Ailesel Akdeniz Ateşi Hastalarında Atak ve Remisyon Döneminde Erken Bir Belirteç Olarak Serum IL-1β, IL-18 ve Kaspaz-1 Düzeylerinin Değerlendirilmesi

Öz

Giriş: FMF hastalığının patogenezinde sitokinler, seröz membranların iltihaplanmasında önemli rol oynarlar. Bu çalışmanın amacı, serum IL–1β, IL-18 ve kaspaz-1 serum düzeylerinin atak ve remisyon dönemde CRP, ESR, fibrinojen ve immün yanıt ile ilişkisini araştırmaktır. Gereç ve Yöntem: Tel-Hashomer kriterlerine göre FMF tanısı almış 60 hasta atak ve remisyon dönemi olarak iki gruba ayrıldı. 60 FMF hastasının ve 30 kontrol grubu bireyin serum sitokin düzeyleri ELISA yöntemi ile incelendi ve akut faz reaktanları ile immün yanıt arasındaki ilişki araştırıldı. Bulgular: Pro-inflamatuar sitokinler olan IL-1β (p = 0.001), IL-18 (p = 0.043) ve kaspaz-1 (p = 0.043) serum konsantrasyonlarında FMF atak dönemi hastalarında kontrole kıyasla belirgin bir artış gözlemlendi. Ayrıca, IL-1β seviyeleri, FMF atak hastalarında nötrofiller, ESR ve CRP ile pozitif korelasyon gösterdi ve hastalık şiddeti ile IL-1β arasında bir ilişki saptandı. Remisyon dönemi hastalarda ise. serum IL-1β (p = 0.075) ve IL-18 (p = 0.516) düzeylerinde artışa yönelik bir eğilim kaydedilirken, istatistiksel anlamlılığa ulaşmadı. Bununla birlikte, kaspaz-1 (p = 0,049) seviyesinde kontrole nazaran anlamlı bir artış gözlemlendi. Sonuç: Bu çalışma, IL-1β, IL-18 ve kaspaz-1’in sadece atak döneminde değil, ataklar arası dönemde de yararlı bir belirteç olarak hizmet edebileceğini ve hastalığın tanı ve tedavisi için yararlı bir ipucu sağladığını ileri sürmektedir.

Anahtar Kelimeler

• Otoinflamatuar Hastalıklar
• Ailevi Akdeniz Ateşi
• Pro-inflamatuar Sitokinler
• Kazpaz-1

IL-1β, IL-18 and Caspase-1 Levels in Serum as an Early Marker in Familial Mediterranean Fever Patients with Attack and Attack-free Period

Öz

Introduction: In the pathogenesis of the FMF disease, cytokines play important roles in the inflammation of the serous membranes. This study aims to investigate the relationship between serum levels of IL-1β, IL-18 and caspase-1 with CRP, ESR, fibrinogen and immune response attack/attack-free period. Material and Method: 60 patients diagnosed with FMF according to Tel-Hashomer criteria were divided into two groups as attack and attack-free period. Serum cytokine levels were examined by the ELISA method in 60 patients and 30 HCs, and the relationship between acute phase reactants and immune response was investigated. Results: A significant increase in serum concentrations of pro-inflammatory cytokines IL-1β (p = 0.001), IL-18 (p = 0.043) and caspase-1 (p = 0.043) was observed in FMF attack patients compared to control.. And also, IL-1β levels were positively correlated with neutrophils, ESR and CRP in FMF attack patients and there was a relationship between disease severity and IL-1β. In FMF attack-free patients, while a trend towards increased serum IL-1β (p=0.075) and IL-18 (p=0.516) levels were noted, it did not reach statistical significance. However, a significant difference was observed in the caspase-1 (p=0.049) levels of attack-free according to HCs. Conclusion: This study suggests that IL-1β, IL-18 and caspase-1 can serve as a useful marker not only in the attack period but also in the attack-free period, and provide a useful clue for the diagnosis and treatment of the disease.

Anahtar Kelimeler

• Autoinflammatory diseases
• Familial Mediterranean Fever
• Pro-inflammatory cytokines
• Caspase-1

Kaynakça

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