Ahmet Godekmerdan

Serum IL-1beta, IL-6, IL-8, and TNF-alpha levels in early diagnosis and management of neonatal sepsis.

Aim. To determine serum IL-1β, IL-6, IL-8, and TNF-α levels in neonatal sepsis at the time of diagnosis and after therapy, and to show the meaningful on the follow up. Methods. This prospective study was performed on newborns who were hospitalized for neonatal sepsis and who were classified as culture-proven sepsis (n=12), as culture-negative sepsis (n=21), and as healthy newborns (n=17). Results. At the time of diagnosis, serum IL-1β, IL-6, IL-8, and TNF-α levels of culture-proven sepsis were significantly higher than those of the control groups (P<.05). At the time of diagnosis, IL-1β, IL-6, IL-8, and TNF-α levels of culture-proven sepsis and culture-negative sepsis were significantly higher than levels at the seventh day after antibiotic treatment. Conclusion. Serum IL-1β, IL-6, IL-8, and TNF-α are mediators of inflammation and can be used at the diagnosis and at the evaluation of the therapeutic efficiency in neonatal sepsis.

Protective effect of curcumin on immune system and body weight gain on rats intoxicated with 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD)

Background and aim: In this study, the negative effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the immune system and body weight gain of rats and the preventive effects of curcumin were examined. Material and methods: For this purpose, 128 3-4-month-old Wistar albino rats with 280-310 g body weights were used. The 2 μg/kg dose of 2,3,7,8-TCDD and 100 mg/kg dose of curcumin were dissolved in corn oil and orally given to the rats found in the experimental and control groups. Then, the serum samples were taken from all rats at 15, 30, 45 and 60 days to analyzed for the determination of TNF-α, IFN-γ, IL-12 and IL-13 levels by ELISA method. The data of body weight gain was measured at 15, 30, 45 and 60 days. Results: The results indicated that 2,3,7,8-TCDD caused a significant increase (p<0.05) in serum TNF-α level. However, it caused significant (p<0.05) decreases in the levels of IFN-γ, IL-12 and IL-13 in rats. On the contrary, curcumin increased IFN-γ, IL-12 and IL-13 levels, but decreased TNF-α level in rats. Additionally, TCDD caused significant (P<0.01) reductions in the body weight gain. However, curcumin reversed this effect of TCDD. Conclusion: 2,3,7,8-TCDD significantly suppressed the humoral immunity and body weight gain in rats at doses of 2μg/kg. However curcumin, which was found in some plants, eliminated the effect of TCDD on immune system and body weight when it was given together with 2,3,7,8-TCDD. It is thought that this effect may have occurred via curcumin and TCDD binding aryl hydrocarbon receptor (AhR) competitively.

Effects of raloxifene, hormone therapy, and soy isoflavone on serum high-sensitive C-reactive protein in postmenopausal women

Objective: To compare the effects of raloxifene, estradiol valerate plus dienogest, and soy isoflavones (genistein) on serum concentrations of high‐sensitive C‐reactive protein in healthy postmenopausal women. Methods: The 80 healthy postmenopausal women enrolled in the study were randomly allocated to receive 60 mg of raloxifene, 2 mg of estradiol valerate plus dienogest, 40 mg of genistein, or placebo (n = 20 in each group). Blood samples were collected at the start of the study and at 3 and 6 months. Lipid profile was also determined. Results: Only the group receiving estradiol valerate plus dienogest showed an increase in serum levels of high‐sensitive C‐reactive protein compared with baseline values and values in the control and other groups. All 3 treatments resulted in an increase in high‐density lipoprotein cholesterol levels and a decrease in total, low‐density, and very‐low‐density lipoprotein cholesterol levels. Conclusions: Estradiol valerate plus dienogest, but not raloxifene and genistein, increase serum high‐sensitive C‐reactive protein levels. All 3 treatments, however, have an estrogen‐like effect on serum lipid profile.

Serum cytokine levels in patients with acute brucellosis and their relation to the traditional inflammatory markers

The number of clinical studies on gamma interferon (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha) and interleukin-4 (IL-4) in human brucellosis is limited. The present study was focused on IFN-gamma, TNF-alpha and IL-4 levels in acute brucellosis cases, in the acute phase and at the end of the treatment. The relation of these cytokines to traditional inflammation markers was also investigated. The study included 27 cases of acute brucellosis and 20 healthy volunteers who had no complaints. It was found that mean IFN-gamma and TNF-alpha levels, CRP (C-reactive protein) levels and ESR (erythrocyte sedimentation rate) values were significantly higher in acute brucellosis cases as compared to post-treatment values and values measured in the control group. In addition, IFN-gamma and TNF-alpha levels measured in the acute phase correlated with the increase in CRP levels and ESR values. Our results confirmed that IFN-gamma and TNF-alpha are involved in the pathophysiology of brucellosis and are closely related to the inflammatory activation of the disease. In view of the present findings, it is suggested that IFN-gamma and TNFalpha may be used for monitoring brucellosis.

Th1 polarization of the immune response in uveitis in Behçet's disease

BACKGROUND It has been reported that abnormalities in the balance of T-helper cells type 1/2 (Th1/Th2) may account for the pathophysiology of human autoimmune diseases. The purpose of this study was to define the role of the Th1/Th2 balance in the pathogenesis of uveitis in Behçets disease (BD). METHODS From February 2003 to August 2005, we studied 31 patients with active BD. Of these patients, 21 (12 female, 9 male; mean age 35.5 [SD 10] years) presented with acute uveitis, and 10 (7 female, 3 male; mean age 34 [SD 11] years) presented with inflammatory arthritis but no prior uveitis attack. The control group consisted of 10 (7 female, 3 male; mean age 34.7 [SD 8] years) age-matched, healthy individuals. CD4+ CD26+ and CD4+ CD30+ cell surface expression of the peripheral blood CD4+ T lymphocytes was evaluated by analytic flow cytometry in order to determine percentages of Th1 and Th2 lymphocyte subsets. RESULTS The mean percentage of CD4+ CD26+ and CD4+ CD30+ cells was 26.27 (SD 6.18) % and 2.56 (SD 0.82) %, 17.42 (SD 5.90) % and 2.86 (SD 0.72) %, and 14.99 (SD 3.96) % and 3.11 (SD 1.25) % in BD with active uveitis, BD with inflammatory arthritis but no prior uveitis attack, and control groups, respectively. T-helper 1 (Th1) cell percentage was significantly higher in the BD with active uveitis group than the BD with arthritis and no prior uveitis attack group (p = 0.001). With respect to the percentage of CD30+ Th2 cells, there was no statistical difference between the 2 BD groups (p = 0.529) or among the 3 groups (p = 0.375). INTERPRETATION Th1 lymphocyte dominance in peripheral circulating blood may play a role in the pathogenesis of BD uveitis.

Evaluation of long-term impacts of tonsillectomy on immune functions of children : A follow-up study

OBJECTIVE The purpose of this follow-up study was to investigate the long-term effects of tonsillectomy in comparison with their short-term results. PATIENTS AND METHODS We successfully retrieved 20 out of our previously reported 37 patients who underwent tonsillectomy in our clinic 54 months ago. The blood levels of CD3+, CD4+, CD8+, CD19+, CD25+ and CD16++56+ (cellular immunity), and IgG, IgA, IgM, C3 and C4 (humoral immunity) were determined and compared with their previously reported short-term respective values. RESULTS There were no statistically significant differences between the short-term (1 month) and long-term (54 months) values of IgA, IgG, IgM and C4 levels of the patients (P>0.05). There was a slight but statistically significant decrease in complement factor C3 value compared to its the early-stage value (P<0.05) but this was not significantly different from age-matched healthy controls (P>0.05). The levels of CD4+ and CD19+ were higher and the levels of CD16++56+ and CD25+ were lower in the late-stage (54 months) compared to their early-stage values (P<0.05). When the long-term immune parameters of the tonsillectomized patients were compared with aged-match healthy controls, there were no significant differences between the levels of immunoglobulins, complements and lymphocytes (IgA, IgG, IgM, C3, C4, CD3+, CD4+, CD8+, CD19+, CD25+, CD16++56+) (P>0.05). CONCLUSION The results of this long-term follow-up study indicate that tonsillectomy do not compromise the immune functions of children as humoral and cellular immunity of patients recovered compared to their early-stage immune status (1 month), as they have similar immune capacity compared to their age-matched healthy controls at both early- and late-stages. Although a small sample of patients enrolled, our results are of importance with respect to the reassuring in settling the widely held urban myth that tonsillectomy compromises life long immunity.

Use of Phototherapy for Neonatal Hyperbilirubinemia Affects Cytokine Production and Lymphocyte Subsets

Background: Most studies regarding the influence of ultraviolet radiation on levels of inflammatory cytokines were conducted mainly in cultures of human keratinocytes or in laboratory animals. Few studies were also performed in human subjects. Objectives: To investigate the influence of the use of phototherapy on the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8 such as cytokines expressed from keratinocytes and on the expression of some lymphocyte subsets in the prevention or treatment of neonatal hyperbilirubinemia. Methods: The study group included 21 term newborns with hyperbilirubinemia and the control group included 16 healthy term newborns. Blood samples were obtained from hyperbilirubinemic newborns before and at 72 h of exposure to phototherapy and from controls at the examination time. The levels of TNF-α, IL-1β, IL-6, IL-8 and lymphocyte subsets were measured in the samples using appropriate methods. Results: Serum TNF-α, IL-1β, IL-6, and IL-8 levels are similar in study and control groups. At 72 h of exposure to phototherapy serum TNF-α, IL-1β and IL-8 levels are significantly increased, while the serum IL-6 level at the same time is not significantly changed. Lymphocytes, lymphocyte subsets and white blood cell levels are similar in the study and control groups. Only, the percentage of CD3+ lymphocyte subset is significantly lower in newborns at 72 h of exposure to phototherapy. All other lymphocyte subsets are decreased by the exposure to phototherapy, and this change was not statistically significant. Conclusions: The results demonstrate that in addition to the well-known positive effect of phototherapy on the neonatal serum bilirubin level, this treatment can affect the function of the immune system in newborns via alterations in cytokine production.

The differential diagnostic values of cytokine levels in pleural effusions.

The aim is to examine whether the changes in pleural fluid interleukin (IL)-1β, IL-2, IL-6, and IL-8 levels were significant in differential diagnosis of childhood pleural effusions. IL-1β, IL-2, IL-6, and IL-8 levels in pleural fluids of all 36 patients were measured. The levels of IL-1β, IL-2, IL-6, and IL-8 in pleural fluids were statistically significantly higher in the transudate group compared with those of the exudate group. The levels of IL-1β, IL-6, and IL-8 were also found to be statistically significantly higher in the empyema group compared with both the parapneumonic and the tuberculous pleural effusion groups. The levels of IL-2 and IL-6 were detected to be statistically significantly higher in the tuberculous pleural effusion group in comparison with those of the parapneumonic effusion group. The results showed that pleural fluids IL-1β, IL-2, IL-6, and IL-8 could be used in pleural fluids exudate and transudate distinction.

Ménière’s disease and allergy: allergens and cytokines

The aim of this article is to evaluate the role of allergy in the pathogenesis of Menieres disease by means of cytokine profiles, allergic parameters and lymphocyte subgroups. A total of 46 patients aged between 26-68 years diagnosed with Menieres disease between 1993-2002 were recruited to this study. The control group consisted of 46 healthy volunteers who were from the same age group, living in the same region and possessing similar socioeconomic indicators. Lymphocyte subgroups were measured from the peripheral blood by employing Becton Dickinson (BD) monoclonal CD4, CD8, CD23 antibodies. IFN-gamma, IL4, total IgE levels, and specific IgE levels pertaining to tree, fungus, fruit, egg-white, cows milk, wheat flour, corn flour, beef, and rice allergens, in all seasons, were measured and compared in the patient and control groups. In patient serum samples there were positive correlations between CD23 and IgE, CD8 and IgE, CD4/CD8 and IgE, and CD23 and CD8 (p <0.01). There were negative correlations between IL-4 and IFN-gamma, IFN-gamma and IgE, and a positive correlation between IL-4 and IgE. Total IgE levels were above the normal values in 19/46 (41.3 per cent) of the patient group, but the ratio was nine out of 46 (19.5 per cent) in the control group. A history of allergy was found in 31/46 (67.3 per cent) when the patients were questioned. The ratio of a history of allergy was 16/46 (34.7 per cent) in the control group. When specific IgE levels were evaluated the ratio of patients with all the panels negative was eight out of 46 (17.9 per cent), but it was 31/46 (67.3 per cent) in the control group. This study found that the prevalence of allergy was higher in patients with Menieres disease than in the control group. Thus the authors suggest that allergy should be taken into account when patients with this disease are treated.

Plasma IL-17, IL-35, interferon-γ, SOCS3 and TGF-β levels in pregnant women with preeclampsia, and their relation with severity of disease

Abstract Objective: To research the hypothesis of preeclampsia (PE) is associated with increased systemic inflammatory responses of Th1-type as well as decreased Th2-type responses; we evaluated the maternal plasma levels of IFN-gamma, TNF-alpha, TGF-beta, IL-4, IL-6, IL-10, IL-17, IL-35 and SOCS3 in preeclamptic and healthy pregnants. Methods: This study was conducted with 40 preeclamptic (study group) and 40 normotensive pregnant (control) women in third trimester when they were admitted to the labor and delivery unit. The extracted maternal plasma samples were assayed by an enzyme-linked immunosorbent assay. Statistical analysis was performed by SPSS 16.0 version. Results: While IFN-gamma and TGF-beta levels of preeclamptic women were significantly higher (p < 0.01), IL-35 and IL-17 levels of preeclamptic women were significantly lower (p < 0.01) than those of controls. The ratios of IFN-gamma/IL-10, IFN-gamma/IL-6, IFN-gamma/IL-4 were significantly high and ratio of IL-35/IL-17 was significantly low in the PE group compared to those in the control group. Maternal plasma SOCS3 levels showed negative correlation with blood pressure and proteinuria severity, but none of the cytokines showed influence on blood pressure and proteinuria after adjusting for maternal and gestational age. Conclusions: Increased IFN-gamma/TGF-beta production and reduced IL-35/IL-17/SOCS3 production in preeclamptic women may lead to less cytokine inhibitory activity in PE, which may account for the increased proteinuria and blood pressure in PE.