Behçet Hastalarında ve Sağlıklı Bireylerde Üroepitel Hücrelerinin Streptococcus pyogenes ve Escherichia coli'ye Karşı Bakterisidal Etkisinin Araştırılması

Behcet hastaligi (BH) tekrarlayici oral aftlar, genital ulserler, deri lezyonlarive uveyit ile birlikte vaskuler, norolojik ve gastrointestinal bulgular ilekarakterize ve sistemik inflamatuar bir hastaliktir. Hastaligin etyolojisibilinmemesine ragmen, immunolojik bozukluklar uzerinde durulmakta,gelisiminden genetik, cevresel, virolojik, bakteriyel ve immunolojik faktorlersorumlu tutulmaktadir.Mukozal immun sistemde epitel hucresi, ozgul olmayan immun yanittankazanilmis immun yanita geciste ve immun hemostazin regulasyon veyatolerans yonunde belirlenmesinde kavsak noktasi olusturmakta; antijene,antijenin yapisi, miktari ve sunum sekline gore nasil bir yanit olusturulacaginibelirlemektedir.Calismamizda, Behcet hastalarinda ve saglikli bireylerde uroepitelyalhucrelerin Streptococcus pyogenes ve Esherichia coli'ye karsi bakterisidaletkisinin olup olmadigi arastirilmasi amaclanmistir. Behcet hastalarinda oralepitel hucresinin azalmis bakterisidal etkisi gosterilmistir. Cesitli hastagruplarinda, epitel hucresinin enfeksiyona yatkinliktaki etkisininincelenmesiyle, hastaligin patogenezine katkisinin olacagini dusunmekteyiz.Efektor hucre olarak kullanilan idrar epitel hucresi (IEH) ve hedef hucreolarak kullanilan S. pyogenes ATCC 49619 ve E. coli O75 suslari 1/1 E/Horaninda plaklarda karsilastirilmistir. 1 saatlik inkubasyonun ardindan her birkuyucuk icerigi toplanmis ve S. pyogenes kanli agara, E. coli adi agarbesiyerine ekilmistir. 37oC'de 1 gecelik inkubasyondan sonra plaklardameydana gelen koloni olusturan birimler sayilmis ve bakterisidal etki yuzdesihesaplanmistir. Calismalarin istatistiksel degerlendirmesi t test ve Dixon testiile yapilmistir.Calismalar sonucunda IEH'nin 1. saatte Behcet hastalarinda S. pyogenes'ekarsi ortalama %31.6, E. coli'ye karsi %23.3, saglikli kontrollerde iseS.pyogenes'e karsi %46.8, E.coli'ye karsi %60 bakterisidal etki gosterdigitesbit edilmistir.Behcet hastalari ve saglikli kontroller arasinda S. pyogenes'e karsiantibakteriyel etkinlik acisindan istatistiksel olarak anlamli bir farksaptanmamistir (p>0.001). Bunun yaninda, Behcet hastalarinda E. coli'yekarsi bakterisidal etkinin, saglikli kontrollere gore anlamli derecede dusukoldugu saptanmistir (p 0.001).Bizim calismamizda, Behcet hastalarinin IEH'nin E. coli'ye karsi bakterisidaletkisinin saglikli bireylere gore anlamli olarak daha dusuk oldugusaptanmistir. Bu durum Behcet hastalarinda, uriner sistem enfeksiyonlarininen sik etkeni olan E. coli'ye karsi konak savunmalarinda koruyucu immunmekanizmalarin eksikliginin bir sonucu olabilir. abstractBehcet?s disease (BD) is a systemic inflamatuar disorder, characterized byrecurrent oral apthous ulcers, genital ulcers, skin lesions and uveitis with theother manifestasions, including vasculer, gastrointestinal and neurologicalinvolvement. Although ethiology of the disease is unknown, viral andbacteriologic agents, genetic, environmental and immunologic factors areresponsible for ethiology.Epithelial cells have critical role at designate immun homeostasis whether asimmun regulation or tolerance and according to antigen structure, dose andform of the presentation way response type will be a determinant in themucosal immun system.The aim of the present study is to investigate whether bactericidal effect ofthe epithelial cells against S. pyogenes and E. coli in Behcet?s disease andhealty controls. In the previous studies, bactericidal effects of vagen,intestine, oral and urogenital epithelial cells and decreased bactericidal effectof the oral epithelial cells in Behcet?s disease have been found. We suggestthat analyzing the effect of epithelial cells on susceptibility to infection inseveral disease groups; thus the contribution to pathogenesis is expected.The investigation with urinary epithelial cells has been chosen due to theabsence of the studies in this topic, and getting epithelial cells from urinesamples with non-invasive methods. If there is any significant bactericidaleffect of uroepithelial cells in between Behcet and healty conrols, findings ofthis study would probably lead further studies, which could explain thepathogenesis of Behcet?s disease.Before the experiment, urine epithelial cells (used for effector cell) and S.pyogenes ATCC 49619 and E. coli O75 (used for target cell) strains wereprepared, and the cells were stimulated with bacteria in plates with aneffector cell/target cell ratio of 1/1. At the end of 1 hour incubation, wellcontents were collected from each wells and were inaculated to blood agarfor S. pyogenes and agar plates for E. coli. Following overnight incubation at37oC colony forming units were enumarated and bacterisidal effect werecalculated. Final data were controlled with Dixon test, and analyzed with ttest.According to the results, the bacterisidal effects against S. pyogenes and E.coli in Behcet?s disease patients are 31,6%, and 23,3%, respectively. Thesepercentages are 46.8% and 60% for healty controls.55In terms of bactericidal effect against S. pyogenes, there was no statisticallysignificant difference between Behcet?s disease patients and healty controls(p>0.001). Besides, the bactericidal effects against E. coli was significantlylower in Behcet?s disease patients than that healty controls (p 0.001).In our study, the bactericidal effect of uroepithelial cell against E. coli is foundsignificantly lower in Behcet?s disease patients than healty controls. This isprobably due to the result of lack of productive immun mechanisms in hostdefence against E. coli, the most frequently agent of urinary tract infections inBehcet?s disease patients.