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Öz

Amaç: Bu çalışmada, klinik ve laboratuvar bulgularıyla kesin pandemic influenza A (H1N1) enfeksiyonu tanısı konan yatan hastalar, üst solunum yolu enfeksiyonu enfeksiyonu tanısı konan poliklinik hastlarında serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ve plazma solubl ürokinaz plazminojen aktivatör reseptörü (suPAR) düzeyinin klinik öneminin belirlenmesi amaçlandı. Yöntem: Çalışmaya influenza A (H1N1) enfeksiyonu tanısı klinik ve laboratuvar testiyle (polimeraz zincir reaksiyonu: PZR) tanısı konan 26 yatan hasta, üst solunum yolu enfeksiyonu (akut sinüzit, akut tonsillofarenjit, akut nazofarenjit vb.)tanısı konan 30 poliklinik hastası ve hiçbir yakınması olmayan 24 sağlıklı birey dahil edildi. Serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ve plazma suPAR düzeyi ELISA yöntemiyle üretici firmanın önerileri doğrultusunda belirlendi. İstatistiksel değerlendirmede Kruskal- Wallis, Mann-Whitney U testi ve Ki-kare testleri kullanıldı.Bulgular: İnfluenza A (H1N1) enfeksiyonu olan yatan hastalarda serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ile plazma suPAR düzeyleri median değeri sırasıyla; 27,8 ng/ml, 9,29 ng/ml, 11,04 ng/ml, 8,82 ng/ml ,5,64 ng/ml olarak belirlendi.Üst solunum yolu enfeksiyonu tanısı konan poliklinik hastalarında serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ve plazma suPAR düzeyi median (ortanca) değeri sırasıyla; 7,24 ng/ml, 1,9 ng/ml, 19,74 ng/ml, 4,37 ng/ml, 3,33 ng/ml idi.Sağlıklı bireylerde ise serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ve plazma suPAR düzeyi median değeri sırasıyla; 0,97 ng/ml, 0,16 ng/ml, 4,46 ng/ml, 2,38 ng/ml, 1,65 ng/ml olarak belirlendi.İnfluenza A (H1N1) enfeksiyonu tanısı konan yatan hastalarda serum IL-6, IL-10, neopterin düzeyleri, üst solunum yolu enfeksiyonu tanısı konan poliklinik hastalarınkınden istatistiksel olarak anlamlı yüksekti. Üst solunum yolu enfeksiyonu tanısı konan poliklinik hastalarında serum TNF-alfa düzeyleri H1N1 tanısı konan yatan hastalardan daha yüksekti. Üst solunum yolu enfeksiyonu tanısı konan poliklinik hastalarında, serum IL-6, IL-10, TNF-alfa, neopterin düzeyleri ile plazma suPAR düzeyleri kontrol grubundan anlamlı oranda yüksekti.İnfluenza A (H1N1) enfeksiyonu tanısı alan yatan hastalarda serum IL-6, IL-10,neopterin ve plazma suPAR düzeyi sağlıklı bireylere göre anlamlı yükseklik gösterdi.Sonuç: Serum IL-6, IL-10, neopterin, TNF-alfa düzeyleri ve plazma suPAR düzeyi influenza A (H1N1) enfeksiyonu olan hastaların klinik izleminde kullanılabilir

Anahtar Kelimeler

• Pandemik H1N1, sitokinler, solubl urokinaz plazminojen aktivatör reseptörü (suPAR) , tanısal değeri

Serum interleukin-6, interleukin -10, tumor necrosis factor -alpha, neopterin and plasma soluble urokinase plasminogen activator receptor levels in the patients with pandemic H1N1 influenza infection

Abstract

Objective: This study aims to investigate the clinical importance of serum interleukin (IL) 6, IL-10, tumor necrosis factor alpha (TNF-alpha), neopterin, and plasma soluble urokinase plasminogen activator receptor (suPAR) levels in patients with pandemic H1N1 influenza infection and outpatients diagnosed with upper respiratory infections. Materials and Methods: Twenty-six inpatients with H1N1 infection confirmed by clinical findings and polymerase chain reaction (PCR) test 30 outpatients diagnosed with upper respiratory infections, and 24 healthy individuals without any complaints were included. Serum IL-6, IL-10, TNF-alpha, neopterin levels and plasma suPAR levels were compared between the patients groups and the 24 healthy controls. Serum IL-6, IL-10, TNF-alpha, neopterin levels and plasma suPAR levels were determined through the enzyme-linked immunosorbent assay (ELISA) as per manufacturer’s instructions.

Results: The median serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 27.8 ng/ml, 9.29 ng/ml, 11.04 ng/ml, 8.82 ng/ml and 5.64 ng/ml, respectively in inpatients with H1N1. In 30 outpatients diagnosed with upper respiratory infections, the median serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 7.24 ng/ml, 1.9 ng/ml, 19.74 ng/ml, 4.37ng/ml and 3.33 ng/ml, respectively. In healthy individuals, the mean IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 97 ng/ml, 0.16 ng/ml, 4.46 ng/ml, 2.38 ng/ml, 1.65 ng/ml, respectively. In inpatients with H1N1, serum IL-6, IL-10, neopterin levels were significantly higher than those of outpatients diagnosed with upper respiratory infections. In outpatients with upper respiratory infections, serum TNF-alpha levels were higher than in inpatients with H1N1 infection as confirmed by laboratory findings (PCR). In outpatients, serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were significantly higher from those in the control group. In patients with influenza A (H1N1) infection, serum cytokine levels and plasma suPAR levels were significantly higher from healthy individuals.

Conclusion: Serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels may be used as clinical follow-up markers in patients with H1N1 infection. J Microbiol Infect Dis 2015;5(3): 119-124 Key words: Pandemic influenz A (H1N1), cytokines, soluble urokinase plasminogen activator receptor (suPAR), diagnostic value.

Keywords

• Pandemic influenz A (H1N1)
• cytokines
• soluble urokinase plasminogen activator receptor (suPAR)
• diagnostic value

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