Ali K. Adiloglu

The role of helper and regulatory T cells in the pathogenesis of vitiligo

BACKGROUND Alterations in cellular immunity, including CD4(+) T and CD8(+) T lymphocytes, have been proposed in the pathogenesis of vitiligo. There is also a proposed role for cytokines in the depigmentation observed in vitiligo. However, previous reports on the role of cytokines in the pathogenesis of vitiligo have been few in number. OBJECTIVE The purpose of this investigation was to assess the role of the major cytokines produced by T-helper 1 and 2 cells as well as T-helper 17 and regulatory T cells in the pathogenesis of vitiligo. METHODS Forty patients with vitiligo and 40 age- and sex-matched healthy control subjects were enrolled in the study. Serum interleukin (IL)-4, IL-6, IL-10, IL-17, interferon-gamma, tumor necrosis factor-beta, and transforming growth factor-beta levels were detected by enzyme-linked immunosorbent assay in both groups. The correlations of serum cytokine levels with age of onset, sex, duration of disease, type and activity of vitiligo, percentage of involved body area, Koebner positivity, family history, and the presence of associated autoimmune diseases were assessed. RESULTS Serum transforming growth factor-beta levels were significantly decreased in the vitiligo group compared with the control group (P = .004). No difference was detected between the patient and control groups in mean levels of serum IL-6, IL-10, and tumor necrosis factor-beta. In the patients with vitiligo, serum IL-17 levels were positively correlated with the extent of body area involvement (rho = 0.329, P = .038). LIMITATIONS Tissue cytokines compared with those in the peripheral blood were not measured. CONCLUSION Although multiple factors have been implicated in the pathogenesis of vitiligo, reduced serum transforming growth factor-beta levels, as observed in patients in the current investigation, may contribute to enhanced cellular immunity. This may facilitate the occurrence of vitiligo by leading to diminished maturation of regulatory T cells, followed by impaired inhibition of inflammation.

Evaluation of serum sCD40L and homocysteine levels with subclinical atherosclerosis indicators in patients with psoriasis: a pilot study

Psoriasis is a chronic inflammatory process associated with an increased risk of cardiovascular risk factors. sCD40L has been suggested to have a possible role in the pathogenesis, of psoriasis and is known to be associated with inflammation, atherogenesis and cardiovascular events. This study investigated cardiovascular risk factors (sCD40L and homocysteine) as well as subclinical atherosclerosis indicators in psoriatic patients and control subjects. The study included 56 consecutive patients with chronic plaque‐type psoriasis and 53 age and gender matched healthy controls admitted to a university hospital. Serum sCD40L and homocysteine levels were measured by ELISA. Carotid artery intima‐media thickness and brachial artery flow mediated dilatation (FMD) measurements were determined ultrasonographically. Subjects who had a history of cardiovascular diseases and cardiovascular risk factors and receiving any systemic treatment were excluded from the study. Plasma sCD40L levels were significantly higher in psoriasis patients compared with healthy controls (1.33 ± 0.72 vs. 0.98 ± 0.70 ng/ml P = 0.012), whereas plasma homocysteine levels did not differ significantly between the two groups. FMD was significantly reduced in the psoriasis group compared to the controls (3.83 ± 5.03 vs. 8.45 ± 7.27% P = 0.0001). Multiple linear regression analyses indicated a significant association between psoriasis, sCD40L, and FMD. Psoriatic patients had higher sCD40L levels than healthy controls, which may lead to an increase in cardiovascular diseases. sCD40L may be a more reliable and early predictive marker of cardiovascular events in psoriatic patients. New treatment options that will be developed over sCD40L will benefit in prevention of psoriasis and its cardiovascular comorbidities.

Microbiological Evaluation of Octenidine Dihydrochloride Mouth Rinse after 5 Days' Use in Orthodontic Patients

OBJECTIVE To determine the absolute and relative antibacterial activity of octenidine dihydrochloride (OCT) against total and cariogenic bacteria in saliva samples of patients with fixed orthodontic appliances during 5 days of usage. MATERIALS AND METHODS The study group consisted of 5 male and 13 female subjects who were selected from patients in the Clinic of Orthodontics. Each patient was given physiologic saline (PS), chlorhexidine gluconate (CHX), polyvinylpyrrolidone-iodine complex (PVP-I), and OCT every morning for 5 days, each separated by a 2-week interval. Total and cariogenic bacteria in saliva samples of orthodontically treated patients with fixed appliances were collected during 5 days of usage. Unstimulated saliva was collected as a baseline sample. Saliva samples were collected at 15 minutes, and on the second, third, and fifth day after rinsing the mouth with any of the solutions for 30 seconds, and bacterial counts were detected. RESULTS OCT showed an ultimate reduction of total viable oral bacteria, Lactobacillus species, and Streptococcus mutans in vivo. OCT also had a significantly greater inhibitory effect than 0.2% CHX and 7.5% PVP-I, from the beginning of the study until the fifth day after the orthodontic appliances were bonded (P < .1). CONCLUSIONS OCT compared favorably with respect to CHX and PVP-I complex in orthodontically treated patients with fixed appliances (P </= .1).

Short-term relative antibacterial effect of octenidine dihydrochloride on the oral microflora in orthodontically treated patients.

OBJECTIVE To evaluate the efficacy of common antiseptic mouth rinses and octenidine dihydrochloride (OCT). METHODS The antibacterial activities of antiseptics against total and cariogenic bacteria (Streptococcus mutans and Lactobacillus species) in saliva were studied in vitro and in vivo. After unstimulated saliva was collected, one of the mouth rinse solutions was applied for 30seconds. Saliva samples were collected 15, 30, 60, and 120min later and evaluated for their bacterial count. RESULTS OCT had a significantly greater inhibitory effect on the studied bacteria than 0.2% chlorhexidine gluconate (CHX) and 7.5% polyvinylpyrrolidone-iodine complex (PVP-I) from 15min to 120min following the application (p<0.01). The antiseptic efficacy of 0.2% CHX on total bacteria and Lactobacillus species was very similar to the efficacy observed with 7.5% PVP-I mouth solution from 15min up to 120min. Streptococcus mutans was completely inhibited by 0.15mg/ml PVP-I, 0.5mg/ml CHX, and 0.1mg/ml OCT concentrations, while Streptococcus salivarius was inhibited by 0.15mg/ml PVP-I, 2mg/ml CHX, and 0.8mg/ml OCT concentrations. Lactococcus lactis subspecies lactis was inhibited with 0.00313mg/ml OCT, 30mg/ml PVP-I, and 0.0063mg/ml CHX concentrations. CONCLUSIONS OCT compared favorably with CHX and PVP-I in its antibacterial effects, both in vitro and in vivo (p<0.01).

Evaluation of activatory and inhibitory natural killer cell receptors in non-segmental vitiligo: a flow cytometric study

Background  Recent observations established the role of altered cellular immunity and autoimmune hypothesis in the pathogenesis of vitiligo. There have been several reports discussing T‐cell and natural killer (NK) cell populations, but NK cell receptors were not evaluated in vitiligo.

UREAPLASMA UREALYTICUM: THEPRESENCE AMONG SEXUALLY TRANSMITTED DISEASES.

The aim of this study was to detect the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Trichomonas vaginalis, and Ureaplasma urealyticum in genital specimens of symptomatic patients. This study also examined the role of U. urealyticum in infections of the lower genital tract. Cervical and urethral samples from 96 patients (46 males, 50 females) were tested using the Seeplex(®) STD6 ACE kit. Consent forms were received and a questionnaire was applied. All statistical analyses were performed using the SPSS statistical software program (version 17.0). Among the samples tested, at least 1 pathogen was detected in 49% of the samples; specifically, the rate of detection of U. urealyticum, M. hominis, C. trachomatis, N. gonorrhoeae, M. genitalium, and T. vaginalis was 29.1%, 10.4%, 8.3%, 7.3%, 6.3%, and 4.2%, respectively. U. urealyticum was detected as the sole pathogen in samples from 10% of female patients and 28.3% of male patients (p = 0.035). U. urealyticum was present in 54.5% (18/33) of samples in which a single pathogen was detected and 71.4% (10/14) of samples in which multiple pathogens were detected. Among men, significant differences in discharge, dysuria, and pruritus were not noted among those with negative results (84.6%, 69.2%, and 38.5%, respectively), among those positive for only U. urealyticum (100%, 66.7%, and 26.7%, respectively), and those positive for N. gonorrhoeae, C. trachomatis, M. genitalium, and T. vaginalis (100%, 93.3%, and 26.7%, respectively). Detection of U. urealyticum, either alone or together with other pathogens, in a symptomatic group of patients is an important finding, particularly in men.

Is gastroesophageal reflux contribute to the development chronic cough by triggering pulmonary fibrosis.

BACKGROUND/AIMS Previous studies have shown that the prevalence of abnormal acid reflux in fibrotic lung disease patients is high, and in particular, patients with secondary pulmonary fibrosis show higher esophageal acid exposure than normal controls. There are also some findings that, in patients with pathological reflux, pulmonary fibrosis may develop. The aim of this study is to investigate if pulmonary fibrosis is involved in the pathogenesis of chronic cough due to Gastroesophageal Reflux. MATERIALS AND METHODS A prospective study was performed in twenty-one patients with chronic cough due to gastroesophageal reflux who was diagnosed as reflux esophagitis by upper gastrointestinal endoscopy, histology, and in ten healthy controls without GER or any lung disease. All participitants underwent laryngoscopic examination and gastroesophageal scintigraphy with late lung imaging. Bronchoalveolar lavage fluid total and differential cell counts, T and B cell subsets, and the concentrations of IL- 1β and TNF-α were measured. RESULTS Reflux extending into the proximal esophagus was noted in 52.5%, and posterior laryngitis was present in 90.5% of the patients. No evidence of pulmonary aspiration was noted in the patients with reflux on scintigraphic examination. No significant difference was found between the GER and control groups in terms of cellular content, IL-1β and TNF-α levels or mean T cell subsets and B cell counts in bronchoalveolar lavage fluid. Forced expiratory volume in one second, forced vital capacity FEV1/FVC, total lung capacity, and carbon monoxide diffusion capacity values were within normal limits in the gastroesophageal reflux group. CONCLUSION Our findings do not support the hypothesis that gastroesophageal reflux leads to chronic cough by triggering alveolar epithelial injury and subsequent pulmonary fibrosis.

The Effect of N ω-Nitro- l -Arginine Methyl Ester and l -Arginine on Lung Injury Induced by Abdominal Aortic Occlusion–Reperfusion

PurposeThe aim of this study was to examine the effects of Nω-nitro-l-arginine methyl ester (l-NAME) and l-arginine on lung injury after aortic ischemia–reperfusion (IR).MethodsTwenty-four Wistar-Albino rats were randomized into four groups (n = 6) as follows: Control (sham laparotomy), Aortic IR (30 min ischemia and 120 min reperfusion), l-Arginine (intraperitoneal 100 mg kg−1 live weight)+aortic IR, and l-NAME (intraperitoneal 10 mg kg−1 live weight)+aortic IR. In the lung specimens, the tissue levels of malondialdehyde (MDA), vascular endothelial growth factor (VEGF), and nitric oxide (NO) were measured and a histological examination was done.ResultsAortic IR increased MDA, VEGF, and NO. l-Arginine further significantly increased MDA and NO, and decreased VEGF (P < 0.05 vs aortic IR). l-NAME significantly decreased MDA and NO (P < 0.05 vs l-arginine+aortic IR) and increased VEGF (P < 0.05 vs other groups). A histological examination showed the aortic IR to significantly increase (P < 0.05 vs control) while l-arginine also further increased (P > 0.05 vs aortic IR), whereas l-NAME caused a significant decrease in pulmonary leukocyte infiltration (P < 0.05 vs aortic IR).ConclusionsOur results indicate that l-arginine aggravates the lung injury induced by aortic IR, while l-NAME attenuates it.

Inspection of Turkish Baths (Hamams) with Regard to Public Health

This study was carried out to evaluate the physical structure and state of hygiene of nine Turkish baths in three provinces, Isparta, Burdur and Afyon, located in the northwest Mediterranean region called the Lake District. The physical conditions of the hamam were assessed according to Article 23922 in Turkish Law which outlines the rules for setting up hamams. A new hygiene assessment form was prepared specifically for the hamams by the public health practitioners in our university department. All the hamams investigated had an appropriate physical structure, although no regular inspections were made. Most of them had been restored and re-structured because of earthquake damage and other reasons. Most of microbiological samples taken from the hamams produced Staphylococcusspp., E. coli and other enteric flora species. No yeast cells were isolated from these samples. No bacterial growth was observed on the water samples although the water sample taken from a swimming pool produced E. coli, enteric flora species and gram-positive micrococcus.