Eozinofilik özofajit tanısında fekal kalprotektin, ECP, IL-5 ve IL-13'ün kullanımı

Year 2024, Volume: 7 Issue: 2, 175 - 181, 30.06.2024

Sibel Laçinel Gürlevik , Faruk Beser , Nuray Kepil , Dildar Konukoğlu , Sibel Erdamar , Tufan Kutlu , Fugen Cullu , Tulay Erkan

Abstract

Amaç: Eozinofilik özofajit (EoE), kronik, eozinofilik inflamasyonun özofagus fonksiyon bozukluğu semptomlarıyla sonuçlandığı, Th2, antijen kaynaklı bir hastalıktır. Ayırıcı tanıda pek çok hastalık vardır, en önemlisi peptik özofajittir (PÖ). Bu iki hastalığın ayrımını yapmada ve eozinofilik özofajit tanısında fekal kalprotektin, ECP, IL-5 ve IL-13'ün kullanımını araştırmayı amaçladık.
Yöntem: Gastroskopi uygulanan, makroskobik ve/veya mikroskobik patolojik bulguları EoE veya PE ile uyumlu olan 64 çocuk çalışmaya alındı. Kalproteiktin düzeyi, eozinofilik katyonik protein (ECP), IL-5, IL-13 incelendi ve sağlıklı kontrollerle karşılaştırıldı.
Bulgular: Eozinofil sayısı, CRP, toplam IgE, serum IL-5, IL-13 ve kalprotektin düzeyleri, kontrol grubuna kıyasla EoE grubunda anlamlı derecede yüksekti (P<0.05). Lökosit sayısı, AEC, CRP, toplam IgE, ECP ve serum IL-5 düzeyleri peptik özofajit grubuna kıyasla EoE grubunda anlamlı derecede yüksekti (P<0.05). Kalprotektin düzeyi EoE'li hastalarda PÖ’lü hastalara göre daha yüksekti ancak istatistiksel olarak anlamlı bir fark yoktu (P=0.055). Total IgE değeri (r=0,489) ve ECP (r=0,810) EoE'deki doku eozinofil sayısı ile koreleydi (P=0,001; <0,001)
Sonuç: Eozinofilik özofajit ayırıcı tanısında ECP'nin kullanılabileceği, kalprotektinin klinik uygulamada bir belirteç olarak yaygın olarak kullanılabilmesi için daha fazla sayıda hastayı içeren daha fazla çalışmaya ihtiyaç vardır.

Keywords

eozinofilik, özofajit, çocuklar, kalprotektin, ECP

Ethical Statement

Istanbul University Cerrahpaşa Medical Faculty Clinical Research Ethics Committee (2012/10051).

Supporting Institution

This project was funded by Istanbul University Scientific Research Projects Unit (SRP) with the number of 23339 and Turkish Pediatrics Association expenditures for analysis of FC and interleukins.

Project Number

Istanbul University Cerrahpaşa Medical Faculty Clinical Research Ethics Committee (2012/10051).

The utility of faecal calprotectin, ECP, IL-5 and IL-13 in the diagnosis of eosinophilic esophagitis

Abstract

Objectives: Eosinophilic esophagitis (EoE) is a Th2, antigen driven disease in which chronic, eosinophilic inflammation results with symptoms of esophageal dysfunction. There are many diseases in the differential diagnosis, the most important one is peptic esophagitis (PE). We aimed to investigate the use of fecal calprotectin, ECP, IL-5 and IL-13 in distinguishing these two diseases and in the diagnosis of eosinophilic esophagitis.
Methods: 64 children who had gastroscopic examination and who had macroscopic and/or microscopic pathologic findings compatible with EoE or PE were enrolled. The FC level, complete blood count, C reactive protein (CRP), eosinophilic cationic protein (ECP), total immunoglobulin E (IgE), specific IgE, IL-5, IL-13 were studied and compared with healthy controls (HCs).
Results: The eosinophil number, CRP, total IgE, serum IL-5, IL-13 and FC levels were significantly higher in the EoE group compared to the HCs (P<0.05). The leukocyte count, AEC, CRP, total IgE, ECP and serum IL-5 levels were significantly higher in the EoE group compared to the PE group (P<0.05). The FC level was higher in patients with EoE than ones with PE but there was no statistically significant difference (P=0.055). Total IgE value (r=0.489) and ECP (r=0.810) were correlated with the tissue eosinophil count in EoE (P=0.001; <0.001).
Conclusion: Our results suggest that FC and ECP can be used in the differential diagnosis of EoE. However, more studies including a higher number of patients are needed to use FC as a diagnostic marker widely in clinical practice.

Keywords

eosinophilic, esophagitis, children, calprotectin, ECP

Project Number

Istanbul University Cerrahpaşa Medical Faculty Clinical Research Ethics Committee (2012/10051).

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