ALERJİK RİNİTLİ HASTALARDA TOPİKAL MOMETAZON FUROAT TEDAVİSİNİN

Year 2005, Volume: 6 Issue: 2, 23 - 27, 01.08.2005

Leyla Didem Kozacı İan C Chıkanza Hülya Eyigor Füruzan Döğer Tülay Kavak Didem Evci Sema Başak

Abstract

Amaç: Bu çalışmada mometazon furoat nazal sprey (MFNS) ile tedavi ettiğimiz alerjik rinitli hastalarda tedaviöncesi (TÖ) / tedavi sonrası (TS) serumda ve nazal lavaj sıvılarında makrofaj migrasyon inhibitör faktör (MİF)düzeylerini araştırdık. Ayrıca, tedavinin nazal mukozadaki eozinofil düzeyine etkilerini irdeledik.Gereç ve Yöntem:İlk muayene sırasında alerjik rinit yakınmalarının en az ikisine sahip olan 22 hastanınsemptomları skorlandı, muayene bulguları kaydedildi; serumda ve nazal lavaj sıvısında MİF değerleri saptandı.Hastalara günde bir kez 100 g MFNS (Nasonex®) başlandı. TS dördüncü haftada semptomlar ve muayenebulguları yeniden değerlendirildi, nazal lavaj/serum MİF değerleri ELISA metodu ile ölçüldü. Nazal mukozaimpresyon sitolojisi materyallerinde eozinofillerin diğer hücrelere göre oranları hesaplandı.Bulgular:TÖ/TS nazal lavaj MİF ortalaması (sırasıyla 503,53P<0.001) ve serum MİF ortalaması (sırasıyla 782,55 759,43 pg/ml ve 917.10 1080,37 pg/ml, p>0.05) bulundu.Nazal mukozanın impresyon sitolojisinde eozinofil yüzdesi TÖ ve TS, sırasıyla 51.86 28,94 ve 25.64 23,60 idi.Eozinofil yüzdeleri arasındaki fark istatistiksel olarak anlamlıydı (p<0.001). Semptom skorları ortalaması TÖ veTS sırasıyla 16,95 4,27 ve 9,24 3,38 idi. Skor ortalamalarındaki fark istatistiksel olarak anlamlıydı (P<0.001).Sonuç:Hastalarımızda TSda anlamlı klinik bir düzelme görüldü. TS semptom skorları ve nazal mukoza eozinofilyüzdeleri belirgin şekilde azaldı. TSda lokal MİF düzeylerinde ise artış izlendi. MFNS tedavisini takiben MİFdeğerlerinde izlenen anlamlı değişikliğin klinik düzelmeyle ilişkisinin daha ayrıntılı incelenmesi gerekmektedir

Keywords

Alerjik rinit, makrofaj migrasyon inhibitor faktör (MİF), mometazon furoat

Effects of Topical Mometasone Furoate Therapy on Local and Systemic Macrophage Migration Inhibitory Factor Levels in Allergic Rhinitis Patients

Abstract

Background: In this study we aimed to investigate the systemic and local levels of   macrophagemigration inhibitory factor (MIF) before and after topically applied mometasone furoate therapy in patients with allergic rhinitis. We also investigated the effects of therapy on local eosinophil accumulation. Material and Methods: Twenty-two patients (8 males and 14 females; median of 46 years ranging, from 17 to 68 years) with AR were subjects of this study. Percentages of eosinophils in nasal smears were calculated. MIF levels in serum and nasal lavage were measured by an enzyme-linked immunosorbent assay. Results: Topical glucocorticoid treatment significantly inhibited total symptom score (TSS) (16,95 4,27 and 9,24 3,38, respectively, p<0.001). After therapy, mean percentages of eosinophils decreased significantly (51.86 28,94 and 25.64 23,60 respectively, p<0.001) by impression cytology. MIF levels both in serum (782,55 759,43pg/ml and 917.10 1080,37 pg/ml, respectively) and nasal lavage (503,53 294,50 pg/ml and 1422.35 1097,98 pg/ml, respectively) increased after mometasone therapy. However, only the change in nasal lavage samples was statistically significant (p<0.001). Conclusions: TSS and nasal eosionophil numbers in nasal mucosa decreased following therapy. Further investigations are needed to evaluate the relations between clinical improvement and the significant changes in MIF levels following MFNS treatment.

Keywords

Allergic rhinitis, macrophage migration inhibitory factor (MIF), mometasone furoate

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• Yrd. Doç. Dr. Leyla Didem KOZACI
• Adnan Menderes Üniversitesi Tıp Fakültesi
• Biyokimya Anabilim Dalı AYDIN, 09100 Tel : + 90 256 225 31 66
• + 90 532 617 80 40 E-Posta
• : [e-mail]
• [e-mail] Geliş Tarihi Kabul Tarihi : 25.05.2005