Akademik Veri Yönetim Sistemi
Tezin Türü: Tıpta Uzmanlık
Tezin Yürütüldüğü Kurum: Bursa Uludağ Üniversitesi, TIP FAKÜLTESİ, TEMEL TIP BİLİMLERİ, Türkiye
Tezin Onay Tarihi: 2018
Tezin Dili: Türkçe
Öğrenci: MERVE SENA DURMAZPINAR
Danışman: Arzu Yılmaztepe Oral
Özet:
Acne
rosacea (AR) is a chronic inflammatory skin disease affecting the facial skin.
The disease is characterized by flashing, facial erythema, inflammatory
papules, pustules and telangiectatic lesions. It is most commonly involved in
the face region, rarely in the scalp, behind the ear, neck region.
Pathophysiology is not entirely clear, as there are many triggering mechanisms,
including genetic and environmental factors (such as heat, ultraviolet, spice,
alcohol, stress), infectious causes, and the immune system.
The
indolamine 2,3-dioxygenase (IDO) is a cytosolic, biosynthetic enzyme composed
of 407 amino acids of 45 kD in the first step in tryptophan catabolism.
Autoimmune diseases have been associated with some pathophysiological
conditions including fetomaternal tolerance, cancer, and infectious diseases.
By consuming tryptophan, an essential amino acid, it inhibits proliferation of
both T lymphocytes and pathogens. By proinflammatory cytokine release such as
interferon-γ, it is expressed from antigen-presenting cells, and the main role
is the immunosuppressive effect. Endocan is a structurally cysteine-rich
proteoglycan composed of 165 amino acids at 20 kDa. It is excreted in the
microvascular endothelial cells of the lung, skin and fat tissue as well as
coronary and pulmonary arteries. Endocan plays a role in the pathogenesis of
various malignancies and inflammatory diseases. It plays a role in the
regulation of biological processes such as adhesion, migration and
proliferation of the cell. Especially its expression is elevated by vascular
endothelial growth factor.
In
this study, we investigated the relationship between IDO and AR, which is
implicated in changes in the immune system for the etiopathogenesis. We also
investigated the relationship between AR disease, in which dilated vascular
structures were seen on the skin, and endocan as an endothelial marker. 81
volunteers participated in the study. The AR group consisted of 52 subjects (36
females, 16 males) while the control group consisted of 29 healthy subjects (21
males, 8 females) without any disease. Serum IDO and endocan levels were
determined by ELISA.
Serum IDO levels were significantly higher in patients with AR compared to healthy group (p <0.001). Patients were also grouped according to the period of the AR (exacerbation / remission) and type (erythematotelangiectatic / papulopustular). Serum IDO levels of patients in remission period of AR and papulopustular type of AR were significantly higher than the control (p = 0.002, p = 0.001, respectively). When serum IDO levels were compared according to sex, serum IDO levels of female AR patients were higher than healthy ones (p <0.001). There was no difference between patient and control groups regarding serum endocan levels. Serum endocan levels of AR patients in the remission period were significantly higher than those in the AR patients in the exacerbation period (p = 0.014). It was seen that the type of AR had no effect on the serum endocan levels. There was no difference between groups when serum endocan levels were examined according to sex. There was also no correlation between serum IDO and endocan levels. In conclusion, serum IDO, a parameter related to immune tolerance, was found to increase in AR patients in this study. However, serum IDO levels were found to be important in gender when assessed. Contrary to expectations, there was no correlation between serum endocan levels and AR with increased local vascularity.