Çölyak hastalarında anti siklik sitrüline peptit antikor, anti nükleer antikor ve romatoid faktör varlığının araştırılması
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çölyak hastalığı (Gluten Enteropatisi), özellikle genetik yatkınlığı olan kişilerde çavdar, arpa ve buğday gibi tahılların içinde bulunan glutenin neden olduğu, genel olarak ince bağırsağın etkilendiği bir hastalıktır. Sistemik otoimmun bir hastalık olan çölyak hastalığının prevalansı ortalama % 0,5-1orana sahiptir. Tanı için yapılan serolojik testler yetersiz kalmakta ve kesin tanı için biyopsi yapılması gerekmektedir. Anti nükleer antikor testi (ANA), klinik uygumada en çok tercih edilen ve otoimmunite şüphesi taşıyan vakalar için kullanılan ilk test olma özelliğini taşımaktadır. Romotoid artrit (RA) hastalığında spesifitesi yüksek olan anti siklik sitrüline peptit antikorları (Anti-CCP) testi RA dışındaki otoimmun hastalıkların teşhisi için de kullanılan antikor testidir. Romatoid faktör (RF), RA teşhisi için değerlendirilen bir test olmakla birlikte RA dışındaki diğer romatizmal, inkeksiyöz ve otoimmun hastalıklarda kullanılır. Bu çalışmanın amacı kesin çölyak tanılı çocuk ve yetişkin hastaların ve sağlıklı gönüllülerin serumlarında anti siklik sitrüline peptit antikor, anti nükleer antikor ve romatoid faktör düzeylerinin varlığı araştırılarak çölyak hastalığı ile bu testler arasında bir ilişkinin olup olmadığının araştırılmasıdır. Selçuk Üniversitesi Tıp Fakültesi Hastanesi Çocuk ve Yetişkin Gastroenteroloji ve Hepatoloji Polikliniği'nde izlenen kesin çölyak hastalığı tanısı almış 68'i (%71,6) çocuk, 27'si (%28,4) yetişkin toplam 95 hasta ve kontrol grubu olarak herhangi bir hastalığı bulunmayan çocuk ve yetişkinlerden oluşan 95 sağlıklı kişi çalışmaya alındı. Hasta ve kontrollerden alınan serum örneklerinde IIFT Mosaic Hep-20-10/Liver (Monkey) (Euroimmun Medizinische Labordiagnostika AG, Almanya) kiti kullanılanarak indirektimmunofloresan yöntemi ile ANA, Anti-CCP ELISA (IgG) (Euroimmun Medizinische Labordiagnostika AG, Almanya) kiti kullanılarak mikroelisa yöntemi ile Anti-CCP ve Rheumatoid Factor (Beckman Coulter, USA) kiti kullanlarak Immage 800 Immunchemistry System'de (Beckman Coulter, USA) nefelometrik yöntem ile RF düzeyleri analiz edildi. Çalışmaya alınan kontrol grubunun hiçbirinde RF pozitifliği görülmezken (%0), hasta grubunda 95 kişiden 39'unda (%41,1) RF pozitifliği saptanmış ve bu oran istatistiksel olarak anlamlı bulunmuştur (p<.001). Kontrol grubunda 95 kişiden 11'inde (%11,6), hasta grubunda ise 95 hastadan 22'sinde (%23,2) ANA pozitifliği anlamlı tespit edilmiş ve arada fark bulunamamıştır (p=.055) Anti-CCP düzeyleri kontrol grubunun birinde (%1,1), hasta grubunun üçünde (%3,2) pozitifti ve istatiksel olarak anlamlı bir fark yoktu (p=.621). Otoimmun temelli bir hastalık olan çölyak hastalığı ile diğer otoimmun bazı hastalıkların bir arada olduğu gösterilmiştir. Bu çalışmada kesin çölyak hastalığı tanısı almış hastalarda serum RF düzeylerinin sağlıklı bireylere göre anlamlı bir fark olduğu saptanmıştır. Anti-CCP ve ANA düzeylerinin kesin çölyak tanılı hastalar ile kontrol grubu arasında anlamlı fark olmadığı tespit edilmiştir. Bu verilere dayanarak RF'nin, çölyak hastalığının tanısında ileriye dönük önemli bir belirteç olabileceği ve çölyak hastalığına eşlik edebilecek RA ve/veya diğer otoimmun hastalıklar açısından önceden uyarıcı olabileceği düşünülmektedir.
Celiac disease (Gluten Enteropathy) is a disease caused by gluten in grains such as rye, barley and wheat, especially in people with genetic predisposition, and generally affects the small intestine. The prevalence of celiac disease, which is a systemic autoimmune disease, has an average of 0,5-1%. Serological tests performed for diagnosis are insufficient and biopsy is required for certain diagnosis. The anti nuclear antibody test (ANA) is the most preferred clinical test and is the first test used for cases with suspected autoimmunity. In addition, it is known that serum RF value increases in some infectious diseases. Anti-cyclic citrulline peptide antibody (Anti-CCP) test has high specificity in rheumatoid arthritis (RA) but it can be used for the diagnosis of the other autoimmune disease as well. Although rheumatoid factor (RF) is a test for the diagnosis of RA, it can be used in rheumatic,infectious and autoimmune diseases. The aim of this study is investigation of the presence of anti-cyclic citrulline peptide antibody, anti-nuclear antibody and rheumatoid factor levels in the serum of pediatric and adult patients diagnosed with celiac disease and healthy volunteers. Additionaly, to show whether there was a relationship between celiac disease and these parameters or not. A total of 95 patients 68 (71,6%) children and 27 (28,4%) adults with celiac disease followed up in the Pediatric and Adult Gastroenterology and Hepatology Clinics of Selcuk University Faculty of Medicine. 95 healthy individuals, who did not have any disease, consisting of children and adults were included in the study as the control group. Romathoid factor and Anti-CCP tests were studied by nephelometric and micro ELISA method in Immage 800 Immunchemistry System (Beckman Coulter, USA) using Anti-CCP and Rheumatoid Factor kits (Beckman Coulter, USA). The anti nuclear antibody tests were carried out by inditrect immunofluorescence method using Mosaic Hep-20-10/Liver (Monkey) (Euroimmun Medizinische Labor diagnostika AG, Germany) kit. RF positivity was not detected in any of the 95 individuals of control group, while RF positivity was detected in 39 (41,1%) of the patients, and this rate has a statistically significant difference (p <.001). ANA positivity was detected in 22 (23,2%) of the patients and 11(11,6%) of the control group and there were no significant difference between them (p = .055). Similarly, Anti-CCP positivity was detected in one (1,1%) of the control group sample and three samples (3,2%) of the patients group and statistically there was not significant difference (p = .621). It has been shown that celiac disease, which is an autoimmune disease, and some other autoimmune diseases coexist. According to the results of this study, there was a significant difference in serum RF levels in celiac patients compared to healthy individuals. It was found that Anti-CCP and ANA levels were not significantly different between patients with celiac disease and control group. Based on these data, it is thought that RF may be an important prospective marker in the diagnosis of celiac disease and it may be a pre-warning for RA and other autoimmune diseases that may accompany celiac disease.
Celiac disease (Gluten Enteropathy) is a disease caused by gluten in grains such as rye, barley and wheat, especially in people with genetic predisposition, and generally affects the small intestine. The prevalence of celiac disease, which is a systemic autoimmune disease, has an average of 0,5-1%. Serological tests performed for diagnosis are insufficient and biopsy is required for certain diagnosis. The anti nuclear antibody test (ANA) is the most preferred clinical test and is the first test used for cases with suspected autoimmunity. In addition, it is known that serum RF value increases in some infectious diseases. Anti-cyclic citrulline peptide antibody (Anti-CCP) test has high specificity in rheumatoid arthritis (RA) but it can be used for the diagnosis of the other autoimmune disease as well. Although rheumatoid factor (RF) is a test for the diagnosis of RA, it can be used in rheumatic,infectious and autoimmune diseases. The aim of this study is investigation of the presence of anti-cyclic citrulline peptide antibody, anti-nuclear antibody and rheumatoid factor levels in the serum of pediatric and adult patients diagnosed with celiac disease and healthy volunteers. Additionaly, to show whether there was a relationship between celiac disease and these parameters or not. A total of 95 patients 68 (71,6%) children and 27 (28,4%) adults with celiac disease followed up in the Pediatric and Adult Gastroenterology and Hepatology Clinics of Selcuk University Faculty of Medicine. 95 healthy individuals, who did not have any disease, consisting of children and adults were included in the study as the control group. Romathoid factor and Anti-CCP tests were studied by nephelometric and micro ELISA method in Immage 800 Immunchemistry System (Beckman Coulter, USA) using Anti-CCP and Rheumatoid Factor kits (Beckman Coulter, USA). The anti nuclear antibody tests were carried out by inditrect immunofluorescence method using Mosaic Hep-20-10/Liver (Monkey) (Euroimmun Medizinische Labor diagnostika AG, Germany) kit. RF positivity was not detected in any of the 95 individuals of control group, while RF positivity was detected in 39 (41,1%) of the patients, and this rate has a statistically significant difference (p <.001). ANA positivity was detected in 22 (23,2%) of the patients and 11(11,6%) of the control group and there were no significant difference between them (p = .055). Similarly, Anti-CCP positivity was detected in one (1,1%) of the control group sample and three samples (3,2%) of the patients group and statistically there was not significant difference (p = .621). It has been shown that celiac disease, which is an autoimmune disease, and some other autoimmune diseases coexist. According to the results of this study, there was a significant difference in serum RF levels in celiac patients compared to healthy individuals. It was found that Anti-CCP and ANA levels were not significantly different between patients with celiac disease and control group. Based on these data, it is thought that RF may be an important prospective marker in the diagnosis of celiac disease and it may be a pre-warning for RA and other autoimmune diseases that may accompany celiac disease.
Açıklama
Anahtar Kelimeler
Anti Nükleer Antikor, Anti Siklik Sitrüline Peptit Antikor, Anti Cyclic Citrullinated Peptide Antibody, Anti Nuclear Antibody
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Ekin, M. (2021). Çölyak Hastalarında Anti Siklik Sitrüline Peptit Antikor, Anti Nükleer Antikor ve Romatoid Faktör Varlığının Araştırılması. (Yüksek Lisans Tezi). Selçuk Üniversitesi, Sağlık Bilimleri Enstitüsü, Konya.
