Serap OZCİMEN, Mehmet BİTİRGEN, Bahar KANDEMİR

Role of Neopterin in Determining the Efficacy of Interferon Therapy in Chronic Hepatitis B and C

Neopterin (NP), hücresel immun sistemin aktivasyonu sonucu, gama interferon stimülasyonuna cevap olarak insan makrofaj ve monositlerinden sekrete edilen bir pteridin derivesidir. Hücresel immünutenin göstergesi olan NP pek çok kanser, infeksiyon hastalığı ve otoimmün hastalıkta vücut sıvılarında çalışılmış ve hücresel immün sistemin aktif durumda olduğu hastalıkların neredeyse tümünde yüksek olarak tespit edilmiştir. Bu çalışmada, kronik hepatit B (KHB) ve kronik hepatit C’li (KHC) hastalarda; NP düzeyleri ile hastalık arasındaki ilişki ve interferon (IFN) tedavisinin etkinliğini belirlemede neopterin rolünün araştırılması amaçlandı. Çalışma, 49 KHB ‘li olgu, 30 KHC’li olgu ve 72 sağlıklı birey üzerinde yapıldı. Serum örnekleri tedavi alan hastalardan tedavi başlangıcı ve bitiminde, kontrol grubundaki sağlıklı bireylerden ise bir kez alındı. Tedaviye yanıtsızlık virolojik ve/veya biyokimyasal cevap alınıp alınmamasına göre değerlendirildi. Kronik hepatit B ve KHC’li hastalarda NP düzeyleri kontrol grubundan anlamlı olarak yüksek saptandı. Pegile interferon tedavisi alan KHB’li ve KHC’li hastaların tedavi öncesi ve sonrası serum NP düzeyleri karşılaştırıldığında tedavi sonrası NP düzeyleri anlamlı olarak yüksek saptandı. Tedaviye yanıt veren??? KHB’li 16 hasta ve KHC’li 14 hastada tedavi sonrası NP düzeylerinde anlamlı yükseklik saptanırken, her iki hasta grubunda da tedaviye yanıtsız hastalarda tedavi öncesi ve sonrası serum NP düzeylerinde anlamlı değişiklik saptanmadı. İnfeksiyonların çoğunda infeksiyon tedavisi öncesi ve sonrasında bir kıyaslama yapıldığında tedavi sonunda immün sistemin aktivasyonu azaldığı için NP düzeylerinde azalma görülmektedir. Fakat immün sistemi uyarıcı bir tedavi olan IFN tedavisi ile hastalık tedavi edildiğinde, tedavi sonunda IFN tedavisine bağlı olarak NP düzeyi yüksek kalmaktadır

Anahtar Kelimeler:

Neopterin, kronik hepatit B, kronik hepatit C

Role of Neopterin in Determining the Efficacy of Interferon Therapy in Chronic Hepatitis B and C

Neopterin (NP) is a pteridine derivative that is secreted as a response to gamma interferon stimulation. The purpose in this study was to investigate the relationship between the NP levels and the disease and determining the efficacy of an interferon (IFN) therapy in patients with chronic hepatitis B (CHB) and C (CHC). The study was conducted on 49 cases with CHB, 30 cases with CHC and 72 healthy individuals. Serum samples were taken from the patients receiving treatment at the beginning and at the end of the treatment and only once from the healthy individuals in the control group. The NP levels were found significantly higher in the patients with CHB and CHC than those in the control group. When the pre and post-treatment serum NP levels of the patients who received an interferon therapy were compared, the post-treatment NP levels of the patients who responded to the treatment were significantly higher. When a comparison was made before and after treatment, a decrease was seen in the NP levels in most of the infections due to decreased activation of the immune system. However, when the disease was treated with an IFN therapy, which is a treatment stimulating the immune system, the post-treatment NP level remained high.

Keywords:

Neopterin, chronic hepatitis B, chronic hepatitis C,

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