Ekspresija receptora 2 za faktor nekroze tumora alfa i interleukina-1 kod holesteatoma srednjeg uva
Sažetak
Uvod/Cilj rada. Holesteatom karakteriše progresivni rast sa erozijom okolnih koštanih struktura usled efekta pritiska, enzimske aktivnosti i aktivacije osteoklasta. Cilj rada bio je da se utvrde nivoi ekspresije receptora 2 za faktor nekroze tumora alfa (TNF R2) i interleukina-1 (IL-1) kod hroničnog otitis media (HOM), sa i bez stečenog holesteatoma, i njihova korelacija sa stepenom koštane destrukcije. Metode. U studiju je bilo uključeno 178 bolesnika oba pola, starosti od 5 do 75 godina, koji su bili podvrgnuti mikrohirurškom lečenju HOM sa i bez holesteatoma, u Klinici za bolesti uva, grla i nosa Univerzitetskog kliničkog centra Republike Srpske (UKC RS), Banja Luka od 2015. do 2018. godine. Na osnovu prisustva ili odsustva holesteatoma, bolesnici su podeljeni u 2 grupe: sa holesteatomom (n = 97) i bez holesteatoma (n = 81). Uzorci perimatriksa holesteatoma (grupa sa holesteatomom) i inflamirane sluznice cavum tympani (grupa bez holesteatoma) su uzeti intraoperativno. Intraoperativna eksploracija srednjeg uva je uključivala proveru stanja osikularnog lanca, pojedinih osikula, koštanih zidova spoljašnjeg slušnog kanala i cavum tympani, kao i susednih anatomskih
struktura. Nivoi ekspresije TNF R2 i IL-1 određeni su imunohistohemijskom analizom intraoperativno dobijenih tkivnih uzoraka. Rezultati. Korelacija između stepena osteodestrukcije i prisustva holesteatoma bila je statistički značajna. Visoki nivoi ekspresije TNF R2 i IL-1 bili su učestaliji u grupi bolesnika s holesteatomom koji su imali osteodestrukciju u odnosu na grupu bolesnika bez holesteatoma. Verovatnoća osteodestrukcije zidova spoljašnjeg slušnog kanala i cavum tympani bila je značajno veća kod bolesnika sa većom ekspresijom TNF R2 (p < 0,05). U odnosu na nivoe ekspresije IL-1, nije uočena značajna korelacija s opisanom patomorfološkom promenom. Korelacija između ekspresije TNF R2 i IL-1 sa destrukcijom osikularnog lanca bila je značajna (p < 0,01). Zaključak. Prisustvo holesteatoma i povišen nivo ekspresije TNF R2 i IL-1 kod bolesnika sa HOM značajno su povezani. Nivoi ekspresije TNF R2 i IL-1 u tkivu stečenog holesteatoma imaju potencijalan klinički značaj kod nastanka koštane destrukcije.
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