the balneotherapy group in cOl1lpariso~to the electrotherapy group. These results indicate that with aeratothermal fuii bath applieations the bost organism's ...
Changes In TNFa plasma levels In osteoarthritic patients under balneotherapy with acratothermal water "
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Z. N. Tütüllcü', i\tf.Turanl, A. Bart/t3, N. 'tii=baslUg/Ii', ii'f. Z. KaragüUe' i Lehrstuhl mr Medizinische Ökologie und Hydroklimatologie der Medizinischen Fakultat der Universimt Istanbul (Leiterin: Prof Dr. N. Özer), Istanbul, 1ürkei . 2 Lehrstuhl mr Medizinische Ökologie und Hydroklimatologie der Medizinischen Akademie Gülhane (GATA), Ankara. Türkei
3 Lehrstuhlmr Infektionskronkheitenund KlinischeMikrobiologieder MedizinischenAkademieGülhane,GATAAnkara. Tiirkei
Veriinderungen des TNFa-Blutspiegels bei Arthrose unter Balneotherapie mit Akratothermahvasser
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Summary
DerTumornekrosefaktora (TNFa) ist ein Zytokin und Hauptmediatorder Reaktionauf [nfektionserreger. [n dieser Studie wurden die Serumspiegeldes TNFa und einiger akuter Phase-Reaktan.ten(ARPs [CRP und Haptoglobin]) untersucht, um die Wirkungvon Akrothermalwasserals Vollbadauf das Immunsystemnachzuweisen.
Tumor Necrosis Factor a (TNFa) is':a eylokine, whieh is one of the principal mediators of host responsc to infeetive agents. In this study TNFa and serum levels of some acute phase reactants (APRs) (CRP and Haptoglobin) were investigated to .show how the immune system is atTcetcd
Zu diesem Zweck wurden zwei Patientengruppen mit Arthrose in die Untersuchung einbeiogen. Die Patienten der ersten Gruppe wurden mit Akratothermalwasservollbiidem und Elektrothempie behandelt Bei den Patienten der zweiten Gruppe wurde ausschlieBlich Elektrotherapie eingesetzt. Am-Anfang und am Ende der Studie wurden die Serumspiege:l von TNFa sowie von ARP und Haptoglobin gemessen.
With this aim, 2 groups of patients with osteoarthritis were included in the study. Group 1 patients werc treated with full baths' with acmtothermal water and eleetrotheiiipy. Group 2 patients were treated with only eleetrotherapy. In the beginnin'g and' at the end of the therapies, TNFa, CRP and haptoglobin levels were measured:. .
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Zum AbschluB erwies sich der Anstieg der
Blutspiegelwerte des TNFa sowie der ARPs in der Balneotherapiegruppe im Vergleicl} mit der Elektrotherapiegruppe als signifikant" höher. Diese Ergt;bnisse zeigen, da/3 akrothermale Vollbider die Schutz- und Abwehrmechanismen aktivieren. SchIüsseiwörter Balneothempie - Kurortbehandlung ne - AkratothermaIwasser
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At the end of the therapy there was a statistieally signifieant inerease in TNFa and APRs serum levels in the balneotherapy group in cOl1lpariso~ to the electrotherapy group. These results indicate that with aeratothermal fuii bath applieations the bost organism's proteetive and response mechanisms are triggered.
Key words
- Zytokj::'
Introduetion During balneothempeutic applieations, organism is under the influenec ofserial stimulations. it was'observed by some researchers .that these stimulations mgger metabolie, hormona! and immune meehanisms (Amehlilg et ai. 1985, Selimidi et ai. 1987).
Cytokines is the genenc term eurrently employed to refer to' the pcptide regulatory faetors released by aetivated cells which influcnce the behaviour of target cells (Kus/iiier 199I). Tumor Neerosis Factor Alpha (TNFa) is a Phys Rehab Kur Med 6 (1996) 80-82 @ Georg Thieme Verlag Stuttgart. New York
by fullbathapplieationswithacratothermalwater.
BaIneothempy - health resort-thempy - eytokines - aeratothermal water
cytokine with a large ae.tivitypotential whieh affeets diffcrcnt eell populations.TNFa plays an cffeetiverole in the metabolie activities of many tissuesand even in immunologicfiiiictions of all leukoeyte types. This is evidcnee of its immunomediatiir funetion in immune response(Abbar et ai. 1991). Acute phase response is the setting of niany of the normal homeostatic mechanisl1ls in response to inflamniatory stimuli. These inflammatory stimuli may be physicul. isehemie or immunological as well as infectious (Kii.rhiier 1991, Riclim'dr et ai. 1991). (n a narrower sense, aeute phase responsc refers to these plasma protein changes which reflec.t reorchcstmtion of the pattem of expression of plasma protein gene!; iii hcpiitoeytcs. CRP is one of the two major human acule phasc proteins. While it is normally present in plasma only in trncc
p'hysReJiabKur Med 6 (1996)
Changes in TNFa. plasma level.. in osteoarthritic pa tierits l/nder balneotherapy
amounts, there may be dramatic.increases in the rates of synihesi:;and conseqiicniplasma concentrations of these proteins Iiillowing siimulus. Haptoglobin is an acute phase protein wliich manifests less spectacularresponse (Kusliner 1991).Experiments revealed that these changes in biosynthesis are \:mi:;edby alterations in gene transcription regulated primarily
by interleukin-6(IL-6),afteninconjunctionwith [L-I andTNF (../bbCls et ai. i 99 i). . [n this study we investigated the changes in plusma TNFa, CRP, and luiptoglobin Icvels in patients with ostcoarthrosis beforeand after acratothermal full bath applicaiiiin:; in order to show how the immune system is affected during balneotherapeuticapplicaiions.
70 "60 50 c
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20
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TNFa
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Patients and Method Arandam cohort of 32 inpatients from the Bursa Military Hospital,Bursa, with generalised osteoarthrosis weri}included in the study.These patients were chosen among ihuse with no other systemic disease. Patients were randamly allocated to 2 groups.Group) (12 females,4 males; mean age: 55.5 years [SO 14.8];mean disease dUr'
