| Abstract | CILJ: Cilj je studije kvantitativnom analizom (stereološkom metodom) usporediti
vaskularizaciju sluznice nosa nealergičara, alergičara i alergičara nakon sprovedene terapije
mometazon furoatom te dokazati poremećaj u angiogenezi u alergičara, odnosno povećanje
broja krvnih žila.
ISPITANICI I METODE: Ispitanici su svrstani u 3 skupine temeljem kožnog
alergijskog testa na aeroalergene. U prvoj skupini ispitanika, kod kojih je senzitizacija na
navedene alergene negativna, obrađeno je 30 ispitanika, a isto toliko u drugoj (alergičari, kod
kojih je senzitizacija pozitivna na više alergena ) i u trećoj skupini ( alergičari liječeni
mometazon furoatom 15 dana prije analize).
Analiziran je bioptirani komadić sluznice nosa prednjeg pola donje nosne školjke, bojan
markerima ( antitijelima ) CD – 31 i VEGF – C.
Stereološkom metodom, a koristeći pojam duljinske gustoće (Lv) određivana je vaskularna
faza sluznice nosa i izračunata srednja vijednost ( x±SD) za svaku skupinu ispitanika.
REZULTATI: Utvrđena je značajna razlika u broju krvnih žila (CD31 vrijednosti) i limfnih
žila (VEGF-C vrijednosti) između svih ispitivanih skupina (svi P<0,001). Broj krvnih žila u
kontrolnoj skupini značajno je manji u odnosu na skupine bilo da se uspoređuju sa skupinom
alergičara koji uzimaju terapiju ili skupinom alergičara koji ne uzimaju terapiju (oba
P<0,001). U skupini alergičara bez terapije značajno je veći broj krvnih žila nego u skupini
alergičara s terapijom (P<0,001).
Broj limfnih žila u kontrolnoj skupini značajno je manji u odnosu na broj limfnih žila
u skupini alergičara bez terapije (P<0,001), kao i u odnosu na skupinu alergičara s terapijom
(P=0,013). U skupini alergičara bez terapije značajno je veći broj limfnih žila nego u skupini
alergičara s terapijom (P<0,001). Multiplom regresijskom analizom određeni su udjeli i značajnost doprinosa ispitivanih
čimbenika na broj krvnih žila (CD31 vrijednosti) i limfnih žila (VEGF-C vrijednosti). Ukupni
udio doprinosa od ispitivanih čimbenika: dob, spol, skupina, broj limfnih žila i uzimanje
mometazon furoata, na broj krvnih žila iznosio je 97 % (P<0,001). Značajni udio na broj
krvnih žila određen je za pripadnost određenoj skupini i iznosio je 59,8% (P<0,001), te za broj
limfnih žila i iznosio je 35,8% (P<0,001). Ukupni udio doprinosa od ispitivanih čimbenika:
dob, spol, skupina, broj krvnih žila i uzimanje mometazon furoata, na broj limfnih žila iznosio
je 51% i statistički je značajan (P<0,001). Pripadnost određenoj ispitivanoj skupini značajno
doprinosi broju limfnih žila (VEGF-C vrijednost) sa 23,4% (P<0,001). Broj krvnih žila
(CD31 vrijednost) također značajno (P=0,033) doprinosi broju limfnih žila (VEGF-C
vrijednost) i to sa 17,8%.
Između broja krvnih žila i pripadnosti ispitanika pojedinoj skupini određena je
pozitivna i značajna korelacija (r=0,634; P<0,001), što znači da povećanje broja krvnih žila je
značajno povezano s pripadnosti ispitanika pojedinoj skupini. Između broja limfnih žila
(VEGF-C vrijednosti) i pripadnosti ispitanika u pojedinoj skupini, također, je određena
pozitivna i značajna korelacija (r= 0,276; P=0,033), što znači da je povećanje broja limfnih
žila (VEGF-C vrijednosti) značajno povezano s pripadnosti ispitanika u pojedinoj skupini.
Između broja krvnih žila i broja limfnih žila (ekspresije CD31 i ekspresije VEGF-C) određena
je pozitivna korelacija (r= 0,667) te povećanje broja krvnih žila (CD31 vrijednost) prati
povećanje broja limfnih žila (VEGF-C vrijednost) i to povećanje statistički je značajno
(P<0,001).
Utvrđena je značajna razlika duljinske gustoće krvnih žila (CD31 vrijednosti) i
duljinske gustoće limfnih žila (VEGF-C vrijednosti) između svih skupina (svi P<0,001). U
skupini alergičara bez terapije značajno je veća duljinska gustoća krvnih i limfnih žila nego u
skupini alergičara s terapijom (P<0,001). Duljinska gustoća krvnih i limfnih žila u kontrolnoj skupini statistički je značajno manja u odnosu na duljinsku gustoću krvnih i limfnih žila u
skupini alergičara bez terapije), kao i u odnosu na skupinu alergičara s terapijom (oba
P<0,001).
ZAKLJUČAK: Studija potvrđuje da petnaestodnevno liječenje mometazon furoatom
značajno reducira gustoću vaskularnih elemenata u alergičara. Na osnovu naših istraživanja i
rezultata možemo pretpostaviti da mometazon furoat smanjuje angiogenezu. |
| Abstract (english) | PURPOSE: The purpose of this study was to compare the vascularization of the nasal
mucous membrane among the non-allergic, non-treated allergic and allergic patients treated
with mometasone furoate, by means of the stereological method in quantitative analysis and
to prove the angiogenetic disorder among the allergic patients i.e. the increase in the number
of blood vessels.
PATIENTS AND METHODS: The patients were sorted into three different groups
according to the results of skin testing to aeroallergens. In the first group, in which the
sensitization to the aeroallergens was negative, 30 patients were examined, the same number
was examined in the second (patients with positive sensitization to more than one allergen)
and the third group (allergic patients treated with mometasone furoate 15 days before the
analysis).
A small piece of the nasal mucous membrane taken from the frontal pole of the lower
nasal shell coloured by markers (antibodies) CD – 31 and VEGF – C was analysed.
Vascular phase of the nasal mucosis was determined using the stereological method and
lenght density (Lv) and medium value ( x±SD) were determined for each group.
RESULTS: Significant difference in the number of blood vessels has been identified
among all the examined groups (all P<0,001). The number of blood vessels in the control
group is significantly lower both in comparison with the group of treated allergic patients and
with the group of non-treated allergic patients (both P<0,001). In the group of non-treated patients there is a significantly larger number of blood vessels than in the group of treated
allergic patients.
The number of lymphatic vessels in the control group is significantly lower in relation
to the number of lymphatic vessels in the group of non-treated allergic patients (P<0,001) as
well as in relation to the group of treated allergic patients (P=0,013). In the group of nontreated
allergic patients there is a significantly larger number of lymphatic vessels than in the
group of allergic patients receiving therapy.
The influence and contribution of examined factors to the number of blood vessels
(CD31 expression) and lymphatic vessels (VEGF-C expression) have been determined by
means of multiple regression analysis. The overall contribution of the examined factors: age,
sex, group, lymphatic vessel number and treatment with mometasone fuorate to the blood
vessel number amounted to 97% (P<0,001). Each specific group of patients has shown
significant contribution to the number of blood vessels in the amount of 59,8% (P<0,001)
while the influence of lymphatic vessels amounted to 35,8% (P<0,001). The overall
contribution of the examined factors of age, sex, group, lymphatic vessel number and
treatment with mometasone fuorate to the blood vessel number amounted to 51% and it is
statistically significant (P<0,001). The particular group the examined patients belonged to
contributed significantly to the number of lymphatic vessels (VEGF-C expression) with
23,4% (P<0,001). The number of blood vessels (CD31 expression) also contributed
significantly (P=0,0033) to the lymphatic vessel number (VEGF-C expression) with 17,8%.
Significant and positive correlation (r=0,634; (P<0,001) has been established between
the number of blood vessels and the particular group the patients belonged to, which means
that the increase in the number of blood vessels is significantly connected with the group the
patients belonged to. Positive and significant correlation (r=0,276; P=0,0033) has also been
established between the number of lymphatic vessels (VEGF-C expression) and the particular group the patients belonged to, which means that the increase in the number of lymphatic
vessels (VEGF-C expression) is significantly connected to the type of the group the patients
belonged to. Positive correlation (r=0,667) has been established between the number of blood
vessels and the number of lymphatic vessels (CD31 expression and VEGF-C expression) as
well as the increase in the number of blood vessels (VEGF-C expression), this increase being
statistically significant (P<0,001).
Significant difference of blood vessel lenght density (CD31 expression) and lymphatic
lenght density (VEGF-C expression) among all groups (all P<0,001) has been established. In
the group of non-treated allergic patients the vessel lenght density and lymphatic lenght
density is significantly greater than among the treated allergic patients (P<0,001). The blood
vessel lenght density and lymphatic lenght density in the control group is statistically
significantly smaller in comparison with the blood vessel and lymphatic lenght density among
the non-treated allergic patients as well as in relation to the group of the treated allergic
patients (both P<0,001).
CONCLUSION: The study has shown that a 15-day treatment with mometasone
furoate results in a significant reduction of the density of vascular elements in allergic
patients. On the basis of our research and results it can be assumed that mometasone furoate
reduces the angiogenesis. |
