Kronik hepatit ve sirozlu vakalarda COX-2 gen polimorfizminin fibrozis gelişimindeki önemi
Importance of COX-2 gene polymorphism to development of fibrosis in patients with cirrhosis and chronic hepatitis
- Tez No: 195700
- Danışmanlar: PROF. DR. HİKMET AKKIZ
- Tez Türü: Tıpta Uzmanlık
- Konular: Gastroenteroloji, Gastroenterology
- Anahtar Kelimeler: COX-2 8473 T>C, 765 G>C genetic polymorphism, Liver fibrosis, Hepatic activity index, chronic hepatitis
- Yıl: 2008
- Dil: Türkçe
- Üniversite: Çukurova Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: Gastroenteroloji Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 80
Özet
Kronik Hepatit ve Sirozlu Vakalarda COX-2 Gen Polimorfizminin Fibrozis Gelişimindeki ÖnemiAmaç: Kronik hepatit ve sirozlu vakalarda COX-2 geninin -765 G>C ve -8473 T>C genetik polimorfizmlerinin nekroinflamatuar aktivite ve fibrozis üzerine olan etkilerini araştırmak.Gereç ve Yöntemler: Çalışmaya HBV ve HCV'ye sekonder kronik hepatit olduğu bilinen ve karaciğer (KC) biyopsileri yapılmış 104 (51/53, K/E) hasta alındı. Hastaların yaş ortalaması (45±15) idi. Vakalardan 54 tanesi HCV, 50 tanesi HBV etiyolojili idi. COX gen polimorfizmi çalışılmak üzere 5'er cc kan örnekleri alındı. KC biyopsi örnekleri Knodell Histolojik Aktivite Skoruna (HAİ) göre değerlendirildi. Biyopsi sonuçlarına göre vakalar fibrozis 1, 3 ve 4 olarak belirlendi. Fibrozis 4 olanlar siroz safhasında olan vakalardı. Buna göre vakaların 75 tanesi kronik hepatit ve 29 tanesi sirozdu. Yine Knodell skoruna göre HAİ'leri hesaplandı. Polimorfizm saptanan olgularla saptanmayanlar arasında HAİ ve fibrosiz skorları kıyaslandı. Sonuçların değerlendirilmesi için Student' t- test (devamlı değişkenler için), X2 test (kategorik değişkenler için) ve lojistik regresyon analizi kullanıldı.Bulgular: HBV ve HCV'li gruplarda HAİ ve Fibrozis skorları arasında fark yoktu (Sırasıyla pC, 765 G>C gen polimorfizmi, karaciger fibrozis, hepatik aktivite indeksi, kronik hepatit.
Özet (Çeviri)
Importance of COX-2 Gene Polymorphism to Development of Fibrosis in Patients with Cirrhosis and Chronic HepatitisAim: The aim of this study was to investigate impact of promoter polymorphisms of COX-2 -765 G>C and -8473 T>C on necroinflammatory activity and fibrosis.Materials and Methods: Promoter polymorphisms of COX-2 -765 G>C and -8473 T>C was studied in 104 patients (51 female, 53 male) who infected with hepatitis B or hepatitis C. Median age of patients were 45±15. 54 patients were infected with hepatitis C. 50 patients were infected with hepatitis B. Liver biopsy was evaluated according to Knodell histological activity score. According to the liver biopsy results the patients were categorized including fibrosis 1, 3 and 4. All of the patients in fibrosis 4 category was the in cirrhosis stage. In respect of this, 75 patients were in the chronic hepatitis stage and 29 patients were in the cirrhosis stage. In addition to this histological activity score was determined by Knodell score. A 5 mL sample of venous blood was collected from each subject into a test tube containing EDTA as anticoagulant. Differences in the distributions of demographic characteristics between patients were evaluated using the Student?s t-test (for continuous variables) and ?2 test (for categorical variables). The associations between COX-2 polymorphisms genotypes and the risk of fibrosis and HAI were estimated by logistic regression analyses.Results: There were not statistically significant difference in the fibrosis and histological activity scores of hepatitis B and C groups. The genotypic frequencies in the patients were TT 52.9%, TC 33.7% and CC 13.5% in -8473 COX-2 polymorphism. In -8473 TT, TC and CC genotypes group, fibrosis score were 2.9±0.9, 2.7±1.2 and 1.8±1.2 respectively. Difference of fibrosis scores of -8473 genotypes group were statistically significant (p=0.008). Histological activity scores were calculated 9,6±1,7, 8,4±2,7, 6,2±2,9 in -8473 TT, TC and CC genotypes respectively (p=0,0001). Compared with COX-2 -8473 the TC and CC genotypes, TT genotype was associated with an increased risk of fibrosis in the logistic regression analysis (p=0,003, OR=10.0, 95% CI =2,2-44,9) between fibrosis group 1 and 3. Between fibrosis group 1 and 4, COX-2 -8473 TT genotype was increased fibrosis risk 8-fold when compared with TC and CC genotypes (p=0,019, OR = 8.0, 95% CI =1,4-45,4). In the COX-2 -765 polymorphism genotypic frequencies in the patients were the following GG 66,3%, GC 26,0%, and CC 7,7%. In -8473 GG, GC and CC genotypes group fibrosis score were 2.9±0.9, 2,6±1,3 and 1,2±0,7 respectively (p=0,0001). Histological activity scores were calculated 9,3±2,0, 8,5±2,7, 5,2±2,5 in -8473 TT, TC and CC genotypes respectively (p=0,0001). We did not find CC genotype in COX-2 -765 G>C polymorphism. Compared with COX-2 -765 the C/C and GC genotypes, G/G genotype was associated with an increased risk of fibrosis in the logistic regression analysis (p=0,006, OR = 22,16 95% CI =2,4-198,7) between fibrosis group 1 and 3.Conclusion: Viral etiologic factors fibrosis score and histological activity score were not statistically different. Polymorphisms of COX-2 -8473 T and -765 G allels may increase risk of both the liver inflammation and the liver fibrosis development when compared to-8473 C and -765 C allels. In addition to this, 8473 C and -765 C allels may have protective effect on liver inflammation and the liver fibrosis development.
Benzer Tezler
- Ege Üniversitesi Tıp Fakültesi Gastroenteroloji Kliniğinde PrimerSklerozan Kolanjit tanılı hastaların demografik, klinik ve laboratuvar özellikleri, klinik sonlanımları ve mortalite prediktörlerinin belirlenmesi
In the Ege University Faculty of Medicine Gastroenterology Clinic determination of demographic, clinical and laboratory characteristics, clinical outcomes and predictors of mortality in patients diagnosed with primary sclerosing cholangitis
MUSTAFA MUSTAFAYEV
Tıpta Uzmanlık
Türkçe
2023
İç HastalıklarıEge Üniversitesiİç Hastalıkları Ana Bilim Dalı
DOÇ. DR. İLKER TURAN
- Kronik karaciğer hastalıklarında Bcl-2 ekspresyonu
Bcl-2 expression in chronic liver disease
RÜYA MUTLUAY
Tıpta Uzmanlık
Türkçe
2001
GastroenterolojiGazi Üniversitesiİç Hastalıkları Ana Bilim Dalı
DOÇ.DR. SEREN ÖZENİRLER
- Viral hepatit ve siroz hastalarında serum sitokin değerleri ve klinik anlamları
Başlık çevirisi yok
CENGİZ KIRMAZ
Tıpta Uzmanlık
Türkçe
1996
Endokrinoloji ve Metabolizma HastalıklarıEge Üniversitesiİç Hastalıkları Ana Bilim Dalı
PROF. DR. TOMRİS KABAKÇI
- Kronik hepatit B'de oral antiviral tedavi ile virolojik yanıt oranları
Virological response rates with oral antiviral treatment in chronic hepatitis B
HAMZA ABBASOV
Tıpta Uzmanlık
Türkçe
2021
İç Hastalıklarıİstanbul Üniversitesi-Cerrahpaşaİç Hastalıkları Ana Bilim Dalı
PROF. DR. ALİ İBRAHİM HATEMİ
- Kronik HCV infeksiyonlu hastalarda otoimmun serolojik göstergelerin ve doku antijenlerinin araştırılması
Başlık çevirisi yok
AYLA YENİGÜN
Tıpta Uzmanlık
Türkçe
2001
MikrobiyolojiOndokuz Mayıs ÜniversitesiMikrobiyoloji ve Klinik Mikrobiyoloji Ana Bilim Dalı
PROF. DR. BELMA DURUPINAR