Sepsis/ağır sepsiste aktive protein C tedavisinin lenfosit, böbrek ve aort endoteli apoptozuna etkisi
Effect of activated protein C treatment on lmphocyte, kidney and aortic endothelium apoptosis in sepsis/severe sepsis
Yazar: EMİNE SARICA HALİL
Danışman: PROF.DR. YALIM DİKMEN
İstanbul Üniversitesi / Cerrahpaşa Tıp Fakültesi / Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2006
Konu: Anestezi ve Reanimasyon = Anesthesiology and Reanimation

Özet:
SEPS S/AĞIR SEPS STE AKT VE PROTE N CTEDAV S N N LENFOS T, BÖBREK VE AORTENDOTEL APOPTOZUNA ETK SDR. EM NE SARICA HAL LÖZETÇalışmamızda sepsis/ağır sepsiste Aktive Protein C tedavisinin lenfosit,böbrek ve aort endoteli apoptozuna etkisini inceledik.Çalışmamızda herbiri 10'ar sıçandan oluşan üç grup oluşturuldu. Birincigrupta sham prosedürü uygulandı (Grup I: sham). kinci grupta CLP(CecalLigation and Puncture) ile intraabdominal sepsis meydana getirildi (Grup II:CLP). Üçüncü gruba CLP'i takiben kuyruk veninden intravenöz bolus 100 Âµg/kgrhAPC(recombinant human Activated Protein C) verildi (Grup III:CLP+rhAPC).Her üç grupta girişimden 24 saat sonra anestezi altında relaparotomiyapıldı. Periferik kan, böbrek ve aorttan doku örnekleri alındı. Periferik kandakilenfositlerde Comet, böbrek ve aorttan alınan doku örneklerinde kaspaz-3iimünohistokimya yöntemiyle endotelyal apoptosis değerlendirildi.Lenfosit ve böbrek apoptozu CLP grubunda sham ve CLP+rhAPCgrubuna oranla istatistiksel açıdan anlamlı yüksek bulundu(p<0.05); sham veCLP+rhAC grupları arasında anlamlı fark saptanmadı. Aort endotelinde gruplararasında anlamlı fark görülmedi.Çalışmamızın sonuçları, sepsiste lenfositler ve böbrek dokusundaapoptotik hücre ölümünün arttığını ve rhAPC'nin bu dokular üzerinde anti-apoptotik etkili olabileceğini göstermiştir.Anahtar Kelimeler: Sepsis, Apoptosis, Aktive Protein C

Abstract:
EFFECT OF ACT VATED PROTEIN C TREATMENTON LYMPHOCYTE, KIDNEY AND AORTICENDOTHELIUM IN SEPS S/SEVERE SEPS SDR. EM NE SARICA HAL LSUMMARYThe aim of this study was to investigate the effect of Activated Protein Ctreatment on lymphocytes and renal and aortic endothelial apoptosis in sepsis.The study was performed on 3 groups of rats ,each consisting of 10animals. First group had the sham procedure (Group I: sham). The second andthird groups contracted intraabdominal sepsis via cecal ligation and puncture(CLP). The third group received an intravenous bolus of 100 Âµg/kg recombinanthuman Activated Protein C (rhAPC) through the caudal vein (Group III:CLP+rhAPC).Relaparotomy was performed under anesthesia in each group to taketissue samples from the kidney, aorta and peripheral blood. Peripheral bloodsamples were evaluated with comet and solid samples were investigated usingcaspase-3 immunohistochemistry to quantify endothelial apoptosis.Lymphocyte and endothelial apoptosis was increased significantly in the sCLP group as compared to the sham and CLP + rhAC groups (P<0,05); therewas no siginificant difference between the sham and CLP+rhAC groups.Apoptosis in the aortic endothelium was also not different between groups.Our study shows increased apoptosis in lymphocytes and renal endothelialcells during sepsis and that rhAPC has an anti-apoptotic property.Key Words: Sepsis, Apoptosis, Activated Protein C