Turkiye Klinikleri Journal of Allergy & Asthma

Otolog Serum Testi Pozitif Kronik İdiopatikÜrtikerli Hastalarda Otoantikorlar
AUTOANTIBODIES IN PATIENTS WITH CHRONIC IDIOPATHIC URTICARIAAND POSITIVE AUTOLOGOUS SERUM SKIN TEST
Nihal METE*, Okan GÜLBAHAR**, Kevser ONBAŞI***, Aytül SİN****, Ali KOKULUDAĞ*****, Filiz SEBİK*****
*, Ege Üniversitesi Tıp Fakültesi Dahiliye AD, İmmünoloji ve Allerji BD**, Ege Üniversitesi Tıp Fakültesi Dahiliye AD, İmmünoloji ve Allerji BD***, Ege Üniversitesi Tıp Fakültesi Dahiliye AD, İmmünoloji ve Allerji BD****, Doç., Ege Üniversitesi Tıp Fakültesi Dahiliye AD, İmmünoloji ve Allerji BD*****, Ege Üniversitesi Tıp Fakültesi Dahiliye AD, İmmünoloji ve Allerji BD, İZMİR
Turkiye Klinikleri J Allergy-Asthma. 2003;5(2):61-6
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmada otolog serum testi pozitif olan kronik idiopatik ürtikerli (KİÜ)li hastalarda antinükleer antikor, gastrik parietal hücre antikoru ve tiroid otoantikor sıklığı araştırılmıştır. Ayrıca bu hasta grubunda son yıllarda bazı yayınlarda kronik ürtiker etiyolojisinden sorumlu tutulan Helikobakter pilori (HP) serolojik olarak araştırılmış ve sonuçlar sağlıklı kontrollerle karşılaştırılmıştır. Materyal ve Metod: Otolog serum testi pozitif 22 kronik idiopatik ürtikerli hasta [4 erkek/18 kadın, ortalama yaş 41.6 (18-61)] ile yaş ve cinsiyet uyumlu 27 sağlıklı [7 erkek/20 kadın, ortalama yaş 39.1 (26-55)] çalışmaya dahil edilmiştir. Her iki grupta antinükleer antikor, gastrik parietal hücre otoantikoru, tiroid otoantikor tayini yapılmıştır. Ayrıca anti-HP IgG düzeyleri serolojik yöntemle çalışılmıştır. Bulgular: Otolog serum testi pozitif kronik idiopatik ürtikerli hastalarda ANA pozitifliği kontrol grubuna göre daha fazla bulundu. 1/40 ve üzeri dilüsyonlarda, 22 KİÜli hastanın 9unda (%40.9), 1/80 ve üzeri dilüsyonlarda ise 22 hastanın 6ında (%27.3) ANA pozitif idi. Her iki dilüsyonda da p<0.05 saptandı (1/40 dilüsyon için p=0.022, 1/80 dilüsyon için p=0.036). Gastrik parietal hücre ve tiroid otoantikorları açısından her iki grup arasında istatistiksel anlamlı fark yoktu. Otolog serum testi pozitif kronik idiopatik ürtiker hastalarında anti-HP IgG pozitiflik oranı kontrol grubuna göre belirgin derecede yüksekti (p=0.038). Sonuç: ANA pozitifliği, kronik idiopatik ürtikerli hastalarda otolog serum test pozitifliği yanısıra kişinin kendi antijenlerine verdiği reaksiyonun bir diğer kanıtı olarak kabul edilebilir. Anti-HP IgG pozitifliğinin de bu hastalarda arttığı saptanmıştır. Belki de Helikobakter pilori enfeksiyonu self antijenlere toleransı ortadan kaldırarak veya moleküler benzerlik mekanizmaları ile söz konusu otoantikorların oluşumuna neden olmaktadır.

Anahtar Kelimeler: Kronik idiopatik ürtiker, Otoimmunite, Otolog serum testi, Antinükleer antikor, Helikobakter pilori, Anti-HP IgG
ABSTRACT
 Purpose: To determine the frequency of antinuclear, antigastric parietal cell and antithyroid autoantibodies in patients with chronic idiopathic urticaria and a positive autologous serum test. Serological evidence of Helicobacter pylori (HP) in the same patient population was also investigated and compared with that seen in a healthy control group. Materials and Methods: Twenty-two chronic idiopathic urticaria patients with a positive autologous serum test [(4 males, 18 females; mean age 41.6 (18-61)] and 27 sex and age matched healthy controls [(7 males, 20 females; mean age 39.1 (26-55)] were included in the study. Anti nuclear, gas-tric parietal cell and thyroid autoantibodies were studied in patients and controls. IgG anti-HP antibody levels were also determined serologically. Results: ANA positivity was found to be higher in patients with chronic idiopathic urticaria and a positive autologous serum test than in the control group. Nine of the 22 CIU patients (40.9%) had ANA positivity at dilutions 1/40 or higher and 6 of the 22 patients (27.3%) had positivity at dilutions 1/80 or higher. The p value was <0.05 for both results obtained using dilutions 1/40 and 1/80 (p=0.022 for dilution 1/40 and p=0.036 for dilution 1/80). There was no statistically sig-nificant difference between the patient and the control groups in the frequency of the gastric parietal cell and thy-roid autoantibodies. IgG anti-HP positivity was significantly higher in patients with CIU and a positive autologous serum test than in the control group (p=0.038). Conclusion: ANA positivity can be interpreted as further evi-dence of self reactivity in CIU patients as suggested by a positive autologous serum test. Higher frequency of IgG anti-HP positivity in patients with CIU has also been shown in this study. It is tempting to think that HP infection lowers self tolerance or alternatively triggers autoreactivity because of molecular similarities between HP and self antigens.

Keywords: Chronic idiopathic urticaria, Autoimmunity,Autologous serum skin test, Antinuclear antibody, Helicobacter pylori, Anti-HP IgG

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