Mezenterik iskeminin erken teþhisinde sitokinler ve kemokinler önemli midir?

AMAÇ: Akut mezenterik iskemi (AMÝ) çok yüksek mortalite ve morbiditeye sahiptir ve AMÝ’nin prognozunda en önemli faktör iskeminin süresidir. Bu çalýþmanýn amacý, AMÝ’nin erken tanýsýnda sitokin ve kemokinlerin olasý kullanýmý ve iskemi süresine göre bu belirteçlerin deðiþimini deðerlendirmektir.
GEREÇ VE YÖNTEM: Yirmi bir erkek Sprague Dawley sýçaný üç eþit gruba ayrýldý. Ýlk iki grupta superior mezenterik arter ve superior mezenterik ven sýkýca baðlanarak grup 1’de iki, grup 2’de altý saat iskemiye maruz býrakýldý. Grup 3’e ise herhangi bir iþlem uygulanmayarak kontrol grubu olarak belirlendi. Grup 1’de iskemiden iki saat sonra ve grup 2 iskemiden altý saat sonar ve grup 3’te ise laparotomiden altý saat sonar intrakardiyak kan örnekleri alýnarak IL-1α, 1β, 6, 10, 12p70, 17A, 18, 33, CXCL1/KC, CCL2/MCP-1, GM-CSF, IFN-γ ve TNF-α düzeyleri flow sitometri kullanýlarak ölçüldü.
BULGULAR: IFN-γ, CXCL1, MCP-1, TNF-α ve IL-6 parametrelerinde gruplar arasýnda önemli farklýlýklar gözlendi. Mezenterik iskemi süresine göre yapýlan korelasyon analizlerinde CXCL1’de çok yüksek, MCP-1, TNF-α ve IL-6’da yüksek düzeyde korelasyon gözlenmektedir. Ayrýca IFN-γ, IL-10 ve IL-18’de orta düzeyde bir korelasyon mevcuttu.
TARTIÞMA: Mezenterik iskemi olan hastalarda iskemi süresi ile yüksek korelasyon gösteren CXCL1, MCP-1, TNF-α ve IL-6 düzeylerinin artmasý, klinisyenin taný koymasýna ve doðru tedaviyi seçmesine yardýmcý olabilir.

Are the cytokines and chemokines important for the early diagnosis of mesenteric ischemia?

BACKGROUND: Acute mesenteric ischemia (AMI) has very high mortality and morbidity rates, and the most important factor in the prognosis of AMI is the duration of ischemia. This study aims to evaluate the changes of these markers according to the ischemia duration and possible use of cytokines and chemokines in the early diagnosis of AMI.
METHODS: Twenty-one male Sprague–Dawley rats were divided into three equal groups. The Superior Mesenteric Artery and Superior Mesenteric Vein were tied tightly and exposed to ischemia for 2 h for Group 1 and 6 h for Group 2. There was no intervention for Group 3, and it was selected as a control group. Intracardiac blood samples were collected after 2 h in Group 1 and 6 h in Groups 2 and 3. The IL-1α, 1β, 6, 10, 12p70, 17A, 18, 33, CXCL1/KC, CCL2/MCP-1, GM-CSF, IFN-γ, and TNF-α were measured using flow cytometry.
RESULTS: Significant differences were observed between the groups in IFN-γ, CXCL1, MCP1, TNF-α, and IL-6 parameters. In the correlation analyses performed according to the mesenteric ischemia time, a very strong correlation was observed in CXCL1, as well as a strong level for MCP-1, TNF-α, and IL-6. Furthermore, a moderate level of correlation was found in IFN-γ, IL-10, and IL-18.
CONCLUSION: The increased levels of CXCL1, MCP-1, TNF-α, and IL-6, which had a high correlation with the duration of ischemia in patients with intestinal ischemia, may help clinicians with diagnoses and treatment decision-making.