Çocukluk çağında kronik hepatit B enfeksiyonunda mannoz bağlayan lektin gen polimorfizminin rolü
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Date
2010
Authors
Erdemir, Gülin
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Önlenebilir kronik hastalıklar arasında kronik hepatit B önemli yer kaplamaktadır. Koruyucu hekimlik hizmetlerine rağmen çocuk ve adölesan yaş grubu gerek vertikal gerekse de horizontal olarak bulaş riskinin en çok olduğu popülasyondur. Hepatit B enfeksiyonunun seyrini etkileyen faktörler bulaş yolu, virüse ait virülans faktörleri ve konağın immün sistemidir.Mannoz bağlayan lektin kompleman sistemi lektin yolundan aktive ederek doğal bağışıklıkta rol alır. Mannoz bağlayan lektin eksikliğinin birçok enfeksiyöz ve otoimmün hastalıkla ilişkili olduğu anlaşılmıştır.Bu çalışmada çocuklarda kronik hepatit B enfeksiyonu seyrinde mannoz bağlayan lektin gen polimorfizmi ve serum düzeyinin rolü araştırılmıştır.Çalışmaya kronik hepatit B tanısı ile izlenmekte olan 2-18 yaş grubun 67 hasta alındı ve bu hastalar immuntoleran, kronik inaktif ve tedavi grubu olmak üzere üç gruba ayrılarak incelendi. Tüm hastalarda mannoz bağlayan lektin gen polimorfizmi ve serum düzeyleri çalışıldı. Hastaların klinik, laboratuar ve histopatolojik özelliklerinin ve kronik hepatit B enfeksiyonu seyrinin mannoz bağlayan lektin gen polimorfizmi ve serum düzeyi ile ilişkisi incelendi.Hastaların %8,9'unda homozigot, %11'9'unda heterozigot kodon 54 mutasyonu saptandı ve çalışma grubunda MBL mutasyon sıklığı toplum ortalamasına göre fazla bulundu. Serum MBL düzeyleri mutasyon varlığı ile ters korelasyon göstermekteydi. Kodon 54 mutasyonu sıklığı ve serum MBL düzeyi gruplar arasında farklılık göstermedi, ayrıca tedaviye yanıtlı ve yanıtsız hastalar arasında da farklı değildi. İstatistiksel anlam taşımamakla birlikte MBL serum düzeyi düşük olan hastalarda karaciğer histolojik aktivitesinin daha fazla olduğu görüldü.Sonuç olarak, MBL genindeki kodon 54 polimorfizmi kronik hepatit B tanılı çocuk hastalarda ortalamanın üzerinde bir sıklıkta görülmektedir. Bu mutasyonun hastalığın kronikleşmesine zemin oluşturduğu ancak kronikleşmiş hastalığın çocukluk yaş grubundaki progresine etkisi bulunmadığı görülmüştür.
Although chronic hepatitis B is a preventable infectious disease, it is still an important health problem. Vertical and horizontal ways are the main transmission routes for children and adolescents. The progression of hepatitis B infection depends on transmission route, virulence factors of the virus and immune system of the host.Mannose binding lectin is a member of innate immune system and activates complement system through lectin pathway. Mannose binding lectin deficiency is considered to be associated with infectious and autoimmune diseases.In this study the relation of mannose binding lectin gen polymorphism and serum levels with the progression of chronic hepatitis B infection in children is evaluated.The study included 67 patients between 2-18 years of age with the diagnosis of chronic hepatitis B. The patients divided into immuntolerant, chronic inactive and treatment groups according to their clinical status. Mannose binding lectin gen polymorphism and serum levels were measured in all patients and their associations with clinical, laboratory and histopathological properties were evaluated.Mannose binding lectin gen polymorphism rates were found to be higher in our patient group than general population that homozygous codon 54 mutation was found in 8.9% and heterozygous mutation was found in 11.9% of our patients. Serum mannose binding lectin levels were inversely correlated with gene polymorphism. The rate of mutation was similar in all groups and moreover it was not different in responsive and non-responsive patients in the treatment group. Lower levels of serum mannose binding lectin are found to be related with higher histological activity in liver biopsy specimens, without a statistical significance.Consequently, codon 54 mutation of mannose binding lectin gene is seen commonly in children with chronic hepatitis B infection. This mutation is considered to be a risk factor for the persistence of disease but it did not have an influence on the progression of chronic hepatitis B infection in children.
Although chronic hepatitis B is a preventable infectious disease, it is still an important health problem. Vertical and horizontal ways are the main transmission routes for children and adolescents. The progression of hepatitis B infection depends on transmission route, virulence factors of the virus and immune system of the host.Mannose binding lectin is a member of innate immune system and activates complement system through lectin pathway. Mannose binding lectin deficiency is considered to be associated with infectious and autoimmune diseases.In this study the relation of mannose binding lectin gen polymorphism and serum levels with the progression of chronic hepatitis B infection in children is evaluated.The study included 67 patients between 2-18 years of age with the diagnosis of chronic hepatitis B. The patients divided into immuntolerant, chronic inactive and treatment groups according to their clinical status. Mannose binding lectin gen polymorphism and serum levels were measured in all patients and their associations with clinical, laboratory and histopathological properties were evaluated.Mannose binding lectin gen polymorphism rates were found to be higher in our patient group than general population that homozygous codon 54 mutation was found in 8.9% and heterozygous mutation was found in 11.9% of our patients. Serum mannose binding lectin levels were inversely correlated with gene polymorphism. The rate of mutation was similar in all groups and moreover it was not different in responsive and non-responsive patients in the treatment group. Lower levels of serum mannose binding lectin are found to be related with higher histological activity in liver biopsy specimens, without a statistical significance.Consequently, codon 54 mutation of mannose binding lectin gene is seen commonly in children with chronic hepatitis B infection. This mutation is considered to be a risk factor for the persistence of disease but it did not have an influence on the progression of chronic hepatitis B infection in children.
Description
Keywords
Çocukluk çağı, Kronik hepatit B, Mannoz bağlayan lektin, Childhood, Chronic hepatitis B, Mannose binding lectin
Citation
Erdemir, G. (2010). Çocukluk çağında kronik hepatit B enfeksiyonunda mannoz bağlayan lektin gen polimorfizminin rolü. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.