Dost Zeyrek

Parasite density and serum cytokine levels in Plasmodium vivax malaria in Turkey

We aimed to investigate the relationship between quantitative Plasmodium vivax parasitaemia and serum cytokine levels in a highly endemic region of Turkey, where such a relation has not been investigated before. Active screening was done in a total of 1316 people residing in 33 villages of Sanliurfa province, Turkey. The study population consisted of 79 consecutive patients with P. vivax malaria, and a control group included 89 healthy subjects. Thick blood smears were examined for malaria parasite and parasite count. Serum samples were analysed for IL‐1β, IL‐2, IL‐4, IL‐6, IL‐8, IL‐10 and IL‐12 by the ELISA method. Compared to controls, levels of pro‐inflammatory cytokines, i.e. IL‐1β, IL‐6 and IL‐12, were significantly higher in patients with parasitaemia. There was a significant positive correlation between serum IL‐10 and IL‐12 levels and the parasite burden (r = 0·264, P = 0·024 and r = 0·264, P = 0·024, respectively). Serum IL‐8 levels showed a significant negative correlation with parasite burden (r =–0·356, P = 0·002). There was a positive correlation between IL‐8 levels and age, while the opposite was observed for IL‐12. High fever was correlated with IL‐6 and IL‐10 levels. Compared to controls, patients with a parasite count greater than 5000/µL had a significantly higher IL‐1β and IL‐10 levels (P < 0·05), while the difference was not significant for patients with a parasite count less than 1000/µL. Thus, we can conclude that pro‐inflammatory response against P. vivax gains more importance during periods of increased parasite burden.

Serum prolidase activity and oxidative status in patients with bronchial asthma.

Asthma is a disease where there is an accumulation of collagen in the reticular basal membrane of the airway leading to chronic inflammation. The enzyme prolidase plays an important role in the breakdown of collagen and the breakdown of intracellular protein especially in the final stage when peptides and dipeptides contain a high level of proline. To evaluate the relationship between prolidase activity and oxidative status in asthma patients. Comparison was made between 42 patients diagnosed with bronchial asthma and 32 healthy children of similar age and gender. Serum prolidase activity was measured spectrophotometrically. Oxidative status was determined using total antioxidant capacity (TAC) and total oxidant status (TOS) measurement. The prolidase activity of the asthma patient group was statistically significant compared with the control group (P≤0.001). TAC and TOS levels in the asthma patient group were higher than the control group (P≤0.001, P≤0.002, respectively). No correlation was found between the prolidase and oxidative levels of the two groups. A positive correlation was determined between the prolidase activity and TAC in the asthma patient group (P≤0.001, r=0.501). The prolidase enzyme activity, which plays a role in the collagen turnover, was low in the asthma patients; therefore, their collagen metabolism had undergone a change and this indicates that there may be an effect on the accumulation of collagen in the reticular basal membrane. Moreover, the high level of TOS indicates that these patients were exposed to severe oxidative stress with an increased TAC response. J. Clin. Lab. Anal. 23:132–138, 2009.

DNA damage in children with asthma bronchiale and its association with oxidative and antioxidative measurements

Increased production of reactive oxygen species leading to an imbalance between the oxidative forces and the antioxidant defense systems favoring an oxidative injury has been implicated in the pathogenesis of asthma. The aim of the study was to investigate the peripheral DNA damage, and its association with oxidative and antioxidative measurements in children with asthma bronchiale. The study population contained 42 children with asthma bronchiale and 32 healthy controls. DNA damage was assessed by alkaline comet assay in peripheral lymphocytes. Plasma levels of total antioxidant status (TAS), total peroxide concentration (LOOHs), and total oxidant status (TOS) were determined. In asthma bronchiale patients, DNA damage was significantly higher than in controls (17.9 ± 11.8 AU vs. 1.2 ± 2.0 AU, p < 0.001). Plasma TOS and LOOHs were higher in patients than in healthy controls (13.4 ± 7.0 vs. 9.0 ± 3.5, p = 0.002; 9.9 ± 3.4 vs. 4.4 ± 1.5, p < 0.001, respectively). Plasma TAS level in patients was higher than in healthy controls (5.5 ± 2.5 vs. 1.0 ± 0.6, p < 0.001). DNA damage was correlated with TOS (r = 0,616, p < 0.001). The findings indicated that lymphocyte DNA damage level increases in children with asthma bronchiale. Elevated DNA damage may be related to increased oxidative stress. However, the mechanism of this association, and whether it is direct or indirect, remains to be explored.

Oxidative Status and DNA Damage in Chidren With Marasmic Malnutrition

Malnutrition as a lack of several substances containing antioxidants such as vitamins and micronutrients, while showing a predisposition for lipid peroxidation and DNA damage, is also characterized by a slowing down of the metabolic processes, which may then have protective properties against DNA damage due to a reduction in endogenous free radical production. This study aimed to examine the oxidative status and DNA damage in cases of marasmus. The study comprised 28 infants aged 6–24 months with marasmus only and 28 age‐matched healthy infants. DNA damage was examined by the alkali single cell electrophoresis method (Comet assay) on mononuclear leukocytes. The total oxidant status (TOS) and total antioxidant status (TAS) were measured by colormetric auto‐analyzer and the oxidative stress index (OSI) was calculated. The TOS, TAS, and OSI levels of the patient group were found to be significantly lower compared to the control group (P < 0.01, P < 0.01, P < 0.01, respectively). No statistically significant difference was found between the two groups in terms of mononuclear leukocyte DNA damage (P > 0.05). The findings of this study showed that in marasmus cases, the oxidative and antioxidative processes, which have a counteractive effect, decreased together. The other results of the study indicate that there is no increase in DNA damage in marasmus cases. J. Clin. Lab. Anal. 26:161‐166, 2012.

DNA damage in children exposed to secondhand cigarette smoke and its association with oxidative stress

ObjectiveTo compare oxidative status, total antioxidant capacity and values of DNA damage in peripheral blood lymphocytes in children exposed to secondhand cigarette smoke with healthy controls.DesignAnalytical, Observational.Participants54 children without any chronic diseases, attending the healthy child monitoring polyclinic. These comprised 27 children who had been exposed to passive cigarette smoke and 27 children who had not been exposed to cigarette smoke.Main Outcome MeasuresUrine cotinine levels by the chemiluminescent technique; DNA damage by alkaline comet assay; and total oxidant status (TOS) using a novel automated measurement method.ResultsThe mean urine cotinine, TOS, Oxidative Stress Index (OSI) and DNA damage values of the group exposed to cigarette smoke were determined to be at significantly higher level compared to the group not exposed to cigarette smoke (P<0.001). No statistically significant difference was determined in the TAS level between the two groups (P=0.1)ConclusionsThe results showed that TOS levels, OSI index and DNA damage in peripheral blood lymphocytes were significantly higher in children exposed to secondhand cigarette smoke than in those not exposed to secondhand cigarette smoke.

Predicting Hospitalization in Children with Acute Asthma

BACKGROUND Acute asthma is one of the most common medical emergencies in children. Appropriate assessment/treatment and early identification of factors that predict hospitalization are critical for the effective utilization of emergency services. OBJECTIVE To identify risk factors that predict hospitalization and to compare the concordance of the Modified Pulmonary Index Score (MPIS) with the Global Initiative for Asthma (GINA) guideline criteria in terms of attack severity. METHODS The study population was composed of children aged 5-18 years who presented to the Emergency Departments (ED) of the tertiary reference centers of the country within a period of 3 months. Patients were evaluated at the initial presentation and the 1(st) and 4(th) hours. RESULTS Of the 304 patients (median age: 8.0 years [interquartile range: 6.5-9.7]), 51.3% and 19.4% required oral corticosteroids (OCS) and hospitalization, respectively. Attack severity and MPIS were found as predicting factors for hospitalization, but none of the demographic characteristics collected predicted OCS use or hospitalization. Hospitalization status at the 1(st) hour with moderate/severe attack severity showed a sensitivity of 44.1%, specificity of 82.9%, positive predictive value of 38.2%, and negative predictive value of 86.0%; for MPIS ≥ 5, these values were 42.4%, 85.3%, 41.0%, and 86.0%, respectively. Concordance in prediction of hospitalization between the MPIS and the GINA guideline was found to be moderate at the 1(st) hour (κ = 0.577). CONCLUSION Attack severity is a predictive factor for hospitalization in children with acute asthma. Determining attack severity with MPIS and a cut-off value ≥ 5 at the 1(st) hour may help physicians in EDs. Having fewer variables and the ability to calculate a numeric value with MPIS makes it an easy and useful tool in clinical practice.

Perceptions of Parents and Physicians Concerning the Childhood Asthma Control Test

Background. The Childhood Asthma Control Test (C-ACT) has been proposed to be a simple, patient-based test that is able to reflect the multidimensional nature of asthma control. In this analysis, the aim was to evaluate the perceptions of physicians and caregivers concerning C-ACT and its predictive value for future asthma-related events. Method. In a multicenter prospective design, 368 children aged 4–11 years with asthma who were either well- or not well-controlled were included in the study. The study participants were evaluated during three visits made at 2-month intervals and the Turkish version of C-ACT was completed each month. Parents completed questionnaires concerning their perception of asthma (before and after the study) and the C-ACT (after the study). Physicians completed a survey about their perception of a control-based approach and the C-ACT. Results. The C-ACT scores increased from visit 1 to visit 3, with improvement seen in all domains of the test. At the end of the study period, the parents more strongly agreed that asthma could be controlled completely and that asthma attacks and nocturnal awakenings due to asthma were preventable (p < .05). Most of the parents reported that the C-ACT helped them to determine asthma treatment goals for their children and also that the C-ACT improved communication with their physicians. The physicians indicated that a control-centered approach was more convenient (95%) and simpler (94.5%) than a severity-centered approach and provided better disease control (93.4%). A higher C-ACT score was associated with a decreased risk of asthma attack and emergency department admittance in the 2 months following the administration of C-ACT. Conclusion. Our findings indicated that the C-ACT improved both parental outlook on asthma control and the communication between the physician and parents. There was a good correlation between the C-ACT score and the level of asthma control achieved, as described by the physician. Additionally the C-ACT score was predictive of future asthma-related events. These findings suggest that the C-ACT may have an important role in asthma management in the future.

FcγRIIIa‐V/F 158 polymorphism in Turkish children with asthma bronchiale and allergic rhinitis

Fc receptors (FcR) play an important role in immune regulation. This might be linked to the variability in immune response, therefore relating to the pathogenesis of atopic diseases. The aim of the present study was to evaluate the FcγRIIIa gene polymorphism in Turkish children with asthma and allergic rhinitis. The study included 364 atopic children (184 bronchial asthma, 180 allergic rhinitis) and 234 healthy subjects as the control group, aged between 5 to 16 years. Patients were recruited from outpatient clinics of allergy and general pediatric care. Plasma IgE concentrations were measured by immunoassays and skin prick test was done in children with atopic diseases. The FcγRIIIa gene polymorphism was determined using the polymerase chain reaction method. Distribution of V158V genotype was significantly different among patient groups compared to controls (for asthmatic children OR: 5.33, 95% CI: 2.80–10.23, p < 0.001; for allergic rhinitis OR: 3.25, 95% CI: 1.75–6.07, p = 0.001). Distribution of 158 V allele was significantly different among asthmatic children (OR: 2.20, 95% CI: 1.65–2.92, p < 0.001) and allergic rhinitis patients (OR: 1.77, 95% CI: 1.32–2.35, p < 0.001) compared to healthy controls. Our study shows that the V158V genotype in FcγRIIIa gene polymorphism may be a genetic risk factor for the development of atopic diseases.

FcgammaRIIIa-V/F 158 polymorphism in Turkish children with asthma bronchiale and allergic rhinitis.

Fc receptors (FcR) play an important role in immune regulation. This might be linked to the variability in immune response, therefore relating to the pathogenesis of atopic diseases. The aim of the present study was to evaluate the FcγRIIIa gene polymorphism in Turkish children with asthma and allergic rhinitis. The study included 364 atopic children (184 bronchial asthma, 180 allergic rhinitis) and 234 healthy subjects as the control group, aged between 5 to 16 years. Patients were recruited from outpatient clinics of allergy and general pediatric care. Plasma IgE concentrations were measured by immunoassays and skin prick test was done in children with atopic diseases. The FcγRIIIa gene polymorphism was determined using the polymerase chain reaction method. Distribution of V158V genotype was significantly different among patient groups compared to controls (for asthmatic children OR: 5.33, 95% CI: 2.80–10.23, p < 0.001; for allergic rhinitis OR: 3.25, 95% CI: 1.75–6.07, p = 0.001). Distribution of 158 V allele was significantly different among asthmatic children (OR: 2.20, 95% CI: 1.65–2.92, p < 0.001) and allergic rhinitis patients (OR: 1.77, 95% CI: 1.32–2.35, p < 0.001) compared to healthy controls. Our study shows that the V158V genotype in FcγRIIIa gene polymorphism may be a genetic risk factor for the development of atopic diseases.

The effects of taekwondo training on oxidative stress levels in children.

Kronik egzersiz, sahip olduğu ikili etkiyle oksidan oluşumunu ve oksidatif stresi ortaya çıkarırken, bir yandan da antioksidan maddelerin sentezini artırmaktadır (1). Fiziksel egzersizin hücre içi sinyal iletimi, apoptozis, antimikrobiyal savunma, kas hasarı ve yorgunluğu, yaşlanma, ateroskleroz, miyokard infarktüsü ve iskemi/reperfüzyon hasarı gibi hem fizyolojik hem de patolojik süreçlerdeki rolü bilinen oksidan/antioksidan dengenin değişmesine yol açtığı bildirilmektedir (2). Fiziksel egzersiz metabolik aktivite ve oksijen tüketiminde artışla karakterlidir. Oksijen tüketimindeki bu artışa reaktif oksijen türlerinin oluşumunda önemli bir artış eşlik eder. Egzersiz sırasında meydana gelen birçok fizyolojik ve biyokimyasal değişikliklerden reaktif oksijen türlerindeki bu büyük artışın sorumlu olabileceği düşünülmektedir (3, 4). Organizma, serbest radikal hasarını en aza indirgemek üzere hücre içi, hücre membranları ve ekstrasellüler sıvıları içine alan karmaşık bir antioksidan savunma sistemine sahiptir (5-7). Oksidan koşullarda redoks dengesinin sürdürülmesi stratejisi içerisinde, antioksidanların vücudun bütün bölümlerine transportunu sağlayan kan, merkezi bir role sahiptir. Total antioksidan statü (TAS), biyolojik sıvılarda mevcut antioksidanların membranları ve diğer hücresel bileşenleri oksidatif hasara karşı koruma kapasitesinin bir göstergesi olarak kabul edilmektedir (8).