VİTİLİGO TANILI HASTALARDA İNTERFERON-GAMMA/ İNTERLÖKİN-10 ORANININ HASTALIK AKTİVİTESİ VE YAYGINLIĞI İLE İLİŞKİSİ The Relationship Between Interferon-gamma / Interleukin-10 Rate with Disease Activity and Enlargement in Vitiligo Patients

OZET Amac: Bu calismada vitiligolu hastalarin serumlarinda proinflamatuvar karakterde olan interferon-gamma (IFN-γ) ve antiinflamatuvar karakterde olan interlokin (IL)-10 seviyeleri ve bu sitokinlerin birbiriyle olan orani; bunlarin hastaligin yayginligi ve aktivitesi ile iliskili olup olmadigini arastirmak amaclanmistir. Gerec ve Yontem: Calismaya klinik olarak vitiligo tanisi konulan 42 hasta ve 42 kontrol alindi. Serum IFN-γ, IL- 10, antinukleer antikor (ANA), C-reaktif protein (CRP) seviyeleri olculdu; vitiligo alan siddet indeksi (VASI) ve vitiligo hastalik aktivite skoru (VIDA) degerleri hesaplandi ve uygun istatiksel analizler yapildi. Bulgular: Hasta ve kontrol grubu arasinda IFN-γ, IL-10, ANA, CRP seviyeleri ve IFN-γ / IL-10 orani acisindan anlamli fark bulunmadi. VASI > 200 (yaygin tutulumlu hastalar) olan hastalarla, kontrol grubu karsilastirildiginda IL-10 degerleri arasinda anlamli farklilik saptandi (p= 0,02). VIDA > 2 (son 6 ayda yeni lezyon cikisi olan, aktif hastalar) hastalarda IL-10 seviyeleri arasinda yapilan korelasyon analizinde serum IL-10 degerinin pozitif yonde etkilendigi gozlendi (p= 0,028; r= 0,656). Hastalik suresinin IL-10 uzerine etkisi olup olmadigi degerlendirildiginde korelasyon saptandi (p= 0,034). Bu korelasyonun negatif yonde orta derecede iliskili oldugu saptandi (r = -0,502). IFN-γ / IL-10 orani VASI > 200 olan hastalar ile VIDA > 2 olan hastalarda kontrole kiyasla anlamli derecede yuksek bulundu (p= 0,04; p= 0,018). Sonuc: Calismamizda en cok dikkat ceken sonuc, IL-10 seviyesinin hastaligin aktif doneminde ve yaygin tutulumu olan hastalarda anlamli derecede yuksek bulunmasiydi. Bu calisma, yuksek sitokin seviyelerinin, melanosit hasarinin daha genis alanlarda gozlenmesinin nedeni oldugunu ve vitiligo patogenezinde otoimmun surecin onemli derecede katkisi oldugunu gostermistir. Anahtar kelimeler: Vitiligo ; Gama- interferon ; Interlokin-10 ABSTRACT Aim: The aim of this study is to investigate whether the levels of interferon-gamma (IFN-γ) which have proinflammatory character, interleukin (IL)-10 which have antiinflamatory character and the ratio of these cytokines with each other are related to the prevalence and activity of the disease. Materials and Methods: The study included 42 patients with clinically diagnosed vitiligo and 42 controls. Serum IFN-γ, IL-10, antinuclear antibody (ANA), C-reactive protein (CRP) levels were measured; vitiligo area severity index (VASI) and vitiligo disease activity score (VIDA) were calculated and appropriate statistical analyzes were performed. Results: There was no significant difference between the patient and control groups in terms of IFN-γ, IL-10, ANA, CRP levels and IFN-γ / IL-10 ratio. There was a significant difference between IL-10 values in patients with VASI > 200 (patients with diffuse involvement) and control group (p = 0,02). In the correlation analysis between IL-10 levels in VIDA > 2 (active patients with new lesion emergence in the last 6 months), a positive effect of serum IL-10 value was observed (p = 0,028; r = 0,656). There was a correlation between the duration of disease and IL-10 (p = 0,034). This correlation was found to be moderately correlated negatively (r = -0,502). IFN-γ / IL-10 ratio was significantly higher in patients with VASI > 200 and patients with VIDA > 2 compared to control (p = 0,04; p = 0,018). Conclusion: The most striking result in our study was that IL-10 levels were significantly higher in patients with active involvement and widespread involvement. This study demonstrated that high cytokine levels are the cause of melanocyte damage observed in larger areas and that autoimmune processes contribute significantly to the pathogenesis of vitiligo. Key words: Vitiligo; Gama-interferon ; Interleukin-10