İrritabl bağırsak sendromunda mukozal mast hücre artışı
Yükleniyor...
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
İrritabl barsak sendromu (IBS), kronik ve tekrarlayıcı karın ağrısı, diyare, kabızlık ve/veya karında şişkinlik ile seyreden fonksiyonel bir gastrointestinal bozukluktur. Kabızlık baskın (IBS-C), diyare baskın (IBS-D), karma tip (IBS-M) ve alt sınıfı olmayan şeklinde alt grupları tanımlanmıştır. Tanıyı kolaylaştırmak ve standardize etmek için semptoma dayalı Roma kriterleri geliştirilmiştir. İBS önemli biyolojik ve psikososyal faktörlerin etkileşimidir. Motilite değişikliği, visseral hiperaljezi, beyin barsak etkileşiminin bozulması, anormal merkezi işlem, otonom ve hormonal olaylar, genetik ve çevresel faktörler, postenfeksiyöz sekeller ve psikososyal bozuklukların bireye göre farklı katılımları olur. Sistemik mastositozun GİS ve GİS dışı semptomlarının IBS ile benzerliği, kolonik mukozal mast hücrelerinin sorumlu olup olmayacağı hipotezini gündeme getirmiştir. Bu hipotezden hareketle yapılan çok sayıda araştırmalarda IBS' lu hastaların kolon mukozasında mast hücre infiltrasyonu saptanmıştır. Çalışmamızda yapılmış araştırmaların işaret ettiği gibi IBS' nun düşük dereceli organik bir hastalık olup olmadığını belirlemeyi amaçladık. Bu amaç için yaş ve cinsiyet uyumlu, Roma-III kriterlerini karşılayan 72 İBS hastası ( IBS-D grup 40 kişi,İBS-K 32) ve 50 kontrol grubu oluşturuldu. Vakaların barsak temizliği lavman ile yapılıp, fleksibil kolonoskopi cihazı ile rektum ve çekum mukozasından forcepsle biopsiler alındı. Alınan biopsi materyeli Giemza ve Hematoksilen-Eozin ile boyandı. Biobsi kesitlerinin histolojik değerlendirmesi, ışık mikroskopisinde 10 odakta mast hücresi sayılıp, ortalaması alınarak 4 basamaklı skala (yok, az, orta, çok) ile yapıldı. Yine her üç grubun serum sitokinleri çalışılıp analizleri yapıldı. Çalışmamızın sonucunda IBS-D gruptaki hastalarımızın rektum ve çekum mukozasında mast hücre artışı ile inflamatuvar sitokinlerden de sIL-2R düzeyinde artış saptandı Çalışmamız IBS'nin fizyopatolojisinde düşük dereceli inflamasyonun olduğunu göstermektedir. IBS' nin patogenezinden sorumlu tutulan inflamasyonda ve visseral hipersensitivitede mukozal mast hücre infiltrasyonun rolu olduğunu desteklemektedir. Anahtar Kelimeler: BS, mast hücre
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic and recurrent abdominal pain, diarrhea, constipation and/or abdominal distention. . Subtypes have been defined as IBS constipation predominant (IBS-C), IBS diarrhea predominant (IBS-D), IBS mixed type (IBS-M) and IBS unsubtyped (IBS-U). The Rome criteria based on symptomes have been improved in order to simplify and standardize the diagnose. IBS has been caused by the interactions of biological and psychosocial factors. Motility changing, visceral hyperalgesy, brain-gut axis interactions disorder, autonom and hormonal, genetic and environmental factors, post-infectious cases, psychosocial disorders affect every patient in a different way. The similarity between GIS and non-GIS symptoms of systemic mastocytosis and IBS reveals the hypothesis whether colonic mucosal mast cells affect it or not. In many researches, made via this hypothesis, mast cell infiltration has been determined in colon mucosa of the patients with IBS. As pointed out in our study, we aim to determine whether IBS is a low graded organic disease or not. For this purpose, age and sex matched 72 patients who met the Rome-III criteria for IBS, and ( IBS-D group 40 patients,IBS-K 32) 50 control groups are made. The bowel cleaning of the cases are carried out via enema, and biopsies are taken with flexible colonoscopy apparatus from rectum and caecum mucosa. The material of the taken biopsy is coloured with `Giemza ve Hematoksilen-Eozin?.The histological evaluation of the biopsy sections is accounted as mast cell in 10 focus in light microscop, and by taking its average is made with 4 graded scala (none,little,middle,much). Serum cytokines of every 3 groups have been studied again and analized. At the end of our study, mast cell increase in rectum and caecum mucosa and an increase in inflammatory cytokine at the level of sIL-2R are determined in patient with IBS-D group. Our study has shown that a low-graded inflamatuar is in the physiopathology of IBS. It is supported that mucosal mast cell infiltration has a role in the inflamation and visceral hypersensitivity leading the pathogenesis of the IBS. Key Words: IBS, Mast cell
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic and recurrent abdominal pain, diarrhea, constipation and/or abdominal distention. . Subtypes have been defined as IBS constipation predominant (IBS-C), IBS diarrhea predominant (IBS-D), IBS mixed type (IBS-M) and IBS unsubtyped (IBS-U). The Rome criteria based on symptomes have been improved in order to simplify and standardize the diagnose. IBS has been caused by the interactions of biological and psychosocial factors. Motility changing, visceral hyperalgesy, brain-gut axis interactions disorder, autonom and hormonal, genetic and environmental factors, post-infectious cases, psychosocial disorders affect every patient in a different way. The similarity between GIS and non-GIS symptoms of systemic mastocytosis and IBS reveals the hypothesis whether colonic mucosal mast cells affect it or not. In many researches, made via this hypothesis, mast cell infiltration has been determined in colon mucosa of the patients with IBS. As pointed out in our study, we aim to determine whether IBS is a low graded organic disease or not. For this purpose, age and sex matched 72 patients who met the Rome-III criteria for IBS, and ( IBS-D group 40 patients,IBS-K 32) 50 control groups are made. The bowel cleaning of the cases are carried out via enema, and biopsies are taken with flexible colonoscopy apparatus from rectum and caecum mucosa. The material of the taken biopsy is coloured with `Giemza ve Hematoksilen-Eozin?.The histological evaluation of the biopsy sections is accounted as mast cell in 10 focus in light microscop, and by taking its average is made with 4 graded scala (none,little,middle,much). Serum cytokines of every 3 groups have been studied again and analized. At the end of our study, mast cell increase in rectum and caecum mucosa and an increase in inflammatory cytokine at the level of sIL-2R are determined in patient with IBS-D group. Our study has shown that a low-graded inflamatuar is in the physiopathology of IBS. It is supported that mucosal mast cell infiltration has a role in the inflamation and visceral hypersensitivity leading the pathogenesis of the IBS. Key Words: IBS, Mast cell
Açıklama
Anahtar Kelimeler
Mast hücre, Mast cell, İrritabl barsak sendromu (IBS), Irritable bowel syndrome (IBS), Gastroenteroloji, Gastroenterology, Kabızlık, Diyare
