Mogući uticaj sniženih nivoa folne kiseline i vitamina B12 na reaktivaciju herpes simpleks virusnog keratitisa
Sažetak
Uvod/Cilj. Herpetični keratitis u većini slučajeva je rekurentna bolest, a nastaje kao rezultat reaktivacije herpes simpleks virusa tipa 1 iz latentnosti u najbližoj senzornoj gangliji. Zbog toga je razumevanje mehanizma latentnosti i reaktivacije latentnog virusa važna karika u razumevanju nastanka recidivne bolesti oka. Sve više studija potvrđuje epigenetsku regulaciju reaktivacije virusa kao posledicu prisustva transkripciono aktivnog transkripta vezanog za latenciju (LAT) regiona u latentnom virusnom genomu. Aktivnost LAT regiona usmerena je na hromatinsko uređenje. Epigenetska modulacija metilacije DNA je povezana sa unosom folata i vitamina B12 ili njihovim koncentracijama u serumu. Prema našim saznanjima, ne postoji izveštaj o potencijalnoj ulozi vitamina B12 i folne kiseline u reaktivaciji HSV keratitisa. Cilj rada bio je analiza moguće uloge folne kiseline i vitamina B12 u kontroli reaktivacije okularnog herpetičnog keratitisa. Metode. Studijom je bilo obuhvaćeno 50 bolesnika starijih od 18 godina sa različitim formama herpetičnog keratitisa, kao posledicom reaktivacije herpes simpleks virusa tipa 1. Nivoi vitamina B12 i folne kiseline mereni su u akutnoj fazi bolesti. Svi bolesnici su praćeni najmanje godinu dana, a beležen je broj recidiva virusne infekcije. Rezultati. Stopa recidiva herpetičnog keratitisa bila je statistički značajno niža kod bolesika sa višim nivoom vitamina B12 u krvi. Pored toga, stopa recidiva herpetičnog keratitisa je bila niža i kod bolesnika sa višim nivoom folne kiseline u krvi, ali sa nižom statističkom značajnošću u poređenju sa onom za vitamin B12. Zaključak. Sniženi nivoi vitamina B12 i folne kiseline mogu imati važnu ulogu u reaktivaciji herpetičnog keratitisa.
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