Plazminojen aktivatör inhibitor-1 (PAI-1) 4g/4g polimorfizminin gebelik kayıplarıyla ilişkisi
Plazminojen aktivatör inhibitor-1 (PAI-1) 4g/4g polimorfizminin gebelik kayıplarıyla ilişkisi
Yazar: Yıldırım, Malik; Dağ, Şeker; Kurtulgan, Hande; Karakuş, Savaş
Dergi: Cumhuriyet Tıp Dergisi, Vol. 36 No. 3, 2014
Anahtar kelimeler: PAI-1, 4G/4G polymorphism, miscarriage ; PAI-1, 4G/4G polimorfizmi, düşük

ÖzetAmaç. Plazminojen aktivatör İnhibitörü Tip 1 (PAI-1) bir serin proteaz inhibitörüdür. Doku plazminojen aktivatörü (tPA) ve ürokinazı (uPA), sonuç olarak fibrinolizi inhibe eder. Genin promotor bölgesinde 4G/5G olarak bilinen bir polimorfizm söz konusudur. Trombozdaki rolü nedeniyle PAI-1 4G/4G polimorfizminin gebelik komplikasyonlarına katkısı olabileceği düşünülmektedir. Biz bu çalışmada, PAI-1 4G/4G polimorfizminin gebelik kayıplarına olası etkisini değerlendirmeyi amaçladık. Yöntem. Çalışma grubu Sivas bölgesinde yaşayan bireylerden seçildi. Araştırmaya 92’si bir veya daha fazla düşük öyküsü olan ve 86 kontrol olmak üzere toplam 178 kadın dahil edildi. Gen mutasyonlarını belirlemek için periferik kan örneklerinden DNA izolasyonu ve sonrasında revers hibridizasyon ilkesine dayanan strip assay tekniği ile mutasyon analizi yapıldı. Veriler SPSS 15,0 istatistik programı aracılığıyla değerlendirildi. Bulgular. Kontrol grubunda 5G/5G polimorfizmi 22 (%25,6), 4G/5G polimorfizmi 53 (%61,6) ve 4G/4G mutant olgular 11 (%12,8) olarak tespit edilmiştir. Düşük olgularında ise 5G/5G polimorfizmi 20 (%21,7), 4G/5G polimorfizmi 49 (53,3) ve 4G/4G mutant olgular ise 23 (%25) bulunmuştur. 4G/4G homozigot mutant olgular için ODDS değeri hesaplanmıştır. Sonuç. Bulgularımıza göre 5G/5G ve 4G/5G polimorfizmleri düşük açısından risk artışı sağlamamaktadır (p=0,546 ve p=0,259 p>0,05). Çalışmamızda PAI-1 4G/4G polimorfizminin düşük riskine katkısı anlamlı bulunmuştur. Bu polimorfizme sahip kadınlarda düşük yapma riski 2,27 kat daha fazladır (p=0,038 p<0,05).Anahtar sözcükler: PAI-1, 4G/4G polimorfizmi, düşük AbstractAim. Plasminogen activator inhibitor type 1 (PAI-1) is a serine protease inhibitor. It inhibits tissue plasminogen activator (tPA) and urokinase (uPA), and consequently inhibits fibrinolysis. There is a common polymorphism known as 4G/5G in the promoter region of PAI-1 gene. PAI-1 4G/4G polymorphism may contribute pregnancy complications because of its role in thrombosis,. In this study, we aimed to evaluate the possible effect of PAI-1 4G/4G polymorphism to miscarriages. Method. The study group was selected between individuals residing in Sivas region. One hundred and seventy eight women (92 of them have miscarriage story and 86 control) were incorporated to study. After DNA isolation, mutation analysis was performed by StripAssay technique based on the reverse-hybridization principle. Data were analysed by SPSS 15.0 statistic program. Results. In control group, the number of 5G/5G polymorphisms was 22 (25.6%), the number of 4G/5G polymorphisms was 53 (61.6%) and the number of 4G/4G mutant cases was 11 (12.8%). In miscarriage group, the number of 5G/5G polymorphisms was 20 (21.7%), the number of 4G/5G polymorphisms was 49 (53.3%) and the number of 4G/4G mutant cases was 23 (25%). ODDS ratio was calculated for 4G/4G homozygot mutant cases. Conclusion. According to our datas, 5G/5G and 4G/5G polymorphism have not higher risk for miscarriage (p=0.546 and p=0.259 p>0.05). In our study, it was detected that the contribution of 4G/4G polymorphism to miscarriage is important. The women who have this polymorphism carry the risk of miscarriage higher 2.27 fold (p=0.038 p<0.05).Keywords: PAI-1, 4G/4G polymorphism, miscarriage

Aim. Plasminogen activator inhibitor type 1 (PAI-1) is a serine protease inhibitor. It inhibits tissue plasminogen activator (tPA) and urokinase (uPA), and consequently inhibits fibrinolysis. There is a common polymorphism known as 4G/5G in the promoter region of PAI-1 gene. PAI-1 4G/4G polymorphism may contribute pregnancy complications because of its role in thrombosis,. In this study, we aimed to evaluate the possible effect of PAI-1 4G/4G polymorphism to miscarriages. Method. The study group was selected between individuals residing in Sivas region. One hundred and seventy eight women (92 of them have miscarriage story and 86 control) were incorporated to study. After DNA isolation, mutation analysis was performed by StripAssay technique based on the reverse-hybridization principle. Data were analysed by SPSS 15.0 statistic program. Results. In control group, the number of 5G/5G polymorphisms was 22 (25.6%), the number of 4G/5G polymorphisms was 53 (61.6%) and the number of 4G/4G mutant cases was 11 (12.8%). In miscarriage group, the number of 5G/5G polymorphisms was 20 (21.7%), the number of 4G/5G polymorphisms was 49 (53.3%) and the number of 4G/4G mutant cases was 23 (25%). ODDS ratio was calculated for 4G/4G homozygot mutant cases. Conclusion. According to our datas, 5G/5G and 4G/5G polymorphism have not higher risk for miscarriage (p=0.546 and p=0.259 p>0.05). In our study, it was detected that the contribution of 4G/4G polymorphism to miscarriage is important. The women who have this polymorphism carry the risk of miscarriage higher 2.27 fold (p=0.038 p