The Distribution of Apolipoprotein E Gene Polymorphism and Apolipoprotein E Levels among Coronary Artery Patients Compared to Controls.

OBJECTIVE: Coronary artery disease (CAD) is a multifactorial disease that is caused by various genetics and environmental factors. Genetically, predisposition is an important component for CAD. The candidate apolipoprotein E (apoE) gene is the most studied one. ApoE is composed of e2, e3, e4 alleles and E2/2, E2/3, E2/4, E3/3, E3/4, E4/4 genotypes. In this study, the relationship between CAD and apoE polymorphism and apoE level has been studied in Tokat region. MATERIALS AND METHODS: The study population is composed of 100 CAD patients diagnosed by coronary angiography and 100 control patients of whom fifty have normal coronary angiography and fifty did not have any CAD symptoms. The serum lipid and apoE levels and apoE genotypes of all participants have been measured, and the relationship between these parameters has been evaluated. RESULTS: Apolipoprotein E, total cholesterol, HDL cholesterol and LDL cholesterol levels were statistically low at CAD patients than control patients (p=0.0004, p=0.0005, p=0.0107, p=0.0052 respectively). There was not any significant difference between triglyceride levels (p=0.0848). Waist circumferences were significantly high at CAD patients (p=0.0012). Allele frequencies were as e2 (7.25%), e3 (83.5%), e4 (9.25%) and genotype distributions were as E2/2 (0.5%), E2/3 (13%), E2/4 (0.5%), E3/3 (68.5%), E3/4 (16.5%), E4/4 (1%). The distribution of alleles and genotypes were not significantly different (p>0.05). ApoE levels were higher at e2 allele carriers than e3 and e4 allele carriers (p<0.05). However, there was no significant difference between e3 and e4 allele carriers. CONCLUSION: In conclusion, the distribution of apoE genotype and allele at our region is similar to the general of Turkey. The low apoE levels in CAD patients may show the influence of apoE on CAD by local and systemic mechanisms.

Vitamin D Treatment Effect on Serum Endocan and High-Sensitivity C-Reactive Protein Levels in Renal Transplant Patients.

CONTEXT: Endocan is a marker showing endothelial dysfunction and inflammation. Significantly increased endocan levels have been observed in serum of patients with sepsis and cancer. OBJECTIVE: Our aim was to investigate the relationship between vitamin D treatment and serum endocan and high-sensitivity C-reactive protein (hs-CRP) levels as inflammatory markers in transplant patients. DESIGN: Prospective. SETTING: Nephrology clinic. PATIENTS: Thirty-eight renal transplant patients with serum 25-hydroxy-vitamin D (25-OH-vitamin D) levels below 20 ng/mL and transplanted at least 12 months. INTERVENTION: One-time oral dose of 300 000 IU vitamin D3. MAIN OUTCOME MEASURES: Before and after vitamin D treatment, serum endocan, hs-CRP, calcium, phosphorus, and parathyroid hormone (PTH) levels were measured. RESULTS: Median serum endocan and PTH values before vitamin D were significantly higher than those of after treatment values ( P = .001 and P < .001, respectively). On the other hand, serum total calcium and phosphorus levels before vitamin D treatment were lower than the values obtained after vitamin D treatment ( P = .0013 and P < .001, respectively). Serum hs-CRP was lower after vitamin D therapy than before, but the difference was not statistically significant ( P = .06). A moderate negative correlation was determined between endocan and 25-OH-vitamin D levels after treatment with vitamin D ( r = -.36, P = .02). CONCLUSION: This study has revealed that vitamin D treatment reduced markers of endothelial dysfunction in patients with renal transplantation and vitamin D deficiency.

Serum levels of pentraxin-3 and other inflammatory biomarkers in migraine: Association with migraine characteristics.

BACKGROUND: Several studies have been conducted on the inflammatory aspects of migraine. Pentraxins are a novel and important part of innate immunity as a superfamily of acute phase proteins. In our study, we aimed to demonstrate the relationship between migraine and the serum levels of pentraxin-3 (PTX-3), C-reactive protein (CRP), fibrinogen and D-dimer. METHODS: We recruited 30 migraine patients (in both the attack and interictal period) and 30 healthy controls. Serum samples were obtained from all participants, and a brain MRI performed in the last six months was assessed regarding the presence of deep white matter lesions. Comparisons between the attack, interictal and control groups regarding the serum levels of PTX-3, CRP, fibrinogen and D-dimer were performed. The association between serum PTX-3 levels and migraine characteristics (disease duration, headache frequency, MRI findings, aura, family history, attack duration, and MIDAS score) was also assessed. RESULTS: We found higher serum levels of fibrinogen and PTX-3 in migraine attack patients compared with the interictal and control groups (p = 0.03 and p < 0.001, respectively). Subgroup analysis also showed that patients with a disease duration of more than five years and with an attack duration of more than 12 hours have lower serum levels of PTX-3 than patients who have a relatively new diagnosis and have relatively short-lasting migraine attacks (p = 0.042 and p = 0.038, respectively). CONCLUSIONS: PTX-3 and fibrinogen exhibit different serum levels in patients undergoing a migraine attack compared with the interictal group and the controls. Participants with longer attacks and disease durations have lower serum levels of PTX-3, suggesting that inflammatory processes change along with disease progression.

Can we distinguish stroke and stroke mimics via red cell distribution width in young patients?

INTRODUCTION: Discrimination of stroke and stroke mimics is problematic in young patients. The aim of the study was to determine whether arterial ischemic stroke and stroke mimics can be differentiated via the red cell distribution width (RDW) value in young patients. MATERIAL AND METHODS: In this retrospective cross-sectional study, a total of 236 patients hospitalized at the neurology ward were investigated. The patients were divided into 3 groups: the 1(st) group included young stroke patients, the 2(nd) group included patients with epilepsy, and the 3rd group included patients with multiple sclerosis (MS). Complete blood count and computed tomographic brain imaging tests were performed in all patients, and magnetic resonance imaging was done when necessary. RESULTS: A total of 236 patients were included in this study. Ninety-five (40%) patients were young stroke patients, 71 (30%) had epilepsy and 70 (30%) had MS. The mean RDW values of young patients with stroke were significantly higher than patients with epilepsy or MS (14.9 ±1.2, 13.3 ±1.2, 13.4 ±0.6, p < 0.0001, respectively). The diagnostic power of RDW in the differentiation of patients with stroke is good (area under the curve (AUC) = 0.89). When an RDW cut-off value of 14.05% is accepted for differentiating young patients with stroke from other disorders, the sensitivity, specificity, positive predictive and negative predictive values were 73.7%, 87.9%, 6.1 and 0.043, respectively. CONCLUSIONS: Red cell distribution width is a promising, rapid, easy and inexpensive parameter to distinguish young stroke from stroke mimics (such as epilepsy and MS) in young patients.

Serum pentraxin-3 levels in acute stroke: No association with stroke prognosis.

BACKGROUND: Stroke is the leading cause of serious disability. Estimating severity of the disease and early risk assessment is crucial. Several studies have been carried on and several biomarkers have been proposed in the literature for risk assessment and to estimate the stroke prognosis. In this study we assessed the association of predictors such as patient age, gender, stroke volume and NIHS scores on prognosis of stroke event. We investigated whether the serum pentraxin-3 levels are linked with stroke prognosis. METHODS: Forty-four stroke patients without cardiovascular risk factors were included in this study. Initial NIHS scores, stroke volumes, serum pentraxin-3 levels and the data regarding the risk factors were collected in the first and seventh days of event. Association of predictors with final NIHS scores were investigated using multivariate regression model. RESULTS: Initial NIHS score, initial and final stroke volumes were independently associated with final NIHS score whereas serum pentraxin-3 levels, whether acquired at the first or seventh day of stroke, were not associated with final NIHS score. CONCLUSIONS: In stroke patients without cardiovascular, cardiopulmonary and infectious diseases, serum pentraxin-3 levels are not associated with stroke prognosis.

Serum fetuin-A levels in subjects with and without choroid plexus calcification.

Choroid plexus is an intraventricular plexus of tissue which is responsible for secretion of cerebrospinal fluid. Calcification of choroid plexus is found to be associated with age and gender. One of novel and popular glycoprotein that involves in inhibition of mineralization is human fetuin-A. In our study, we investigated plasma levels of fetuin-A in subjects with and without choroid plexus calcification. For this purpose, 41 subjects with choroid plexus calcification and 41 age and gender matched subjects with normal appearing choroid plexus were recruited. Calcified and normal choroid plexus tissue identified on computed tomography images. Overnight fasting venous blood samples were collected to measure serum fetuin-A levels using a human fetuin-A enzyme-linked immunosorbent assay kit. Statistically significant difference concerning the median concentration of fetuin-A was found between subjects with and without choroid plexus calcification (p: 0.040). Significance was also present between male subgroups (p: 0.017) and 18-27 years age subgroups (p: 0.025). Our results suggest that fetuin-A has an potent role in calcification process of choroid plexus.

A novel insertion mutation identified in exon 10 of the MEFV gene associated with Familial Mediterranean Fever.

BACKGROUND: Familial Mediterranean Fever (FMF), characterized by recurrent fever and inflammation of serous membranes, is an autosomal recessive disease caused by mutations in the Mediterranean fever (MEFV) gene. Around 296 mutations have been reported to date. METHODS: Two two-generation Turkish families with a total of four members diagnosed with FMF clinically were screened with DNA sequencing performed on exon 2 and exon 10 of the MEFV genes. Then, complete exome sequencing analysis of MEFV gene was done for four patients in whom novel mutation was detected. RESULTS: A novel single base Guanine (G) insertion mutation in the coding region of MEFV gene, named c.2330dupG (p.Gln778Serfs*4 or Q778SfsX4) resulting in a mutated Pyrin/Marenostrin protein was identified. CONCLUSIONS: This is the first report of a new mutation in exon 10 of the MEFV gene in two Turkish families. This novel pattern of insertion mutation may provide important information for further studies on FMF pathogenesis.

Serum vanin-1 levels in renal transplant patients.

OBJECTIVES: Vascular noninflammatory molecule 1 is a plasma membrane enzyme, also known as pantetheinase. It has been shown that vascular noninflammatory molecule 1 urinary and serum concentrations of vascular noninflammatory molecule 1 increase in nephrotoxicant-induced renal injury before classic markers. Tacrolimus and cyclosporine used as immunosuppressive agents are nephrotoxic drugs. This study sought to investigate alterations of vascular noninflammatory molecule 1 levels after a kidney transplant. MATERIALS AND METHODS: This study included 28 renal allograft recipients without acute rejection. Before transplant, and the first and sixth months after the transplant, vascular noninflammatory molecule 1 and creatinine levels were measured in renal transplant recipients using enzyme-linked immunosorbent assay and spectrophotometric methods. RESULTS: During the first month after transplant, we observed a significant increase in vascular noninflammatory molecule 1 levels compared with previous levels (P < .0001). Also, during the sixth month, vascular noninflammatory molecule 1 levels were higher than values previously taken (P < .01), although they were lower compared with the first month values (P = .004). No correlation was found between vascular noninflammatory molecule 1 and creatinine before transplant or during the first and sixth months after transplant. When the patients were divided into subgroups according to the immunosuppressive drugs used, in tacrolimus-treated patients, serum vascular noninflammatory molecule 1 levels were no different from the cyclosporine-administered levels measured at 3 different times. CONCLUSIONS: We conclude that serum vascular noninflammatory molecule 1 levels may be low in the end-stage renal failure and transiently increase after transplant owing to transient renal function deterioration, which does not lead to elevation of serum creatinine levels in renal transplant patients.

The association of human leukocyte antigen polymorphisms with disease severity and latency period in patients with silicosis.

BACKGROUND: Denim sandblasting may cause silicosis as a result of free crystalline silica inhalation. Its pathogenesis remains unclear, but autoimmunity may play a role in the development of silicosis. The present study aimed to investigate the relationships between human leukocyte antigen (HLA) and the severity and latency period of silicosis. METHODS: 48 silicotic patients in the Eastern part of Turkey were classified according to their latency period and disease severity. The distribution of HLAs according to disease severity and latency period was assessed. RESULTS: A23 (7.5%), B49 (7.5%), and B51 (25%) were more common in the mild group than in the severe group, and B55 (8.9%) and DR4 (17.9%) were more common in the severe group than in the mild one. Only B51 was significantly more common in the mild group than in the severe one (25%, n = 10 vs. 7.1%, n = 4; p = 0.016). CONCLUSIONS: This study suggests that HLA antigens may play a particular role in the severity of silica-induced lung disease, but there was no association between HLA and progression time of the disease.

Antioxidant status and oxidative stress in primary open angle glaucoma and pseudoexfoliative glaucoma.

PURPOSE: The aim of this study was to establish the antioxidant status and oxidative stress in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEG). METHODS: Serum levels of total antioxidant capacity (TAC) and superoxide dismutase (SOD) as indicators of antioxidant status; and total oxidant status (TOS), nitric oxide (NO), protein carbonyl (PC), and malondialdehyde (MDA) as indicators of oxidative stress were measured from the blood samples of patients with POAG (n = 23), PEG (n = 24) and healthy control subjects (n = 19) by spectrophotometry. RESULTS: Mean TAC level was 0.6 ± 0.1 mmol/L in the POAG group; 0.5 ± 0.1 mmol/L in the PEG group and 1.2 ± 0.3 mmol/L in the control group (p = 0.001). Mean SOD level was 13 ± 0.5 mg/L in the POAG group, 11.6 ± 0.2 mg/L in the PEG group and 9.4 ± 0.6 mg/L in the control group (p = 0.001). Mean TOS level was 19.6 ± 2.6 µmol/L in the POAG group, 21.2 ± 4.2 µmol/L in the PEG group and 15.1 ± 7 µmol/L in the control group (p = 0.001). Mean NO level was 74.3 ± 14.4 µmol/L in the POAG group, 66.1 ± 8.1 µmol/L in the PEG group and 62.3 ± 13.5 µmol/L in the control group (p = 0.005). Mean PC level was 641.5 ± 102.5 nmol/mg in the POAG group, 988.3 ± 214.7 nmol/mg in the PEG group and 654.4 ± 150.7 nmol/mg in the control group (p = 0.001). Mean MDA level was 1.9 ± 0.2 µmol/L in the POAG group, 1.7 ± 0.4 µmol/L in the PEG group and 1.1 ± 0.2 µmol/L in the control group (p = 0.001). CONCLUSION: The findings of the present study are potentially of significance and add to the growing body of evidence for oxidative stress in POAG and PEG. Decreased antioxidant defense and increased oxidative stress system may play an important role in the pathogenesis of POAG and PEG.

Association between elevated aminotransferase levels and the metabolic syndrome in Northern Turkey.

INTRODUCTION: Elevated aminotransferase levels(ATLs) are alert the physicians for liver-affecting disease and may reflect liver injury. We aimed to determine the prevalence of elevated ATLs and the association of elevated ATLs with the metabolic syndrome (MetS) in a northern province of Turkey. MATERIALS AND METHODS: Elevated ATLs were evaluated among 1,095 individuals of the Tokat Prevalence Study which have been described in detail elsewhere. 1,095 participants had been selected by a simple random sampling method among 530,000 inhabitants in 70 (12 urban and 58 rural) areas in the province of Tokat which is located in the Black Sea Region of Turkey. RESULTS: The prevalence of elevated serum ALT, AST, and ALT and/or AST were found as 11%, 7.2%, and 13.3%, respectively. Increased BMI, fatty liver, and MetS were higher in our general population with elevated ATLs. After exclusion of individuals with hepatitis B or hepatitis C infection, 132 individuals with elevated ATLs (91 male and 41 female) were evaluated. MetS was found in 59 participants and its prevalence was markedly higher in females with elevated ATLs (p < 0.0001). When the males with elevated ATLs were evaluated, the ALT levels of the persons who have no risk of MetS (p =0.007) and the persons who have one risk of MetS (p = 0.001) were lower than the persons with MetS. CONCLUSIONS: Elevated ATLs are common and it's an important cause is MetS in Northern Turkey.

Increased oxidative stress in patients with pseudoexfoliation syndrome.

PURPOSE: The objective of this study was to investigate the antioxidant/oxidant status of serum in patients with pseudoexfoliation syndrome (PEX). METHODS: Forty-seven patients with PEX and 32 healthy controls were included in the study. Serum total antioxidant capacity (TAC) and total oxidant status (TOS) levels were determined by using a novel automated method. RESULTS: A significant increase in serum TOS (p < 0.001) and a significant decrease in serum TAC (p < 0.0001) were observed in PEX patients compared to control subjects. CONCLUSION: TAC decreases while the oxidative stress increases in PEX.

The effect of dietary ginger (Zingiber officinals Rosc) on renal ischemia/reperfusion injury in rat kidneys.

Oxidative stress has been considered as one of the possible mechanisms of ischemia/ reperfusion (I/R) injury in the kidney. The aim of this study was to analyze the possible protective effect of dietary ginger (Zingiber officinals Rosc), a free radical scavenger, on renal I/R injury in rats. The protective effect of ginger against the damage inflicted by reactive oxygen species (ROS) during renal I/R was investigated in Wistar albino rats using histopathological and biochemical parameters. Thirty rats were randomly divided into five experimental groups (i.e., control, sham-operated, ginger, I/R, and I/R + ginger groups, n = 6 each). The ginger and I/R + ginger groups were fed on the test diet containing 5% ginger. The rats were subjected to bilateral renal ischemia followed by reperfusion in I/R and I/R + ginger groups. At the end of the reperfusion period, rats were sacrificed, and kidney function tests, serum and tissue oxidants and antioxidants, and renal morphology were evaluated. Serum urea, creatinine, and cystatin C (CYC) levels were significantly elevated in the ischemia group, but these levels remained unchanged in the ginger + I/R group compared to the I/R group. Reduction of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) enzyme activity was significantly improved by the treatment with ginger compared to I/R group. Administration of ginger resulted in significant reduction levels of tissue malondialdehyde (MDA), NO, protein carbonyl contents (PCC) in the ginger + I/R group compared with the I/R group. Ginger supplementation in the diet before I/R injury resulted in higher total antioxidant capacity (TAC) and lower total oxidant status (TOS) levels than I/R group. The ginger supplemented diet prior to I/R process demonstrated marked reduction of the histological features of renal injury. The findings imply that ROS play a causal role in I/R-induced renal injury, and ginger exerts renoprotective effects probably by the radical scavenging and antioxidant activities.

Seroprevalence of hepatitis B and C viruses in the province of Tokat in the Black Sea region of Turkey: A population-based study.

BACKGROUND/AIMS: Viral hepatitides are considered a major health problem worldwide. There are only a few studies relevant to the epidemiology of these types of infection in the normal healthy population. In this study, we aimed to determine the seroprevalence of hepatitis B and hepatitis C as well as the frequency of isolated anti-HBc IgG positivity among a normal healthy population in a northern province of Turkey. METHODS: This study was conducted in 70 areas (12 urban and 58 rural) in the province of Tokat, which is in the Black Sea region of Turkey, with about 530,000 inhabitants 18 years and older. All urban regions and some rural regions selected by a cluster sampling method were included in the study. The study population of 1,095 subjects (541 male and 554 female; urban 555 and rural 540) was selected by a random sampling method among 530,000 individuals. All individuals were tested for HBsAg, anti- HBs, anti-HBc IgG, anti-HCV, and alanine aminotransferase. RESULTS: The mean age of all participants was 41.4+/-17 years (range, 18-95). HBsAg, anti-HBs, anti-HBc IgG only, isole and anti-HCV were detected in 60 (5.5%), 250 (22.8%), 132 (12.1%), and 23 (2.1%) individuals of the 1,095 total participants, respectively. We did not find statistically significant differences between hepatitis B and C markers for men versus women or those living in rural versus urban areas. The rate of HBsAg positivity in individuals with a history of marriage to close relatives was higher. CONCLUSIONS: We found that the seroprevalences of hepatitis B and C in a northern province of Turkey are similar to the averages reported in other studies that were conducted in a different region of our country. The history of marriage to close relatives was associated with hepatitis B.

Oral beta-glucan protects kidney against ischemia/reperfusion injury in rats.

BACKGROUND: Ischemia-reperfusion (I/R) injury is one of the leading causes of acute renal failure. Beta-(1-->3)-glucans are glucose polymers with a variety of stimulatory effects on the immune system. We designed this study to determine the possible protective effect of the orally administered soluble beta-glucan against I/R injury. METHODS: 30 rats were randomly divided into 5 experimental groups (control, sham operated, beta-glucan, I/R and I/R+beta-glucan groups, n = 6 each). Beta-glucan was administered orally to 6 rats of the beta-glucan and I/R+beta-glucan groups. The rats were subjected to bilateral renal ischemia followed by reperfusion in the I/R and I/R+beta-glucan groups. All of the rats were then sacrificed and kidney function tests, serum and tissue oxidants and antioxidants were evaluated. RESULTS: The serum urea and cystatin C levels were significantly higher in the I/R group compared to the I/R+beta-glucan group (p < 0.01). The serum and tissue antioxidant markers (SOD, GSH-Px) were significantly lower in the I/R group than the I/R+beta-glucan group (p < 0.01). The serum oxidant markers (NO and PC) were significantly higher in the I/R group than the I/R+beta-glucan group (p < 0.01). CONCLUSION: Based on the present data, we conclude that increased antioxidants and decreased oxidants modulated by beta-glucan attenuated the renal I/R injury.

A preliminary study of the levels of testis oxidative stress parameters after MK-801-induced experimental psychosis model: protective effects of CAPE.

We evaluated the effects of caffeic acid phenethyl ester (CAPE) on antioxidant enzyme levels and histopathologic changes in dizocilpine (MK-801) induced schizophrenic rat testis. A total of 30 adult male Wistar-Albino rats were divided into three groups. Group-I was used as control. Rats in the Group-II were intraperitoneally injected with MK-801, whereas those in Group-III were intraperitoneally injected with CAPE in addition to MK-801. The testes were collected for biochemical and histopathological examinations. Antioxidant enzyme activities, malondialdehyde, protein carbonyl and nitric oxide levels in testicular tissues were analyzed with spectrophotometric methods. Induction of schizophrenia resulted in a significant oxidative stress by increasing the levels of antioxidant enzymes. Tissue malondialdehyde and protein carbonyl levels were also increased. Treatment with CAPE led to significant decrease in oxidative injury. Administration of CAPE reduced the detrimental histopathologic changes caused by MK-801. The results showed that experimentally induced schizophrenia caused oxidative stress in testes of rats and treatment with CAPE reduced these harmful effects.