Publication: Nötropenik çocukların polimof nüveli lökosit fonksiyonları üzerine bazı antibiyotiklerin ve A vitamininin etkisinin araştırılması
Abstract
Çalışmamızda terapötik konsantrasyonlarda imipenem, sefodizim, vankomisin, teikoplanin, imipenem-amikasin, imipenem-teikoplanin ve A vitamininin akut lösemili nötropenik çocuk hastaların polimorf nüveli lökosit (PNL) fonksiyonları (fagositik ve hücre içi öldürme aktivitesi) üzerine etkilerinin in vitro araştırılması amaçlanmıştır. Yaş ortalaması 7,5 olan 21 akut lösemili nötropenik çocuk çalışmaya alınarak klinik açıdan 3 gruba ayrılmıştır. Birinci grup kemoterapi almayan nonfebril 7; 2. grup kemoterapi alan febril 7; 3. grup kemoterapi alan nonfebril 7 çocuktan oluşturulmuştur. PNL'ler kan örneklerinden ficoll-hypaque gradient santrifüj yöntemi ile ayrılmıştır. Fagositik ve hücre içi öldürme aktivitesi tayininde C. albicans ATCC 10231 kullanılmıştır. Birinci grupta, fagositik aktiviteyi sefodizim, vankomisin, teikoplanin, imipenem-teikoplanin kombinasyonu ve A vitamini p<0.01, imipenem ve imipenem-amikasin kombinasyonu ise p<0.05 değerinde artırmıştır. Hücre içi öldürme aktivitesini sefodizim ve vankomisin artırmış (p<0.05) diğer ilaçlar etkilememiştir. İkinci grupta, fagositik aktiviteyi sefodizim (p<0.001), vankomisin, imipenem-teikoplanin kombinasyonu ve A vitamini artırmış (p<0.05) diğer ilaçlar etkilememiştir. Hücre içi öldürme aktivitesini yalnız sefodizim (p<0.05) artırmış, diğerleri etkisiz kalmıştır. Üçüncü grupta, fagositik aktiviteyi yalnız vankomisin artırmış (p<0.05), tüm ilaçlar hücre içi öldürme aktivitesini etkilememiştir. Üç grup arasında fagositik aktivite açısından anlamlı bir fark bulunmazken (p>0.05); 1. grupta kontrol PNL (p<0.001) ve imipenemle inkübe edilen PNL'lerin (p<0.01) hücre içi öldürme aktivitesi 3. grup kontrol PNL'lere göre artmıştır. Sonuç olarak; terapötik konsantrasyonlardaki antibiyotiklerin hepsi ve A vitamini 1. grup hasta PNL'lerinin yalnız fagositik aktivitesini, sefodizim 1. ve 2. grupta, vankomisin ise yalnız 1. grupta hücre içi öldürme aktivitesini artırarak immünomodülatör etki gösterdiği sonucuna varılmıştır. Investigation of The Effects of Some Antibiotics and Vitamin A on the Polymorphonuclear Leukocyte Functions of Neutropenic Children
In this study the in vitro effects of of imipenem, cefodizime, vancomycin, teicoplanin, imipenem-amikacin, imipenem-teicoplanin combinations at therapeutic concentration and vitamin A on phagocytic and intracellular killing activity of polymorphonuclear leukocytes (PMNs) in neutropenic children with acute leukemia were investigated. Twenty one neutropenic children with mean age of 7,5 were included in the study and were clinically divided in 3 groups. The first group included 7 nonfebrile neutropenic children not receiving chemotherapy; the second group included 7 febrile neutropenic children with fever and received chemotherapy; the third group included 7 nonfebrile neutropenic children receiving chemotherapy. PMNs were isolated by ficoll-hypaque gradient centrifugation method from venous blood. C. albicans ATCC 10231 was used to measure the phagocytosis and intracellular killing activity of PMNs. In the first group, cefodizime, vancomycin, teicoplanin, imipenem-teicoplanin combination and vitamin A (p<0.01), imipenem and imipenem-amikacin combination (p<0.05) significantly increased the phagocytic activity. Cefodizime, vancomycin (p<0.05) significantly increased the intracellular killing activity. In the second group cefodizime (p<0.001), vancomycin, imipenem-teicoplanin combination and vitamin A (p<0.05), significantly increased the phagocytic activity. While cefodizime significantly increased the intracellular killing activity, the other drugs did not. In the third group, only vancomycin significantly increased the phagocytic activity (p<0.05), while non of the drugs did not affect the intracellular killing. There were no significant differences between the phagocytosis of the three groups. In the first group the intracellular killing activity of control PMNs (p<0.001) and PMNs incubated with imipenem (p<0.01) was higher than that of control PMNs of the third group.
In this study the in vitro effects of of imipenem, cefodizime, vancomycin, teicoplanin, imipenem-amikacin, imipenem-teicoplanin combinations at therapeutic concentration and vitamin A on phagocytic and intracellular killing activity of polymorphonuclear leukocytes (PMNs) in neutropenic children with acute leukemia were investigated. Twenty one neutropenic children with mean age of 7,5 were included in the study and were clinically divided in 3 groups. The first group included 7 nonfebrile neutropenic children not receiving chemotherapy; the second group included 7 febrile neutropenic children with fever and received chemotherapy; the third group included 7 nonfebrile neutropenic children receiving chemotherapy. PMNs were isolated by ficoll-hypaque gradient centrifugation method from venous blood. C. albicans ATCC 10231 was used to measure the phagocytosis and intracellular killing activity of PMNs. In the first group, cefodizime, vancomycin, teicoplanin, imipenem-teicoplanin combination and vitamin A (p<0.01), imipenem and imipenem-amikacin combination (p<0.05) significantly increased the phagocytic activity. Cefodizime, vancomycin (p<0.05) significantly increased the intracellular killing activity. In the second group cefodizime (p<0.001), vancomycin, imipenem-teicoplanin combination and vitamin A (p<0.05), significantly increased the phagocytic activity. While cefodizime significantly increased the intracellular killing activity, the other drugs did not. In the third group, only vancomycin significantly increased the phagocytic activity (p<0.05), while non of the drugs did not affect the intracellular killing. There were no significant differences between the phagocytosis of the three groups. In the first group the intracellular killing activity of control PMNs (p<0.001) and PMNs incubated with imipenem (p<0.01) was higher than that of control PMNs of the third group.