Gene Expression and DNA Variation Analysis of Sacs to Identify the Pathophysiology of Indirect Inguinal Hernia
Gene Expression and DNA Variation Analysis of Sacs to Identify the Pathophysiology of Indirect Inguinal Hernia
The aim of the project is to show that gene expression levels change in at least one of the
 GATA6 and T-box transcription factor 3 (TBX3) genes in indirect inguinal hernia sacs, thus
 revealing that this pathway causes an error in the sac closure pathway.

 Indirect inguinal hernia is an important condition for human health as it is common in the
 community and can lead to life-threatening or permanent loss of function. In addition, since
 the treatment is performed surgically, the follow-up and treatment process of the patients
 should be managed carefully in terms of complications and costs. By explaining the mechanisms
 of the occurrence of this disease, important steps will be taken in terms of both human
 health and the development of science. Moreover, the data to be collected may open new
 horizons in the treatment of inguinal hernia.

 20 inguinal hernia patients those consecutively applied to Trakya University Medical Faculty
 Department of Pediatric Surgery and 20 circumcision patients as control group will be
 included in the study.
Indirect inguinal hernia is one of the pathologies that is widely researched in national and
 international studies because of its high prevalence in the community and its
 life-threatening or permanent loss of function. However, no point has been reached regarding
 the etiology of this disease and a consensus has been reached.

 The investigators believe that the study will contribute to the explanation of the formation
 mechanisms of the mentioned disease. Considering the high prevalence of this disease and its
 potential for life-threatening, the investigators anticipate that the analysis of the
 relevant genes for the Turkish population will make significant contributions to the public
 health. In the literature, analysis of GATA6 SNPs in the Chinese population has subsequently
 associated certain polymorphisms with indirect inguinal hernia. It is also been stated that
 TBX3 gene pathologies may be associated with inguinal hernia.

 However, there is no study in the literature about the patent processus vaginalis expression
 levels of these genes. There is no study on the SNP analysis of these genes in Turkish
 population. For these reasons, the first time the expression / SNP analysis of the specified
 genes in Turkish society will be carried out will make an additional contribution to
 scientific knowledge. As stated clearly in the studies, the implementation of medical
 treatment of indirect inguinal hernia may change the approach of the pediatric surgical
 community to indirect inguinal hernia. In order for medical treatment to be carried out, the
 formation pathways and genetic origins of the disease must be clearly revealed.

 Investigating the relationship of GATA6 and TBX3 genes, which are known to be involved in
 connective tissue homeostasis, with the mechanisms of indirect inguinal hernia formation,
 will contribute to the studies in the literature and is important in terms of revealing
 whether the treatment of these diseases can be performed medically in the future.

 The study aims to reveal that gene expression levels in indirect inguinal hernia sacs due to
 SNPs in at least one of the GATA6 and TBX3 genes, thus causing an error in the sac closure
 pathway. The hypothesis of the study; It is stated that the gene expression levels of at
 least one of GATA6 and TBX3 in the sacs of inguinal hernia patients are altered.

 The primary goal of this study is; To determine the level of GATA6 and TBX3 gene expression
 in sacs obtained from indirect inguinal hernia patients. The secondary goal is to investigate
 SNPs in the leukocytes of these patients and to investigate whether the genetic elements in
 our hypothesis in these diseases are regulated by different genes acting as transcription
 factors.

 Considering that indirect inguinal hernia poses significant health risks, especially in
 children, it is predicted that the results to be obtained may contribute to clarification of
 the etiology and non-invasive methods other than surgery.
Inclusion Criteria:

 -  to accept to participate the study

 -  pediatric age

 -  isolated indirect inguinal hernia patient with no additional systemic/congenital
 disease

 -  patients requesting circumcision procedure with no additional systemic/congenital
 disease

 Exclusion Criteria:

 -  patients with any syndromic disease

 -  patients with hypospadias

 -  patients with undescended testes

 -  patients with umbilical hernia