Mehmet Caglayan

Serum prolidase enzyme activity and oxidative status in patients with fibromyalgia

Abstract Objective This study was performed to investigate serum prolidase enzyme activity and oxidative stress in patients diagnosed with fibromyalgia (FM). Methods The study population consisted of 40 patients with a previous diagnosis of FM and 30 healthy subjects. We measured serum prolidase enzyme activity, total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), and paraoxonase-1 (PON-1) levels. Results On average, FM patients were diagnosed within 3.2 years of symptom onset, and patients had a mean of 14 tender points. There were no significant differences between patients and controls in age, body mass index, serum TAS, or PON-1 levels. However, patients with FM demonstrated higher serum prolidase activity, TOS, and OSI than the control group. Serum prolidase activity was positively correlated with serum TOS, OSI, and visual analog scale pain and fatigue scores. No correlation was found between serum prolidase activity and FM duration or the average number of tender points. Discussion Our results demonstrate a previously unreported association between serum prolidase enzyme activity and FM. Increased prolidase activity may contribute to the pathogenesis of FM, and measuring serum prolidase enzyme activity may be a useful FM biomarker.

Elevated serum levels of calprotectin (MRP8/MRP14) in patients with Behçet's disease and its association with disease activity and quality of life

Abstract Background. Behçets disease (BD) is an inflammatory disease with multisystem chronic vasculitis. The disease is characterized by attacks of oral and genital ulcerations, skin lesions, arthritis, uveitis and deep vein thrombosis. The main histopathological feature is known to be vascular inflammatory change. Calprotectin (MRP8/MRP14) has been identified as an important alarmin that is expressed by activated phagocytes, granulocytes, monocytes and vascular endothelial cells, recognized by toll-like receptors, and induces a thrombogenic and inflammatory response in human microvascular endothelial cells. Aim. We aimed to investigate the serum levels of calprotectin in patients with BD and its association with disease activity and quality of life. Materials and methods. Forty-eight patients (25 males and 23 females) and 47 healthy controls (29 males and 18 females) were included to study. BD Current Activity Form (BDCAF) was used to assess the disease activity of patients with BD. Quality of life was assessed by using the Nottingham Health Profile (NHP). Depression and anxiety symptoms were assessed by using the Hospital Anxiety and Depression Scale (HADS). Serum level of calprotectin was determined using an ELISA kit. Results. Serum levels of calprotectin was significantly higher in patients with BD compared to healthy controls (p = 0.001). Serum levels of calprotectin did not correlate with the sores of BDCAF, NHP and HADS. Conclusion. Calprotectin may play a significant role in the pathogenetic mechanisms of BD. Further insight into this area of research might provide opportunities to develop novel treatment strategies.

Serum Prolidase Activity in Ankylosing Spondylitis and Rheumatoid Arthritis

The aim of the present study was to emphasize the collagen turnover in 2 of the most common chronic inflammatory rheumatic diseases by evaluating serum prolidase activity (SPA) in ankylosing spondylitis (AS) and rheumatoid arthritis (RA). 30 patients who met the modified New York Criteria for the classification of AS, 29 patients who met the 2010 Rheumatoid Arthritis Classification Criteria for the classification of RA, and 31 healthy controls were enrolled in the study. Serum samples of the patients and the controls were collected and SPA was measured by a spectrophotometric method. The comparison of the SPA in these 3 groups was statistically examined. In both patient groups, the SPA was lower than in the control group. SPA in patients with AS was statistically significantly lower than in the control and RA groups (P < 0.001/P = 0.002). No statistically significant difference was found between the RA and the control groups (P = 0.891). In conclusion, lower SPA is presumably associated with decreased collagen turnover and fibrosis, leading to decreased physical functions in both chronic inflammatory musculoskeletal diseases.

Psychological health of caregivers and association with functional status of stroke patients

Abstract Objective: Stroke does not only affect the physical state of patients but also the emotional state of their relatives, most effectively their caregivers. The study aims to examine the mood of caregivers experienced with care for patients with stroke who are highly dependent on the assistance and also to establish the relationship between the emotional state of caregivers and the severity of disability of the patients. Methods: This study contained a total of 76 patients with sufficient cognitive functions and severe physical disabilities with hemiplegia caused by a cerebrovascular accident and their caregivers and 94 controls. The functional state of patients was assessed by the Barthel Index (BI). Furthermore, emotional state of the caregivers was assessed by the Hospital Anxiety and Depression Scale (HADS) and their life quality was assessed by the SF36 Health Survey. Results: The mean anxiety (9.73 ± 4.88) and depression rates (9.81 ± 5.05) in the caregivers were significantly higher than those in controls (p<0.001, respectively). Significant impairments were observed in both their mental and physical health. Regression analysis also showed a significant negative correlation between the BI scores and the HADS scores. Conclusion: Caregivers had an impaired emotional state and the level of their anxiety was associated with the severity of functional disability of the patients. Therefore, the support provided to the caregiver might be influential on the functional recovery of the patients.

Serum Coenzyme Q10 Levels and Oxidative Status in Patients with Fibromyalgia Syndrome

Abstract Objectives: The aim of this study was to determine the relationship between serum coenzyme Q10 [CoQ10] levels and symptoms of fatigue associated with fibromyalgia syndrome [FMS]. Methods: Patients diagnosed with primary FMS and domographically matching healthy normal controls [HNCs] were sought to participate in the study. The total antioxidant status, total oxidative status, and CoQ10 levels were measured in blood samples from the patients and the controls. Results: A total of 40 patients with FMS and 30 HNCs were recruited. There were no statistically significant differences between the two groups in regard to C-reactive protein, mean erythrocyte sedimentation rate, mean age, and mean body mass index [p > 0.05]. The mean time from symptom onset to diagnosis for the FMS patients was 2.88 years, and the average number of tender points was 14. The serum CoQ10 levels were significantly lower in the FMS patients compared with the HNC group [p = 0.000]. The serum total oxidative status and oxidative stress index levels were higher, and the serum total antioxidant status levels were lower in the FMS patients compared with those of the HNC group [p < 0.05]. The visual analog scale [VAS] pain scores and the VAS fatigue scores were significantly higher in the FMS group than in the HNC group [p = 0.000]. The serum CoQ10 levels were negatively correlated with the mean Modified Fatigue Impact Scale scores [p = 0.02, r = 0.30], VAS pain scores [p = 0.00, r = 0.38], and VAS fatigue scores [p = 0.03, r = 0.28]. Conclusions: The CoQ10 deficiency may contribute to the etiopathogenesis of FMS fatigue.

Effects of lumbosacral angles on development of low back pain

Abstract Objective: Low back pain [LBP] is an important health issue due the diagnosis and treatment expenses and loss of workforce it leads to. Biomechanical changes in the vertebral column caused by changes in the lumbosacral angles [LSAs] may lead to LBP. The purpose of this study was to assess body mass index [BMI] and LSAs in patients with LBP and investigate the association between LBP, LSAs and BMI. Methods: Lumbar lordotic angle [LLA], LSA, sacro-horizontal angle [SHA] and sacral inclination angle [SIA] were measured in 117 patients with chronic LBP and 85 healthy normal controls [HNCs] by means of lumbosacral radiography. In addition, association between LSAs, BMI and LBP was investigated. Results: There were no significant differences between patients and HNCs regarding LSAs and BMI. LLA was lower in male patients with LBP compared to male HNCs without LBP [p = 0.013]. In addition, SIA [p = 0.002] and BMI [p = 0.006] were higher in female patients with LBP compared to male patients with LBP. It was found that an increase in LLA increased the risk of having LPB by approximately 1.04-folds [ranging from 1.01 to 1.08; p = 0.045]. On the other hand, no association was found between LSAs and BMI. Conclusion: Changes in LSAs may cause LBP. An increase in LLA may be influential in increasing the risk of LBP. Therefore, measurement of LSAs may guide the physician who is to make clinical decisions in examination of patients with LBP.

Vitamin D Levels and Related Factors in Patients with Chronic Nonspecific Low Back Pain

Abstract Objectives: To evaluate the 25-hydroxy vitamin D3 [25OHD3] levels and the associated factors in patients with chronic nonspecific low back pain [LBP] in our region. Methods: Sixty patients diagnosed with chronic nonspecific LBP and a control group of 30 healthy subjects were enrolled. The demographic characteristics were recorded and the serum 25OHD3 level was measured. The severity of the LBP was measured with a visual analog scale. Milk and dairy product consumption, fish consumption, dressing style, exposure to the sunlight, and physical activity levels of the individuals in each group were recorded. The quality of life was evaluated with the Short Form 36. Depression status was evaluated through the Beck Depression Inventory. The Oswestry Disability Scale was used for the functional assessment of the patient group. Results: The mean age of the patients was 30.58 ± 7.78 years and control group was 30.97 ± 6.70 years. The sun exposure and fish consumption were significantly higher in the control group. The scores from all the dimensions of the Short Form 36 [except for the mental health parameter] and Beck Depression Inventory were significantly lower in the patient group. The 25OHD3 level was also significantly lower in the patient group. According to the Oswestry Disability Scale, the daily life of the patients was observed to be limited due to LBP. Conclusions: In the patients with chronic LBP [CLBP], 25OHD3 level is lower than the healthy controls. In CLBP, increasing incidence of depression, deterioration in the quality of life, and serious functional impairment are observed. Vitamin D levels should be evaluated and any deficiency should be treated in patients with CLBP.

Serum prolidase activity in benign joint hypermobility syndrome

BackgroundModerate joint laxity is widespread in many joints of the body, and this condition is considered to be caused by an abnormality in the collagen structure. This study was carried out to determine the serum prolidase activity in female patients with benign joint hypermobility syndrome (BJHS), and to evaluate its correlation with their clinical features.MethodsA total of 45 patients with BJHS and 40 healthy controls were included in the study. All of the patients with BJHS met the Beighton diagnostic criteria. All the patients and the control group underwent a comprehensive examination of the locomotor system and took the New York Posture Rating Test. The examination and test results were recorded. Serum prolidase activity was measured in both the groups.ResultsProlidase activity was significantly lower in patients with BJHS (479.52 ± 126.50) compared to the healthy controls (555.97 ± 128.77) (p = 0.007). We found no correlation between serum prolidase activity and Beighton scores or New York rating test scores. On the other hand, mean prolidase activity was significantly lower in patients with pes planus or hyperlordosis compared to those without (p = 0.05, p = 0.03, respectively). We did not find such a correlation with the other clinical features.ConclusionsSignificantly lower prolidase activity in patients with BJHS suggests that prolidase may affect the collagen metabolism and cause hyperlaxity.

Investigation of Pathergy In Patients With Fibromyalgia

Aim: Recent studies showed increased axon reflex flare reaction to mechanical and chemical stimuli associated with neurogenic inflammation in patients with fibromyalgia (FM). Pathergy test is identified as a non-specific hypersensitivity reaction to minimal trauma. The purpose of this study was to investigate whether patients with FM had a positive pathergy test or not. Methods: Forty-six patients who met the 1990 American College of Rheumatology (ACR) criteria for the classification of FM and fifty-one healthy control subjects (HCs) were included in this study. Twenty-eight patients with Behcet’s disease were included as disease control for Pathergy test. The Fibromyalgia Impact Questionnaire (FIQ) was used for assessment of functional status in patients with FM. The Nottingham Health Profile was used for assessment of quality of life in all subjects. Results: There was no significant difference in demographic characteristics between the three groups (p > 0.05). NHP-pain, NHP-physical mobility, NHP-energy, NHP-emotional reaction, NHP-sleep and NHP-total scores were significantly higher in patients with FM compared to HCs (p < 0.001). Neither patients with FM nor HCs had a positive pathergy test. Conclusion: There are some pathophysiological changes in the skin biopsies of patients with FM; however, these changes are not accompanied by a positive pathergy test. Key Words: Fibromyalgia, Pathergy test

Serum relaxin levels in benign hypermobility syndrome.

OBJECTIVE In this study, we investigated the activity of serum relaxin in female patients with benign joint hypermobility syndrome (BJHS), locomotor system findings accompanying BJHS, and its relation to relaxin. METHODS Into the study, female patients with BJHS and healthy women as the control group were included. The patients were diagnosed by using the Brighton 1998 criteria. Examination of the locomotor system for study groups were performed. Serum relaxin levels of both patient and control group were measured. RESULTS There were 48 female patients with BJHS and 40 healthy women in the study. With respect to the control group, the level of serum relaxin was higher in the patients (47.1 ± 20.3, 34.4 ± 22.1; p> 0.05). Again compared with the control group, arthralgia (p= 0.00), myalgia (p= 0.01), shoulder impingement syndrome (p= 0.05), pes planus (p= 0.01), and hyperkyphosis (p= 0.000) were higher in the patients. The level of relaxin median was significantly higher in the patients with pesplanus and hyperkyphosis than those who did not have them (p= 0.05, p= 0.01, respectively). CONCLUSIONS Although serum relaxin level is not considered a causative factor for BJHS, the significant increases found in those patients with hyperkyphosis and pes planus suggest the hypothesis that relaxin has a limited and indefinite role in patients with BJHS.