Gönül Gürol

Overlooked hematological markers of disease activity in rheumatoid arthritis.

The aim of this study was to investigate the relationship between hematological markers and disease activity in patients with rheumatoid arthritis (RA).

The effects of vagal nerve stimulation in focal cerebral ischemia and reperfusion model.

AIM This study aimed to investigate the effects of VNS in transient middle cerebral artery occlusion and reperfusion (MCAO/R) rat model of ischemia based on behavioral, morphological, and molecular approaches. MATERIAL AND METHODS Wistar albino rats were divided into 3 groups: ischemia-reperfusion (I/R), I/R+VNS, and sham (for I/R). Each group was further divided into two subgroups for the assessment of neurological deficits and infarct area, or biochemical parameters related to oxidative stress. RESULTS The infarct area and neurological scores were significantly lower in I/R+VNS group compared with the I/R group. MDA levels were significantly higher in I/R group compared to control and I/R+VNS groups in the cortical and subcortical specimens. There were also betweengroup differences in terms of GSH levels. GSH levels were higher in sham group compared with and I/R and I/R+VNS groups in cortical specimens whereas these levels for lower in I/R group compared to control and I/R+VNS groups in the subcortical specimens. SOD activity was higher in control group compared to I/R and I/R+VNS groups both in the cortical and subcortical specimens. There was no difference between I/R and I/R+VNS groups in neither cortical nor subcortical specimens. CONCLUSION The neuroprotective and antioxidant properties of VNS suggest its efficacy as a potential anti-ischemic treatment.

Comparative Proteomic Approach in Rat Model of Absence Epilepsy

The aim of this study was to investigate cellular proteins in the pathogenesis of the genetic rat model of absence epilepsy. Protein spots were identified with peptide mass fingerprinting analysis using matrix-assisted laser desorption ionization time of flight mass spectrometry. Data were gathered from the frontoparietal cortex and thalamus of Wistar Albino Glaxo/Rij (WAG/Rij) and Wistar by using two-dimensional gel electrophoresis (2D-PAGE). Six proteins (Clathrin light chain-A protein, Transmembrane EMP24 Domain-Containing Protein, Stathmin-4, Myosin Light Chain4, Rheb, phosphoserine phosphatase) were found to be differentially expressed in the frontoparietal cortex of WAG/Rij and Wistar rats in both age groups. Another set of six proteins (Protein FAM89A and Oasl1, Gemin2, NuDEL1, Pur-beta, 3-alpha HSD) were found to be differentially expressed in the thalamus of WAG/Rij and Wistar rats. Findings from the frontoparietal cortex suggest the presence of altered serine metabolism and increased vesicular trafficking in the frontoparietal cortex of WAG/Rij rats compared with Wistar rats. These differences in the protein levels might reflect the crucial role of these proteins and related pathways in the generation of absence seizures. In the thalamic specimens, age-dependent changes in protein expression were remarkable, suggesting that this phenomenon may be a precursor or a consequence of absence seizures. Our findings further highlight the potential role of the mTOR signaling pathway in absence epilepsy.

Comparison of fetuin-A and transforming growth factor beta 1 levels in patients with spondyloarthropathies and rheumatoid arthritis.

We investigated the serum transforming growth factor beta 1 (TGFβ1) and fetuin‐A levels, and determined the relationships between these biomarkers and disease activity, mobility and radiologic progression in patients with spondyloarthropathy (SpA) and rheumatoid arthritis (RA).

A Controversial New Approach to Address Hematological Parameters in Hashimoto's Thyroiditis

BACKGROUND Hashimotos thyroiditis (HT) is a common autoimmune disorder. Genetic, environmental, and immunological factors all play a role in the pathogenesis of HT, but the effects of lymphocytes and platelets on the pathophysiology of HT are still unknown. In this study, we evaluated the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) in HT groups and HT subgroups with low cardiovascular risks. METHODS This study included 92 patients with HT and 38 control subjects. Among the HT patients, three subgroups were formed according to thyroid function: overt (n = 12), subclinical (n = 38), and euthyroid (normally functioning thyroid; n = 42). RESULTS Age and gender distributions were similar between the patient and control groups. Body mass index was higher in the patient group than in the control group. The C reactive protein level was higher in patients than controls (p = 0.064). The thyroid stimulating hormone (TSH) level was higher and the mean free thyroxine level lower in the patient group than in the control group (p < 0.05). There were no differences between the groups with regard to leukocytes, neutrophils, platelets, or MPV (p > 0.05). The NLR and PLR were significantly different in one subgroup of HT patients relative to healthy subjects (p < 0.05). However, we did not find any statistical differences in the MPV among the three subgroups (p = 0.547). A positive correlation was found among the NLR, anti-thyroglobulin (TG) antibodies, and anti-thyroid peroxidase (TPO) antibodies (p < 0.01), although there was a negative correlation between the PLR, TSH, anti-TPO, and anti-TG (p < 0.001). CONCLUSIONS A single marker or panel of biomarkers is not a consistent indicator of HT, but NLR combined with PLR testing may offer a more reliable diagnosis.

A New Explanation of Inflammation in Rheumatoid Arthritis Patients With Respect to Claudin-5, Matrix Metalloproteinase-9, and Neuroserpin

Objectives This study aims to investigate the relationship between neuroserpin (NSP) and claudin-5, as well as matrix metalloproteinase-9 (MMP-9), with respect to clinical activity of disease in patients with rheumatoid arthritis. Patients and methods The study included a total of 75 patients (18 males, 57 females; mean age 48.12±11.23 years; range 20 to 60 years) who were admitted to the rheumatology outpatient facility at the Medical Faculty Hospital, Sakarya University, in October 2014. Patients were divided into four groups based on their Disease Activity Score 28 (DAS28) scores as remission group (n=16, DAS28 <2.6), low disease activity group (n=16, DAS28 between 2.6-3.2), moderate disease activity group (n=28, DAS28 between 3.2-5.1), and high disease activity group (n=15, DAS28 >5.1). Ten healthy subjects (HS) served as controls. Results Claudin-5, MMP-9, and NSP levels were significantly different in rheumatoid arthritis patients compared to HS (p=0.035, 0.026, and 0.014, respectively). Additionally, there were no differences between claudin-5 levels and disease activity among all RA groups. However, compared to HS, patient groups showed a significant difference (p=0.035) in terms of claudin-5 levels. Serum levels of MMP-9 were significantly different in moderate disease activity group compared to HS (p=0.013). Levels of NSP were significantly different in moderate disease activity and high disease activity groups compared to HS (p=0.008 and 0.031, respectively). Conclusion Our study demonstrated the differential associations of endothelial function/dysfunction biomarkers and disease activity in rheumatoid arthritis. How and why this impairment occurs is not fully understood and more data regarding NSP, MMP, and claudin expression in plasma are warranted.

The Circulating Levels of Selenium, Zinc, Midkine, Some Inflammatory Cytokines, and Angiogenic Factors in Mitral Chordae Tendineae Rupture

Chordae tendineae rupture process is associated with increased production of inflammatory and angiogenesis mediators in connective tissues, which contributes to chronic inflammation and pathogenesis of degenerative chordae. A few trace elements are known to possess antioxidant, anti-inflammatory, and antiangiogenic properties. Therefore, the aim of this study was to determine whether zinc, selenium, midkine (MK), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), vascular endothelial growth factor-A (VEGF-A), platelet-derived growth factor-BB (PDGF-BB), and reduced glutathione (GSH) levels are associated with inflammation and angiogenesis processes in the context of a potential etiology causing aggravation of mitral regurgitation and/or ruptured chordae tendineae. Seventy-one subjects comprising 34 patients with mitral chordae tendineae rupture (MCTR) and 37 healthy controls diagnosed on the basis of their clinical profile and transthoracic echocardiography were included in this study. The levels of GSH, MK, selenium, and zinc were found to be lower in the patients group when compared to control group. There were no significant difference in plasma TNF-α, IL-1β, IL-6, IL-8, VEGF-A, and PDGF-BB levels between two groups. There were positive significant correlations between MK and GSH, MK, and selenium levels in patients with MCTR. According to our data in which selenium, zinc, MK, and GSH decreased in MCTR patients, inflammatory response, oxidative stress, and trace element levels may contribute to etiopathogenesis of mitral regurgitation and/or ruptured chordae tendineae.

AB0154 Comparison of Fetuin-A and Transforming Growth Factor Beta 1 Levels in Patients with Spondyloarthropathies and Rheumatoid Arthritis

Background New bone formation plays an important role in the progression of inflammatory lesions in inflammatory rheumatic diseases. In recent literature, the question of which molecules to use for estimating new bone formation is a particularly interesting research topic. Fetuin-A and transforming growth factor beta 1 (TGFβ1) have been studied in many diseases, including metabolic, cardiovascular, and neoplastic diseases. Objectives We investigated the serum TGFβ1 and fetuin-A levels, and determined the relationships between these biomarkers and disease activity, mobility, and radiologic progression in patients with SpA and RA. Methods The study included 55 patients with SpA and 38 patients with RA, together with 28 healthy subjects. In AS patients, we assessed disease activity using the Bath AS disease activity index (BASDAI), functional ability using the Bath AS functional index (BASFI), and mobility using the Bath AS metrology index (BASMI), radiologic progression using the Bath Ankylosing Spondylitis Radiology Index (BASRI). Serum feutin-A and TGFβ1 were determined using enzyme-linked immunosorbent assay (ELISA) equipment Results Fetuin-A was significantly higher in the axial SpA and RA groups than in healthy subjects (p<0.01). Serum TGFβ1 and fetuin-A levels were similar in the peripheral SpA group and in healthy subjects. A significant positive correlation was found between the fetuin-A and TGFβ1 levels in the axial SpA, peripheral SpA, and RA groups (r =0.293, p=0.009; r =0.215, p=0.04; r =0.223, p=0.05, respectively). Significant correlations were found between fetuin-A and the BASMI and BASRI values in the axial SpA patients (r =0.244, p=0.031; r =0.416, p<0.001, respectively). There were no correlations of TGFβ1 or fetuin-A levels with CRP, ESR, or all of the clinical parameters in the peripheral SpA and RA patients (p>0.05). Conclusions In conclusion, high levels of fetuin-A and TGFβ1 in patients with axial SpA indicate that fetuin-A could be used as a marker for bone proliferation. We hypothesize that fetuin-A may be one of the possible active steps in new bone formation. The data obtained in the present study will contribute to identifying differences between RA and SpA, and in clarifying the disease process, thereby helping to identify specific therapeutic targets. Disclosure of Interest None declared