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GEMİCİOĞLU B, YALÇIN AD, HAVLUCU Y, KARAKAYA G, ÖZDEMİR L, KEREN M, BAVBEK S, EDİGER D, OĞUZÜLGEN İK, ÖZŞEKER ZF, YORGANCIOĞLU A. Country-based report: the safety of omalizumab treatment in pregnant patients with asthma. Turk J Med Sci 2021; 51:2516-2523. [PMID: 34174791 PMCID: PMC8742481 DOI: 10.3906/sag-2101-341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/24/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND/AIM We aimed to report outcomes of pregnant patients with asthma under omalizumab treatment and their infants in our country. MATERIALS AND METHODS Patients with asthma who received omalizumab for at least 6 months and at least one dose during their pregnancy were retrospectively evaluated using a questionnaire regarding their disease and therapy and the health of their infants. RESULTS Twenty pregnant patients and their 23 infant’s data were analyzed. The mean delivery age was 31.8 ± 7.4 years. They received omalizumab for 28.9 ± 21.8 months. Eight (36.4%) patients showed exacerbation of the disease during pregnancy. Forced expiratory volume in 1 s (FEV1) and asthma control test (ACT) scores at the starting time of omalizumab administration, first month of the pregnancy, and after delivery were 71 ± 18%, 83.4 ± 10.5%, and 80.5 ± 13% (FEV1), and 11.9 ± 4.9, 20.2 ± 2.6, and 20.4 ± 2.2 (ACT), respectively. One patient gave birth to twin infants, two patients to two infants each in different years, and 17 to one infant each. Three (13%) infants had low birth weight and five (21.7%) were born prematurely. No congenital anomalies were detected. Seven (30.4%) infants presented atopic diseases during their life. CONCLUSION Omalizumab treatment during pregnancy seems to be safe for both patients and their infants.
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Affiliation(s)
- Bilun GEMİCİOĞLU
- Department of Pulmonary Diseases, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, IstanbulTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Arzu Didem YALÇIN
- Department of Internal Medicine, Division of Allergy and Immunology, Health Science University Antalya Education and Research Hospital, AntalyaTurkey
| | - Yavuz HAVLUCU
- Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, ManisaTurkey
| | - Gül KARAKAYA
- Department of Pulmonary Diseases, Division of Immunology and Allergy, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Levent ÖZDEMİR
- Department of Pulmonary Diseases, Dörtyol Goverment Hospital, AdanaTurkey
| | - Metin KEREN
- Department of Pulmonary Diseases, Süreyyapaşa Pulmonary Diseases Education and Research Hospital, IstanbulTurkey
| | - Sevim BAVBEK
- Department of Pulmonary Diseases, Division of Allergy and Clinical Immunology, Faculty of Medicine, Ankara University, AnkaraTurkey
| | - Dane EDİGER
- Department of Pulmonary Diseases Faculty of Medicine, Uludağ University, BursaTurkey
| | | | - Zeynep Ferhan ÖZŞEKER
- Department of Pulmonary Diseases, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, IstanbulTurkey
| | - Arzu YORGANCIOĞLU
- Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, ManisaTurkey
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Sarıoglu N, Yalcın AD, Sahin F, Soyyigit S, Tepetam FM, Erel F. Does vitamin D deficiency in asthma affect clinical and functional parameters? A Turkish multicenter study. Allergy Asthma Proc 2021; 42:e152-e158. [PMID: 34474718 DOI: 10.2500/aap.2021.42.210056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: In recent years, interest in the effects of vitamin D on human health and the immune system has increased. Objective: This study aimed to investigate the relationship of vitamin D with asthma severity, attacks, and clinical and functional parameters in adult patients with asthma who were living in different geographic regions in Turkey. Methods: A total of 384 patients with stable asthma and 87 control subjects were included. A physical examination and a pulmonary function test were performed, and routine blood analyses and vitamin D levels were evaluated. Asthma Control Test was applied. The number of exacerbations in the previous year, asthma therapy, and medication adherence were recorded. Results: In our study, vitamin D levels were below the target values in both patients with asthma (median [minimum-maximum] 16.0 ng/mL [3.5-48 ng/ml]) and control subjects (median [minimum-maximum] 20.0 ng/mL [5.8-58.79 ng/mL]). However, it was lower in the patients with asthma than in the control subjects (p = 0.001). There was a negative relationship between the levels of vitamin D and the severity of asthma (Kendall τ = -0.146; p < 0.001). Furthermore, the patients with severe asthma were received The Global Initiative for Asthma (GINA) step 5 treatment showed significantly lower vitamin D compared with the patients who received GINA step 4 treatment (p = 0.037). Vitamin D levels correlated with forced vital capacity (FVC), forced expiratory volume in the first second of expiration (FEV1), and peak expiratory flow (r, 0.221-0.236; p ≤ 0.001). In addition, a positive relationship was found between Asthma Control Test and vitamin D (r = 0.229; p = 0.001). However, body mass index (BMI), asthma exacerbation, and hospitalization were inversely related to vitamin D (r, 0.198-0.233; p = 0.001). Multivariable regression analysis revealed that FVC (p = 0.002), FEV1 (p = 0.033), and BMI (p = 0.037) were independent determinants associated with vitamin D. Conclusion: This study suggested a high prevalence of vitamin D deficiency in adults with asthma living in different geographic areas in Turkey. Vitamin D deficiency is associated with asthma severity, poor control, and lower lung function.
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Affiliation(s)
- Nurhan Sarıoglu
- From the, Department of Chest Diseases, Medicine Faculty, Balıkesir University, Balıkesir, Turkey
| | - Arzu Didem Yalcın
- Division of Allergy and Immunology, Department of Internal Medicine, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Fusun Sahin
- Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sadan Soyyigit
- Department of Allergy and Immunology, Medicine Faculty, Yıldırım Beyazıt University, Ankara, Turkey; and
| | - Fatma Merve Tepetam
- Department of Allergy and Immunology, Sureyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Fuat Erel
- From the, Department of Chest Diseases, Medicine Faculty, Balıkesir University, Balıkesir, Turkey
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Abstract
The SARS-CoV-2 is a β-CoV, which is enveloped by non-segmented positive-stranded RNA virüs. When β-CoV infects the respiratory tract, it can cause mild and/or severe acute respiratory syndrome (SARS) with consequent release of cytokines/mediators, including interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8 (CXCL8), IL-10, IP10, IL-12, IL-13, IL-17, IL-33, IL-25, IL-37, IL-38, GCSF, GM-CSF, HGF, IP-10, MCP-1, MIP-1α (also known as CCL3), IFN-γ, IFN-α, TRAIL, MCSF, and TNF-α. Our hypothesis of writing this article can be summarized as; if the monoclonal antibody (mAb) administered by us does not inhibit the immune response for the β-CoV and inhibits uncontrolled-adaptive/hyperimmune responses (also called cytokine storm) on endothelium level, then it may cause severe coronavirus disease 2019 (COVID-19). Anakinra is a human IL-1 receptor antagonist. By inhibiting IL-1α/IL-1β competitively from binding to the IL-1 type-I receptor, anakinra, neutralizes the activity that pertains to these key mediators of autoinflammatory and/or immune processes. Tocilizumab is a blocker of IL-6R that can effectively block IL-6 signal transduction pathway. Omalizumab that binds to the CH3 domain is near to the binding site for the high-affinity IgE Fc receptors type-I of human IgE. Myocardial, lung and hepatorenal injury in patients with COVID-19 could be due to cytokine storm, hypoxic injury, or/and direct endothelial/vascular injury. We propose combination of mAbs with remdesivir and/or favipiravir in severe COVID-19 cases, such as septic shock, acute respiratory deficiency syndrome, and/or multiple organ failure. Finally, we highlight the therapeutic mAbs that target patients with severe COVID-19.
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Affiliation(s)
- Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology Section, Biotechnology and Moleculer Biology Unit, Academia Sinica, Genomics Research Center, Taipei, Taiwan
- Division of Allergy and Immunology, Department of Internal Medicine, Health Science University Antalya Education and Research Hospital, Antalya, Turkey
| | - Ata Nevzat Yalcin
- Medicine Faculty, Department of Infectious Disease and Clinical Microbiology, Akdeniz University, Antalya, Turkey
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Yalcin AD, Yalcin AN. A case of asthma with Behcet's disease: successful treatment with omalizumab and its effects on recurrent aphthous lesions. Immunopharmacol Immunotoxicol 2020; 42:379-382. [PMID: 32605504 DOI: 10.1080/08923973.2020.1789656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Monoclonal antibody therapies have revolutionized the treatment of autoinflammatory-immune/genetic disease including spondylarthritis, asthma and rheumatoid arthritis. Behcet's disease (BD) is a multi-systemic vasculitis, which is generally recurrent aphthous lesions (RAL) as well as ocular and skin lesions. Today, the immunohistopathogenesis of BD is mostly unknown. METHOD Omalizumab (Anti-IgE humanized monoclonal antibody) therapy is given for severe persistent allergic asthma, and unintentionally it had effect on RAL. Our patient has received omalizumab treatment for 3 years. The steroid treatment was completely discontinued a month later and the systemic-steroid dependent diabetes mellitus was healed. The IL-1 β, IL-6, IL-8, IL-33, IL-25, IL-10, IL-23, and IL-17A levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) kit. RESULTS After a long-term omalizumab treatment administered, the levels of WBC, d-dimer, IL-33, IL-6, IL-25 and IL-1 β decreased. The patient's hsCRP decreased from 3 to 0.1 and Eosinophil Cationic Protein (ECP) levels decreased from 78 to 21. A significant improvement was noticed in the RAL, the asthma symptoms (cough, shortness of breath), the number of emergency admissions, and the average length of stay of the patient within the days following the initiation of the omalizumab treatment. CONCLUSIONS Here, for the first time, we introduce omalizumab treatment of a patient diagnosed with BD and the examination of the treatment for the clinical manifestations and the cytokines/coagulant protein levels. A significant improvement is observed in the patient's RAL following the initiation of omalizumab. There is strong evidence that the serum proinflammatory cytokines/coagulant factors could also play an important role in the relationship between RAL and IgE-dependent vascular autoinflammation.
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Affiliation(s)
- Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology, Academia Sinica, Genomics Research Center, Taipei, Taiwan
| | - Ata Nevzat Yalcin
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Akdeniz University, Antalya, Turkey
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Celik B, Bulut T, Yalcin AD. Tissue HE4 Expression Discriminates the Ovarian Serous Carcinoma but Not the Uterine Serous Carcinoma Patients. A New Adjunct to the Origin of the Tumor Site. Pathol Oncol Res 2020; 26:1145-1151. [PMID: 31165997 DOI: 10.1007/s12253-019-00675-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/23/2019] [Indexed: 02/05/2023]
Abstract
Both uterine serous carcinoma (USC) and ovarian serous carcinoma (OSC) are presented at advanced stage at the first admittion and dissseminated disease makes the anatomical site of the tumor origin imposible. CA125 and p53 are reliable markers that are useful for differentiating both uterine serous and ovarian serous carcinoma from their most common subtypes (endometrioid type carcinoma of ovary and uterus) but so far there is no histopathologic marker that differentiates USC from OSC. On the other hand, Trastuzumab (Herceptin) increases progression-free survival among USC patients, but not OSC patients and makes the histopathologically assigning the origin of the tumor important. So, the aim of this study was to evaluate the immunohistopathological discriminative value of the human epididymis secretory protein 4 (HE4) between OSC and USC patients. Patients with a diagnosis of OSC and UTC were enrolled. HE4 expression was evaluated by immunohistochemistry. The results were compared between groups. Of the tumor tissues studied, HE4 immunostaining was seen in the majority of ovarian serous carcinoma cases (89.65%), while endomatrial serous carcinoma cases were devoid of HE4 immunostaining. HE4 immunostaining was seen in 39.1% uterin serous carcinoma cases and this difference was statistically significant (p = 0.001). Our study demonstrated for the first time the potential of HE4 expression to predict the anatomical site of tumor origin. HE4 is a novel tumor marker that differentiates USC from OSC.
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Affiliation(s)
- Betul Celik
- Pathology Department, Health Science University, Antalya Hospital, Antalya, Turkey.
- Department of Pathology, Training Hospital, Varlik Mah, 07100, Antalya, Turkey.
| | - Tangul Bulut
- Pathology Department, Health Science University, Antalya Hospital, Antalya, Turkey
| | - Arzu Didem Yalcin
- Immunology Unit, Health Science University, Antalya Hospital, Antalya, Turkey
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YALCIN ARZUDIDEM, ONBASI KEVSER, UZUN RUSEN, HERTH FELIX, SCHNABEL PHILIPPALBERT. Human(ized) monoclonal antibodies in atopic patients - state of the art. Cent Eur J Immunol 2020; 45:195-201. [PMID: 33456331 PMCID: PMC7792442 DOI: 10.5114/ceji.2020.97909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 04/13/2017] [Indexed: 02/05/2023] Open
Abstract
Asthma is an important chronic disease affecting a lot of people worldwide. Treatment options for asthma like biological agents are being developed more frequently nowadays. Despite a lot of treatment options, some patients still remain symptomatic. As more and more practitioners choose treatment with biologic agents as a convenient way of therapy, biologic agents and other valuable methods must be discovered in order to cope with a growing number of treatment agents. This manuscript emphasizes on new generation monoclonal human(ized) antibodies in asthmatics and off-label use . The first developed biologic agent is the anti-immunoglobulin E monoclonal antibody called omalizumab. Currently it is an approved treatment option for asthma.
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Affiliation(s)
- ARZU DIDEM YALCIN
- Department of Internal Medicine, Allergy and Clinical Immunology, Genomics Research Center, Academia Sinica, Taipei, Taiwan
- Department of Allergy and Clinical Immunology, Antalya Training and Research Hospital, University of Medical Science, Antalya, Turkey
- Correspondence: Arzu Didem Yalcin, Department of Internal Medicine, Allergy and Clinical Immunology, Genomics Research Center, Academia Sinica, 11529 Tapei,Taiwan, e-mail:
| | - KEVSER ONBASI
- Department of Internal Medicine, Allergy and Clinical Immunology, Dumlupinar University, Kütahya, Turkey
| | - RUSEN UZUN
- Department of Pulmonology, Antalya Training and Research Hospital, University of Medical Science, Antalya, Turkey
| | - FELIX HERTH
- Department of Pulmonary and Critical Care Medicine, Thoraxklinik Translational Lung Research Center, University of Heidelberg, Heidelberg, Germany
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Yalcin AD, Uzun R. Anti-IgE Significantly Changes Circulating Interleukin-25, Vitamin-D and Interleukin-33 Levels in Patients with Allergic Asthma. Curr Pharm Des 2019; 25:3784-3795. [PMID: 31566129 DOI: 10.2174/1381612825666190930095725] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/24/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Multi-center, randomized-controlled trials and observational studies have demonstrated that, in severe asthmatic patients receiving omalizumab treatment, the frequency of exacerbations, the number of urgent adverse events, and the need for oral steroids tend to decrease. MATERIALS AND METHODS This study included a total of 32 patients. The patients were divided into two groups as Group IA (pre-omalizumab) and Group IB (post-omalizumab). Serum IL-25 and IL-33 levels were measured and the number of emergency admissions, length of hospitalization (day), Asthma Control Test (ACT) scores, eosinophil cationic protein (ECP), and fractional exhaled nitric oxide (FeNO) value were analyzed. RESULTS ACT and FeNO values increased after omalizumab treatment, while IL-33, IL-25 levels decreased after the completion of omalizumab treatment. Furthermore, there was a weak, positive, and significant relationship between the changes in the ECP levels and IL-33 levels (r=0.38, p=0.03). CONCLUSION To the best of our knowledge, this is the first study to compare circulating IL-25 and IL-33 levels with specific IgE synthesis in the literature. Multivariate correlation analysis showed that the changes in serum IL-33 levels were significantly correlated with the changes in the mite sIgE levels and length of hospital stay (Fmodel=11.2, p=0.01, r2=0.45). On the other hand, there was no significant relationship between the other variables and changes in the IL-25 levels.
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Affiliation(s)
- Arzu D Yalcin
- Internal Medicine, Allergy and Clinical Immunology, Academia Sinica, Genomics Research Center, 11529, Taipei, Taiwan
| | - Rusen Uzun
- University of Medical Science, Antalya Hospital, Antalya 07070, Turkey
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Sari F, Gumuslu S, Cetinkaya R, Sarikaya M, Yalcin AD. High serum soluble CD200 levels in patients with autosomal dominant polycystic kidney disease. J Investig Med 2017; 65:784-786. [PMID: 28179401 DOI: 10.1136/jim-2016-000326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2017] [Indexed: 02/05/2023]
Abstract
CD200 is a novel immune-effective molecule, existing in a cell membrane-bound form, as well as in a soluble form in serum, which performs to modulate inflammatory and acquired immune responses. Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the development of large renal cysts and progressive loss of renal function. As defects in cell cycle arrest and apoptosis of renal tubular epithelial cells occur in ADPKD, we asked whether serum soluble CD200 might underlie and effect on ADPKD. Serum soluble CD200 levels were measured in 44 patients with ADPKD and 24 healthy volunteers. Concentrations of soluble CD200 in the serum samples were quantified using an ELISA kit. The mean serum soluble CD200 levels were higher in patients with ADPKD than in the control group (71.4±29.2 and 21.4±5.6 pg/mL, p<0.001). Positive correlation was detected between serum soluble CD200 levels and glomerular filtration rate (r=0.772, p<0.001), and serum albumin level (r=0.466, p=0.001). Negative correlation was detected between serum soluble CD200 levels and serum creatinine levels (r=-0.761, p<0.001), and C reactive protein levels (r=-0.364, p=0.015). In the ADPKD patients group, serum soluble CD200 levels were lower in patients with stage 5 chronic kidney disease (CKD) than in patients with stages 1-2 (p<0.001), 3 (p=0.005) and 4 CKD (p=0.006). Serum soluble CD200 levels were similar in patients with stages 1-2, 3, and 4 CKD (p>0.05). Our results show that patients with ADPKD have activated soluble CD200 levels which were related to renal function and inflammation.
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Affiliation(s)
- Funda Sari
- Division of Nephrology, Department of Internal Medicine, Akdeniz University, School of Medicine, Antalya, Turkey
| | - Saadet Gumuslu
- Department of Biochemistry, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Ramazan Cetinkaya
- Division of Nephrology, Department of Internal Medicine, Akdeniz University, School of Medicine, Antalya, Turkey
| | - Metin Sarikaya
- Division of Nephrology, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
| | - Arzu Didem Yalcin
- Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
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Gunal O, Yigit S, Yalcın AD, Celik B, Barut S, Demir O, Ates O, Duygu F, Kaya S, Rustemoglu A, Sezer O. The IL4-VNTR P1 Allele, IL4-VNTR P2P2 Genotype, and IL4-VNTR_IL6-174CG P2P1-GG Genotype Are Associated with an Increased Risk of Brucellosis. Jpn J Infect Dis 2017; 70:61-64. [PMID: 27169944 DOI: 10.7883/yoken.jjid.2015.550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In this study, associations between IL-4, IL-6, and macrophage migration inhibitory factor (MIF) polymorphisms and susceptibility to brucellosis were investigated. Consecutive adult patients with no known treatment against brucellosis and who did not have any other autoimmune and/or chronic disorders, were included in this study (n = 120, Group I). Age and sex-matched controls who had no other autoimmune and/or chronic disorders were also included (n = 120, healthy volunteers, Group II). The IL4_P2P2 genotype, IL4_P1 allele, and IL4_variable number of tandem repeats (VNTR)_IL6-174CG compound genotype were found to be more frequent in the patient group than in control subjects. There were significant differences between the patients and controls with respect to the frequencies of the IL4_P2P2 genotype (77.5% versus 87.5%; p = 0.001; OR, 0.36; 95% confidence interval [CI], 0.21-0.62) and the IL4_P1 allele (12.1% versus 6.7%; p = 0.030; OR, 0.92; CI, 1.02-3.64). The IL4-VNTR_IL6-174CG compound genotype was also present at a significantly higher frequency in the patient group than in control subjects (11.7% versus 4.2%; p = 0.027, OR, 3.04; CI, 1.06-8.68). No statistically significant differences in the frequencies of the IL-6-174, MIF-173, IL-4_P1P1, and IL4_P2P1 genotypes were observed between patients and control subjects. The IL4_VNTR P1 allele, P2P2 genotypes, and IL4-VNTR_IL6-174CG P2P1-GG genotypes are common in southern Turkey, and carriers of these polymorphisms are susceptible to brucellosis.
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Affiliation(s)
- Ozgur Gunal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital
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Harman R, Yildirim E, Gunal O, Yalcin AD, Namiduru M, Sokucu M, Eyigun CP. Acute Generalized Exanthematous Pustulosis Due to Pyrazinamide in a Patient Receiving Antituberculous Treatment: A Case Report. Klimik Dergisi 2016. [DOI: 10.5152/kd.2016.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Uzun R, Yalcin AD, Celik B, Bulut T, Yalcin AN. Levofloxacin Induced Toxic Epidermal Necrolysis: Successful Therapy with Omalizumab (Anti-IgE) and Pulse Prednisolone. Am J Case Rep 2016; 17:666-71. [PMID: 27634312 PMCID: PMC5027856 DOI: 10.12659/ajcr.899823] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Toxic epidermal necrolysis (TEN) is characterized by widespread erythematous and bullous lesions on the skin. Nowadays, considerable progress has been made in the understanding of its pathogenesis. Immunologically it is similar to graft-versus-host disease. Therefore, we may propose that TEN is a disorder of cell-mediated immunity. CASE REPORT Our patient was a 74-year-old white female who had pneumonia and was positive for hepatitis C virus (HCV), and who had been on levofloxacin therapy. After the first levofloxacin dose, erythematous dusky red macules occurred on her extremities and trunk, and on the following day, confluent purpuric lesions tended to run together over 85% of her body. Her biopsy results indicated TEN. Laboratory testing for serum ECP (eosinophil cationic peptide) and serum immunoglobulin (Ig) levels were performed, and blister fluid was investigated. The patient responded positively to omalizumab treatment and after treatment laboratory tests revealed decreased high sensitive CRP, ECP, IgG1, IgG2, IgG3, IgG4, IgA, and IgM levels. CONCLUSIONS To the best of our knowledge, this is the first case of a patient with HCV who developed cutaneous adverse drug reaction on levofloxacin medication and recovered with omalizumab treatment. This is the first documentation of omalizumab treatment of a TEN patient.
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Affiliation(s)
- Rusen Uzun
- Department of Pulmonology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology, Academia Sinica, Genomics Research Center, Taipei, Taiwan
- Antalya Education and Research Hospital, Antalya, Turkey
- Corresponding Author: Arzu Didem Yalcin, e-mail:
| | - Betul Celik
- Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Tangul Bulut
- Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Ata Nevzat Yalcin
- Department of Infectious Disease, Akdeniz University, Faculty of Medicine, Antalya, Turkey
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Sarı F, Yalçın AD, Genç GE, Sarıkaya M, Bisgin A, Çetinkaya R, Gümüşlü S. Autosomal Dominant Polycystic Disease is Associated with Depressed Levels of Soluble Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand. Balkan Med J 2016; 33:512-516. [PMID: 27761278 PMCID: PMC5056653 DOI: 10.5152/balkanmedj.2016.150685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 05/07/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Autosomal dominant polycystic kidney disease (ADPKD) is characterized by multiple, large renal cysts and impaired kidney function. Although the reason for the development of kidney cysts is unknown, ADPKD is associated with cell cycle arrest and abundant apoptosis of renal tubular epithelial cells. AIMS We asked whether serum-soluble TNF-related apoptosis-inducing ligand (sTRAIL) might underlie ADPKD. STUDY DESIGN Case-control study. METHODS Serum sTRAIL levels were measured in 44 patients with ADPKD and 18 healthy volunteers. The human soluble TRAIL/Apo2L ELISA kit was used for the in vitro quantitative determination of sTRAIL in serum samples. RESULTS Mean serum sTRAIL levels were lower in patients with ADPKD as compared to the control group (446.9±103.1 and 875.9±349.6 pg/mL, p<0.001). Serum sTRAIL levels did not differ among stages of renal failure in patients with ADPKD. There was no correlation between serum sTRAIL levels and estimated glomerular filtration rate in patients with ADPKD (p>0.05). CONCLUSION Our results show that ADPKD patients have depressed sTRAIL levels, indicating apoptosis unrelated to the stage of chronic renal failure.
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Affiliation(s)
- Funda Sarı
- Division of Nephrology, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
- Address for Correspondence: Dr. Funda Sarı, Division of Nephrology, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey, Phone: +90 532 646 34 42, e-mail:
| | - Arzu Didem Yalçın
- Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gizem Esra Genç
- Department of Biochemistry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Metin Sarıkaya
- Division of Nephrology, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
| | - Atıl Bisgin
- Department of Clinical and Experimental Medicine, University of Linköping School of Health Sciences, Linköping, Sweden
| | - Ramazan Çetinkaya
- Division of Nephrology, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
| | - Saadet Gümüşlü
- Department of Biochemistry, Akdeniz University School of Medicine, Antalya, Turkey
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Celik B, Yalcin AD, Genc GE, Bulut T, Kuloglu Genc S, Gumuslu S. CXCL8, IL-1β and sCD200 are pro-inflammatory cytokines and their levels increase in the circulation of breast carcinoma patients. Biomed Rep 2016; 5:259-263. [PMID: 27446554 PMCID: PMC4950671 DOI: 10.3892/br.2016.709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/03/2016] [Indexed: 02/05/2023] Open
Abstract
The influence of biomarkers on carcinogenesis has been investigated extensively. Whether they promote carcinogenesis or work against cancer development remains to be elucidated. To the best of our knowledge, the novel molecule cluster of differentiation 200 (CD200) has not been studied on human breast cancer subjects. The present study aimed to evaluate interleukin-1β (IL-1β), C-X-C motif chemokine ligand 8 (CXCL8), cancer antigen 15.3 (CA 15.3) and the soluble CD200 (sCD200) levels in the serum samples of breast carcinoma patients in order to predict their role in breast carcinoma. The subjects included individuals with early and advanced stage breast cancers, as well as healthy controls. Commercially available ELISA kits were used to measure the serum concentrations of sCD200, IL-1β, CXCL8, CA 15.3, C-reactive protein (CRP) and leukocyte count. A total of 130 subjects were recruited; 50 early stage cancer, 50 advanced stage and 30 control subjects. Serum sCD200, CXCL8, IL-1β and CRP levels were significantly higher in the early as well as the advanced stage breast cancer patients compared to the control group. The level of CA 15.3 was statistically different between early and advanced stage. There were significant positive correlations between IL-1β and CXCL8, and IL-1β and serum sCD200 levels in the control group. These correlations did not persist in the early or the advanced stage cancer groups except CRP and CA 15.3, but new correlations appeared between serum sCD200 level and leukocyte count for advanced stage breast cancer group. Multivariate regression correlation analysis revealed positive correlation between IL-1β and sCD200; and IL-1β and CXCL8. In conclusion, sCD200, CXCL8, CA 15.3 and IL-1β are proinflammatory molecules and their levels are influenced in breast cancer patients.
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Affiliation(s)
- Betul Celik
- Department of Pathology, Antalya Training and Research Hospital, 07100 Antalya, Turkey
- Correspondence to: Dr Betul Celik, Department of Pathology, Antalya Training and Research Hospital, Varlik Mahallesi Kazim Karabekir Cad, 07100 Antalya, Turkey, E-mail:
| | - Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology Unit, Antalya Training and Research Hospital, 07100 Antalya, Turkey
- Genomics Research Center, Academia Sinica, Taipei 115, Taiwan, R.O.C
| | - Gizem Esra Genc
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey
| | - Tangul Bulut
- Department of Pathology, Antalya Training and Research Hospital, 07100 Antalya, Turkey
| | - Sibel Kuloglu Genc
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey
| | - Saadet Gumuslu
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey
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Yalcin AD, Celik B, Yalcin AN. Omalizumab (anti-IgE) therapy in the asthma-COPD overlap syndrome (ACOS) and its effects on circulating cytokine levels. Immunopharmacol Immunotoxicol 2016; 38:253-6. [PMID: 27121601 DOI: 10.3109/08923973.2016.1173057] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT The term "asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome" (ACOS) has been applied to the condition, in which a person has clinical features of both asthma and COPD. METHODS The patients (N = 10) were presented to our clinic with low lung function, limited reversibility of airway obstruction, hyperinflation, abnormal body composition, dyspnea and episodic wheezing. Based on the clinical and laboratory findings, the patients were diagnosed with ACOS. Patients' serum IL-2 (sIL-2), sIL-4 sIL-6, sIL-10, sIL-17, sTNF-α and sIFN-γ levels were investigated as an apoptotic marker and a marker for inflammation. RESULTS Having undergone omalizumab treatment and a long-term (12 months) later, patients had a decreased IgE, fractional exhaled nitric oxide concentrations (FENO), eosinophil, neutrophils, macrophages, eosinophil cationic peptide (ECP) and sIL-4 levels. CONCLUSION To our knowledge, this is the first documentation of omalizumab use in ACOS. We demonstrated decreased IL-4, allergic pulmonary symptoms (dyspnea, wheezing, bronchial hyper responsiveness) and migraine attacks in the patients.
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Affiliation(s)
- Arzu Didem Yalcin
- a Department of Internal Medicine, Clinical Immunology and Allergy Unit , Antalya Research Hospital , Antalya , Turkey
| | - Betul Celik
- b Department of Pathology and Laboratory Medicine , Antalya Research Hospital , Antalya , Turkey
| | - Ata Nevzat Yalcin
- c Department of Infections Unit , Akdeniz University , Antalya , Turkey
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Yalcin AD. A case of netherton syndrome: successful treatment with omalizumab and pulse prednisolone and its effects on cytokines and immunoglobulin levels. Immunopharmacol Immunotoxicol 2016; 38:162-6. [PMID: 26592187 DOI: 10.3109/08923973.2015.1115518] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT Netherton syndrome (NS) is associated with the mutation in the SPINK5 gene, which codes LEKTI (lymphoepithelial Kazaltype related inhibitor), a serine protease inhibitor. As a result of aging coupled with immune deficiency, clinical symptoms may vary. METHODS The patient was presented to our clinic with sparse and brittle hair along with pruritic, erythematous and scaling cutaneous lesions. The patient underwent a clinical examination and laboratory analyzes. Based on the clinical and laboratory findings, the patient was diagnosed with NS. Moreover, CRP, Complement-3 (C3), C4 IL-4, IL-5, IL-1β and IL-17A levels of serum were investigated as an apoptotic marker and a negative marker for inflammation. RESULTS Having undergone omalizumab treatment and a short-term (4 months) later, he had a decreased IgE, Ig G, prolactin, CRP, IL-4, IL-5, IL-1β and IL-17A levels. The IgA, IgM and C3, C4 levels were insignificant between before and after Omalizumab treatment. CONCLUSION To the best of our knowledge, this is the first time that an association between omalizumab and NS was documented. In conclusion allergic skin symptoms (pruritus, erythema and desquamation) and mucosal symptoms decreased in the patient.
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Affiliation(s)
- Arzu Didem Yalcin
- a Department of Internal Medicine , Clinical Immunology and Allergy Unit, Antalya Training and Research Hospital , Antalya , Turkey
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Bisgin A, Eyigor H, Osma U, Yilmaz MD, Yalcin AD. Serum soluble tumour necrosis factor related apoptosis-inducing ligand level and peripheral eosinophil count in patients with nasal polyposis. J Laryngol Otol 2015; 129:250-3. [PMID: 25655059 DOI: 10.1017/s0022215114003442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Nasal polyposis is one of the most common inflammatory pathologies of the nasal cavity. Eosinophilic inflammation plays an important role in the pathogenesis. This study aimed to investigate soluble tumour necrosis factor related apoptosis-inducing ligand levels and eosinophil count in nasal polyposis patients. METHODS The study was performed on 24 adult nasal polyposis patients and 24 age-matched healthy individuals. The patients had not received any medical or surgical treatment. Pre-operative computed tomography scans were assessed using the Lund-MacKay grading system, and soluble tumour necrosis factor related apoptosis-inducing ligand levels were measured with a sandwich enzyme-linked immunosorbent assay. RESULTS Compared with controls, eosinophil levels in nasal polyposis patients were increased (p = 0.024), but there was no significant difference in soluble tumour necrosis factor related apoptosis-inducing ligand levels (p = 0.529). The Lund-MacKay mean grading was 12.43 ± 6.9. There was no correlation between soluble tumour necrosis factor related apoptosis-inducing ligand level and Lund-MacKay grading and eosinophil count. CONCLUSION There was no relationship between soluble tumour necrosis factor related apoptosis-inducing ligand level and blood eosinophil or clinical markers; however, soluble tumour necrosis factor related apoptosis-inducing ligand level remains of interest for future studies.
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Affiliation(s)
- A Bisgin
- Medical Genetics Department of Balcali Clinics and Hospitals,Faculty of Medicine,Cukurova University,Adana,Turkey
| | - H Eyigor
- Department of Otorhinolaryngology,Antalya Training and Research Hospital,Turkey
| | - U Osma
- Department of Otorhinolaryngology,Antalya Training and Research Hospital,Turkey
| | - M D Yilmaz
- Department of Otorhinolaryngology,Antalya Training and Research Hospital,Turkey
| | - A D Yalcin
- Department of Internal Medicine,Allergy and Clinical Immunology Unit,Antalya Training and Research Hospital,Turkey
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Tural Onur S, Yalcin AD, Celik B, Gumuslu S. Evaluation of d-dimer, CXCL8, homocysteine, eosinophil cationic peptide, 25(OH)-vitamin D and immunomodulatory OX-2 levels in allergic patients. J Asthma 2015; 52:123-7. [PMID: 24986253 DOI: 10.3109/02770903.2014.936450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Studies on sCD200 (OX-2), 25-hydroxyvitamin-D (25(OH)D), homocysteine (hcy), eosinophil cationic peptide (ECP), d-dimer, CXCL8 and fractional exhale nitric oxide concentrations in allergic patients in Mediterranean regions under various climatic conditions have not been performed. In this report, blood samples were taken in May and June during times of high air pollination. This study was performed to compare serum biomolecule concentrations in allergic patients and matched controls and to evaluate the characteristics of allergic disease. METHODS The study participants (n = 129) included 25 healthy individuals (controls) and 104 allergic patients. Consecutive patients with managed allergic disease (Group II, III, IV and V) above the age of 18 years were included. RESULTS In the control group, there was a significant positive correlation between ECP level and body mass index (BMI). Positive correlations among ECP, IgE and OX-2 levels were detected in Group IV. In Group V patients, positive correlations between age and IgE and between BMI and 25(OH)D were identified. Statistical analysis revealed positive correlations among basophil, eosinophil and OX-2 levels, and a negative correlation between ECP and age in Group V. CONCLUSION Overall, these data suggest that hcy, 25(OH)D and OX-2 may be useful biomarkers for conventional clinical measurements.
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Affiliation(s)
- Seda Tural Onur
- Yedikule Chest Disease and Thorax Surgery Education and Research Hospital , Chest Disease Clinic, Istanbul , Turkey
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Abstract
Omalizumab depletes free IgE in the blood and interstitial space and inhibits IgE binding to FcεRI on basophils, mast cells, and dendritic cells. We stopped omalizumab treatment after four years. Recurrences of urticaria symptoms were found to be higher in patients with chronic urticaria than recurrences of asthmatic symptoms in severe persistent asthma patients. For the very first time, we used omalizumab in symptomatic therapy of recurrent laryngeal oedema and urticaria attacks in a patient with postoperative pulmonary carcinoid tumor for eight months. During the four years of follow-up, no recurrence was noted in pulmonary carcinoid tumor. Control PET CT results revealed normal findings. After omalizumab treatment, laryngeal oedema and urticaria symptoms were decreased. The most common adverse reaction from omalizumab is injection site induration, injection site itching, injection site pain, and bruising but the package insert contains warnings regarding parasitic infections. While there are no reports of fatal anaphylaxis as a result of omalizumab, some cases have been serious and potentially life-threatening. Therefore, the FDA requires that people receiving omalizumab be monitored in the physician's office for a period of time after their injections.
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Affiliation(s)
- Arzu Didem Yalcin
- 1Internal Medicine, Allergy and Clinical Immunology, Near East University, Northern Cyprus, Mersin 10, Turkey
- 2Genomics Research Center, Academia Sinica, Taipei, Taiwan
- 3Antalya Education Research Hospital, Antalya, Turkey
- *Arzu Didem Yalcin:
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Celik B, Didem Yalcin A, Esra Genc G, Gumuslu S. Proteomics pattern of peritoneal sApo-2L but not CD200 (OX-2) as a possible screening biomarker for metastatic ovarian, endometrial and breast carcinoma. J BUON 2015; 20:280-6. [PMID: 25778329 DOI: pmid/25778329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the soluble Apo-2L (sApo-2L) levels in the ascitic fluid and to study its potential in detecting malignant ascites and soluble CD200 (sCD200,sOX-2) levels so as to predict its clinical usage for detecting stage 4 metastatic endometrial, ovarian and breast cancer in serum samples. METHODS Ascitic fluid from 53 and blood from 25 subjects without known malignancy on admission were collected. There were 14 breast cancer (BC), 17 ovarian cancer (OC) and 19 endometrial cancer (EC) patients diagnosed later on. Blood samples for sApo-2L, sCD200, liver function tests and CEA, CA-19.9 and CA-125 were always taken and assayed in the morning. RESULTS Significantly low levels of sApo-2L were observed in peritoneal fluid from OC and EC patients compared to benign peritoneal fluid from control individuals. Positive correlation was observed between sApo-2L and aspartate aminotransferase (AST) in benign peritoneal fluid and sCD200, and creatinine and sCD200 and platelets in OC patients; also, sCD200 and CEA in EC patients and sCD200 and blood urea nitrogen (BUN) in healthy subjects. CONCLUSIONS Our data indicate that low proteomics pattern of sApo-2L but not sCD200 is a good biochemical marker. Further decline in the level of sApo-2L was seen in EC compared to OC. Since higher levels of sApo-2L were seen with higher levels of AST, the liver might be involved in its metabolism. The positive correlation detected between sCD200 and creatinine, platelets, CEA and BUN needs to be elucidated.
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Affiliation(s)
- Betul Celik
- Department of Pathology, Antalya Training Hospital, Antalya, Turkey
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Yalcin AD, Celik B, Kose S, Seyman D, Gumuslu S, Yalcin AN. Circulating Apo 2L levels decreased in genotype II hepatitis C with pegylated interferon-2 alpha treatment. Infez Med 2014; 22:283-7. [PMID: 25551843 DOI: pmid/25551843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Pro-inflammatory factors regulated by TRAIL in vivo may lead to the development of novel therapeutic strategies for diseases as diverse as infection, autoimmunity and allergy. In this study we aimed to investigate the relationship between IFN treatment response, HCV viral load and sApo 2L levels. Eleven HCV-treatment naive HCV-infected patients were treated with pegIFN alfa-2a. Intensive serum circulating Apo 2L levels were monitored at study visits on day 0 (pretreatment), and in weeks 4, 6 and 12. HCV-RNA and sApo 2L levels decreased gradually with PegIF-alfa 2 treatment and the differences were significant between day 0 and week 4 (p 0.001, p 0.005 and p 0.01, p 0.005 respectively); between day 0 and week 12 (p 0.001, p 0.005 and p 0.001, p 0.000 respectively); between weeks 6 and 12 (p 0.01, p 0.05 and p 0.01, p 0.05 respectively). We suggest that decreased levels of circulating Apo 2L may reflect its increased binding to its ligand expressed on hepatocytes or lymphocytes under the influence of PegIFN treatment.
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Affiliation(s)
- Arzu Didem Yalcin
- Department of Allergy and Clinical Immunology, Antalya Training Hospital, Antalya, Turkey; Department of Pathology, Antalya Training Hospital, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Allergy and Clinical Immunology Unit, Tepecik Education and Research Hospital, Izmir, Turkey; Department of Infectious Diseases and Clinical Microbiology, Antalya Education and Research Hospital, Turkey; Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Betul Celik
- Department of Allergy and Clinical Immunology, Antalya Training Hospital, Antalya, Turkey; Department of Pathology, Antalya Training Hospital, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Allergy and Clinical Immunology Unit, Tepecik Education and Research Hospital, Izmir, Turkey; Department of Infectious Diseases and Clinical Microbiology, Antalya Education and Research Hospital, Turkey; Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Sukran Kose
- Department of Allergy and Clinical Immunology, Antalya Training Hospital, Antalya, Turkey; Department of Pathology, Antalya Training Hospital, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Allergy and Clinical Immunology Unit, Tepecik Education and Research Hospital, Izmir, Turkey; Department of Infectious Diseases and Clinical Microbiology, Antalya Education and Research Hospital, Turkey; Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Derya Seyman
- Department of Allergy and Clinical Immunology, Antalya Training Hospital, Antalya, Turkey; Department of Pathology, Antalya Training Hospital, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Allergy and Clinical Immunology Unit, Tepecik Education and Research Hospital, Izmir, Turkey; Department of Infectious Diseases and Clinical Microbiology, Antalya Education and Research Hospital, Turkey; Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Saadet Gumuslu
- Department of Allergy and Clinical Immunology, Antalya Training Hospital, Antalya, Turkey; Department of Pathology, Antalya Training Hospital, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Allergy and Clinical Immunology Unit, Tepecik Education and Research Hospital, Izmir, Turkey; Department of Infectious Diseases and Clinical Microbiology, Antalya Education and Research Hospital, Turkey; Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Ata Nevzat Yalcin
- Department of Allergy and Clinical Immunology, Antalya Training Hospital, Antalya, Turkey; Department of Pathology, Antalya Training Hospital, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Allergy and Clinical Immunology Unit, Tepecik Education and Research Hospital, Izmir, Turkey; Department of Infectious Diseases and Clinical Microbiology, Antalya Education and Research Hospital, Turkey; Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Abstract
Omalizumab, a humanized mAb that binds to the CH3 domain near the binding site for the high-affinity type-I IgE Fc receptors of human IgE, can neutralize free IgE and inhibit the IgE allergic pathway without sensitizing mast cells and basophils. We found that omalizumab in patients with severe persistent asthma (SPA) was an effective therapy for asthma and the following co-morbid conditions: chronic urticaria (CU), bee venom allergy, latex allergy, atopic dermatitis, food allergy and Samter's syndrome. Information on the use of omalizumab in treatment of asthma and other allergic diseases has improved our understanding that treatment acts on many levels, including regulating levels of inflammatory proteins, including cytokines (copper-containing alpha- 2-glycoprotein, total antioxidant capacity, MDA, NO, H2O2, CXCL8, IL-10, TGF-β, GMCSF, IL-17, IL-1β), MPV, Hs-CRP, eosinophil cationic peptide, vitamin-D (25(OH)D), homocysteine (Hcy), OX-2, d- dimer, albumin, and sApo-2L. The decrease in Hcy concentrations and increase in 25(OH)D also support the existence of a vascular endothelial protection mechanism. Mediators and cells classically involved in pro-coagulant and anticoagulant pathways together play a role in SPA and CU pathophysiology and omalizumab effect. The mechanism of action of omalizumab in the treatment of asthma is believed to be multifactorial, and includes effects mediated through altered production of redox metabolites, extrinsic coagulation pathway, oxidative markers-related mi RNA, TRAIL-related mi RNA, and regulation of production of known inflammatory proteins.
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Arik HO, Yalcin AD, Celik B, Seyman D, Tetik G, Gursoy B, Kose S, Gumuslu S. Evaluation of soluble CD200 levels in type 2 diabetic foot and nephropathic patients: association with disease activity. Med Sci Monit 2014; 20:1078-81. [PMID: 24964809 PMCID: PMC4085116 DOI: 10.12659/msm.890517] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND CD200 (OX-2) is a novel immune-effective molecule, existing in a cell membrane-bound form, as well as in a soluble form in serum (s OX-2), which acts to regulate inflammatory and acquired immune responses. MATERIAL AND METHODS We planned this study to evaluate the sOX-2 levels of type 2 diabetic foot (group B), and compare it with that of healthy controls (group A). The patient group had the following values: DM period: 27.9±10.3 year [mean ±SD], HbA1c: 9.52±2.44% [mean ±SD]. RESULTS Blood samples for sCD200 measurement were always taken in the morning between 8 and 10 A.M.. The results were reported as means of duplicate measurements. Concentrations of sOX-2 in the serum samples were quantified using an ELISA kit. Serum hs-CRP levels were measured using an hs-CRP assay kit. The sOX-2 level in group B was 173.8±3.1 and in group A was 70.52±1.2 [p<0.0001). In subgroup analysis of T2DM-DFI patients, we noticed that sOX-2 levels were higher in WGS (Wagner grading system) I and II patients than in WGS III and IV patients. The HbA1c, BUN, creatinine, hs-CRP levels, and sedimentation rates were higher in the patient group (p<0.0001, p<0.001, p<0.001, p<0.005, and p<0.0001, respectively). CONCLUSIONS We suggest that there are vascular, immunologic, and neurologic components in DFI, whereas autoimmune diseases and inflammatory skin disorders have only an immunologic component. This is possibly evidence of a pro-inflammatory effect seen in DFI as a vascular complication.
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Affiliation(s)
- Hasan Onur Arik
- Orthopaedics and Traumatology Clinic, Yozgat State Hospital, Yozgat, Turkey
| | - Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology Unit, Genomics Research Center, Academia Sinica, Taipei, Taiwan
- Corresponding Author: Arzu Didem Yalcin, e-mail: and
| | - Betul Celik
- Department of Laboratory Medicine and Pathology, Mayo Clinic in Jacksonville, Jacksonville, FL, U.S.A
| | - Derya Seyman
- Department of Infectious Disease, Antalya Training and Reseach Hospital, Antalya, Turkey
| | - Gulsum Tetik
- Department of Plastic Surgery, Antalya Education and Research Hospital, Antalya, Turkey
| | - Bensu Gursoy
- Infection Disease Clinic, Tekirdag State Hospital, Tekirdag, Turkey
| | - Sukran Kose
- Department of Infection, Allergy and Clinical Immunology Unit, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Saadet Gumuslu
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Abstract
BACKGROUND D-dimer (DD), a fibrin degradation product formed during the lysis of a thrombus, is also detected in high levels in patients with active chronic urticaria (CU). Severe persistent allergic asthma (SPA) is associated with a procoagulant state in the bronchoalveolar space, further aggravated by impaired local activities of the anticoagulant protein C/protein S, antithrombin III system and fibrinolysis. This was demonstrated as massive fibrin depositions found in the alveoli of a SPA patient who died from a SPA attack and who did not respond to treatment. OBJECTIVES For this reason, we investigated the effect of omalizumab both in bronchial and systemic vascular areas and evaluated SPA (group I) and CU (group II) patients before and after therapy period. METHODS Blood samples were taken before treatment (A), on 4th month (B), on 8th month (C) and on 12th month (D) post treatment in both groups. RESULTS We compared DD levels between groups: the significant DD difference was observed between group-IA and group-IC (p = 0.031); between group-IA and group-ID (p = 0.003); between group-IB and group-ID (p = 0.049) and between group IIA-1 and group-IID (p = 0.015). In the IIA-1 group, there was a significant positive correlation between DD and age (p = 0.008, r = 0.848). CONCLUSION In conclusion, mediators and cells classically involved in procoagulant and anticoagulant pathways together play a role in SPA and CU pathophysiology, where omalizumab has its effect.
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Affiliation(s)
- Arzu Didem Yalcin
- Genomics Research Center, Allergy and Clinical Immunology, Internal Medicine, Academia Sinica , 11529 Taipei , Taiwan ,
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Yalcin AD, Genc GE, Celik B, Gumuslu S. Anti-IgE monoclonal antibody (omalizumab) is effective in treating bullous pemphigoid and its effects on soluble CD200. Clin Lab 2014; 60:523-4. [PMID: 24697134 DOI: 10.7754/clin.lab.2013.130642] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Herein, we report a case of a man with pruritic bullous pemphigoid (BP) and very high levels of total IgE (5000 kU/L) who was refractory to standard aggressive immunosuppressive regimens (systemic steroids, daily cyclophosphamide) for BP but responded rapidly to systemic anti-IgE (omalizumab). Our patient is a 28 year-old white male. On admission 70% of his body surface area was involved with large bullae overlying urticarial plaques, involving his upper and lower extremities, chest, and abdomen. The circulating level of sCD200 was 48.45 pg/mL in serum and 243 pg/mL in blister fluid. During the second month of follow-up, the patient's sCD200 level decreased to 26.7 pg/mL. After the second round of omalizumab (300 mg), frequency of exacerbations decreased and after the 13th round it had completely disappeared.
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Yalcin AD, Gorczynski RM, Cilli A, Strauss L. Omalizumab (anti-IgE) therapy increases blood glucose levels in severe persistent allergic asthma patients with diabetes mellitus: 18 month follow-up. Clin Lab 2014; 60:1561-4. [PMID: 25291953 DOI: 10.7754/clin.lab.2013.130302] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Therapeutic anti-IgE antibodies (Xolair, omalizumab) able to reduce free IgE levels and to block the binding of IgE to Fcepsilon RI without cross-linking IgE and triggering degranulation of IgE-sensitised cells have been developed. METHODS We had two male patients of severe persistent allergic asthma with type-2 diabetes mellitus at the ages of 57 and 52 and who had suffered a side-effect of increased blood glucose level that caused a need for an extra insulin injection to control the hyperglycemia. Their asthma was not under control, frequent emergency department admissions lead us to use omalizumab treatment. Assessment of clinical changes and adverse effects were evaluated at each bimonthly patient visit including vital signs, full physical examination, details of any allergy incidents, total and specific IgE levels, serum ECP (eosinophilic cationic peptid) levels, pulmonary function test, exhaled nitric oxide concentrations, and asthma control test. RESULTS Both patients were on week 42 - 45 of omalizumab treatment with a the dosage of 375 and 300 mg when they had the adverse reaction we reported here; they also had no other complaints. Blood levels of ECP and high sensitive CRP (hs-CRP) were decreased after starting the treatment of anti-IgE. CONCLUSIONS To our knowledge, this is the first time an association between omalizumab use and hyperglycemia has been documented. Every vial of Xolair (150 mg) contains 145.5 mg sucrose and it might increase the blood levels of glucose in diabetics. As a conclusion the prescribing information might have been revised based on post marketing surveillance data and reported such cases indicating that different side effects may occur beyond 2 hours of the injection.
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Yalcin AD, Kargi A, Gumuslu S. Blood eosinophil and platelet levels, proteomics patterns of trail and CXCL8 correlated with survival in bevacizumab treated metastatic colon cancers. Clin Lab 2014; 60:339-40. [PMID: 24660552 DOI: 10.7754/clin.lab.2013.130425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
STrail (soluble TNF-related apoptosis-inducing-ligand) has also been observed where the cytotoxic effects of antiangiogenic agents are increased in clinical phase II and III studies when these agents are combined with TRAIL related therapies. Recent studies have shown that CXCL8 and its receptors are significantly up-regulated in CRC and act as regulators of proliferation, angiogenesis, and metastasis. sTRAIL, CXCL8, CEA, together with complete blood count parameters (hemoglobine, platelet, eosinophil, basophil, neutrophil, lymphocyte) were recorded in the beginning and every three months afterwards for a period of 4 years. The study population comprised 21 of the 42 patients with metastatic colorectal cancer (MCRC), undergoing 18 FDG-PET/CT scanning prior to treatment. Progression free survival was 262 days and overall survival was 1148 days. Overall survival was higher in patients whose Karnofsky Performance scores were above 86% (p = 0.003). Progression free survival was higher in patients whose blood eosinophil counts at 0, 6, and 9 months were higher than the mean levels of corresponding values (p-values are 0.016, 0.032, and 0.001, respectively). Another significant positive correlation was found between the platelet levels at 9 months and progression free survival (p = 0.019). There were significant changes (p < 0.05) prior to treatment and three months later for sTRAIL (p = 0.0060) and CXCL8 (p = 0.00001), based on the Wilcoxon matched pairs signed rank test. Generally, sTRAIL values increased during therapy, while a decrease was observed for CXCL8 without any significant differences for other variables.
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Akman-Karakaş A, Yalcin AD, Koç S, Gumuslu S, Ergun E, Genc GE, Ongut G, Uzun S, Alpsoy E. Serum soluble CD200 level was higher in patients with bullous pemphigoid during the active phase of the disease than for healthy individuals. Clin Lab 2014; 60:1237-40. [PMID: 25134396 DOI: 10.7754/clin.lab.2013.130744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND CD200 is a novel immunosuppressive molecule, existing both as cell membrane bound and as a soluble form in serum (sCD200), which acts to regulate inflammatory and acquired immune responses. Recently, our study group showed that sCD200 was found in serum and blister fluid in a patient with bullous pemphigoid and that anti-IgE therapy impacted those levels. We therefore planned this study to evaluate the soluble serum CD200 levels of bullous pemphigoid patients and compare it with that of healthy controls. We also analysed the association between the sCD200 levels and the clinical severity of the disease in bullous pemphigoid patients. METHODS We investigated 5 consecutive patients with bullous pemphigoid, and 15 healthy controls were included in this study. Assessment of clinical examination and measurement of laboratory investigation were performed on the same day. Bullous pemphigoid patients were also assessed for Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). Concentrations of anti-BP180 and soluble CD200 in the serum samples were quantified using ELISA kits. RESULTS The serum soluble CD200 level was observed to be statistically significantly higher in patients with BP (77.6 +/- 15.7 pg/mL) compared with healthy controls (26.1 +/- 6.7 pg/mL), (p < 0.001). Nevertheless, there was no statistically significant correlation between serum soluble CD200 levels and clinical severity scores and Anti-BP180 values (p = 0.402, p = 0.395, respectively). However, there was a statistically significant correlation between ABSIS and Anti-BP180 levels in patients with BP (p = 0.036). CONCLUSIONS CD200 might play a role in the immune response in the pathogenesis of bullous pemphigoid. However, we do not know the exact mechanism of CD200 in the disease initiation and/or progression.
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Akman-Karakaş A, Yalcin AD, Koç S, Gumuslu S, Şenol YY, Özkesici B, Genc GE, Ergun E, Ongut G, Yilmaz E, Uzun S, Alpsoy E. There might be a role for CD200 in the pathogenesis of autoimmune and inflammatory skin disorders. Med Sci Monit 2013; 19:888-91. [PMID: 24157657 PMCID: PMC3809986 DOI: 10.12659/msm.889624] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Soluble CD200 (sCD200) is a novel immuno-effective molecule, which acts to regulate inflammatory and acquired immune responses. Recently, our study group showed that sCD200 was present in serum and blister fluid in a patient with bullous pemphigoid and a patient with toxic epidermal necrolysis. We therefore planned this study to evaluate the sCD200 levels of autoimmune and inflammatory skin disorder patients and to compare them with that of healthy controls. MATERIAL/METHODS Our study included 30 consecutive patients with psoriasis vulgaris, 15 with pemphigus vulgaris, and 15 healthy controls. Clinical examination and laboratory tests were performed on the same day. Psoriasis patients were also assessed with the Psoriasis Area and Severity Index (PASI) and pemphigus patients were assessed using the Pemphigus Disease Area Index (PDAI). Levels of sCD200 in the serum samples were quantified using ELISA kits. RESULTS The serum sCD200 level was observed to be statistically significantly higher in patients with psoriasis vulgaris (96.7±15.8) compared to patients with pemphigus vulgaris (76.2±14.6), (p<0.001) and healthy controls (26.8±7.0) (p<0.001). The serum sCD200 levels were observed to be statistically significantly higher in patients with pemphigus vulgaris compared with that in healthy controls (p<0.001). In addition, there was a statistically significant correlation between serum sCD200 levels and PDAI (r=0.987, p=0.001). Nevertheless, there was no statistically significant correlation between serum sCD200 levels and PASI (r=0.154, p=0.407). CONCLUSIONS sCD200 might play a role in immune response in the pathogenesis of autoimmune and inflammatory skin disorders. However, it remains to be fully elucidated how sCD200 can orchestrate inflammatory response in psoriasis and pemphigus.
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Affiliation(s)
- Ayşe Akman-Karakaş
- Department of Dermatology and Venerology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology Unit, Genomics Research Center, Academia Sinica, Taiwan
- Corresponding Author: Arzu Didem Yalcin, e-mail: and Ayşe Akman-Karakaş, e-mail:
| | - Saliha Koç
- Department of Dermatology and Venerology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Saadet Gumuslu
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | | | - Birgül Özkesici
- Department of Dermatology and Venerology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Gizem Esra Genc
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Erkan Ergun
- Department of Dermatology and Venerology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Gozde Ongut
- Department of Medical Microbiology, Akdeniz University, Faculty of Medicine, Antalya
| | - Ertan Yilmaz
- Department of Dermatology and Venerology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Soner Uzun
- Department of Dermatology and Venerology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Erkan Alpsoy
- Department of Dermatology and Venerology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Celik B, Yalcin AD, Bisgin A, Dimitrakopoulou-Strauss A, Kargi A, Strauss LG. Level of TNF-related apoptosis-inducing-ligand and CXCL8 correlated with 2-[18F]Fluoro-2-deoxy-D-glucose uptake in anti-VEGF treated colon cancers. Med Sci Monit 2013; 19:875-82. [PMID: 24145180 PMCID: PMC3808407 DOI: 10.12659/msm.889605] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The changes and correlations of TRAIL (TNF-related apoptosis-inducing-ligand) and CXCL8 (IL8) prior to treatment and three months following therapy as well as the corresponding Positron emission tomography (PET/CT) (SUV(max): standardized uptake maximum values) results were evaluated. MATERIAL AND METHODS The measurements were taken before and after treatment for comparison purposes. The study population comprised 29 patients with Metastatic Colorectal cancer (MCRC), undergoing PET/CT scanning prior to treatment. RESULTS There were significant changes prior to treatment and three months later for sTRAIL (p=0.0080) and CXCL8 (p=0.0001)values. Generally, sTRAIL values were increasing during therapy, while a decrease was observed for CXCL8. Correlation analysis was applied to the data and revealed significant correlations for the SUV(max) in the primary tumor prior to treatment and CXCL8 prior to therapy (p=0.0303). Furthermore, significant correlations were observed for the SUV(max) and sTRAIL (p=0.0237) as well as CXCL8 (p=0.0002) three months after treatment initiation. CXCL8 prior to treatment was also correlated with the SUV three months after onset of treatment (p=0.0072). A significant correlation was noted for one combination of two variables, the SUV(max) in the metastases and CXCL8 prior to treatment (p=0.0175). These results are supported when we group the SUV(max) in the metastases following treatment into two groups with SUV(max) <5 and SUV(max) >5. CONCLUSIONS This study provides evidence that proteomics patterns of sTRAIL and CXCL8 predict tumor response und survival in MCRC patients treated with bevacizumab and within a high concordance of FDG-PET/CT findings.
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Affiliation(s)
- Betül Celik
- Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology Unit, Antalya Education and Research Hospital, Antalya, Turkey
- Academia Sinica, Genomics Research Centre, Taipei, Taiwan
- Corresponding Author: Arzu Didem Yalcin, e-mail:
| | - Atil Bisgin
- Division of Oncology, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden
| | | | - Aysegül Kargi
- Oncology Unit, Antalya Education and Research Hospital, Antalya, Turkey
| | - Ludwig G. Strauss
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg, Germany
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Bisgnin A, Yalcin AD, Gumuslu S, Kargi B, Kargi A, Savas B, Strauss LG. Correlation of serum proteomics patterns of sCD200 (OX-2), sApo-2L (sTRAIL), vitamin-D and homocysteine to quantitative FDG-PET/CT findings in newly diagnosed non-small cell lung cancer. J BUON 2013; 18:1099-100. [PMID: 24344047 DOI: pmid/24344047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- A Bisgnin
- Cukurova University, Faculty of Medicine, Dept of Medical Genetics of Balcali Clinics and Hospitals, Adana, Turkey
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Yalcin AD, Cilli A, Bisgin A, Strauss LG, Herth F. Omalizumab is effective in treating severe asthma in patients with severe cardiovascular complications and its effects on sCD200, d-dimer, CXCL8, 25-hydroxyvitamin D and IL-1β levels. Expert Opin Biol Ther 2013; 13:1335-41. [PMID: 23883435 DOI: 10.1517/14712598.2013.819338] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND There have been concerns about the cardiovascular safety of omalizumab. OBJECTIVES In this study, the clinical status of the omalizumab receiving severe asthma patients and the cytokine expressions patterns were investigated. MATERIALS AND METHODS In a pilot study described below we examined the levels of serum eosinophil cationic peptid (ECP), CD200, d-dimer, 25-hydroxyvitamin D (25(OH)D), CXCL8 and IL-1β in asthma patients treated with anti-IgE therapy, to explore their relationship with disease activity, and the impact of anti-IgE therapy impact on those levels. Exercise stress testing and blood samples were taken at all follow up visits from the time of first diagnosis and after 20 months of treatment during the disease remission. RESULTS Fractional exhaled nitric oxide concentrations and serum levels of sTRAIL, sCD200, D-dimer, ECP, total IgE, IL-1β and Hs-CRP were decreased while CXCL8, 25(OH)D were increased after starting the treatment of anti-IgE. Our first case of a patient, who had both protein C and S deficiency and hence a high risk for thromboembolism, documents for the first time the safety of omalizumab for asthmatic patients with concurrent risk factors contributing to arteriothrombotic events. CONCLUSION Omalizumab might be used carefully in patients with cardiovascular diseases.
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Affiliation(s)
- Arzu Didem Yalcin
- Antalya Training and Research Hospital, Allergy and Clinical Immunology Unit, Antalya, Turkey
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Arık HO, Yalcin AD, Gumuslu S, Genç GE, Turan A, Sanlioglu AD. Association of circulating sTRAIL and high-sensitivity CRP with type 2 diabetic nephropathy and foot ulcers. Med Sci Monit 2013; 19:712-5. [PMID: 23986130 PMCID: PMC3762395 DOI: 10.12659/msm.889514] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hyperglycemia is among the potent factors that may induce or facilitate apoptosis. TNF-Related Apoptosis-Inducing Factor (TRAIL) is known for its apoptotic and immunomodulatory effects that have recently been correlated with diabetes. We examined serum-soluble TRAIL (sTRAIL) and high-sensitivity CRP (hs-CRP) levels and their association with various distinct parameters in type 2 diabetic nephropathy patients with diabetic foot disease. MATERIAL/METHODS Twenty-two diabetic nephropathy patients with foot ulcers were enrolled in our study. Patients had been diagnosed with diabetes at age 24±10.58 years. Circulating sTRAIL and Hs-CRP levels were compared with control values, and possible correlations were investigated with parameters such as age, Wagner's Grade (WG), BMI, HbA1c, and creatinine. RESULTS Serum sTRAIL levels were significantly reduced in the patient group, compared to healthy subjects. High HsCRP levels correlated with age, and WGS correlated with BMI and creatinine levels. CONCLUSIONS Significantly suppressed sTRAIL levels in diabetic nephropathy patients with foot ulcers compared to healthy controls suggest a protective role for TRAIL in the disease setting.
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Affiliation(s)
- Hasan Onur Arık
- Department of Orthopedics, Antalya Education and Research Hospital, Antalya, Turkey
| | - Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology Unit, Antalya Education and Research Hospital, Antalya, Turkey
- Academia Sinica Genomics Research Center, Taipei, Taiwan
- Corresponding Author: Arzu Didem Yalcin, e-mail:
| | - Saadet Gumuslu
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Gizem Esra Genç
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Adil Turan
- Department of Orthopedics, Antalya Education and Research Hospital, Antalya, Turkey
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Yalcin AD, Basaran S. The effects of climate and aero allergens changes in allergic rhinoconjunctivitis and allergic asthma patients in Mediterranean region between 2011 and 2012. Med Sci Monit 2013; 19:710-1. [PMID: 23982474 PMCID: PMC3762396 DOI: 10.12659/msm.889304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Arzu Didem Yalcin
- Genomics Research Center, Academia Sinica, Taiwan. Department of Internal Medicine, Allergy and Clinical Immunology Unit, Antalya Training and Research Hospital, Antalya Turkey
- Corresponding Author: Arzu Didem Yalcin, e-mail:
| | - Saime Basaran
- Southwest Anatolia Forest Research Institute, Antalya, Turkey
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Yalcin AD, Uçar S, Gumuslu S, Strauss LG. Effects of omalizumab on eosinophil cationic peptide, 25-hydroxyvitamin-D, IL-1β and sCD200 in cases of Samter's syndrome: 36 months follow-up. Immunopharmacol Immunotoxicol 2013; 35:524-7. [PMID: 23841472 DOI: 10.3109/08923973.2013.811598] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT The historic triad of nasal polyposis, asthma and intolerance to aspirin and related chemicals, recently designated as Samter's syndrome, is an inflammatory condition of unknown pathogenesis. This study surveyed the levels of chosen serum eosinophil cationic peptide (ECP), soluble CD200 (SCD200), interleukin (IL)-1β, high sensitive C-reactive protein (hs-CRP) and 25-hydroxyvitamin-D (25(OH)D) in the aspirin-induced asthmatic patients treated with anti-IgE therapy to investigate their roles in the pathogenesis of disease perpetuation and anti-IgE therapy's impact on them. METHODS Medical history, lung function tests and measurement of fractional exhale nitric oxide concentrations were performed on the same day. Concentrations of IL-1β and SCD200 in the serum samples were quantified using ELISA kits. Total and specific IgE and hs-CRP levels were enumerated by fluoroenzyme immunoassay. Serum levels of 25(OH)D were quantified by a radioimmunoassay. RESULTS We had three patients of severe persistent allergic asthma with Samter's syndrome. Levels of total IgE, ECP, fractional exhale nitric oxide concentrations, SCD200, IL-1β and hs-CRP were decreased while 25(OH)D was increased after starting the treatment of anti-IgE. CONCLUSIONS To our knowledge, this is the first time an association between omalizumab use and Samter's syndrome has been documented. As a conclusion allergic nasal symptoms (sneezing, postnasal drip) and asthma symptoms were decreased in patients, but no change was seen on nasal polyposis development after omalizumab treatment.
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Affiliation(s)
- Arzu Didem Yalcin
- Antalya Training and Research Hospital, Department of Internal Medicine, Clinical Immunology and Allergy Unit, Antalya, Turkey.
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Yalcin AD, Basaran S, Bisgin A, Polat HH, Gorczynski RM. Pollen aero allergens and the climate in Mediterranean region and allergen sensitivity in allergic rhinoconjunctivitis and allergic asthma patients. Med Sci Monit 2013; 19:102-10. [PMID: 23396359 PMCID: PMC3629014 DOI: 10.12659/msm.883762] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND We evaluated the profiles of allergic rhino-conjunctivitis and asthma patients annually in Antalya, a Mediterranean coastal city in Turkey. MATERIAL AND METHODS We evaluated patients' allergic clinical status, and recorded the climate and pollens in the city center air, investigating any correlation between pollination, climatic conditions and allergic disorders. The meteorological conditions and the pollen count/cm2 during every month of the year and the concordance of this with the patient's clinical status were evaluated. RESULTS SPT positivity for plantago lanceolata, aspergillus fumigatus and d. pteronyssinus was significant in patients younger than 40 years old. Pollination levels are consistent from March 2010 to February 2011. In Antalya, high levels occur mostly from April to June, thus we performed skin prick tests mostly in May/June (~30%). During these months meteorological conditions of the city were windy with low humidity, without rain, and lukewarm temperatures, all of which contribute to high-risk conditions for seasonal allergies. CONCLUSIONS The major allergen between April and June was derived from Graminea; between February and March was Cupressus spp; and between March and June was Pinus spp. These results suggest that the pollination is correlated with allergic conditions and thus SPT might be best performed according to the pollen count.
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Affiliation(s)
- Arzu Didem Yalcin
- Allergy and Clinical Immunology Unit, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey.
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Kargi A, Bisgin A, Yalcin AD, Kargi AB, Sahin E, Gumuslu S. Increased serum S-TRAIL level in newly diagnosed stage-IV lung adenocarcinoma but not squamous cell carcinoma is correlated with age and smoking. Asian Pac J Cancer Prev 2013; 14:4819-22. [PMID: 24083751 DOI: 10.7314/apjcp.2013.14.8.4819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer mortality in the world. Many factors can protect against or facilitate its development. A TNF family member TRAIL, has a complex physiological role beyond that of merely activating the apoptotic pathway in cancer cells. Vitamin D is converted to its active form locally in the lung, and is also thought to play an important role in lung health. Our goal was to investigate the possible clinical significance of serum sTRAIL and 1,25-dihydroxyvitamin D(3) levels in patients with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS Totals of 18 consecutive adenocarcinoma and 22 squamous cell carcinoma patients with stage-IV non-small cell lung cancer referred to our institute were included in this study. There were 12 men and 6 women, with ages ranging from 38 to 97 (mean 60.5) years with adenocarcinoma, and 20 men and 2 women, with ages ranging from 46 to 80 (mean 65) years with squamous cell carcinoma. Serum levels of sTRAIL and 1,25-dihydroxyvitamin D(3) were measured in all samples at the time of diagnosis. RESULTS sTRAIL levels in NSCLC patients were higher than in the control group. Although there was no correlation between patient survival and sTRAIL levels, the highest sTRAIL levels were correlated with age and cigarette smoking in the adenocarcinoma patients. sTRAIL level in healthy individuals were correlated with serum 1,25-dihydroxyvitamin D(3). CONCLUSIONS Serum sTRAIL concentrations were increased in NSCLC patients, and correlated with age and smoking history, but not with overall survival.
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Affiliation(s)
- Aysegul Kargi
- Division of Medical Oncology, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey E-mail :
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Yalcin AD, Karakas AA, Soykam G, Gorczynski RM, Sezer C, Bisgin A, Strauss LG. A case of toxic epidermal necrolysis with diverse etiologies: successful treatment with intravenous immunoglobulin and pulse prednisolone and effects on sTRAIL and sCD200 levels. Clin Lab 2013; 59:681-5. [PMID: 23865370 DOI: 10.7754/clin.lab.2012.120814] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Here, we report the first case of patient with intracranial tumors (ICT) who developed a cutaneous adverse drug reaction during lansoprazole and prophylactic anticonvulsant treatment. SCORTEN is a scoring system used to predict mortality in TEN patients. If SCORTEN index is 5 or more, mortality rate is more than 90%. SCORTEN of our patient was calculated as 5. METHODS Our patient is a 64 year-old white female, who had glioma and had been on post-op prophylactic anticonvulsant therapy. On the 3rd day post operation, lansoprazole was added to the therapy. After the first lansoprazole dose, erythematous dusky red macules occurred on extremities and trunk and on the following day confluent purpuric lesions tended to run together in 95% of the whole body including scalp, oral and genital mucosa. Nikolsky's Sign was positive on the skin. Physical examination; body temperature was 38.4 degrees C with a heart rate of 146 beats/minute and 80/50 mm Hg arterial blood pressure, Glascow Coma Scale was E1 M1e, pupillary light reflex was 2/2 +/+ and she was confused. Her biopsy resulted as toxic epidermal necrolysis. Moreover, sTRAIL and sCD200 levels of serum and blister fluid were investigated as an apoptotic marker and a negative marker for inflammation. RESULTS AND CONCLUSIONS sTRAIL and sCD200 were evaluated both in the sera and blister fluid. sTRAIL level was lower than for healthy individuals with high levels in blister fluid; and sCD200 level was depressed by up to 10% of the normal values of healthy individuals but with high levels in the blister fluid during the active phase of the disease. After our successful treatment with human albumin, prednisolone pulse therapy, and IVIG at a dose of 400 mg/kg, she was discharged from the hospital on the 23rd day and followed up after 2 months. The increase in sTRAIL (up to two-fold) and sCD200 (up to six-fold) levels may provide useful information in understanding disease pathogenesis and monitoring treatment efficacy.
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Affiliation(s)
- Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology Unit, Antalya Training and Research Hospital, Antalya, Turkey.
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Yalcin AD, Bisgin A, Cetinkaya R, Yildirim M, Gorczynski RM. Clinical course and side effects of anti-IgE monoclonal antibody in patients with severe persistent asthma. Clin Lab 2013; 59:71-7. [PMID: 23505909 DOI: 10.7754/clin.lab.2012.120406] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Omalizumab, a recombinant humanized monoclonal antibody to IgE, is recommended as a new option for the treatment of severe persistent allergic asthma. The purpose of this study is to assess the effects omalizumab treatment on life quality and its side effects in severe persistent asthma patients. METHODS In this study, we evaluated 19 severe persistent asthma patients who received therapy with omalizumab for 8 months. Omalizumab was administered every 2 weeks at doses between 150 to 375 mg. Symptoms and severity of allergic reactions were recorded before and after being on omalizumab. IgE levels, mean platelet volume (MPV), platelet levels, pulmonary function test, and asthma control test were evaluated in all patients before and 8 months after the treatment. Local and systemic side effects of omalizumab were evaluated. Stool parasites were examined in the 4th and 8th month after initiation of treatment to investigate any parasitosis. RESULTS The patients had severe persistent asthma for periods ranging from 3 to 8 years, and they were diagnosed with allergic asthma for 7 - 28 years. Thrombocytopenia developed in a male patient after the 22nd dose of the drug was given. When the platelet count fell down to 55000, the omalizumab treatment was suspended. During the therapy period, one patient had parasitosis (giardiasis), one patient had severe side effects, one patient had dyspnea two hours after the injection, and one patient had a dyspnea attack 2 hours after the injection. The changes in MPV levels were not statistically significant. There was also a significant decrease in IgE levels after the treatment. CONCLUSIONS Monitoring of complete blood cell count is very important when using this drug. Though we did not see anaphylaxis in any patients, we believe that the patients should be monitored at least for 3 hours after the omalizumab injection.
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Affiliation(s)
- Arzu Didem Yalcin
- Allergy and Clinical Immunology Unit, Department of Internal Medicine, Antalya Education and Research Hospital, Antalya, Turkey.
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Yalcin AD, Gumuslu S, Parlak GE, Bisgin A, Yildiz M, Kargi A, Gorczynski RM. Systemic levels of ceruloplasmin oxidase activity in allergic asthma and allergic rhinitis. Immunopharmacol Immunotoxicol 2012; 34:1047-53. [PMID: 22737977 DOI: 10.3109/08923973.2012.697902] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT The role of ceruloplasmin oxidase activity (COA) involving the interaction of oxidant and antioxidant balance in allergic diseases is still unknown. OBJECTIVE Our study was designed to examine the changes in COAs in severe persistent asthma-allergic rhinitis, new diagnosed allergic asthma-allergic rhinitis and allergic rhinitis patients. METHODS The study included 20 age- and sex-matched healthy individuals as control (Group I); Group II included 15 newly diagnosed allergic asthma-allergic rhinitis; Group III included 15 patients with severe persistent asthma-allergic rhinitis and in the fourth group there were 20 patients with allergic rhinitis. Group III was divided in two groups, severe persistent asthma-allergic rhinitis who were pre-(III-A) and post-treated (III-B) with omalizumab. Group IV was divided to two groups, pretreatment (IV-A) and posttreatment (IV-B) with specific subcutaneous immunotherapy modalities. All the posttreatment measurements were 12 months after the therapy. All the patients were assessed by the skin prick test, high sensitive C-reactive protein (hs-CRP) and COA. RESULTS There were significant differences between Group I and Groups III-A, III-B, IV-A and IV-B; Group II and Groups III-A, III-B, IV-A and IV-B; Group III-A and Groups III-B, IV-A and IV-B; Group III-A and Groups IV-A and IV-B; and Group IV-A and IV-B. Interestingly, there was a correlation between the hs-CRP and COA levels in Group III-A. CONCLUSIONS Our data suggest that hs-CRP and COA levels might be an indicator of an inflammation and important in revelation of patients with allergy related diseases, especially of asthma patients.
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Affiliation(s)
- Arzu Didem Yalcin
- Internal Medicine, Allergy and Clinical Immunology Unit, Antalya Education and Research Hospital, Antalya, Turkey.
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Yalcin AD, Gumuslu S, Parlak GE, Bısgın A. Soluble trail as a marker of efficacy of allergen-specific immunotherapy in patients with allergic rhinoconjunctivitis. Med Sci Monit 2012; 18:CR617-21. [PMID: 23018355 PMCID: PMC3560552 DOI: 10.12659/msm.883488] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 06/13/2012] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Allergic rhinitis is a common health problem affecting the immune system. The homeostasis of the immune system is regulated by apoptosis. In this study, serum circulating soluble TRAIL levels of allergic rhinoconjunctivitis patients before and after allergen-specific immunotherapy were evaluated. MATERIAL/METHODS The sTRAIL levels of pre- and post-treated allergic rhinoconjunctivitis patients (n=25) were compared to age- and sex-matched healthy individuals (n=25). sTRAIL levels were measured by ELISA. The skin prick test (SPT) results were recorded before and after treatment. RESULTS The sTRAIL levels between the pre-treated and control groups were significantly different (p<0.0001). However, there was no significant difference between the post-treated group and healthy individuals (p=0,801). SPT was a statistically significant difference between the values of the research group before and after immunotherapy (grasses mixture, barley mixture, Oleaauropeae, D. Pteronyssinus, D. farinae). CONCLUSIONS The sTRAIL levels were decreased after allergen-specific immunotherapy to healthy levels and may be of use as a marker of efficacy of immunotherapy in allergic rhinoconjunctivitis patients.
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Affiliation(s)
- Arzu Didem Yalcin
- Internal Medicine, Allergology and Clinical Immunology Unit, Antalya Education and Research Hospital, Antalya, Turkey.
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Yalcin AD, Bisgin A. The relation of sTRAIL levels and quality of life in severe persistent allergic asthma patients using omalizumab. Med Sci Monit 2012; 18:LE9-10. [PMID: 22847211 DOI: 10.12659/msm.883249] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Bisgin A, Yalcin AD, Gorczynski RM. Circulating soluble tumor necrosis factor related apoptosis inducing-ligand (TRAIL) is decreased in type-2 newly diagnosed, non-drug using diabetic patients. Diabetes Res Clin Pract 2012; 96:e84-6. [PMID: 22446096 DOI: 10.1016/j.diabres.2012.02.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 02/27/2012] [Accepted: 02/28/2012] [Indexed: 02/08/2023]
Abstract
We examined the association between serum sTRAIL measured by ELISA and HbA1C levels, pre/post-prandial blood glucose levels and body mass index in 22 newly diagnosed type-2 diabetic patients. A significant difference in sTRAIL levels was found between study group and controls.
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Affiliation(s)
- A Bisgin
- Department of Medical Genetics, Human Gene and Cell Therapy Center of Akdeniz University Hospital and Clinics, Antalya, Turkey.
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Yalcin AD, Bisgin A, Kargi A, Gorczynski RM. Serum-soluble TRAIL levels in patients with severe persistent allergic asthma: its relation to omalizumab treatment. Med Sci Monit 2012; 18:PI11-5. [PMID: 22367138 PMCID: PMC3560751 DOI: 10.12659/msm.882504] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In this study we compare the Omalizumab treatment modality in the dynamics of cell apoptosis regulating molecules in both severe persistent asthma patients who had no other any allergic disease, newly diagnosed patients with allergic asthma, and healthy volunteers. MATERIAL/METHODS Severe persistent allergic asthma patients were subjected to measurement of serum soluble TRAIL (TNF-related apoptosis-inducing ligand) levels during the active disease phase and the stable phase which occurred 4 months after Omalizumab treatment. Serum sTRAIL concentrations were measured by a solid phase sandwich enzyme-linked immunosorbent assay. Concentration levels were compared with those of age- and sex-matched newly diagnosed patients with allergic asthma, and healthy controls. All assays were carried out in duplicate. Total serum IgE levels, antinuclear antibody (ANA), rheumatoid factor (RF), hepatitis markers, C3, C4 and eosinophil levels were evaluated in all patients. RESULTS ANA, RF, hepatitis markers were negative in all patients. Complement 3 and 4 levels were normal in all patients. Prick tests in all patients were detected in mite and grass allergy. These results correlated with specific IgE. There were no differences between the healthy controls, newly diagnosed allergic asthma patients, and non-treated severe persistent allergic asthma patients during the active phase. Interestingly, the levels in variances of the patients who had the effective omalizumab treatment were significantly lower than the healthy controls, while the mean values were not statistically significant. CONCLUSIONS Our study gives a different perspective on severe persistent allergic asthma and omalizumab treatment efficacy at the cell apoptosis-linked step by the serum sTRAIL levels.
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Affiliation(s)
- Arzu Didem Yalcin
- Allergy and Clinical Immunology Unit, Antalya Education and Training Hospital, Antalya, Turkey.
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Bisgin A, Kargi A, Yalcin AD, Aydin C, Ekinci D, Savas B, Sanlioglu S. Increased serum sTRAIL levels were correlated with survival in bevacizumab-treated metastatic colon cancer. BMC Cancer 2012; 12:58. [PMID: 22313795 PMCID: PMC3359245 DOI: 10.1186/1471-2407-12-58] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 02/07/2012] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Colorectal cancer is the third most common cancer and the third leading cause of cancer-related death. Bevacizumab is a humanized monoclonal antibody developed against vascular endothelial growth factor (VEGF) for the treatment of metastatic cancer. The parameters of RECIST (Response Evaluation Criteria for Solid Tumors) are not adequate to detect important treatment effects and response. Our goal was to evaluate the possibility of using sTRAIL (serum-soluble TNF-related apoptosis-inducing ligand) and VEGF as markers of treatment efficacy and prognosis in patients with metastatic colon cancer. METHODS sTRAIL and VEGF levels were measured by ELISA in the sera of 16 bevacizumab-treated metastatic colon cancer patients and 10 presumably healthy age-matched controls. The measurements were taken before and after treatment for comparison purposes. RESULTS Elevated levels of sTRAIL were found in seven out of 16 patients after bevacizumab treatment. Although these patients had a median survival time of 20.6 months, the remaining bevacizumab-treated patients who did not show an increase in sTRAIL had a median survival time of 9.4 months. As expected, serum VEGF levels were decreased in all patients who received bevacizumab therapy and showed no correlation between serum VEGF levels and patient survival (data not shown). CONCLUSIONS Serum sTRAIL levels might be a useful predictor of prognosis in metastatic colon cancer, in the early evaluation stages following bevacizumab treatment.
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Affiliation(s)
- Atil Bisgin
- Human Gene and Cell Therapy Center of Akdeniz University Hospitals and Clinics, Department of Medical Genetics, Antalya, Turkey
| | - Aysegul Kargi
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Arzu D Yalcin
- Allergy and Clinical Immunology Unit, Antalya Education and Training Hospital, Antalya, Turkey
| | - Cigdem Aydin
- Human Gene and Cell Therapy Center of Akdeniz University Hospitals and Clinics, Department of Medical Genetics, Antalya, Turkey
| | - Deniz Ekinci
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Burhan Savas
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Salih Sanlioglu
- Human Gene and Cell Therapy Center of Akdeniz University Hospitals and Clinics, Department of Medical Genetics, Antalya, Turkey
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Yalcin AD, Gorczynski RM, Kahraman MS, Demirel MU, Terzioglu E. CD40, CD45 CTLA-4 levels are elevated in healthy older adults. Clin Lab 2012; 58:449-56. [PMID: 22783574 DOI: pmid/22783574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND The immune system changes with age. In this study we characterized immune changes by performing immunologic screening profiles on ageing individuals. METHODS This study was performed at Akdeniz University, in the Faculty of Medicine, Department of Immunology. Healthy volunteers consisted of a younger group (22 donors) and an older group (45 individuals). All subjects had no serious health problems (i.e. chronic heart, lung, liver or immunological diseases) and were taking no prescribed medications. Flow cytometry analysis was used to evaluate CD3, CD4, CD8, CD16, CD19, CD28, CD40, CD45, CD56, CD80, CD86, CTLA-4 and ELISA for IL-1 beta, IL-2, IL-6, IL-10, IFN-gamma, TNF-alpha expression In addition, NK activity and induced cytokine expression (by bioassay and ELISA, respectively) were evaluated. RESULTS No statistical differences were observed between the two groups in expression of CD3, CD8, CD19, CD80, CD86, CD16, CD 56, or CD28. A higher frequency of expression of CD4, CTLA-4, CD40, and CD45 was seen in older subjects by comparison with younger subjects. Cytokine profiles expressed by stimulated monocytes and lymphocytes from the two groups showed no difference in IL-1 beta, IL-2, IL-6, IL-10, TNF-alpha, and IFN-gamma production levels. CONCLUSIONS We found increased expression levels of CD40 and CD45 levels in healthy older (age: 59.42 +/- 5.89) versus younger individuals (age: 30.32 +/- 2.29). CTLA-4 expression levels were also higher in older subjects, with no difference in CD28 expression levels between younger/older individuals.
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Affiliation(s)
- Arzu Didem Yalcin
- Internal Medicine, Allergology and Clinical Immunology Unit, Antalya Education and Research Hospital, Antalya, Turkey
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Avci AB, Yazisiz V, D MH, Erbasan F, Demirel M, Yalçin AD, Gorczynski RM, Terzioğlu E. Natural Killer Cell Cytotoxicity in Rheumatoid Arthritis Patients Treated with TNF Inhibitors. Turkiye Klinikleri J Med Sci 2012; 32:485-93. [DOI: 10.5336/medsci.2011-26488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Yalcin AD, Gorczynski RM, Parlak GE, Kargi A, Bisgin A, Sahin E, Kose S, Gumuslu S. Total antioxidant capacity, hydrogen peroxide, malondialdehyde and total nitric oxide concentrations in patients with severe persistent allergic asthma: its relation to omalizumab treatment. Clin Lab 2012; 58:89-96. [PMID: 22372350 DOI: pmid/22372350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Asthma is a chronic inflammatory disease and omalizumab is indicated for moderate-to-severe persistent asthma. The results of many studies have shown that oxidative stress is involved in asthma pathogenesis. However, there is no data available to evaluate the alterations in total antioxidant capacity, hydrogen peroxide, malondialdehyde, and total nitric oxide concentrations. OBJECTIVES The objective was to determine whether treatment with omalizumab in severe allergic asthma influences systemic levels of oxidative stress markers. METHODS The first group of 14 patients included 6 male and 8 female subjects with severe persistent asthma, having a mean age of 42.4 years. The second group included 14 newly diagnosed allergic asthma patients with a mean age of 43.8 years. All patients were followed in the Immunology and Allergy Clinic of the Antalya Education and Training Hospital and were evaluated by clinical status. A third group of 14 age-sex matched healthy controls were also included. Serum samples were collected and stored at -70 degrees C until use for the determination of total antioxidant capacity, hydrogen peroxide, malondialdehyde, and total nitric oxide concentrations. Serum IgE levels, ANA (antinuclear antibody), RF (rheumatoid factor), hepatitis markers, C3, C4, and eosinophil levels were evaluated in all patients. All assays were carried out in duplicate. RESULTS The mean IgE levels were as follow: Group I: 459.785 IU/mL; Group II: 124.8 IU/mL, and Group III: 39.88 IU/mL. Total antioxidant capacity levels of Group IB, group II, and group III were lower than the IA group. Total antioxidant capacity levels of groups II and III were higher than in group IB. Hydrogen peroxide concentrations in group IB were lower than in group IA, while concentrations in group II were higher than in group IB. The malondialdehyde concentration of group IB was lower than in all other groups. The malondialdehyde concentration of group III was higher than all other groups. The malondialdehyde concentration of group II was lower than in group III. The total nitric oxide level of group IB was lower than all other groups. The total nitric oxide level of group III was higher than all other groups, while that of group II was higher than for both groups IA/IB. CONCLUSIONS To monitor the omalizumab treatment efficacy in severe allergic asthma patients, total antioxidant capacity, hydrogen peroxide, malondialdehyde, and total nitric oxide concentrations might be new markers.
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Affiliation(s)
- Arzu Didem Yalcin
- Allergology and Clinical Immunology Unit, Antalya Education and Research Hospital, Antalya, Turkey.
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Kargi A, Yalcin AD, Erin N, Savas B, Polat HH, Gorczynski RM. IL8 and serum soluble TRAIL levels following anti-VEGF monoclonal antibody treatment in patients with metastatic colon cancer. Clin Lab 2012; 58:501-5. [PMID: 22783581 DOI: pmid/22783581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Colorectal cancer is the third most common human cancer and the third leading cause of cancer related death. BevacizumAb is a humanized monoclonal antibody developed against vascular endothelial growth factor (VEGF) for the treatment of metastatic cancers. Our goal was to evaluate the possibility of using serum sTRAIL and IL8 as markers of treatment efficacy and prognosis in patients with metastatic colon cancer. METHODS The study was conducted in Denizli between November 10, 2009 and September 20, 2010. 25 patients (6 female, 19 male) with metastatic colon cancer whose mean age was 58.7 years, were selected and included in the study. All patients received therapy with BevacizumAb. All patients were followed in the Oncology Clinic of Denizli State Hospital and were evaluated by clinical status, sTRAIL and IL8 levels were measured by ELISA in the sera of 25 BevacizumAb treated metastatic colon cancer patients and 20 healthy age-gender matched controls. Measurements were taken before and after treatment. RESULTS The serum sTRAIL concentrations in patients before therapy were similar to those of healthy age-gender matched controls, namely 1.23 +/- 0.06 ng/mL and 1.21 +/- 0.04 ng/mL, respectively. After BevacizumAb treatment, sTRAIL ratios were increased significantly in 11 of 25 patients. 14 patients showed progressive disease with median overall survival of only 8.1 +/- 0.4 months. These 14 patients were the same ones who showed no increase in sTRAIL levels after BevacizumAb treatment. We explored evidence for a correlation between sTRAIL levels and overall survival rates and observed that elevated sTRAIL levels after the BevacizumAb treatment were significantly associated with increased median overall survival up to 22.6 months. Serum IL8 levels were decreased in all patients who received BevacizumAb therapy. CONCLUSIONS In BevacizumAb therapy, serum IL8 levels were decreased in all patients, and thus, changes in such levels were not correlated with disease outcome. Our data suggest measurement of changes in sTRAIL following BevacizumAb treatment may have prognostic value in metastatic colon cancer patients.
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Affiliation(s)
- Aysegul Kargi
- Oncology Unit, Denizli Education and Research Hospital, Denizli, Turkey
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Yalcin AD, Bisgin A, Akman A, Erdogan G, Ciftcioglu MA, Yegin O. Jessner lymphocytic infiltrate as a side effect of bee venom immunotherapy. J Investig Allergol Clin Immunol 2012; 22:308-9. [PMID: 22812210 DOI: pmid/22812210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- A D Yalcin
- Allergy and Clinical Immunology Unit, Antalya Education and Training Hospital, Antalya, Turkey
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