times (once before treatment and three times after treatment) from the renal transplant and pediatric oncology patients, whereas once from the control group. ELISA and Real Time Polymerase Chain Reaction (RT-PCR) tests were used for the evaluation of Viral Capsid Antigen (VCA)-IgG avidity and EBV-DNA respectively.EBV-DNA was found positive in three (4.8%) of renal transplant patients. In these patients, CD4/CD8 ratios were found significantly lower one week and three months after transplantation comparing with pre-transplantation period but there was no organ rejection associated with EBV infections.EBV-DNA was found positive in three (8.1%) of pediatric oncology patients. The positivity of EBV-DNA was considered associated with Hodgkin's lymphoma disease in two patients and reactivation in the other patient.EBV-DNA was found positive in 10 (20%) of the control group. At acute infections, immunoblot serology were found significantly compatible with Paul-Bunnel, EBV-DNA positivity and low avidity in adult controls but only low avidity were significantly found compatible in pediatric controls.In this study, the usefulness of EBV-DNA was shown; in determining the reactivation in renal transplant patients; in evaluation of the diagnosis and prognosis of EBV associated cancers in pediatric oncology patients and the diagnosis and monitoring of acute infections associated with Paul-Bunnel, immunblotting and VCA-IgG avidity at the adult and pediatric immunocompetant control patients.
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Keywords
EBV, Paul-Bunnel, İmmünblot, VCA-IgG avidite, RT-PCR, Immunoblotting, VCA-IgG avidity
Citation
Geçgel, S. K. (2011). Epstein-Barr Virüs (EBV) enfeksiyonlarının tanısında Polimeraz Zincir Reaksiyonunun (PCR) yeri. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.