The Effects of Diet and Microbiota on Attacks in Familial Mediterranean Fever

Abstract

Familial Mediterranean fever (FMF) is one of the common autoinflammatory diseases with autosomal inheritance. It is more common, especially in certain European ethnic groups, and is seen frequently in Turks, North Africans, Arabs, Jews, and Armenians. In our country, the prevalence varies between 1/400 and 1/1000. In the pathogenesis, there is a mutation in the MEFV gene, composed of 10 exons and localized at the 16p13.3 chromosome. A 781 amino acid protein is encoded by (pyrine or marenostrin) the MEFV gene and regulates intranuclear peptide transcription when inflammation occurs. Clinically, FMF is characterized by pronounced acute phase response (leukocytosis, high erythrocyte sedimentation rate, C reactive protein, serum amyloid, fibrinogen) accompanied by recurrent fever and symptoms. Although the reasons that stimulate and terminate attacks are not known exactly, several factors such as infection, menstruation, surgical intervention, cold climatic conditions, a high-fat diet, and excessive physical activity can trigger attacks. In a small number of studies, it has been examined that the species that dominates the microbiota of individuals with FMF is also different from the microbiota patterns of healthy individuals. The purpose of this study is to evaluate some factors that affect the attacks’ frequency and duration in individuals with FMF, especially diet patterns.

Keywords

• Familial Mediterranean fever
• Nutrition
• Diet

Ailesel Akdeniz Ateşinde Diyet ve Mikrobiyotanın Ataklar Üzerindeki Etkileri

Abstract

Ailesel Akdeniz ateşi otozomal geçişli ve en sık görülen otoinflamatuar hastalıklardan birisidir. Özellikle Avrupa kökenli bazı etnik gruplarda daha yaygındır. Türkler, Kuzey Afrikalılar, Araplar, Yahudiler ve Ermenilerde sıklıkla görülmektedir. Ülkemiz de ise prevalansı 1/400 ve 1/1000 arasında değişmektedir. Patogenezinde 16p13.3. kromozomda lokalize olan 10 ekzondan oluşan MEFV genindeki mutasyon etkilidir. MEFV geni 781 amino asitlik bir proteini (pirin veya marenostrin) kodlamaktadır ve inflamasyon durumunda intranükleer peptidlerin transkripsiyonunu düzenlemektedir. Klinik olarak Ailesel Akdeniz ateşi, tekrarlayan ateş ve semptomların eşlik ettiği belirgin akut faz yanıtı (lökositoz, yüksek eritrosit sedimantasyon hızı, fibrinojen, C reaktif protein, serum amiloid) ile karakterizedir. Atakları uyaran ve sonlandıran nedenler tam olarak bilinmemekle birlikte enfeksiyon, menstrüasyon, cerrahi girişim gibi çeşitli faktörlerin, soğuk iklim koşulları, yüksek yağlı diyet ve fazla fiziksel aktivitenin atakları tetikleyebileceği bilinmektedir. Yürütülen az sayıdaki çalışmada Ailesel Akdeniz ateşi hastalığına sahip bireylerin mikrobiyotasında hakim olan türün de sağlıklı bireylerin mikrobiyota örüntülerinden farklı olduğu gözlenmiştir. Bu çalışmanın amacı Ailesel Akdeniz ateşi hastalığına sahip bireylerin atak sıklık ve sürelerine etki eden başta diyet örüntüsü dahil olmak üzere bazı faktörleri incelenmeyi amaçlamaktadır.

Keywords

• Ailesel Akdeniz Ateşi
• Beslenme
• Diyet

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