Bruselloz Hastalığı Sürecinde Nötrofil Ekstrasellüler Tuzaklarının ve Klinik Bulgularla İlişkisinin Tanımlanması

Abstract

Brucellosis, is a zoonotic infectious disease caused by Brucella spp. Some biomarkers that can be used as prognostic criteria in the course of brucellosis have been discovered, but these biomarkers are still insufficient to predict the course of the disease. Neutrophils are the first line of defense of natural immunity in the organism. NETosis is a form of death for neutrophils and a defense system involving extracellular trapping of neutrophils with extracellular chromatin, proteins and granules. Peptidyl arginine deiminase 4 (PAD4), neutrophil elastase (NE), myeloperoxidase (MPO), proteinase-3 and neutrophil gelatinase-associated lipocalin (NGAL), “cell-free” nucleosomes are biomarkers related to NETosis. NETosis can aggravate the course of the disease and NETosis markers can be used as an indirect prognostic factor. In this thesis study, it was aimed to define the temporal changes of NETosis markers in the course of brucellosis disease and to correlate these changes with the clinic of the disease. The study was conducted with 36 patients diagnosed with acute brucellosis and 20 healthy volunteers. The clinical findings and blood values were recorded on the 0th day of diagnosis and on the 45th day at the end of the treatment. Blood samples were collected from all patients on day 0 at diagnosis and on day 45 after treatment from 19 patients to study PAD4, NE, NGAL NETosis markers by ELISA method. As a result of the study, PAD4 and NGAL levels of the patient group at day 0 at the time of diagnosis were higher than those of the healthy control group and 45 days after treatment, while NE values were found to be lower (p<0.001). NE levels were found to be higher in patients with low back pain complaints than in patients without complaints (p=0.018). According to our study results, NE, NGAL and PAD4 are markers of NETosis in brucellosis, and it is a pioneering study that has not been shown in the literature before; NE, NGAL and PAD4 indicate that NETosis markers may be biomarkers that can be used to evaluate brucellosis treatment response.