SEPSÝSTE HEMOPOETÝK BÜYÜME FAKTÖRLERÝNÝN ETKÝNLÝÐÝ

Bu çalýþmada, 54 adet Sprague-Dawley cinsi rat üzerinde intraabdominal sepsis oluþturularak, Granülosit Koloni Sümük Edici Faktör (G-CSF) ve Granülosit-Makrofaj Koloni Stimule Edici Faktör (GM-CSF)gibi hemapoietik büyüme faktörlerinin saðkalým, periferik kan tablosu ve makrofaj fagositik aktivitesi üzerine olan etkileri araþtýrýldý. Çalýþmanýn ilk aþamasýnda; her birinde 7'þer denek bulunan 3 grup ile baþlandý. Her bir deneðe çekal ligasyon ve delme (ÇLD) uygulanarak sepsis oluþturuldu. Kontrol grubuna; 2x0.2 cc % 5 dextroze SC enjekte edildi. G-CSF grubuna; 2x 1 g G-CSF 0,2 cc %5 Dextroz içinde SC enjekte edildi. GM-CSF grubuna; 1x2 g GM-CSF 0,2 cc %5 Dextroz içinde SC enjekte edildi. Bu 3 grupta kriter olarak 7 günlük saðkalým dikkate alýndý. Çalýþmanýn ikinci bölümünde ise, her birinde 11 denek bulunan 3 grup kullanýldý. Ayný iþlemler bu gruplara da uygulandý. Postoperatif 24 ve 72. saatlerde lökosit sayýsý, periferik yayma ve 72. saatte peritoneal ve alveoler makrofajlara bakýldý. G-CSF verilen rotlarda, kontrol grubuna göre anlamlý derecede nötrojilik lökositoz geliþti (p < 0.001). Buna karþýn, peritoneal ve alveoler makrofajlarýn fagositik aktivitelerinde bir deðiþim olmadý. GM-CSF ise sepsiste lökosit sayýsýný deðiþtirmeksizin makrofajlarýn fagositik aktivitesi üzerine pozitif etki gösterip, periferik kanda nötrofili, monositoz ve lenfositopeniye yol açtý. G-CSF, GM-CSF ve kontrol grubunda 7. günde sað kalým oraný sýrasýyla %71.4, %28.5 ve %42.8 bulundu. Sonuç olarak sepsis yerleþtikten sonra G-CSF uygulanýmý, periton makrofajlarýnýn fagositik aktivitesini etkilememesine karþýn, periferik kan nötrofillerinde ve ortalama saðkalýmda artýþ meydana getirmiþtir. GM-CSF ün sepsisli organizmaya uygulanmasý ile uyarýlan makrofajlarýn fagositik yeteneklerinin ve nötrofil fraksiyonunun arttýðý, ancak sað kalýmýn olumsuz yönde etkilendiði görüldü.

THE EFFECTIVENESS OF HEAMOTOPOIETIC GROWTH FACTORS IN SEPSIS

In this experimental study, consist of 54 Sprague-Dawley rats, we tried to observe the effectiveness of haemopoietic growth factors such as G-CSF and GM-CSF in treatment of sepsis and see if they have any effects on phagocytic activity of macrophages when are administered after establishment of sepsis. In first phase of this study, twenty one rats were randomly divided into three groups of 7 animals each. Cecal ligation and perforation were carried out in each rat and sepsis made up. The Control group received 2x0.2 cc%5 dextrose injection subcutaneous (SC).. The G-CSF group received 2x 1g G-CSF with 0,2 cc %5 dextrose SC. The GM-CSF received 1x2 g GM-CSF with 0,2 cc %5 dextrose SC. Seventh day survival was considered as criterion in the three groups. In second phase of this study, thirty three rats were randomly divided into three groups of 1 animals each. The same procedures were carried out also in these groups. Leukocyte counts and peripheric spread were aralyzed in postoperative 24th and 72th hours, alveolar and peritoneal macrophages were investigated in postoperative 72th hour. There was significantly neutrophilic leukocytosis in the G-CSF group according to the control group. Nevertheless, there was no change in the phagocytic activity of alveolar and peritoneal macrophages. GM-CSF brought about positive effect of phagocytic activity of macrophages without change of leucocyte count in the sepsis, but it caused neutrophili, monocytosis and lymphocytopenia. The seventh day survival rates in control, G-CSF, GM-CSF groups were as; 42.8 %, 71.4 %, 28.5 % respectively. As a result, we saw that G-CSF has no effect on the phagocytic activity of macrophages, while increases the survival by enhancing the count and probably the function of neutrophils. GM-CSF fails to increase survival while effects the phagocytic activities of macrophages positively and enhances the peripheral neutrophil and monosit counts without changing the total number of leukocytes.