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Duman N, Tuncel G, Bisgin A, Bozdogan ST, Sag SO, Gul S, Kiraz A, Balta B, Erdogan M, Uyanik B, Canbek S, Ata P, Geckinli BB, Arslan Ates E, Alavanda C, Yesim Ozdemir S, Sezer O, Ozgon GO, Gurkan H, Guler K, Boga I, Kaya N, Alemdar A, Sayan M, Dundar M, Ergoren MC, Temel SG. Analysis of ACE2 and TMPRSS2 coding variants as a risk factor for SARS-CoV-2 from 946 whole-exome sequencing data in the Turkish population. J Med Virol 2022; 94:5225-5243. [PMID: 35811452 PMCID: PMC9349697 DOI: 10.1002/jmv.27976] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/14/2022] [Accepted: 07/02/2022] [Indexed: 12/15/2022]
Abstract
Heterogeneity in symptoms associated with COVID-19 in infected patients remains unclear. ACE2 and TMPRSS2 gene variants are considered possible risk factors for COVID-19. In this study, a retrospective comparative genome analysis of the ACE2 and TMPRSS2 variants from 946 whole-exome sequencing data was conducted. Allele frequencies of all variants were calculated and filtered to remove variants with allele frequencies lower than 0.003 and to prioritize functional coding variants. The majority of detected variants were intronic, only two ACE2 and three TMPRSS2 nonsynonymous variants were detected in the analyzed cohort. The main ACE2 variants that putatively have a protective or susceptibility effect on SARS-CoV-2 have not yet been determined in the Turkish population. The Turkish genetic makeup likely lacks any ACE2 variant that increases susceptibility to SARS-CoV-2 infection. TMPRSS2 rs75603675 and rs12329760 variants that were previously defined as common variants that have different allele frequencies among populations and may have a role in SARS-CoV-2 attachment to host cells were determined in the population. Overall, these data will contribute to the formation of a national variation database and may also contribute to further studies of ACE2 and TMPRSS2 in the Turkish population and differences in SARS-CoV-2 infection among other populations.
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Affiliation(s)
- Nilgun Duman
- Department of Medical Genetics, Faculty of MedicineBezmialem Vakif UniversityIstanbulTurkey
| | - Gulten Tuncel
- DESAM Research InstituteNear East UniversityNicosiaCyprus
| | - Atil Bisgin
- Department of Medical Genetics, Faculty of MedicineÇukurova UniversityAdanaTurkey,AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center)Cukurova UniversityAdanaTurkey
| | - Sevcan Tug Bozdogan
- Department of Medical Genetics, Faculty of MedicineÇukurova UniversityAdanaTurkey,AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center)Cukurova UniversityAdanaTurkey
| | - Sebnem Ozemri Sag
- Department of Medical Genetics, Faculty of MedicineBursa Uludag UniversityBursaTurkey
| | - Seref Gul
- Department of Biology, Biotechnology Division, Faculty of SciencesIstanbul UniversityIstanbulTurkey
| | - Aslihan Kiraz
- Department of Medical GeneticsKayseri Education and Research State HospitalKayseriTurkey
| | - Burhan Balta
- Department of Medical GeneticsKayseri Education and Research State HospitalKayseriTurkey
| | - Murat Erdogan
- Department of Medical GeneticsKayseri Education and Research State HospitalKayseriTurkey
| | - Bulent Uyanik
- Department of Medical GeneticsIstanbul Bakırkoy Dr. Sadi Konuk Education and Research HospitalIstanbulTurkey
| | - Sezin Canbek
- Department of Medical GeneticsUmraniye City HospitalIstanbulTurkey
| | - Pinar Ata
- Department of Medical Genetics, Faculty of MedicineMarmara UniversityIstanbulTurkey
| | | | - Esra Arslan Ates
- Department of Medical Genetics, Faculty of MedicineMarmara UniversityIstanbulTurkey
| | - Ceren Alavanda
- Department of Medical Genetics, Faculty of MedicineMarmara UniversityIstanbulTurkey
| | - Sevda Yesim Ozdemir
- Department of Medical Genetics, Faculty of MedicineUskudar UniversityİstanbulTurkey
| | - Ozlem Sezer
- Department of Medical GeneticsSamsun Education and Research HospitalSamsunTurkey
| | | | - Hakan Gurkan
- Department of Medical Genetics, Faculty of MedicineTrakya UniversityEdirneTurkey
| | - Kubra Guler
- Mikrogen Genetic Diagnostic CenterAnkaraTurkey
| | - Ibrahim Boga
- Department of Medical Genetics, Faculty of MedicineÇukurova UniversityAdanaTurkey,AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center)Cukurova UniversityAdanaTurkey
| | - Niyazi Kaya
- Department of Medical Genetics, Faculty of MedicineBursa Uludag UniversityBursaTurkey
| | - Adem Alemdar
- Department of Medical Genetics, Faculty of MedicineBursa Uludag UniversityBursaTurkey
| | - Murat Sayan
- DESAM Research InstituteNear East UniversityNicosiaCyprus,PCR Unit, Kocaeli University Education and Research HospitalKocaeliTurkey
| | - Munis Dundar
- Department of Medical Genetics, Faculty of MedicineErciyes UniversityKayseriTurkey
| | - Mahmut Cerkez Ergoren
- DESAM Research InstituteNear East UniversityNicosiaCyprus,Department of Medical Genetics, Faculty of MedicineNear East UniversityNicosiaCyprus
| | - Sehime Gulsun Temel
- Department of Medical Genetics, Faculty of MedicineBursa Uludag UniversityBursaTurkey,Department of Medical Genetics, Faculty of MedicineNear East UniversityNicosiaCyprus,Department of Histology and Embryology, Faculty of MedicineBursa Uludag UniversityBursaTurkey,Department of Translational Medicine, Institute of Health SciencesBursa Uludag UniversityBursaTurkey
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Yegit CY, Ergenekon P, Yanaz M, Guliyeva A, Kalyoncu M, Meral O, Selcuk M, Taştan G, Uzunoglu B, Ozturk N, Toktas F, Atas A, Kara H, Oruc Y, Acar M, Collak A, Bal N, Gedik O, Dogan R, Tan EG, Kafi HM, Karasu N, Ayhan Y, Yumusakhuylu A, Sakallı AK, Cakır E, Girit S, Gokdemir Y, Eralp EE, Ata P, Ciprut A, Karakoc F, Karadag B. P149 The association between the cumulative dose of aminoglycoside exposure and hearing loss in children with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00480-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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3
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Turkyilmaz A, Alavanda C, Ates EA, Geckinli BB, Polat H, Gokcu M, Karakaya T, Cebi AH, Soylemez MA, Guney Aİ, Ata P, Arman A. Whole-exome sequencing reveals new potential genes and variants in patients with premature ovarian insufficiency. J Assist Reprod Genet 2022; 39:695-710. [PMID: 35066699 PMCID: PMC8995228 DOI: 10.1007/s10815-022-02408-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/06/2021] [Accepted: 01/19/2022] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Premature ovarian insufficiency (POI) is a heterogeneous disorder characterized by the cessation of menstrual cycles before the age of 40 years due to the depletion or dysfunction of the ovarian follicles. POI is a highly heterogeneous disease in terms of etiology. The aim of this study is to reveal the genetic etiology in POI patients. METHODS A total of 35 patients (mean age: 27.2 years) from 28 different families diagnosed with POI were included in the study. Karyotype, FMR1 premutation analysis, single nucleotide polymorphism (SNP) array, and whole-exome sequencing (WES) were conducted to determine the genetic etiology of patients. RESULTS A total of 35 patients with POI were first evaluated by karyotype analysis, and chromosomal anomaly was detected in three (8.5%) and FMR1 premutation was detected in six patients (17%) from two different families. A total of 29 patients without FMR1 premutation were included in the SNP array analysis, and one patient had a 337-kb deletion in the chromosome 6q26 region including PARK2 gene, which was thought to be associated with POI. Twenty-nine cases included in SNP array analysis were evaluated simultaneously with WES analysis, and genetic variant was detected in 55.1% (16/29). CONCLUSION In the present study, rare novel variants were identified in genes known to be associated with POI, which contribute to the mutation spectrum. The effects of detected novel genes and variations on different pathways such as gonadal development, meiosis and DNA repair, or metabolism need to be investigated by experimental studies. Molecular etiology allows accurate genetic counseling to the patient and family as well as fertility planning.
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Affiliation(s)
- Ayberk Turkyilmaz
- Department of Medical Genetics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
| | - Ceren Alavanda
- grid.16477.330000 0001 0668 8422Department of Medical Genetics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Esra Arslan Ates
- grid.414850.c0000 0004 0642 8921Department of Medical Genetics, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Bilgen Bilge Geckinli
- grid.16477.330000 0001 0668 8422Department of Medical Genetics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Hamza Polat
- grid.16477.330000 0001 0668 8422Department of Medical Genetics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Mehmet Gokcu
- grid.31564.350000 0001 2186 0630Department of Medical Genetics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Taner Karakaya
- Department of Medical Genetics, Isparta City Hospital, Isparta, Turkey
| | - Alper Han Cebi
- grid.31564.350000 0001 2186 0630Department of Medical Genetics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Mehmet Ali Soylemez
- grid.16477.330000 0001 0668 8422Department of Medical Genetics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ahmet İlter Guney
- grid.16477.330000 0001 0668 8422Department of Medical Genetics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Pinar Ata
- grid.16477.330000 0001 0668 8422Department of Medical Genetics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ahmet Arman
- grid.16477.330000 0001 0668 8422Department of Medical Genetics, School of Medicine, Marmara University, Istanbul, Turkey
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Gulcan-Kersin S, Kirkgoz T, Eltan M, Rzayev T, Ata P, Bilgen H, Ozek E, Bereket A, Turan S. Cinacalcet as a First-Line Treatment in Neonatal Severe Hyperparathyroidism Secondary to Calcium Sensing Receptor (CaSR) Mutation. Horm Res Paediatr 2021; 93:313-321. [PMID: 33147586 DOI: 10.1159/000510623] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 07/31/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Neonatal severe hyperparathyroidism (NSHPT) is a rare cause of neonatal hypercalcemia caused by a loss of function mutation in the calcium-sensing receptor (CaSR). Hypercalcemia in NSHPT can be life-threatening. Maintenance of serum calcium within a safe range is the primary goal of treatment through hydration, forced diuresis, and bisphosphonate treatment, nevertheless most cases require parathyroidectomy. We report a case with NSHPT diagnosed on the first day of life (DoL) and successfully treated with cinacalcet as the first-line treatment from the 2nd DoL up to the age of 18 months. CASE REPORT A full-term baby evaluated for weight loss at postnatal 14th hour and found to have hypercalcemia (14.4 mg/dL, reference range [RR]: 8.0-11.3). Despite hydration and diuresis, hypercalcemia persisted. Further evaluation revealed a parathyroid hormone (PTH) level of 1,493 pg/mL (RR: 15-65) and urine Ca/Cr of 0.09 mg/mg (RR: 0.03-0.81). Cinacalcet treatment was initiated on the 2nd DoL with the diagnosis of NSHPT due to hypocalciuric hypercalcemia and elevated PTH level. Ca levels decreased to normal levels on the 7th DoL. She was discharged from hospital at postnatal day 15 on cinacalcet treatment and still continued at 18 months of age. Sequencing of CaSR revealed a novel homozygous c.1836G>A (p.G613E) mutation in the patient, for which the parents and sister were heterozygous. CONCLUSION This case represents the youngest age at cinacalcet initiation and the longest duration without parathyroidectomy in a homozygous NSHPT and demonstrates that cinacalcet is an effective first-line treatment in patients who are responsive to this treatment modality and allows avoiding/delay in surgical intervention in NSHPT.
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Affiliation(s)
- Sinem Gulcan-Kersin
- Department of Neonatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Tarik Kirkgoz
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Mehmet Eltan
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Turkay Rzayev
- Department of Neonatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Pinar Ata
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Hulya Bilgen
- Department of Neonatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Eren Ozek
- Department of Neonatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Abdullah Bereket
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Serap Turan
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey,
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Kaygusuz SB, Alavanda C, Kirkgoz T, Eltan M, Yavas Abali Z, Helvacioglu D, Guran T, Ata P, Bereket A, Turan S. Does Genotype-Phenotype Correlation Exist in Vitamin D-Dependent Rickets Type IA: Report of 13 New Cases and Review of the Literature. Calcif Tissue Int 2021; 108:576-586. [PMID: 33386952 DOI: 10.1007/s00223-020-00784-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/18/2020] [Accepted: 11/28/2020] [Indexed: 11/28/2022]
Abstract
Vitamin D-dependent rickets type IA (VDDR-IA) is caused by biallelic mutations in CYP27B1. Data regarding genotype-phenotype correlation in VDDR-IA are scarce. Here, we aimed to investigate clinical/genotypic features and long-term follow-up of 13 new cases with VDDR-IA and genotype-phenotype correlation of reported cases in the literature. Thirteen patients with VDDR-IA were evaluated. Eight patients had reached their final height at the time of the study and, for whom, long-term outcome data were analyzed. Further, all VDDR-IA patients in the literature (n:183) were analyzed and clinical-genetic features were recorded. The median age of diagnosis was 2.55 ± 1.13 (1.0-12) years. Initial diagnoses before referral to our clinic were nutritional rickets (n:7), hypophosphatemic rickets (n:2), and pseudohypoparathyroidism (n:1). All had biochemical evidence suggestive of VDDR-IA; except one with elevated 1,25(OH)2D3 and another with hyperphosphatemia, in whom pseudohypoparathyroidism was excluded with molecular tests. Combined analyses of our cohort and other series in the literature demonstrated that three most common CYP27B1 mutations are p.F443Pfs*24, c.195 + 2T > G, and p.V88Wfs*71. In Turkish population, p.K192E mutation along with the former two is the most common mutations. Comparison of clinical features demonstrated that c.195 + 2T > G mutation causes the most severe and p.K192E mutation causes the least severe phenotype with respect to age and height at presentation and calcitriol requirement. We found a clear genotype-phenotype correlation in VDDR-IA, notably CYP27B1 intronic c.195 + 2T > G mutation causes a more severe phenotype with lower height SDS at presentation and, higher calcitriol requirement, while less severe phenotype occurs in p.K192E mutation.
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Affiliation(s)
- Sare Betul Kaygusuz
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Ceren Alavanda
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Tarik Kirkgoz
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Mehmet Eltan
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Zehra Yavas Abali
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Didem Helvacioglu
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Tulay Guran
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Pinar Ata
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Abdullah Bereket
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Serap Turan
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey.
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Ateş EA, Turkyilmaz A, Delil K, Alavanda C, Söylemez MA, Geçkinli BB, Ata P, Arman A. Biallelic Mutations in DNAJB11 are Associated with Prenatal Polycystic Kidney Disease in a Turkish Family. Mol Syndromol 2021; 12:179-185. [PMID: 34177435 DOI: 10.1159/000513611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/31/2020] [Accepted: 12/05/2020] [Indexed: 11/19/2022] Open
Abstract
Polycystic kidney disease (PKD) is a life-threatening condition resulting in end-stage renal disease. Two major forms of PKD are defined according to the inheritance pattern. Autosomal dominant PKD (ADPKD) is characterized by renal cysts, where nearly half of the patients suffers from renal failure in the 7th decade of life. Autosomal recessive PKD (ARPKD) is a rarer and more severe form presenting in childhood. Whole-exome sequencing (WES) analyses was performed to investigate molecular causes of the disease in the fetus. In this study, we present 2 fetuses prenatally diagnosed with PKD in a consanguineous family. WES analysis of the second fetus revealed a homozygous variant (c.740+1G>A) in DNAJB11 which is related to ADPKD. This study reveals that DNAJB11 biallelic mutations may cause an antenatal severe form of ARPKD and contributes to understanding the DNAJB11-related ADPKD phenotype. The possibility of ARPKD due to biallelic mutations in ADPKD genes should be considered in genetic counseling.
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Affiliation(s)
- Esra Arslan Ateş
- Department of Medical Genetics, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey
| | - Ayberk Turkyilmaz
- Department of Medical Genetics, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Kenan Delil
- Department of Medical Genetics, Marmara University School of Medicine, İstanbul, Turkey
| | - Ceren Alavanda
- Department of Medical Genetics, Marmara University School of Medicine, İstanbul, Turkey
| | - Mehmet Ali Söylemez
- Department of Medical Genetics, Marmara University School of Medicine, İstanbul, Turkey
| | - Bilgen Bilge Geçkinli
- Department of Medical Genetics, Marmara University School of Medicine, İstanbul, Turkey
| | - Pinar Ata
- Department of Medical Genetics, Marmara University School of Medicine, İstanbul, Turkey
| | - Ahmet Arman
- Department of Medical Genetics, Marmara University School of Medicine, İstanbul, Turkey
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Turkyilmaz A, Kurnaz E, Alavanda C, Yarali O, Kartal Baykan E, Yavuz D, Cayir A, Ata P. The Spectrum of Low-Density Lipoprotein Receptor Mutations in a Large Turkish Cohort of Patients with Familial Hypercholesterolemia. Metab Syndr Relat Disord 2021; 19:340-346. [PMID: 33794673 DOI: 10.1089/met.2021.0004] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Monogenic hypercholesterolemia with Mendelian inheritance is a heterogeneous group of diseases that are characterized by elevated plasma low-density lipoprotein cholesterol (LDL-C) levels, and the most common form of this disorder is autosomal-dominant familial hypercholesterolemia (FH). Methods: A total of 104 index cases with the clinical diagnosis of FH were included in this study. Low-density lipoprotein receptor (LDLR) was sequenced using the Sanger sequencing method. Results: Pathogenic/likely pathogenic variants were detected in LDLR in 55 of the 104 cases (mutation detection rate = 52.8%). Thirty different variants were detected in LDLR, three of which were novel. The total cholesterol and LDL-C values of the patients in the group of premature termination codon (PTC) mutation carriers were significantly higher than those of the patients in the group of non-PTC mutation carriers. A total of 87 patients (17 pediatric and 70 adult cases) were diagnosed with cascade genetic screening. Statin treatment was recommended to all 87 patients and was accepted and initiated in 70 of these patients. Conclusions: This study is the largest patient cohort that evaluated FH cases in the Turkish population. Herein, we revealed the LDLR mutation spectrum for a Turkish population and compared the cases in the context of genotype-phenotype correlation. Genetic screening of individuals with suspected FH not only helps to establish their diagnosis, but also facilitates early diagnosis and treatment initiation in other family members through cascade screening.
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Affiliation(s)
- Ayberk Turkyilmaz
- Department of Medical Genetics, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Erdal Kurnaz
- Department of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Ceren Alavanda
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Oguzhan Yarali
- Department of Medical Genetics, Erzurum City Hospital, Erzurum, Turkey
| | | | - Dilek Yavuz
- Department of Endocrinology, Marmara University School of Medicine, Istanbul, Turkey
| | - Atilla Cayir
- Department of Pediatric Endocrinology, Erzurum City Hospital, Erzurum, Turkey
| | - Pinar Ata
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
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Eltan M, Alavanda C, Yavas Abali Z, Ergenekon P, Yalındag Ozturk N, Sakar M, Dagcinar A, Kirkgoz T, Kaygusuz SB, Gokdemir Y, Elcioglu HN, Guran T, Bereket A, Ata P, Turan S. A Rare Cause of Hypophosphatemia: Raine Syndrome Changing Clinical Features with Age. Calcif Tissue Int 2020; 107:96-103. [PMID: 32337609 PMCID: PMC7222149 DOI: 10.1007/s00223-020-00694-3] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/11/2020] [Indexed: 11/29/2022]
Abstract
Raine Syndrome (RS) is caused by biallelic loss-of-function mutations in FAM20C gene and characterized by hypophosphatemia, typical facial and skeletal features. Subperiosteal bone formation and generalized osteosclerosis are the most common radiological findings. Here we present a new case with RS. A 9-month-old male patient on a home-type ventilator was referred for hypophosphatemia. He was born with a weight of 3800 g to non-consanguineous parents. Prenatal ultrasound had demonstrated nasal bone agenesis. A large anterior fontanel, frontal bossing, exophthalmos, hypoplastic nose, high arched palate, low set ears, triangular mouth, and corneal opacification were detected on physical examination. Serial skeletal X-rays revealed diffuse osteosclerosis at birth which was gradually decreased by the age of 5 months with subperiosteal undermineralized bone formation and medullary space of long bone could be distinguishable with bone-within-a-bone appearance. At 9 months of age, hand X-ray revealed cupping of the ulna with loose radial bone margin with minimal fraying and osteopenia. Cranial computed tomography scan showed bilateral periventricular calcification and hydrocephalus in progress. The clinical, laboratory, and radiological examinations were consistent with RS. Molecular analyses revealed a compound heterozygous mutation in FAM20C gene (a known pathogenic mutation, c.1645C > T, p.Arg549Trp; and a novel c.863 + 5 G > C variant). The patient died due to respiratory failure at 17 months of age. This case allowed us to demonstrate natural progression of skeletal features in RS. Furthermore, we have described a novel FAM20C variant causing RS. Previous literature on RS is also reviewed.
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Affiliation(s)
- Mehmet Eltan
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Ceren Alavanda
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Zehra Yavas Abali
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Pinar Ergenekon
- Department of Pediatric Chest Disease, Marmara University School of Medicine, Istanbul, Turkey
| | - Nilufer Yalındag Ozturk
- Department of Pediatric Intensive Care Unit, Marmara University School of Medicine, Istanbul, Turkey
| | - Mustafa Sakar
- Department of Pediatric Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Adnan Dagcinar
- Department of Pediatric Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Tarik Kirkgoz
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Sare Betul Kaygusuz
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Yasemin Gokdemir
- Department of Pediatric Chest Disease, Marmara University School of Medicine, Istanbul, Turkey
| | - Huriye Nursel Elcioglu
- Department of Pediatric Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Tulay Guran
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Abdullah Bereket
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Pinar Ata
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Serap Turan
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey.
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Abstract
PURPOSE OF REVIEW Fibrodysplasia ossificans progressiva (FOP) is an extremely rare and severely disabling autosomal dominant disease that is yet to be clearly understood. The purpose of this review is to present recent literature on pathophysiology, clinical features, diagnosis and treatment of FOP. RECENT FINDINGS FOP is characterized by congenital great toe deformity and progressive heterotopic ossifications in connective tissue. Heterotopic ossifications occur after painful flare-ups that can arise spontaneously or can be triggered by minor trauma. Each flare-up ultimately causes restriction of related-joint, and along with the others eventually leads to immobility. Death is usually caused by pulmonary complications because of chest wall involvement. The causative gene of FOP is activin A receptor type 1 (ACVR1), a bone morphogenetic protein-signalling component, which normally acts to inhibit osteoblastogenesis. The treatment of FOP is still preventive and supportive. SUMMARY Although there are still gaps in the underlying mechanism of FOP, effective treatment options, such as potential pharmacologic targets and cell-based therapies are promising for the future. Some of these were tested without a clinical trial setting, and are currently in the process of evidence-based research.
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Affiliation(s)
- Gulseren Akyuz
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine
| | - Kardelen Gencer-Atalay
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine
| | - Pinar Ata
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
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Atag E, Bas Ikizoglu N, Ergenekon AP, Gokdemir Y, Eralp EE, Ata P, Ersu R, Karakoc F, Karadag B. Novel mutations and deletions in cystic fibrosis in a tertiary cystic fibrosis center in Istanbul. Pediatr Pulmonol 2019; 54:743-750. [PMID: 30938940 DOI: 10.1002/ppul.24299] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 02/02/2019] [Accepted: 02/10/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) genotyping has garnered increased attention since the discovery of the cystic fibrosis transmembrane conductance regulator (CFTR) gene in 1989 led to the identification of over 1700 mutations on chromosome 7. Yet, little is known about the genetic profile of CF patients in Turkey. This study sought to determine the mutation distribution among CF patients seeking care at Marmara University. METHODS Two hundred fifty previously diagnosed CF patients were included in the study. CFTR gene exons 1 to 27 were amplified by a polymerase chain reaction and whole DNA sequencing was performed. Duplications and deletions were investigated by the multiplex ligation-dependent probe amplification (MLPA) technique in patients with one or two unidentified mutations in sequence analysis. RESULTS CFTR mutation analysis revealed 80 mutations and five large deletions were present in our study population. The five most common mutations were (delta) F508 (c.1521-1523delCTT) (28.4%), 1677delTA (c.1545-1546delTA) (6.4%), 2789 + 5G- > A (c.2657 + 5G > A) (5.8%), N1303K (c.3909C > G) (2.4%), and c.2183AA- > G (c.2051-2052delAAinsG) (4.0%). Large deletions were found in 16 patients. Four novel mutations and two novel deletions were detected in this study. CONCLUSIONS We have identified four novel mutations and two novel deletions using next-generation DNA sequencing and the MLPA technique and obtained an overall mutation detection rate of 91.4%. Detection of novel variants in CF patients will assist in genetic counseling and in determining appropriate patients for new therapies.
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Affiliation(s)
- Emine Atag
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nilay Bas Ikizoglu
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Almala Pinar Ergenekon
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ela Erdem Eralp
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Pinar Ata
- Department of Medical Genetics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Refika Ersu
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Fazilet Karakoc
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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Gencer-Atalay K, Ozturk EC, Yagci I, Ata P, Delil K, Ozgen Z, Akyuz G. Challenges in the treatment of fibrodysplasia ossificans progressiva. Rheumatol Int 2018; 39:569-576. [PMID: 30343406 DOI: 10.1007/s00296-018-4179-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 08/04/2018] [Accepted: 10/15/2018] [Indexed: 01/19/2023]
Abstract
Fibrodysplasia ossificans progressiva (FOP), is a rare autosomal dominant connective tissue disease with a prevalence of 1 in 2 million. It is characterized by congenital foot deformities and multiple heterotopic ossifications in fibrous tissue. It usually starts with painful soft tissue swellings occurring with attacks at the ages of three or four. The attacks develop spontaneously or after minor trauma, and gradually turn into heterotopic ossifications that cause joint limitations, growth defects, skeletal deformities and chronic pain. The average life expectancy is forthy, and most of the patients are lost due to pulmonary complications. FOP is often misdiagnosed as fibromatosis, desmoid tumour or cancer, bunion, myositis, arthritis and rheumatic diseases. After clinical suspicion, confirmatory genetic analysis should be used for the diagnosis. The treatment of FOP is currently supportive. An effective, proven method has not yet been established. Herein, we present an 18-year-old female patient with FOP who underwent different treatment modalities in a 5-year period. This case-based review reveals all available treatment approaches with at least 6-month follow-up for FOP in the literature.
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Affiliation(s)
- Kardelen Gencer-Atalay
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, 34899 Pendik Ust Kaynarca, Istanbul, Turkey
| | - Ekim Can Ozturk
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, 34899 Pendik Ust Kaynarca, Istanbul, Turkey
| | - Ilker Yagci
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, 34899 Pendik Ust Kaynarca, Istanbul, Turkey
| | - Pinar Ata
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Kenan Delil
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Zerrin Ozgen
- Department of Radiation Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Gulseren Akyuz
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, 34899 Pendik Ust Kaynarca, Istanbul, Turkey.
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Rabus MB, Cekmecelioglu D, Ata P, Salihi S, Selcuk E, Balkanay M. Intraoperative Tissue-Immunosuppressive Therapy Reduces Rejection Episodes in Heart Transplant Recipients. EXP CLIN TRANSPLANT 2018; 20:762-767. [PMID: 30251943 DOI: 10.6002/ect.2017.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Our study was conducted to determine the effects of intraoperative antithymocyte globulin administration on donor hearts procured after cardiocirculatory death. We evaluated the impact of antithymocyte globulin on graft function and related parameters during isothermic blood cardioplegia. MATERIALS AND METHODS In this prospective and randomized single center study, 30 patients with orthotropic heart transplant were divided into 2 groups: group 1 included 15 patients who received retrograde antithymocyte globulin infusion via coronary sinus intraoperatively and immediately after organ procurement and group 2 included 15 patients who received traditional antithymocyte globulin infusion after implantation. RESULTS Study patients had a mean age of 33.8 years (range, 15-56 y). All patients had panel reactive antibody less than 10% except for 3 patients. The cluster of differentiation 3-positive cell count decrease was more than 20%. The inotropic therapy dose required and the myocardial pressure (stiffness) were less for group 1 patients. These patients had less acute rejection episodes than group 2 (0% vs 13.3%; P < .05). CONCLUSIONS Favorable clinical outcomes were observed in terms of less acute rejection episodes and better graft function at least during the early posttransplant period. Intraoperative antithymocyte globulin treatment may have a preventive effect for acute cellular rejection in heart transplant patients.
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Affiliation(s)
- Murat Bulent Rabus
- From the Cardiovascular Surgery Department, Kartal Koşuyolu Yuksek Ihtisas Research and Training Hospital, Istanbul
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13
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Abstract
BACKGROUND Complement-dependent lymphocytotoxicity (CDC-XM) and flow-cytometric (FCXM) cross-match are analyzed individually for each donor and recipient pair, because these techniques have fundamental differences for the evaluation of histocompatibility. Lately, cytotoxic flow-cytometric cross-match (cFCXM) has been developed as an alternative to both CDC-XM and FCXM techniques. We evaluated the limits of cFCXM with the use of different positive serum dilutions. METHODS CDC-XM, FCXM, and cFCXM tests were performed with the use of commercially available negative and positive serum samples and lymphocytes from healthy donors. RESULTS Complement-dependent cell death was successfully detected with the use of cFCXM. Complement-dependent cell death ratios in cFCXM were similar those in CDC-XM. With cFCXM, not only complement-dependent cell death but also IgG binding could be detected within a single assay. At higher concentrations of the positive serum, IgG-fluorescein isothiocyanate (FITC) mean fluorescent intensity (MFI) values detected with the use of cFCXM were less than those of conventional FCXM. Correspondingly, for dead cells, MFI values of IgG-FITC were less than those of live cells in higher positive serum concentrations in the cFCXM assay. Moreover, our results demonstrated that in cFCXM analysis, the decreasing ratio of dead cells at increasing positive serum dilutions was not in parallel with the same decrease in IgG-FITC MFI values. CONCLUSIONS The cFCXM technique detects complement-mediated cytotoxic cell death with the additional ability to show IgG binding in the same tube and therefore may reduce the necessary bench time and workload.
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Affiliation(s)
- T Bilgen
- Research and Application Center for Scientific and Technological Investigations, Namık Kemal University, Tekirdag, Turkey
| | - P Ata
- Department of Medical Genetics, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - J Tozkir
- Health Services Vocational College, Trakya University, Edirne, Turkey
| | - H Tozkir
- Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - M I Titiz
- Department of General Surgery, Faculty of Medicine, Namık Kemal University, Tekirdag, Turkey.
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14
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Rabus M, Cekmecelioglu D, Ata P, Salihi S, Selcuk E, Balkanay M. May Intraoperative Immunosuppressive Therapy Reduce the Rejection Episodes at Cardiac Transplant Recipients? J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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15
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Deniz S, Sancar M, Okuyan B, Ata P, Ozakpinar OB, Talas A, Gunes T, Caliskan M, Izzettin FV. Determination of CYP2C19 Polymorphism, Side Effects, and Medication Adherence in Patients Who have Utilized Selective Serotonin Reuptake Inhibitors. Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology 2016. [DOI: 10.5455/bcp.20151003060610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Semanur Deniz
- Marmara University, Faculty of Pharmacy, Department of Clinical Pharmacy, Istanbul - Turkey
| | - Mesut Sancar
- Marmara University, Faculty of Pharmacy, Department of Clinical Pharmacy, Istanbul - Turkey
| | - Betul Okuyan
- Marmara University, Faculty of Pharmacy, Department of Clinical Pharmacy, Istanbul - Turkey
| | - Pinar Ata
- Marmara University, Faculty of Medicine, Department of Medical Genetics, Istanbul - Turkey
| | | | - Anil Talas
- Haydarpasa Numune Training and Research Hospital, Department of Psychiatry, Istanbul - Turkey
| | - Tufan Gunes
- Haydarpasa Numune Training and Research Hospital, Department of Psychiatry, Istanbul - Turkey
| | - Mecit Caliskan
- Haydarpasa Numune Training and Research Hospital, Department of Psychiatry, Istanbul - Turkey
| | - Fikret Vehbi Izzettin
- Marmara University, Faculty of Pharmacy, Department of Clinical Pharmacy, Istanbul - Turkey
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16
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Gökçe AM, Fındık H, Ata P, Gümrükçü G, Özel L, Gündoğdu K, Yazıcıoğlu B, Titiz MI. Relationship of Urothelial Gene Expressions in Urine-Deprived Bladders of Renal Recipients With Posttransplant Urinary Infections. Transplant Proc 2016; 47:1331-5. [PMID: 26093712 DOI: 10.1016/j.transproceed.2015.04.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In this study, we analyzed gene expression levels of apoptotic (Fas, FasL, Bcl-2, Bax) and survival (CXCR1, CXCR2, IL-8) signal pathways of the urine-deprived bladder tissues and the relation of urinary tract infections with these pathways. MATERIAL AND METHODS We included 37 patients admitted for renal transplantation between December 2009 and December 2012. Bladder mucosal samples were obtained at the time of transplantation and 6-8 weeks posttransplantation, at the time of ureteral catheter removal. RNA extraction and cDNA synthesis were done using guanidium-thiocyanate and colon filter methods. Expression analysis was studied with quantitative real-time polymerase chain reaction optimized with ROX dye and internal control β-actin. RESULTS According to our findings Fas, FasL, Bcl-2, and Bax expression was higher in urine-deprived bladder samples than those in the posttransplant samples (P < .05). Although Fas, FasL, Bcl-2, and Bax expression levels increased in pretransplant samples, there was an increase in posttransplant bladder samples; however, this increase was not as marked as those of pretransplant samples. IL-8, CXCR1, and CXCR2 expression was decreased at the pretransplant samples and increased in posttransplant bladder samples. CONCLUSIONS We have found an upregulated apoptotic process and decreased survival signals at the urine-deprived bladder tissue. After transplantation, bladder tissue survival parameters were increased, demonstrating the importance of urinary flow for bladder tissue.
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Affiliation(s)
- A M Gökçe
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - H Fındık
- Department of Molecular Genetics, Haliç University, Istanbul, Turkey
| | - P Ata
- Faculty of Medicine, Department of Medical Genetics, Marmara University, Istanbul, Turkey; Haydarpasa Numune Training and Research Hospital Tissue Typing Laboratory, Istanbul, Turkey.
| | - G Gümrükçü
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - L Özel
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - K Gündoğdu
- Department of Molecular Genetics, Haliç University, Istanbul, Turkey
| | - B Yazıcıoğlu
- Department of Molecular Genetics, Haliç University, Istanbul, Turkey
| | - M I Titiz
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
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17
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Demir T, Ozel L, Gökçe AM, Ata P, Kara M, Eriş C, Özdemir E, Titiz MI. Cancer Screening of Renal Transplant Patients Undergoing Long-Term Immunosuppressive Therapy. Transplant Proc 2016; 47:1413-7. [PMID: 26093731 DOI: 10.1016/j.transproceed.2015.04.073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE With this study we aimed to research the effects of immunosuppressive drugs, their cumulative doses, and viral infections on development of malign tumors in patients who have undergone treatment for 5 years. METHODS We examined 100 patients who underwent renal transplantation from 2004 to 2009. Patients had mycophenolate mofetil and steroid in addition to cyclosporine, sirolimus, or tacrolimus as immunosuppressive treatment. For malignancy screening, physical examination, radiologic and endoscopic screening were done, and immunosuppressive drugs and their cumulative doses, age, sex, body mass index (BMI), dialysis history, and viral infection history were investigated. RESULTS The mean age of patients was 42.03 ± 11.30 years. There were 1 colon cancer patient, 1 retroperitoneal liposarcoma, 1 renal oncocytoma, 3 Kaposi sarcoma patients treated with cyclosporine; in those treated with Tac there were 1 basal cell carcinoma, 1 Kaposi sarcoma, 2 thyroid carcinoma, 1 breast carcinoma, 1 bladder carcinoma, 1 renal cell carcinoma, and 1 colon carcinoma patients. The mean age of patients having carcinoma was statistically significant compared with those without cancer (P < .01). The prednisolone cumulative dose was significantly higher in carcinoma patients than in patients without carcinoma (P < .01). RESULTS The use of long-term chronic immunosuppressive therapy may increase the development of cancer. The risk of carcinoma increases with increasing drug dose and time period of the immunosuppressive drug. There was not a negative effect on cancer prevalence in patients with cyclosporine or tacrolimus. But the cumulative dose of steroids significantly increased malignancy occurence.
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Affiliation(s)
- T Demir
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - L Ozel
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey.
| | - A M Gökçe
- Department of Urology and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - P Ata
- Department of Medical Genetics, Faculty of Medicine, Marmara University, Istanbul, Turkey; Tissue Typing Laboratory, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - M Kara
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - C Eriş
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - E Özdemir
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
| | - M I Titiz
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey
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18
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Can Ö, Kasapoğlu U, Boynueğri B, Tuğcu M, Çağlar Ruhi B, Canbakan M, Murat Gökçe A, Ata P, İzzet Titiz M, Apaydın S. Factors Affecting the Selection of Patients on Waiting List: A Single Center Study. Transplant Proc 2016; 47:1265-8. [PMID: 26093695 DOI: 10.1016/j.transproceed.2015.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION There is an increasing gap between organ supply and demand for cadaveric transplantation in our country. Our aim was to evaluate factors affecting selection of patients on waiting list at our hospital. METHOD Patients who have been waiting on list and who were transplanted were compared in order to find factors, which affected the selection of patients. Non-parametric Mann-Whitney U test was used for comparison and cox regression analysis was used to find the risk factors that decrease the probability of transplantation in this retrospective case-control study. RESULTS Patients in the transplanted group were significantly younger, had relatively lower body mass index than the awaiting group. Cardiovascular diseases were more in the awaiting group than the transplanted group. There was no patient with diabetes in transplanted group, despite fifteen diabetic patients were in the awaiting group. Selected patients had lower immunologic risk with regard to peak panel reactive antibody levels. No significant difference was found for gender, hypertension, hyperlipidemia, viral serology, time spent on dialysis and on waiting list between two groups. With cox regression analysis female gender, older age, diabetes mellitus, high body mass index, positive hepatitis B serology and high levels of peak class 1-2 peak panel reactive antibody positivity were found as risk factors that decrease the probability of transplantation. CONCLUSION A tendency for selection of low risk patients was found with this study. Time and energy consuming complications and short allograft survival after transplantation in high risk patients and the scarcity of cadaveric pool in our country may contribute to this tendency.
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Affiliation(s)
- Ö Can
- Department of Nephrology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
| | - U Kasapoğlu
- Department of Nephrology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - B Boynueğri
- Department of Nephrology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - M Tuğcu
- Department of Nephrology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - B Çağlar Ruhi
- Department of Nephrology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - M Canbakan
- Department of Nephrology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - A Murat Gökçe
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - P Ata
- Genetic Diseases Diagnosis Center, Molecular Genetics Laboratory, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - M İzzet Titiz
- Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - S Apaydın
- Department of Nephrology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Kiziltas S, Ata P, Colak Y, Mesçi B, Senates E, Enc F, Ulasoglu C, Tuncer I, Oguz A. TLR4 gene polymorphism in patients with nonalcoholic fatty liver disease in comparison to healthy controls. Metab Syndr Relat Disord 2014; 12:165-70. [PMID: 24443993 DOI: 10.1089/met.2013.0120] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Recent studies have suggested that bacterial overgrowth and endotoxemia along with its receptor, Toll-like receptor 4 (TLR-4), play a role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The present study was designed to test and evaluate the TLR4 gene polymorphism in patients with NAFLD in comparison to healthy controls. METHODS A total of 119 patients [mean (standard deviation, SD) age 43.4 (11.5) years, 55.5% were males] with NAFLD and 80 healthy controls [mean (SD) age 40.9 (8.1) years, 67.5% were females)] were evaluated in terms of patient demographics, anthropometrics, blood biochemistry, liver histology, and ultrasonographic (USG) findings. Histological evaluation was performed in 111 patients, and blood samples were collected from 119 patients with NAFLD and 80 healthy persons. Allelic variants of TLR4 (Asp299Gly and Thr399Ile) were assayed by real-time PCR. Genomic DNA was amplified using FAM/VIC primers specific for allelic variants of TLR4 Asp299Gly and Thr399Ile with real-time PCR. Amplicons were analyzed with high-resolution melting on a Light Cycler 480 for detecting different melting patterns of polymorphic and wild-type alleles. RESULTS The number of the subjects with heterozygous mutation at genotype 299 (Asp299Gly) was significantly lower in the NAFLD than in the control group (23.8 vs. 10.9%, P=0.027). Logistic regression analysis revealed that female gender [odds ratio (OR)=2.984, 95% confidence interval (CI) 1.561-5.360, P=0.001] and heterozygous (Asp299Gly) mutation at codon 299 (OR=2.998, 95% CI 1.325-6.783, P=0.008) were the significant predictors of higher likelihood of TRL4 gene polymorphism-related prevention of NAFLD. CONCLUSIONS As the first-time-in-humans controlled study related to investigation of TLR4 gene polymorphism in NAFLD, our findings contribute to the available data that TLR-4 signaling is pivotal for the pathogenesis of NASH and indicate that the TLR4 codon 299 heterozygous gene mutation (Asp299Gly) in humans may have a preventive role against the genesis of NAFLD.
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Affiliation(s)
- Safak Kiziltas
- 1 Department of Gastroenterology, Goztepe Training and Research Hospital , Istanbul, Turkey
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20
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Ata P, Kara M, Özdemir E, Canbakan M, Gökçe AM, Bayraktar FA, Şahin G, Özel L, Titiz MI. Monitoring of CD3(+) T-cell count in patients receiving antithymocyte globulin induction after cadaveric renal transplantation. Transplant Proc 2013; 45:929-31. [PMID: 23622590 DOI: 10.1016/j.transproceed.2013.02.092] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIM Although antithymocyte globulin (ATG) has been used for years, its ideal dose and administration period is obscure. Herein, we sought to use the CD3(+) cell count to detect the optimal ATG dosage. MATERIAL AND METHODS Twenty-one patients who underwent cadaveric donor renal transplantation from January 2009 to January 2012 received a 1 mg/kg ATG initial dose at the time of the operation. Patients were randomized into 2 cohorts. Group 1 (n = 11) received ATG according to the clinical and total lymphocyte count and group 2 (n = 10), the dose was tailored according to the CD3(+) cell count. We compared the total and daily ATG dosages, ATG administration period, side effects of ATG, the number of days to a serum creatinine level <2 mg/dL, graft function at 3 months, acute rejection episodes, infection rates, costs of CD3(+) analysis, and ATG amounts. RESULTS Both groups showed similar gender, age, and human leukocyte antigen matching data. There was no difference in presensitizing events or panel-reactive antibody class 1 and 2 levels. The number of days to a serum creatinine level of <2 mg/dL was 11 ± 1.5 for group 1 versus 10.4 ± 0.8 for group 2 (P = .45). Between groups 1 and 2, there was a significant difference between the mean total (P = .031) and mean daily ATG dosages (P = .006). We used a total dose of 3800 mg ATG for group 1 and 2200 mg for group 2 and for the group 2 who underwent 43 CD3(+) cell counts. The expenditure per patient was 20% higher among group 1 than group 2. CONCLUSION Determination of appropriate ATG dosages by CD3(+) cell counts was useful, reliable, and cost effective.
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Affiliation(s)
- P Ata
- Department of Transplantation and 1st General Surgery, Haydarpasa Numune Hospital, Istanbul, Turkey.
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Ertugay OC, Ata P, Kalaycik Ertugay C, Kaya KS, Tatlipinar A, Kulekci S. Association of COL1A1 polymorphism in Turkish patients with otosclerosis. Am J Otolaryngol 2013; 34:403-6. [PMID: 23601588 DOI: 10.1016/j.amjoto.2013.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 02/03/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the role of COL1A1 gene polymorphism in the etiology of otosclerosis. MATERIAL AND METHODS Peripheric blood samples are obtained from 28 patients diagnosed with otosclerosis and 50 control subjects. DNA's of all samples are isolated and amplified by using the PCR technique. The products are restricted by appropriate enzymes and the allele distributions were compared. RESULTS SS (homozygous normal), Ss (heterozygous mutant) and ss (homozygous mutant) alleles of the otosclerotic and control subjects were significantly different from each other. CONCLUSION Otosclerosis is a disease with progressive hearing loss. There are viral, hormonal, immunologic and genetic hypothesis of etiology. In this study, we concluded that the polymorphism seen in the COL1A1 gene resulting in production of excessive type 1 collagen, could play a role in the pathogenesis of otosclerosis.
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Affiliation(s)
- Omer Cagatay Ertugay
- Zile State Hospital, Department of Otorhinolaryngology/Head and Neck Surgery, Tokat, Turkey.
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22
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Kara M, Demir F, Ata P, Ozel L, Gumrukcu G, Unal E, Canbakan M, Gucun M, Esadoglu V, Ozdemir E, Cemel H, Titiz MI. The impact of C4d staining as a humoral injury marker. Transplant Proc 2013; 44:1694-6. [PMID: 22841245 DOI: 10.1016/j.transproceed.2012.05.029] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Acute and chronic humoral injuries in renal transplant recipients are the main reasons for graft rejection and failure. Histological and clinical characteristics of humoral rejection and symptoms are variable and not always helpful for differential diagnosis. Clinical monitoring of the allograft, an elevated serum panel-reactive antibody (PRA), and the presence of donor-specific antibody (DSA) during immune monitoring as well as C4d staining of biopsy material can establish the differential diagnosis. Even without a cellular component, humoral rejection reaction is serious because the target tissue is the graft endothelium. Because the kidney graft has a rich vascular structure this attack causes permanent injury to the kidney in the long term. Graft dysfunction in this setting is usually more severe, requiring dialysis therapy, compared with acute cellular reactions. Positive C4d staining of peritubular capillaries in biopsy material represent a hallmark of complement-dependent cytotoxicity, supporting the diagnosis of humoral rejection. We analyzed C4d staining as a hallmark of humoral rejection. METHODS From 2009 to 2011, we analyzed the relationship between pathological findings of C4d immunohistochemistry staining and the clinical outcomes of 45 kidney transplant recipients who underwent a kidney biopsy because of graft dysfunction due to possible humoral rejection. RESULTS Biopsy specimens of 15 patients stained C4d positive; the remaining 30 showed negative results. Intravenous steroids, PP + IVIG with or without antithymocyte globulin (ATG), was administered for treatment. Sixty six percent (n = 10) of patients were C4d positive with 16% (n = 5) of those showing C4d-negative biopsy results, losing their grafts, and returning to hemodialysis. CONCLUSIONS C4d staining refractory humoral rejection injury was related to poor graft outcomes.
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Affiliation(s)
- M Kara
- First General Surgery, Transplantation and Genetics Units, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey.
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Ata P, Cetinkaya F, Ozgezer T, Ozel L, Tulunay A, Eksioglu E, Titiz MI. Flow cytometric detection of anti-AB antibody titers in blood group O recipients of blood group A2 donor kidneys. Transplant Proc 2013; 44:1706-9. [PMID: 22841249 DOI: 10.1016/j.transproceed.2012.05.051] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AIM ABO-incompatible kidney transplantation has been accepted for end-stage renal failure patients who have no ready opportunity for a deceased or living donor. Antibody titration for ABO-incompatible renal transplantation is not only difficult but also lacks conformity among laboratories. Herein we analyzed 20 living related renal transplant couples to detect recipient anti-A2 antibody using flow cytometric analysis. MATERIALS AND METHODS Patients were admitted to our center for renal transplantation between January 1999 and December 2010. All but four of them had undergone a previous renal transplantation from an ABO-compatible donor but experienced graft failure. All donor blood groups were subtyped by our blood bank using a lectin-based dilution assay. To detect recipient anti-A2 antibody titers we used a tube hemagglutination method. A/B antibody titer analysis by flow cytometry incubated serially diluted serum samples with donor erythrocytes. Each analysis was repeated three times over a 2-week period using an older and the last sera simultaneously. RESULTS The 13 male and 7 female patients showed our overall mean age of 32 ± 12 years. All patients had panel-reactive antibody levels below 15%. The level of flow cytometric antibody titers did not vary upon repeated analysis (P = .01). When compared with the tube method there was a discrepancy of the level at which the antibody titer became negative. DISCUSSION Flow cytometric antibody titration is a practical and rapid technique to determine the amount of anti-A2 antibody in renal recipients.
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Affiliation(s)
- P Ata
- Department of Molecular Genetics, Haydarpasa Numune Research and Training Hospital, Genetic Diseases Diagnosis Center, Turkey.
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Abstract
Inactivation of the klotho gene in mice causes serious systemic disorders, resembling human aging. However, at the molecular level, its action mechanisms are not well understood. The stimulatory or inhibitory effects of cis- and trans-regulatory factors on the klotho gene expression are also still unclear. We studied the effects of intra- and extracellular factors on human klotho gene expression. For this purpose, pHKP-Luc and pHKP-GFP reporter vectors were constructed with the 2.1-kbp upstream region of human klotho, covering its promoter region, using luciferase and GFP genes as the reporter. A series of vectors that have deletions in the upstream region of the klotho gene were constructed to assay cis-acting factors. Deletion of some parts of the klotho gene upstream region significantly affected reporter gene expression in HEK293 cells. p16 and p53 proteins inhibited reporter luciferase expression under the control of human klotho promoter in a dose-dependent manner. Calcium and phosphate ions stimulated klotho expression. p21, PTH, IGF-1, and angiotensin-II had no significant effect on klotho expression in HEK293 cells.
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Affiliation(s)
- K Turan
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Marmara University, Haydarpasa, Uskudar, Istanbul, Turkey.
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Ata P. [Recent status of fluoride research]. J Istanb Univ Fac Dent 1969; 3:127-35. [PMID: 5265427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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