İnflamatuar Bağırsak Hastalığında Hastalık Tanısını ve Aktivitesini Belirlemede Belirteçlerin Önemi

Abstract

The aim of this study is to comparatively analyze the levels of selected pro-inflammatory and cytotoxic markers in pathologically inflamed mucosal regions and macroscopically healthy mucosal tissues of patients diagnosed with Inflammatory Bowel Disease (IBD). Between March 2025 and June 2025, patients who were newly diagnosed with IBD after endoscopy were included in the study at Ankara Bilkent City Hospital. Biopsy samples were collected from both macroscopically healthy and pathological mucosa during colonoscopy. Quantitative measurements were performed for interleukins (IL-17A, IL-2, IL-4, IL-10, IL-6), apoptosis-related molecules (Fas, Fas Ligand [FasL]), and cytotoxic response indicators (IFN-γ, Granzyme A, Granzyme B, Perforin, Granulysin). Significant elevations in IL-6, Fas, Granzyme B, and Perforin levels were observed in pathological mucosa. Conversely, Granzyme A levels were found to be significantly higher in normal mucosa compared to pathological mucosa. Correlation analysis revealed a significant positive relationship between age and Granzyme B and Perforin levels. IL-6, Fas, Granzyme B, and Perforin demonstrated high discriminative power in distinguishing pathological tissue presence. No significant correlations were found between these markers and white blood cell count, CRP, platelet count, or hemoglobin levels. In conclusion, the assessment of biopsy-based inflammatory and cytotoxic marker levels in patients with IBD offers a scientific foundation for the development of personalized therapeutic strategies tailored to the molecular characteristics of the disease.