Turkiye Klinikleri Cardiovascular Sciences

.: ORIGINAL RESEARCH
Romatoid Artritte Serumda Çözünebilir Adezyon Molekülleri Düzeyleri ile Lipid Parametreleri Arasındaki İlişkiler
Relationships Between Serum Levels of Soluble Adhesion Molecules with Lipid Parameters in Rheumatoid Arthritis
Ayşenur ATAYa, Rezzan GÜNAYDINb, Aysel HÜRa, Mehmet H. KÖSEOĞLUa, Neşe ÖLMEZb
aII. Biyokimya ve Klinik Biyokimya Laboratuvarı, İzmir Atatürk Eğitim ve Araştırma Hastanesi, bFizik Tedavi ve Rehabilitasyon Kliniği, İzmir Bozyaka Eğitim ve Araştırma Hastanesi, İzmir
Turkiye Klinikleri J Cardiovasc Sci. 2010;22(1):34-40
Article Language: TR
Full Text
ÖZET
 Amaç: Adezyon moleküllerinin yüzey ekspresyonunun birçok faktör ile birlikte serum lipidleri tarafından da regüle edilebileceği veya birbirleri ile çeşitli yollarla etkileşebileceği düşünülmektedir. Bu çalışmada romatoid artritli (RA) hastalarda inflamatuvar ve immunolojik cevapları içeren çeşitli hücrelerarası ilişkilerde önemli role sahip serum hücrelerarası adezyon molekülü-1 (ICAM-1), vasküler hücre adezyon molekülü-1 (VCAM-1) ve Tümör Nekrozis Faktör-alfa (TNF-alfa) düzeylerinin serum lipid, lipoprotein düzeyleri ile ilişkilerinin incelenmesi amaçlandı. Ayrıca hastalık aktivitesinin klinik ve laboratuvar parametreleri ile etkileşimleri de incelendi. Gereç ve Yöntemler: Çalışmaya Amerikan Romatizma Birliği kriterlerine göre RA tanısı alan ve çalışmaya dahil olma kriterlerini karşılayan ardışık 41 hasta ve 25 inflamatuvar hastalığı olmayan gönüllü alındı. Hastalar aktivite skorlarına göre yüksek ve hafif/orta aktivite grubu olarak 2 grupta incelendi. Tüm hasta ve kontrol grubunda total kolesterol (TK), yüksek yoğunluklu lipoprotein kolesterol (HDL-K), trigliserid (TG) lipoprotein(a) [Lp(a)] düzeyleri spektrofotometrik, apolipoprotein A (Apo A) ve B (Apo B) immunotürbidimetrik, C-reaktif protein (CRP) düzeyleri nefelometrik ve eritrosit sedimantasyon hızı (ESH) Westergreen, ICAM-1, VCAM-1 ve TNF-alfa düzeyleri sandviç tip enzim-bağlı immunosorbent ölçüm (ELISA) yöntemi ile ölçüldü. Düşük yoğunluklu lipoprotein kolesterol (LDL-K) Friedewald formülü ile hesaplandı. Hastalarda romatoid faktör (RF) düzeyleri nefelometrik yöntem ile ölçüldü. Bulgular: Hasta ve kontrol grubu arasında yaş, cins, vücut kitle indeksi açısından fark yoktu. ICAM-1, VCAM-1, TNF-alfa ve TK düzeyleri RA hastalarında kontrole göre yüksek bulundu (sırasıyla p= 0.001, p= 0.004, p= 0.014 ve p= 0.009). Hastalık aktivitesi ile ICAM-1, VCAM-1 ve TNF-alfa arasında anlamlı ilişki saptanmadı. ICAM-1 düzeyleri ile HDL-K arasında; VCAM-1 düzeyleri ile HDL-K arasında anlamlı negatif, TNF-alfa ile TK, LDL-K ve Apo B arasında anlamlı pozitif korelasyonlar olduğu görüldü. Sonuç: Bu çalışmada RA'li hastalarda ICAM-1, VCAM-1 ve TNF-alfa düzeylerinin kontrol grubuna göre yüksek bulunmasına karşın hastalık aktivitesi ile ilişkili olmadıkları, buna karşın lipid ve lipoprotein metabolizması üzerine etkilerinin olabileceği gözlendi.

Anahtar Kelimeler: Hücrelerarası yapışma molekülü-1; lipidler; artrit, romatoid; damar hücre yapışma molekülü-1; tümör nekroze edici faktör-alfa
ABSTRACT
 Objective: It may be thought that the surface expression of adhesion molecules may be modulated by serum lipids together with many factors, or interact with each other in various ways. The aim of this study was to evaluate the correlations between intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1)], tumor necrosis factor- alpha (TNF-alfa) -which have important roles in intercellular relationships, inflammatory and immunological responses- and lipid, lipoprotein levels in rheumatoid arthritis (RA). The aim was also to investigate the interaction betweeen clinical and laboratory parameters of disease activity. Material and Methods: Forty-one patients fulfilling American College of Rheumatology criteria for a diagnosis of RA and 25 volunteers who had no inflammatory diseases were subsequently accepted to this study. According to activity scores, patients were grouped into two groups as having high or mild to moderate disease activity. Total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), lipoprotein(a) [Lp(a)] levels of all participants were measured spectrophotometrically, while apolipoprotein A (Apo A) and B (Apo B) were measured immunoturbidimetrically. Nephelometry was used for C-reactive protein (CRP) levels, and Westergreen method for erythrocyte sedimentation rate (ESR). ICAM-1, VCAM-1 and TNF-alfa levels were determined by sandwich type enzyme immunosorbant assay (ELISA). Low density lipoprotein cholesterol (LDL-C) was calculated using Friedewald's formula. Rheumatoid factor (RF) levels of patients were measured by nephelometry. Results: Age, sex and body mass index did not show a statistically significant difference between RA and control subjects (p> 0.05). ICAM-1, VCAM-1, TNF-alfa and total cholesterol levels were higher than control in RA (p= 0.001, p= 0.004, p= 0.014 ve p= 0.009 respectively). There were no correlations between disease activity and ICAM-1, VCAM-1 and TNF-alfa levels. There were negative correlations between ICAM-1-HDL-C levels, and VCAM-1-HDL-C levels. Additionaly, positive correlations between TNF-alfa, Apo B, TC and LDL-C levels were observed. Conclusion: ICAM-1, VCAM-1 and TNF-alfa levels were found to be significantly higher in RA group in this study, but any parameter has no correlation with disease activity. Besides, it was concluded that there may be some effects of those parameters on lipid and lipoptotein metabolism.

Keywords: Intercellular adhesion molecule-1; lipids; arthritis, rheumatoid; vascular cell adhesion molecule-1; tumor necrosis factor-alpha

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