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  • Küçük Resim
    Öğe
    Koroner arter bypass cerrahisinde ramiprilin miyokardiyal hasar ve inflamatuvar yanıttaki etkisi üzerinde sitokin gen polimorfizmlerinin rolü
    (2017) Urhan Küçük, Meral; Karaca, Kerem; Şahan Fırat, Seyhan; Vezir, Özden; Canacankatan, Necmiye; Aytaçoğlu, Barlas Naim; Erden, Sema; Tunçtan, Bahar; Sucu, Nehir
    Amaç: Ramipril, inflamatuar miyokardial hasarın tedavisinde TNF-?, IL-6 ve IL-8 gibi sitokin seviyelerini azaltarak etkili olmaktadır. Çalışmamızda, ramipril tedavisinin, koroner arter bypass cerrahisi esnasında oluşan inflamatuar yanıt ve miyokardiyal hasara yönelik etkisi üzerinde, sitokin gen polimorfizmlerinin herhangi bir rolü olup olmadığını araştırdık. Gereç ve Yöntem: Çalışmamıza, koroner arter bypass cerrahisi uygulanan hastalardan cerrahi öncesi ramipril alan 51, kontrol grubu olarak ise ramipril almayan 51 olmak üzere toplam 102 hasta dahil edildi. Her iki grupta, anestezi başlamadan hemen önce (t1), kros klemp sonrası 20. dakikada (t2), ameliyatın sonunda (t3) ve anestezinin başlangıcından 24 saat sonra (t4) alınan kan örneklerinden TNF?, IL-6, IL-8 ve TnT serum düzeyleri ELISA yöntemi ile, genotipleme ise PCR-RFLP yöntemleri ile belirlendi. Bulgular: Her iki grupta TNF-? artışı cerrahi ile başlarken, IL-6 ve IL-8 artışı kardiyopulmoner bypass sırasında kardiyak arrestle başlayıp ameliyat sonuna kadar devam etmiştir. Postoperatif dönemde ise sadece IL-8 kontrol grubunda yüksek kalırken; çalışma grubunda TNF?, IL-6, IL-8 düşüşe geçmektedir. t3 zaman aralığında IL-6, t4 zamanında TNF? değerlerinde anlamlı azalma gözlenmiştir. Sonuç: Ramiprilin kardiyak arrest sonrası sitokin ve TnT düzeylerini azaltarak inflamatuar miyokardiyal hasarı önlemede yeri olabilir.
  • Küçük Resim
    Öğe
    Role of ACE I/D gene polymorphisms on the effect of ramipril in inflammatory response and myocardial injury in patients undergoing coronary artery bypass grafts
    (Springer Heidelberg, 2014) Kucuk, Meral Urhan; Sucu, Nehir; Firat, Seyhan Sahan; Aytacoglu, Barlas Naim; Vezir, Ozden; Bozali, Caner; Canacankatan, Necmiye
    Angiotensin-converting enzyme (ACE) inhibitors block angiotensin II formation and release bradykinin, which is effective in the regulation of oxidoinflammatory injury. Some reports denote alterations in the effectiveness of ACE inhibitors in association with ACE insertion/deletion (I/D) gene polymorphisms. This study investigates the effects of ramipril on the oxidoinflammatory cytokines (IL-6, IL-8, TNF-alpha) and TnT (myocardial injury marker) and their alteration in association with ACE I/D gene polymorphisms. The study group (n = 51) patients received ramipril before coronary artery bypass grafting (CABG), while patients not receiving ramipril (n = 51) constituted the controls. TNF alpha, IL-6, and IL-8 were evaluated using ELISA and TnT by electrochemiluminescence methods before the induction of anesthesia (t1), at the 20th minute following cross-clamping (t2), at the end of the operation (t3), and at the 24th hour from the commencement of anesthesia (t4). Genotyping was performed by PCR. Differences between the groups were significant at t4 for the TNF alpha and at t3 for IL-6 (p < 0.05). The TnT levels increased from t2 onward in the control group and were highest in t3. Changes in t3 and t4 values in both groups according to their t1 values were significant (p < 0.05). However, differences between the groups were insignificant (p > 0.05). The IL-6, IL-8, TNF alpha, and TnT serum levels had no correlation with the ACE I/D gene polymorphism. Low cytokine and TnT levels in the study group, especially after cross-clamping, may indicate the protective effect of ramipril from oxidoinflammatory injury. This effect did not appear to be associated with the ACE I/D gene polymorphism.
  • Küçük Resim
    Öğe
    Role of cytokine gene polymorphisms on ramipril-altered inflammatory response and myocardial injury in patients undergoing coronary artery bypass surgery
    (2017) Urhan Küçük, Meral; Karaca, Kerem; Şahan Fırat, Seyhan; Vezir, Özden; Canacankatan, Necmiye; Aytaçoğlu, Barlas Naim; Erden, Sema; Tunçtan, Bahar; Sucu, Nehir
    Purpose: Ramipril is effective in treating inflammatory myocardial injury by reducing cytokines such as TNF-?, IL-6, and IL-8. In this study, we investigated the effect of cytokine gene polymorphisms on inflammatory response which might be reduced by ramipril. Material and Methods: Of 102 patients undergoing on-pump coronary artery bypass grafting surgery, 51 were the treatment group which received ramipril and the remaining 51 were the non-treated control group. TNF-?, IL-6, and IL-8 were measured with Enzyme-Linked Immuno Sorbent Assay (ELISA), before anesthesia induction (t1), at 20 min following cross clamping (t2), at the end of the operation (t3), and 24 hours after anesthesia (t4). Genotyping was performed with PCR method. Results: While TNF-? increase began with surgery, IL-6 and IL-8 increase began with cardiac arrest during cardiopulmonary bypass and continued until the end of the operation. In contrast, only IL-8 remained high in the control group during the postoperative period, while TNF-?, IL-6, and IL-8 began to decrease. The decreases in IL-6 at t3 and in TNF-? at t4 were significant. Conclusion: Ramipril might have a role in preventing inflammatory myocardial injury by reducing cytokine and TnT levels after cardiac arrest.