İnterstisyel sistitli hastalarda idrar sekretuvar immünoglobulin A'nın patofizyolojideki rolü
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Dosyalar
Tarih
2020
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Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Mesane ağrı sendromu / İntertisyel sistit, yaşam kalitesi üzerine ciddi olumsuz etkilere sahip, etiyolojisi henüz net olarak aydınlatılamamış önemli bir kronik hastalık olup aynı zamanda klinisyenleri de oldukça zor duruma sokan tanısı ve tedavisi güç bir hastalıktır. Patofizyolojisi henüz net olarak aydınlatılmamış olup, bu çalışmada idrar sekretuvar IgA seviyelerinin MAS/İS ve kontrol grupları ele alınarak patofizyolojisiyle olan ilişkisi incelenmiştir. Gereç ve Yöntem: Etik kurul onayı sonrası dahil edilme kriterlerini karşılayan MAS/İS hastaları ve kontrol grubu veriler kaydedildikten sonra idrar sIgA'nın seviyelerinin tespiti için alınan uygun idrar örnekleri ELİSA yöntemi kullanılarak çalışılmıştır. İstatistiksel analiz için IBM SPSS Statistics 25. 0 paket programı kullanıldı. Bulgular: MAS/İS ve kontrol grubu karşılaştırıldığında idrar sIgA seviyeleri açısından istatistiksel anlamlı farklılık saptanmamıştır (p=0. 173). Kardiyak hastalığı olan hastalar olmayanlar ile kıyaslanarak MAS/İS ve kontrol gruplarının kendi içinde değerlendirildiğinde yalnızca MAS/İS grubunda idrar sIgA seviyesi istatistiksel açıdan anlamlı yüksek bulunmuştur (p=0. 015 (0, 82 µg/L [0, 1;6, 850]), aynı zamanda gruplar arasında değerlendirildiğinde yine MAS/İS grubu açısından istatiksel açıdan anlamlı yüksek bulunmuştur (p=0. 003). Sigara içen hastalar içmeyenler ile kıyaslanarak MAS/İS ve kontrol grupları kendi içinde değerlendirildiğinde yalnızca MAS/İS grubunda idrar sIgA istatistiksel açıdan anlamlı düşük bulunmuştur (p=0. 004 (0, 01 µg/L [0,00;0,820])), ancak gruplar arasında değerlendirildiğinde istatiksel açıdan anlamlı farklılık bulunamamıştır (p=0. 536). Sonuç: Bu çalışma MAS/İS ve kontrol grubu hastalarında demografik veriler, komorbidite, IS semptom ve problem indeksi, inkontinans, sigara, geçirilmiş cerrahi, hasta grubunda tedavi süresi ve kullandığı ilaçların idrar sIgA seviyelerine etkisini gösteren literatürdeki ilk çalışmadır. Kardiyak hastalıklar üroepitelyum disfonksiyonu sonucunda idrar sIgA seviyelerinin yükselmesine neden olabilir. Sigara, içerdiği toksik metabolitlerin atılımı esnasında mesane irritasyonuna sekonder gelişen fibrozisle idrar sIgA seviyelerinde azalmaya neden olabilir. MAS/İS hastalarının konservatif yönetiminde sigaranın bırakılması halen önerilmektedir ve hasta semptomlarında azalmaya neden olmaktadır. İdrar sIgA seviyelerinin patofizyolojideki rolünün daha tutarlı şekilde ortaya konulması için güncel kanıtların sınırlılığı nedeniyle daha geniş hasta popülasyonu ile yapılacak olan prospektif, kontrollü, randomize çalışmalara ihtiyaç vardır.
Background and Aim: Bladder pain syndrome/Interstitial cystitis is an important chronic disease with serious adverse effects on the quality of life and its etiology has not been clarified yet, and it is also a difficult disease to diagnose and treat, putting clinicians in a very difficult situation. Its pathophysiology has not been clearly elucidated yet. In this study, the relation of urinary secretory IgA levels with the pathophysiology of the BPS/IC and control groups was examined. Materials and Methods: After the approval of the ethics committee, BPS/IC patients and control group who met the inclusion criteria data were recorded, and appropriate urine samples were taken to determine the levels of urinary secretory IgA using the ELISA method. IBM SPSS Statistics 25. 0 was used for statistical analysis. Results: When BPS/IC and control groups were compared, no statistically significant difference was found in terms of urinary secretory IgA levels (p = 0. 173). When the BPS/IC and control groups were evaluated within the BPS/IC and control groups in comparison with those without cardiac disease, the urinary secretory IgA level was found to be statistically significantly higher only in the BPS/IC group (p = 0. 015 (0, 82 µg / L [0, 1; 6, 850]), but also between the groups. When evaluated, it was found to be statistically significantly higher for the BPS/IC group (p = 0. 003). When the smoking patients were compared with the non-smokers and the BPS/IC and control groups were evaluated within themselves, urine secretory IgA was found to be statistically significantly lower only in the BPS/IC group (p = 0. 004). (0, 01 µg / L [0, 00; 0, 820])), but when evaluated between groups, no statistically significant difference was found p = 0. 536). Conclusions: This study is the first study in the literature showing the effects of demographic data, comorbidity, IS symptom and problem index, incontinence, smoking, previous surgery, duration of treatment in the patient group, and the drugs used on urinary secretory IgA levels in BPS/IC and control group patients. Cardiac diseases may cause urinary secretory IgA levels to increase as a result of uroepithelial dysfunction. Smoking may cause a decrease in urinary secretory IgA levels with fibrosis developing secondary to bladder irritation during the excretion of toxic metabolites it contains. In the conservative management of BPS/IC patients, smoking cessation is still recommended and causes a decrease in patient symptoms. Due to the limited current evidence, prospective, controlled, randomized studies with larger patient populations are needed to more consistently demonstrate the role of urinary secretory IgA levels in pathophysiology.
Background and Aim: Bladder pain syndrome/Interstitial cystitis is an important chronic disease with serious adverse effects on the quality of life and its etiology has not been clarified yet, and it is also a difficult disease to diagnose and treat, putting clinicians in a very difficult situation. Its pathophysiology has not been clearly elucidated yet. In this study, the relation of urinary secretory IgA levels with the pathophysiology of the BPS/IC and control groups was examined. Materials and Methods: After the approval of the ethics committee, BPS/IC patients and control group who met the inclusion criteria data were recorded, and appropriate urine samples were taken to determine the levels of urinary secretory IgA using the ELISA method. IBM SPSS Statistics 25. 0 was used for statistical analysis. Results: When BPS/IC and control groups were compared, no statistically significant difference was found in terms of urinary secretory IgA levels (p = 0. 173). When the BPS/IC and control groups were evaluated within the BPS/IC and control groups in comparison with those without cardiac disease, the urinary secretory IgA level was found to be statistically significantly higher only in the BPS/IC group (p = 0. 015 (0, 82 µg / L [0, 1; 6, 850]), but also between the groups. When evaluated, it was found to be statistically significantly higher for the BPS/IC group (p = 0. 003). When the smoking patients were compared with the non-smokers and the BPS/IC and control groups were evaluated within themselves, urine secretory IgA was found to be statistically significantly lower only in the BPS/IC group (p = 0. 004). (0, 01 µg / L [0, 00; 0, 820])), but when evaluated between groups, no statistically significant difference was found p = 0. 536). Conclusions: This study is the first study in the literature showing the effects of demographic data, comorbidity, IS symptom and problem index, incontinence, smoking, previous surgery, duration of treatment in the patient group, and the drugs used on urinary secretory IgA levels in BPS/IC and control group patients. Cardiac diseases may cause urinary secretory IgA levels to increase as a result of uroepithelial dysfunction. Smoking may cause a decrease in urinary secretory IgA levels with fibrosis developing secondary to bladder irritation during the excretion of toxic metabolites it contains. In the conservative management of BPS/IC patients, smoking cessation is still recommended and causes a decrease in patient symptoms. Due to the limited current evidence, prospective, controlled, randomized studies with larger patient populations are needed to more consistently demonstrate the role of urinary secretory IgA levels in pathophysiology.
Açıklama
Anahtar Kelimeler
Mesane Ağrı Sendromu, İnterstisyel Sistit, İdrar sIgA, Bladder Pain Syndrome, Interstitial Cystitis, Urinary Secretory IgA
