Turkiye Klinikleri Journal of Internal Medicine

.: REVIEW
Böbrek Nakillerinde Kompleman Sistemine Bakış
Overview of Complement System in Renal Transplantation
Tülay KILIÇASLAN AYNAa,b, İbrahim PİRİMa,b
aİzmir Kâtip Çelebi Üniversitesi Tıp Fakültesi, Tıbbi Biyoloji ABD, İzmir, TÜRKİYE
bSağlık Bilimleri Üniversitesi Tepecik Eğitim ve Araştırma Hastanesi, Doku Tipleme Laboratuvarı, İzmir, TÜRKİYE
Turkiye Klinikleri J Intern Med. 2020;5(3):123-36
doi: 10.5336/intermed.2019-72752
Article Language: TR
Full Text
ÖZET
 İmmün sistem, 3 ana kısımdan oluşmaktadır. Bunlar; immün sistem organları, immünositler adı da verilen immün sistem hücreleri ve immün moleküllerdir. Kompleman, çok sayıda protein içeren, doğal ve edinsel immün sistemin temel moleküllerindendir. Vücuttaki kompleman proteinlerinin oranı ve farklı kompleman proteinleri arasındaki denge, hastalıklarla yakından ilişkilidir. Kompleman sistemi, 3 farklı yolla aktifleşerek yabancı olan moleküllerden konağı korur. Farklı kompleman proteinleri ile başlayan aktivasyon süreci ortak bir mekanizma ile sonlanır. Böbrek nakli de aslında immün sistemin bir sınavıdır. Canlı veya kadavra vericiden (donör) alınan böbrek, hastaya yabancıdır ve nakil hastadaki immün sistemi harekete geçirir. Kompleman proteinleri de doğal olarak bu sürece katılır. Bu derlemede, naklin 2 tarafı olan hasta ve donörün, kompleman sistemine olan katkısı değerlendirilmiştir. Hastada, böbrek yetersizliğine gidişi tetikleyen kompleman proteinlerindeki anormal durumlar, hastalıktan kaynaklanan inflamasyon ve son dönem böbrek yetersizliği olan hastalardaki diyalizin, kompleman proteinlerini etkilemesi muhtemeldir. Özellikle kadavradan yapılan nakillerde, yoğun bakım ünitelerindeki donörlerden kaynaklı veya iskemi süreleri ile kompleman sisteminin aktivasyonu oluşur. Bu donörlerdeki, hemodinamik dengesizlik, hormon düzensizliği ve inflamatuar reaksiyonlar önemli fizyolojik değişikliklere neden olur. Sonuçta olarak, hücre fenotiplerinin değişimi, kemokin ve sitokin havuzlarındaki farklılıklar, kompleman aktivasyonuyla sonuçlanabilir. Farklı yolların aktivasyonu ve bu yollar arasındaki sinerji, immün reaksiyonu güçlendirir. Nakil öncesinde ve sonrasında immün sistem aktivasyonunun, kompleman penceresinden de değerlendirilmesi organ nakli kliniklerine katkı sağlayacaktır.

Anahtar Kelimeler: Böbrek transplantasyonu; diyaliz; kompleman
ABSTRACT
 The immune system consists of three main parts. These are organs of the immune system, cells of the immune system, also called immunocytes, and immune molecules. Complement is one of the basic molecules of the natural and acquired immune system that contains a large number of proteins. The proportion of complement proteins in the body and the balance between different complement proteins are closely related to diseases. The complement system is activated in three different ways to protect the host from foreign molecules. The activation process starts with different complement proteins and ends with a common mechanism. Renal transplantation is also the factor that activates the immune system. The kidney from living or cadaver donor is foreign to the patient and the transplant activates the immune system. Complement proteins are also naturally involved in this process. In this review, the contribution to the complement system of the patient and donor, who are on both sides of the transplant was evaluated. Abnormal conditions in the complement proteins that triggering the progression to renal failure in the patient, inflammation caused the disease, and dialysis in patients with endstage renal failure are likely to affect complement proteins. Especially in cadaver transplants, activation of the complement system occurs due to donor in intensive care units or ischemia times. Hemodynamic imbalance, hormone disorder and inflammatory reactions in these donors cause important physiological changes. As a result, changes in cell phenotypes, differences in chemokine and cytokine pools may result in complement activation. The evaluation of immune system activation before and after transplantation from the complement window will contribute to organ transplantation clinics.

Keywords: Kidney transplantation; dialysis; complement
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www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com