TB’a karşı inflamatuvar cevapta rol alan pro-inflamatuvar sitokin IL-1β ile aşırı inflamatuvar yanıtın doku ve hücreleri harabedici özelliğini kontrol altına alma adına vücudun doğal immun cevapta rol alan IL-10, A20, SOCS-1, SOCS-3, SIGIRR, ST2, TOLLIP, MKP1, IRAK-M gibi anti-inflamatuvar sitokin ve negatif regülatör genlerin TB’a yatkınlıkla ilişkilerini araştırdığımız çalışmamız sonucunda;
1. TOLLIP’e ait rs5743899 ve rs3750920, IL-1β’ya ait +3954 ve IL-10’a ait 1082 polimorfizmleri arasından ki kare testi ile istatistiksel olarak anlam çıkmadığı ancak IL-10’a ait 1082 polimorfizm Hardy Weinberg equilibrium analizine göre anlamlı çıktığı,
2. Üç farklı istatiksel analiz yöntemi ile değerlendirdiğimiz A20, SOCS-1, SOCS-3, SIGIRR, ST2, TOLLIP, MKP1, IRAK-M negatif regülatör genlerinin 2-ΔΔCt istatistiksel yöntem sonucuna göre sırasıyla ST2, TOLLIP ve SIGIRR’in hastalarda sağlıklı kontrol grubuna kıyasla mRNA ekspresyon seviyesinin yüksek olduğu, bunun aksine hasta grupta sağlıklı kontrol grubuna karşın IRAK-m ve MKP1’in IRAK-mRNA ekspresyon sevilerinin ise oldukça düşük olduğu,
3. Çalışmamızda iki grubu kıyasladığımız negatif regülatör genlerin ortalama ve standartlar ile hesaplanan Two-Tailed Student’s T Testi yöntemine göre sırasıyla IRAK-M, ST2, TOLLIP, MKP1 ve SIGIRR genlerinin istatistiksel olarak anlamlı çıktığı;
4. IRAK-M, ST2, SIGIRR, TOLLIP ve MKP1 negatif regülatör genlerin ROC analizine göre hasta ve sağlıklı kontrol grupta anlamlı bulunduğu ve bu iki grubu ayırt etmede bu negatif regülatör genlerin kullanılabileceği;
5. TOLLIP’in rs5743899 polimorfizminin genotiplerinin negatif regülatör genler ile birlikte değerlendirildiği Non-parametrik Kruskal Wallis istatistiksel yönteme göre; hasta grupta ST2 ve IRAK-M negatif regülatör genlerin anlamlı, TOLLIP negatif regülatör genin ise sınırda anlamlı olduğu;
6. TOLLIP’in rs3750920 polimorfizminin genotiplerinin negatif regülatör genler ile birlikte değerlendirildiği Non-parametrik Kruskal Wallis istatistiksel yönteme
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göre; sağlıklı grupta A20 ve MKP1 negatif regülatörlerin anlamlı, SIGIRR’ın ise sınırda anlamlı olduğu;
7. IL-1β’nın +3954 polimorfizminin genotiplerinin negatif regülatör genler ile Non-parametrik Kruskal Wallis yöntemine göre değerlendirildiğinde hasta ve sağlıklı kontrol grubun ikisinde de anlamlı bir fark yaratmadığı ve
8. IL-10’un +1082 polimorfizmin genotiplerinin negatif regülatör genler ile Non-parametrik Kruskal Wallis yöntemine göre değerlendirildiğinde IRAK-M negatif regülatör genin hasta grupta, SIGIRR’ın ise sağlıklı kontrol grupta anlamlı olduğu belirlendi.
Bildiğimiz kadarıyla, çalışmamız bu biomarkerların birarada TB’a duyarlılıkla ilişkilendirildiği ilk çalışma özelliğini taşımaktadır.
TB’a duyarlılıkta konağa ait faktörlerin bu derece etkili olması fikri TB’a karşı aşılamanın şimdiye kadar neden bu kadar başarısız olduğunu düşündürmektedir.
Çalışmamız içinde yer alan tüm immün mediatörlerin birlikte değerlendirilmesi ileride bu biomarkerların TB’a karşı kullanılabileceğini göstermektedir. Çalışmamızın hızlı tanıya ek olarak bu biomarkerların birlikte değerlendirilmesi ile TB immünpatogenezinin daha iyi anlaşılacağı dolayısıyla kontrol ve tedavi protokollerinin yeniden düzenlenmesine ve daha geniş populasyonlu sürveyans çalışmalarına ışık tutacağı kanaatindeyiz.
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8. ÖZGEÇMİŞ
16.02.1989 tarihinde Ankara Altındağ’da doğan Emel EKER; ilk ve orta okulu Recep Birsin Özen ilköğretim okulunda 2004 yılında, liseyi ise Özel Perihan Üçgül Anadolu lisesinde 2007 yılında bitirdi. 2008 yılında Çukurova Üniversitesi Biyoloji Bölümü’nü kazandı ve 2012 yılında mezun oldu.
2012-2014 yılları arasında Çukurova Üniversitesi Sağlık Bilimleri Enstitüsü Tıp Fakültesi Tıbbi Mikrobiyoloji Anabilim Dalında Yüksek Lisans eğitimini tamamladı.
2014 yılında Çukurova Üniversitesi Sağlık Bilimleri Enstitüsü Tıp Fakültesi Tıbbi Mikrobiyoloji Anabilim Dalında Doktora eğitimine başladı. İyi derece İngilizce bilmektedir.