N-Asetilsistein Tedavisinin Bronşektazi Hastalarında 8-OHDG, İmmünoglobulinler, CRP, Prokalsitonin, Prolidaz ve Oksidatif Stres Düzeylerine Etkisi

Öz

Amaç: Bronşektazi giderek daha fazla tanınan ve bronşların kalıcı ve geri dönüşümsüz genişlemesi olarak tanımlanan bir hastalıktır. Akciğerin hava yollarının aşırı mukus birikmesine yol açtığı, akciğerlerin enfeksiyona karşı daha savunmasız olduğu uzun vadeli bir durumdur. Çalışmamızda N-asetilsistein (NAC) kullanan ve kullanmayan bronşektazi hastalarında 8-hidroksi deoksi guanozin (8-OHdG), C-Reaktif Protein (CRP), immünoglobulinler (IgA, IgG, IgM), prokalsitonin, prolidaz enzimi ve oksidatif stres belirteçlerinin serum düzeylerinin bronşektazi hastalarının tanı ve takibinde yararlı olup olmayacağını incelemeyi amaçladık. Materyal ve metod: Bronşektazi hastalarından NAC kullanan 30 hasta, NAC kullanmayan 30 hasta ve 30 sağlıklı kontrol grubu olarak seçildi. Analiz sonucunda 8-OHdG, Prolidaz, seviyeleri ELISA yöntemi ile çalışıldı. TAS, TOS, OSİ düzeyleri spektrofotometrik Rel Assay marka ticari kitler kullanılarak ölçüldü. IgA, IgM ve IgG Siemens markalı Adviye center cihazında, prokalsitonin ve CRP Atellica CH ciha-zında çalışıdı. Elde edilen verileri SPSS 22.0 (SPSS® for Windows Chicago, IL, USA) paket programı kullanılarak istatistiksel analizleri yapıldı. Bulgular: Bu çalışmada N-Asetilsistein tedavisi alan ve almayan bronşektazili hasta gruplarında 8-OHdG, prolidaz, TOS, OSI, IgG ve IgA düzeylerinin daha yüksek olduğu bulundu. Ayrıca toplam antioksidanın diğer gruplara göre daha yüksek olduğu görüldü. IgG solunum yollarının konak savunma sisteminin önemli bir bileşeni olarak kabul edilirken, yüksek IgA düzeylerinin enfeksiyon riskinin azalmasıyla ilişkili olabileceği düşünülmüştür. Çalışmamızda bu biyobelirteçlerin NAC tedavisi almayan bronşektazili hastalarda diğer gruplara göre anlamlı olarak daha yüksek olduğu görüldü (p<0,001). TAS düzeylerindeki azalma bronşektazi varlığında antioksidan savunmanın zayıfladığını göstermektedir. Sonuç: Bu çalışmada NAC kullanmayan bronşektazili hastalarda 8-OHdG, prolidaz, TOS, OSİ, IgG ve IgA değerlerinin diğer gruplara göre daha yüksek olduğu bulunmuştur. TAS bronşektazi varlığında toplam antioksidan düzeyinin azaldığını göstermektedir. IgG, solunum yolunun konak savunma sisteminin önemli bir bileşenidir IgA düzeyi enfeksiyon riski daha fazladır. Çalışmamızda NAC kullanmayan bronşektazi hastalarında 8-OHdG, prolidaz, TOS, OSI, IgG ve IgA değerleri diğer gruplara göre daha yüksek bulunmuştur. TAS bronşektazi varlığında total antioksidan seviyesinin azaldığını göstermektedir.Analiz sonucunda 8-OHdG, TOS, OSİ, Prolidaz, IgA, prokalsitonin ve CRP seviyeleri NAC kullanmayan gruplara göre istatiksel olarak anlamlı yüksek bulundu (p<0.001). IgM seviyesi ise NAC kullanmayan gruplara göre istatiksel olarak anlamlı düşük bulundu (p<0.001). Çalışma, NAC'ın incelenen değişkenleri önemli ölçüde etkilediğini gösterdi. Bu biyobeliteçlerin tanı ve takip parametrelerinin önemli bir bileşeni olabileceği ve tedaviye katkı sağlayacağını ümit ediyoruz

Anahtar Kelimeler

• Bronşektazi
• N-Asetilsistein
• 8-OHdG
• Prolidaz

Effects of N-Acetylcysteine Therapy on 8-OHDG, Immunoglobulins, CRP, Pro-calcitonin, Prolidase and Oxidative Stress Levels in Bronchiectasis Patients

Öz

Background: Bronchiectasis is defined as the permanent and irreversible dilatation of the bronchi. It is a long-term condition in which the lung airways are excessively mucus-filled, making the lungs more vulnerable to infection. In our study, we aimed to investigate whether the serum levels of 8-hydroxydeoxyguanosine (8-OHdG), C-Reactive Protein (CRP), antibodies (IgA, IgG, IgM), procalcitonin, prolidase enzyme and oxidative stress markers would be useful in the diagnosis and follow-up of bronchiectasis patients having taken N-acetylcysteine (NAC). Materials and Methods: The study included 30 bronchiectasis patients taking NAC therapy, 30 ones without NAC therapy and 30 healthy control groups. Their serum 8-OHdG, Prolidase levels were studied by ElISA method. Serum antioxidants levels such as TAS, TOS, OSI were also measured using spectrophtometric metod using Rel Assay brand commercial kit. Serum antibodies (IgA, IgM and IgG) were studied on the Siemens brand Adviye center device, and procalcitonin and CRP were determined by the Atellica CH device. Statistical analysis of the obtained data was performed using the SPSS 23,0 (SPSS® for Windows Chicago, IL, USA) package program. Results: In this study, it was found that 8-OHdG, prolidase, TOS, OSI, IgG and IgA levels were higher in bronchiectasis patients groups with and without N-Acetylcysteine therapy. In addition, it was observed that total antioxidant compared to other groups. While IgG is considered an important component of the host defense system of the respiratory tract, it has been thought that high IgA levels may be associated with decreased risk of infection. In our study, it was observed that these biomarkers were significantly higher in bronc-hiectasis patients who did not get NAC therapy compared to other groups (p<0.001). The decrease in TAS levels indicates that anti-oxidant defense is weakened in the presence of bronchiectasis. Conclusions: In this study, 8-OHdG, prolidase, TOS, OSI, IgG and IgA values were found to be higher in bronchiectasis patients who did not use NAC compared to other groups. TAS shows that the total antioxidant level decreases in the presence of bronchiectasis. As a result of the analysis, 8-OHdG, TOS, OSI, Prolidase, IgA, procalcitonin and CRP levels were found to be statistically significantly higher compared to the groups not using NAC (p <0.001). IgM level was found to be statistically significantly lower compared to the groups not using NAC (p<0.001). The study showed that NAC significantly affected the variables studied. We hope that these biomar-kers can be an important component of diagnostic and follow-up parameters and contribute to treatment.

Kaynakça

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