Akut Pankreas İltihabı Süresince Metillenmiş Arginin Rezidüleri ve İlişkili Amino Asitlerdeki Değişimler

Abstract

Amaç: Enflamasyonun yayılma derecesi, akut pankreatitin (AP) şiddetini belirler. Bir tür inflamasyon mediyatörü olan metillenmiş arjinin rezidüleri (MAR), nitrik oksit seviyelerini düşürür ve vazokonstriksiyona bağlı endotel hasarına neden olur. Bu çalışma, akut pankreas iltihabı sırasında MAR ve ilişkili amino asitleri araştırmayı amaçladı. Gereç ve Yöntem: Bu prospektif, yarı deneysel çalışma, AP tanısı konan hastalar ve yaşca uyumlu bir kontrol grubu ile yürütülmüştür. Hasta örnekleri tanı anı ve iyileşme sırasında, kontrol grubunda ise çalışma sırasında alındı. Başlıca Asimetrik dimetilarjinin (ADMA), Arjinin (ARG), Sitrulin (CIT), ve ilişkili kimyasallar kütle spektrometre ile çalışıldı. Bulgular: Çalışmaya toplam 30 AP (ortalama yaş=53,3±17,8) ve 30 kontrol (ortalama yaş=53,4±18,0) dahil edildi. Hastalar şiddetli (n=22) ve şiddetli olmayan (n=8) olarak tanımlandılar. Kontrol grubuna göre hastaların ADMA düzeylerinde belirgin azalma saptanıldı (p=0,01). MAR seviyelerinde hastalık şiddeti yönünden farklılık yoktu (p>0,05). Ancak, diyabet ya da kronik böbrek hastalığı (KBH) olan hastalarda MAR seviyeleri daha yüksek oranda düşmüştü. İki kan örneklemesi arasında ARG düzeyi ve ARG/ADMA oranı artarken MAR ve CIT/ARG oranı azaldı. Sonuç: Sonuçlarımız, AP iyileşmesi ile MAR düzeylerinin düştüğünü gösterdi. Yüksek kan MAR seviyelerinde azalmanın başlaması, pankreas iltihabının iyileşmeye başlamasını gösterebilir. AP inflamasyonu diyabet veya KBH olan hastalarda daha yıkıcı olabilir.

Keywords

• Akut pankreatit
• Arjinin metabolizması
• Asimetrik dimetilarjinin
• Nitrik oksit

Alterations of Methylated Arginine Residues and Related Amino Acids During Acute Pancreatic Inflammation

Abstract

Aim: The extent of the spread of inflammation determines the severity of acute pancreatitis (AP). Methylated arginine residues (MAR), a type of inflammatory mediator, reduce nitric oxide levels and cause vasoconstriction-induced endothelial damage. This study aimed to investigate MAR and related amino acids during acute pancreatic inflammation. Material and Method: This prospective, quasi-experimental study was conducted with patients diagnosed with AP and an age-matched control group. The patient samples were taken during the diagnosis and recovery time, whereas during the study for the control group. Mainly, Asymmetric dimethylarginine (ADMA), Arginine (ARG), Citrulline (CIT), and related chemicals were studied via a mass spectrometer. Results: A total of 30 patients with AP (mean age=53.3±17.8) and 30 controls (mean age=53.4±18.0) were included in the study. All patients were identified as non-severe (n=8) and severe (n=22). A decrease was detected in the patients' ADMA levels compared to the control group (p=0.01). MAR did not differ concerning disease severity (p > 0.05). However, MAR levels decreased higher in patients with diabetes or chronic kidney disease (CKD). Between the two samplings, the ARG level and ARG to ADMA ratio increased, while the MAR and CIT to ARG ratio decreased. Conclusion: Our results showed that MAR levels decreased with AP recovery. The start of a decrease in the high-level blood MAR may indicate the healing of pancreatic inflammation. AP inflammation may be more destructive in patients with diabetes or CKD.

Keywords

• Acute pancreatitis
• Arginine metabolism
• Asymmetric dimethylarginine
• Nitric oxide

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