Browsing by Author "Turkeli, A"

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    Influence of VEGF and TNF antagonism on zonula occludens proteins in an experimental asthma model
    Yuksel, H; Yilmaz, O; Karaman, M; Firinci, F; Turkeli, A; Kanik, ET; Inan, S
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    Changes in epithelial barrier components E-cadherin, Beta-catenin, EGR with steroid treatment in murine model of asthma
    Yuksel, H; Yilmaz, O; Karaman, M; Firinci, F; Turkeli, A; Kanik, ET; Inan, S
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    Effects of vitamin D levels on asthma control and severity in pre-school children
    Turkeli, A; Ayaz, O; Uncu, A; Ozhan, B; Bas, VN; Tufan, AK; Yilmaz, O; Yuksel, H
    OBJECTIVE: Prevalence of asthma and vitamin D deficiency has been increasing and leading to significant morbidities. This study aimed to compare the vitamin D levels in the pre-school children with asthma and in healthy controls and to assess the relationship between vitamin D levels and asthma clinical parameters and control. PATIENTS AND METHODS: Vitamin D [25(OH) D 3] levels were measured in 102 preschool children, aged 1-4 years with asthma and 102 healthy controls in winter. The patients with asthma were grouped according to serum vitamin D levels as sufficient, insufficient and deficient. Asthma control was classified according to the Global Initiative for Asthma (GINA) guidelines and the Test for Respiratory and Asthma Control in Kids (TRACK) in 1-4 years-old children. RESULTS: Serum vitamin D levels were 22.64 (9.96) ng/ml in the asthma group and 32.11 (14.74) ng/ml in the control group (p = 0.001). Total number of exacerbations during the previous year were significantly lower in the vitamin D sufficient group, compared to the deficient and insufficient groups (p = 0.03). Frequency of patients with controlled asthma was higher in the sufficient group compared to the deficient and insufficient groups (p = 0.001 and p = 0.001, respectively). There was a positive correlation between serum vitamin D levels and asthma control. CONCLUSIONS: The frequency of vitamin D deficiency and insufficiency was higher in children with asthma, compared to the controls. Therefore, we suggest that lower levels of vitamin D are associated with poor asthma control and increased asthma severity.
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    Sensitization to food allergens is associated with more severe wheezing in children
    Yilmaz, O; Patino, CM; Taneli, F; Kanik, ET; Turkeli, A; Gozukara, C; Irmak, S; Yuksel, H
    Aims: We investigated sensitization to food allergens as a prognostic factor for wheezing in children with recurrent wheezing and compared serum club cell 16 (CC16) and surfactant protein D (SP-D) among these children with and without sensitization to food allergens. Materials and methods: Children with recurrent wheezing were enrolled in this prospective cohort study. Specific IgE to five common food allergens (Fx5) was assessed at baseline, and children were followed-up for 1 year for new-onset wheezing episodes. Baseline wheezing severity score, CC16, and SP-D levels were measured. Results: We enrolled 295 children (44 Fx5(+)). Poisson regression analysis revealed that Fx5 positivity changed the yearly frequency of wheeze by a factor of 1.66 (p = 0.05, 95% CI: (0.99 - 2.75)). Levels of CC16 and SP-D were not significantly different between the groups (p = 0.679 and p = 0.988). Conclusion: Sensitization to food allergens irrespective of food associated clinical allergy findings is associated with worse prognosis of wheezing in children.
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    Defective epithelial barrier function related to zonula occludens proteins of nasal mucosa in subjects with atopy
    Yilmaz, O; Inan, S; Pinar, E; Turkeli, A; Turkoz, E; Kanik, ET; Yuksel, H
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    Role Of Vascular Endothelial Growth Factor Antagonism On Airway Remodelling In Asthma
    Yuksel, H; Yilmaz, O; Karaman, M; Bagriyanik, AH; Firinci, F; Kiray, M; Turkeli, A; Karaman, O
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    Changes in epithelial barrier components E-cadherin, beta-catenin, EGF with steroid treatment in murine model
    Yuksel, H; Yilmaz, O; Karaman, M; Firinci, F; Turkeli, A; Kanik, E; Inan, S
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    Vascular endothelial growth factor antagonism restores epithelial barrier dysfunction via affecting zonula occludens proteins
    Yuksel, H; Yilmaz, O; Karaman, M; Firinci, F; Turkeli, A; Kanik, ET; Inan, S
    Epithelial barrier dysfunction is important in the pathogenesis of asthma and allergic responses, and is therefore a therapeutic target. The aim of the present study was to investigate the effects of dexamethasone, a classic therapeutic agent, an anti-tumor necrosis factor agent (etanercept), which is used to treat difficult cases of asthma, and an anti-vascular endothelial growth factor (VEGF) agent (bevacizumab), which is an angiogenesis inhibitor, on zonula occludens (ZO) proteins in an experimental asthma model. The experimental model of asthma was developed using intraperitoneal (IP) and inhaled administration of ovalbumin in 38 BALB/c mice, which were divided into four groups. The control group (n=6) did not receive any treatment, while the four remaining groups (n=8 per group) received an IP injection of saline, etanercept, bevacizumab or dexamethasone, respectively. Occludin, claudin and junctional adhesion molecule (JAM) were immunohistochemically stained in the left middle lobe samples using an indirect avidin-peroxidase method, after which the staining was semiquantified with H-scores. Statistically significant differences were observed in the occludin, claudin and JAM H-scores among the four groups (P<0.001). In the untreated asthma, etanercept, bevacizumab and dexamethasone groups, the median H-scores for occludin were 93, 177, 280 and 198, respectively, while the H-scores for claudin were 82, 193.5, 274 and 202.5, respectively, and the median H-scores for JAM were 130, 210, 288 and 210, respectively. Pairwise comparisons revealed that all three ZO protein H-scores were significantly lower in the saline group when compared with each treatment group. However, the H-scores of the ZO proteins were not significantly different between the etanercept and dexamethasone groups. Furthermore, the bevacizumab group exhibited higher H-scores for all the proteins compared with the dexamethasone group. Therefore, antagonism of VEGF with bevacizumab restores the epithelial barrier to a greater extent when compared with dexamethasone treatment. This result may be promising for the development of novel therapeutic agents.
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    Effects of Vitamin D Levels on Asthma Control and Severity in Children
    Turkeli, A; Ayaz, O; Uncu, A; Özhan, B; Kavaz Tufan, A; Bas, VN; Yilmaz, Ö; Yüksel, H
    Objective: The prevalence rates of asthma and vitamin D deficiency have been increasing in parallel, leading to significant morbidity. This study aimed to compare the vitamin D levels in the children with asthma and in healthy controls and to assess the relationship between vitamin D levels and asthma clinical parameters and control. Materials and Methods: 115 children with asthma and 115 controls who presented to the Pediatric Immunology and Allergy outpatient clinic between December 2014 and February 2015 were enrolled in the study. Vitamin D levels were measured. Levels = 20 ng/ml were considered adequate and those lower than 20 ng/ml as deficient. Asthma control was classified according to the Global Initiative for Asthma guidelines (GINA) and Childhood asthma control test (C-ACT). Results: Serum vitamin D levels were 17.27 (5.77) ng/ml in the asthma group and 22.78 (10.64) ng/ml in the control group, indicating statistical significance (p= 0.001). When the asthma patients were divided into groups according to vitamin D level, 72.2% were deficient while 27.8% had adequate levels. The number of asthma exacerbations, number of emergency service visits and the number of hospitalizations within the last year were higher in the deficient group, compared to the adequate group (p < 0.001, p 0.001 and p < 0.002, respectively). Uncontrolled asthma rates were higher in the deficient group, compared to the adequate group (p < 0.01). Serum vitamin D levels were correlated with the ACT score (r= 0.204, p= 0.03). Conclusion: The rate of vitamin D deficiency was higher in asthmatic children compared to the controls. We also showed that increased asthma severity and reduced asthma control were associated with vitamin D deficiency. There was a positive correlation between serum vitamin D levels and asthma control.
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    Food Allergen Sensitivity As A Prognostic Factor For Wheezing In Children
    Yilmaz, O; Taneli, F; Kanik, ET; Turkeli, A; Gozukara, C; Yuksel, H
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    Predictive Value of the TRACK Questionnaire as a Measure of Asthma Control in Preschool Aged Children
    Yilmaz, O; Turkeli, A; Sahin, S; Yuksel, H
    Assessment of asthma control in preschool children is important for therapeutic decisions. Aim of this study was to evaluate the predictive value of TRACK questionnaire scores for subsequent clinical parameters and to investigate the validity and reliability of the Turkish version of the TRACK questionnaire. We enrolled 100 children with asthma aged 4 years or younger in this cohort study. We recorded sociodemographic characteristics and clinical severity parameters. A pediatric allergist filled in the asthma severity scale and the caregiver of the child filled in the TRACK questionnaire. We called in the children again at the end of one month and recorded the same parameters and administered TRACK again. Uncontrolled asthma was defined as a TRACK score below 80. According to the TRACK score, 65% of the children had controlled asthma initially while at the end of the study 64.1% had controlled asthma. At the beginning of the study, all clinical parameters were worse in children with uncontrolled asthma according to TRACK score. Similarly, other objective clinical parameters during the following one month period were worse in children with initial uncontrolled asthma. Cronbach's alpha score for the TRACK questionnaire was 0.84. Turkish TRACK questionnaire is a valid and reliable tool that is predictive of short term asthma prognosis.
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    Clinical characteristics and prognosis of respiratory viral agents in hospitalized children during one Year period
    Toprak, E; Yilmaz, O; Turkeli, A; Borucu, T; Sanlidag, T; Yuksel, H
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    E-cadherin as an epithelial barrier protein in exhaled breath condensate
    Yuksel, H; Turkeli, A; Taneli, F; Horasan, GD; Kanik, ET; Kizilkaya, M; Gozukara, C; Yilmaz, O
    Airway epithelium plays an important role as a physical barrier and a modulator of allergic response. Junctions between cells provide epithelial integrity and barrier function. The aim of this study was to investigate the influence of atopy on airway epithelial integrity in asthma and to measure E-cadherin levels in exhaled breath condensate as an indicator epithelial damage. A total of 74 patients with asthma (35 atopic and 39 non-atopic) and 39 healthy children were enrolled in this case-control study. Sociodemographic characteristics and asthma severity parameters in the last three-month period were recorded and pulmonary function tests were performed. Blood samples were obtained to measure serum immunoglobulin E (IgE) levels and peripheral blood eosinophil count, and exhaled breath condensate (EBC) was obtained to measure E-cadherin. EBC E-cadherin levels were significantly lower in the asthmatics when compared to non-atopic controls (0.109 (0.076) versus 0.191 (0.184) ng mL(-1) respectively, p = 0.01). Atopic and non-atopic asthmatic groups had lower EBC E-cadherin levels compared to the control group. (0.112 (0.060) ng ml(-1), 0.106 (0.089) ng ml(-1) and 0.191 (0.184) ng ml(-1), p = 0.02 and p < 0.01 respectively). However, EBC E-cadherin levels were not different between atopic and nonatopic asthmatics. The results of our study support the role of E-cadherin in the pathogenesis of asthma. However, the absence of difference in E-cadherin levels between atopic and non-atopic asthmatics suggests that allergic sensitization is not the primary factor for development of epithelial barrier dysfunction in asthma.
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    Low Mononuclear Cell IL-18 and IL-27 Response in Children: Susceptibility to Tuberculosis Infection after Contact
    Karabacak, HA; Yilmaz, O; Tuglu, I; Taneli, F; Surucuoglu, S; Kanik, ET; Ozkutuk, N; Gozukara, C; Ozkut, MM; Turkeli, A; Yuksel, H
    Background Identification of the immune response against tuberculosis is vital to develop new diagnostic and therapeutic modalities. The objective of this study was to determine IL (interleukin)-18 and IL-27 responses of peripheral blood mononuclear cells to early secreted antigen (ESAT-6) and culture filtrate protein-10 (CFP-10) stimulation in children with a (+) or (-) tuberculin skin test (TST) with in-house tuberculosis contact. Methods We enrolled 40 children aged 1 to 5 years who had an in-house contact with a tuberculous adult. Blood samples were obtained from all children for QuantiFERON tuberculosis (TB) gold in tube (QFT-GIT), and peripheral blood mononuclear blood cell culture tests. The subjects were grouped as TST (-) QFT-GIT (-), TST (+) QFT-GIT (-), and TST (+) QFT-GIT (+). Supernatant of peripheral blood mononuclear cell culture was separated with and without stimulation of ESAT-6 and CFP-10, and IL-18 and IL-27 levels were measured with enzyme linked immunoassay (ELISA) test. Results The study group included 22 boys and 18 girls with mean age 4.25 +/- 0.9 years. IL-18 and IL-27 levels were statistically significant in ESAT-6/CFP-10-stimulated supernatants of peripheral blood mononuclear cell (PBMC) samples among the three groups (p = 0.000,p = 0.007, respectively). IL-18 levels between the TST (-) QFT-GIT (-) and TST (+) QFT-GIT (+) groups were significantly different (p = 0.026). Both IL-18 and IL-27 levels were significantly different between ESAT-6/CFP-10 stimulated PBMC supernatants of TST (-) QFT-GIT (-) and TST (+) QFT-GIT (-) groups (p = 0.000,p = 0.003, respectively). Conclusion Low IL-18 and IL-27 responses of peripheral blood mononuclear cells in children with Bacillus Calmette-Guerin (BCG) vaccine may play a role inMycobacterium tuberculosisinfection after in-house contact.
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    Influence Of Second Hand Smoke On Nasal Anti-Oxidant Levels In Wheezy Children
    Yilmaz, O; Turkeli, A; Onur, E; Bilge, S; Yuksel, H
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    Atopy may result in more severe airway damage independent of the inflammatory cell type in pediatric asthma
    Turkeli, A; Yilmaz, O; Taneli, F; Horasan, GD; Kanik, ET; Kizilkaya, M; Gozukara, C; Yuksel, H
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    Peripheral mononuclear cell response to nonspecific antigenic stimulation in children with obese asthma phenotype
    Yuksel, H; Yilmaz, O; Vatansever, S; Onur, E; Kirmaz, C; Nal, E; Turkeli, A; Bozyigit, F
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    E-cadherin as an epithelial barrier protein: relation to atopy in children with asthma
    Turkeli, A; Yilmaz, O; Taneli, F; Horasan, GD; Kanik, ET; Kizilkaya, MH; Gozukara, C; Yuksel, H