Eritema multiforme, Stevens Johnson sendromu ve Stevens Johnson sendromu/toksik epidermal nekroliz overlap sendrom'da toll like reseptör polimorfizmi
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Date
2008
Authors
Turan, Hakan
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Publisher
Uludağ Üniversitesi
Abstract
"Toll like reseptör'' (TLR) 9, farklı viral ve bakteriyel patojenlere karşı doğal immün sistemin devreye girmesini sağlayarak, kazanılmış immün yanıtın etkili bir şekilde oluşmasında görev almaktadır. TLR 9 gen polimorfizmi halinde, reseptör fonksiyonları bozulacağından, konak mikrobiyal patojenlere duyarlı hale gelir. Bu çalışmada, TLR 9 gen polimorfizmininin viral ve bakteriyel enfeksiyonları takiben deri ve mukozalarda yaygın, şiddetli bir inflamasyona neden olabileceği düşüncesinden yola çıkarak, "eritema multiforme'' (EM), "Stevens Johnson sendromu'' (SJS) ve "Stevens Johnson sendromu/toksik epidermal nekroliz overlap sendrom''a (SJS/TEN) yatkınlık oluşturup oluşturmadığı araştırılmıştır.Çalışmamıza 42 hasta ve kontrol grubu olarak da 50 sağlıklı birey alındı. TLR 9 geni 1237 Timin/Sitozin (T/C) polimorfizmi için polimeraz zincir reaksiyonu-restriksiyon fragment uzunluk polimorfizmi (polymerase chain reaction-restriction fragment length polymorphism=PCR-RFLP) yöntemi uygulandı. Agaroz jel elektroforezinde oluşan bantlara göre genotip tayini yapıldı. İstatistiksel değerlendirme Uludağ Üniversitesi Tıp Fakültesi Biyoistatistik Anabilim Dalı'nda SPSS 13.0 paket programı kullanılarak yapıldı.Hasta grubunda TT genotipi oranı %73,8, TC genotipi oranı %26,2 iken CC genotipi saptanmadı; kontrol grubunda TT genotipi oranı %74, TC genotipi oranı %24 ve CC genotipi oranı %2 bulundu. TT, TC ve CC genotipleri açısından hasta grubu ile kontrol grubu karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmadı. Hasta grubu ve sağlıklı bireylerde T ve C alel sıklığı sırasıyla %84,5 ve %15,5; kontrol grubunda % 86 ve %14 olarak hesaplandı.Bu çalışma EM, SJS ve SJS/TEN overlap sendrom'un TLR ile ilişkisini inceleyen ilk çalışma olma özelliği taşımaktadır. Bulgularımız TLR gen polimorfizmi ile EM, SJS ve SJS/TEN overlap sendrom arasında bir ilişki olmadığını göstermiştir; ancak, olgu sayısı sınırlı olduğu için bu sonuç daha geniş serili çalışmalarla desteklenmelidir.
"Toll like receptor" (TLR) 9 functions in stepping in of native immune system against different viral and bacterial pathogens and induction of adaptive immune response effectively. TLR 9 gene polymorphism makes host predisposed to microbial pathogens by affecting the functional capabilities of the receptor. In this study, thinking of TLR 9 gene polymorphism may cause a severe inflammation that can not be limited within skin and mucosa following the viral and bacterial infections, we aimed to determine if it makes a predisposition to "erythema multiforme" (EM), "Stevens Johnson syndrome" (SJS) and "Stevens Johnson syndrome/toxic epidermal necrolysis overlap syndrome" (SJS/TEN).Forty-two patients and 50 healthy control subjects were enrolled in our study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was applied for TLR 9 gene 1237 thymine/cytosine (T/C) polymorphism. Genotypes were determined according to bands occurring on agarose gel electrophoresis. Statistical analyses were performed at Uludag University Biostatistics Department using SPSS version 13.0 programme.In patients group, the frequencies of TT and TC genotypes were 73.8% and 26.2% while CC genotype wasn't detected. In control group, the frequencies of TT, TC and CC genotypes were 74%, 24%, and 2%. There wasn't statistically significant difference for TT, TC and CC genotypes between patients and controls. The frequencies of T and C alleles were 84.5% and 15.5% in patients and 86% and 14% in controls, respectively.Our study is the first one investigating the association of TLR with EM, SJS, SJS/TEN overlap syndrome. Our results show that there isn't any association between TLR gene polymorphism and EM, SJS, SJS/TEN overlap syndrome. However, these findings should be confirmed by a larger study population.
"Toll like receptor" (TLR) 9 functions in stepping in of native immune system against different viral and bacterial pathogens and induction of adaptive immune response effectively. TLR 9 gene polymorphism makes host predisposed to microbial pathogens by affecting the functional capabilities of the receptor. In this study, thinking of TLR 9 gene polymorphism may cause a severe inflammation that can not be limited within skin and mucosa following the viral and bacterial infections, we aimed to determine if it makes a predisposition to "erythema multiforme" (EM), "Stevens Johnson syndrome" (SJS) and "Stevens Johnson syndrome/toxic epidermal necrolysis overlap syndrome" (SJS/TEN).Forty-two patients and 50 healthy control subjects were enrolled in our study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was applied for TLR 9 gene 1237 thymine/cytosine (T/C) polymorphism. Genotypes were determined according to bands occurring on agarose gel electrophoresis. Statistical analyses were performed at Uludag University Biostatistics Department using SPSS version 13.0 programme.In patients group, the frequencies of TT and TC genotypes were 73.8% and 26.2% while CC genotype wasn't detected. In control group, the frequencies of TT, TC and CC genotypes were 74%, 24%, and 2%. There wasn't statistically significant difference for TT, TC and CC genotypes between patients and controls. The frequencies of T and C alleles were 84.5% and 15.5% in patients and 86% and 14% in controls, respectively.Our study is the first one investigating the association of TLR with EM, SJS, SJS/TEN overlap syndrome. Our results show that there isn't any association between TLR gene polymorphism and EM, SJS, SJS/TEN overlap syndrome. However, these findings should be confirmed by a larger study population.
Description
Keywords
Eritema multiforme, Stevens Johnson sendromu, Stevens Johnson sendromu/toksik epidermal nekroliz overlap sendromu, Toll like reseptör 9, Erythema multiforme, Stevens Johnson syndrome, Stevens Johnson syndrome/toxic epidermal necrolysis overlap syndrome, Toll like receptor 9
Citation
Turan, H. (2008). Eritema multiforme, Stevens Johnson sendromu ve Stevens Johnson sendromu/toksik epidermal nekroliz overlap sendrom'da toll like reseptör polimorfizmi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.