Comparison of anti-spike IgG, anti-spike IgA levels and neutralizing antibody activity induced by CoronaVac and BNT162b2 vaccines in patients with inflammatory rheumatic diseases receiving immunosuppressive therapy.

BACKGROUND: The importance of COVID-19 vaccination for patients on immunosuppressive (IS) medication has increased due to the high risk of severe disease or mortality. Different vaccines have varying efficacy rates against symptomatic COVID-19, ranging from 46.8% to 95%. The objective of this study was to examine the differences in anti-Spike IgG, anti-Spike IgA, and neutralizing antibody (NAb) activity between the inactive CoronaVac vaccine and the mRNA-based BNT162b2 vaccine in IS patients. METHOD: A total of 441 volunteers, including 104 IS patients, 263 healthy controls (HC), who received two doses of CoronaVac or BNT162b2, and 74 unvaccinated patients with a history of SARS-CoV-2 infection, were included in the study. Anti-spike IgG, IgA, and NAb activity were investigated. RESULTS: Immunogenicity with BNT162b2 was higher than with CoronaVac, but in IS groups, it was lower than HC (CoronaVac-IS: 79.3%, CoronaVac-HC: 96.5%, p < 0.001; BNT162b2-IS: 91.3%, BNT162b2-HC: 100%, p = 0.005). With CoronaVac, anti-Spike IgG levels were significantly lower than BNT162b2 (CoronaVac-IS: 234.5AU/mL, CoronaVac-HC: 457.85AU/mL; BNT162b2-IS: 5311.2AU/mL, BNT162b2-HC: 8842.8AU/mL). NAb activity in the BNT162b2 group was significantly higher. NAb and anti-Spike IgG levels were found to be correlated. Among the IS group, a significantly lower response to the vaccines was observed when using rituximab. IgA levels were found to be lower with CoronaVac. CONCLUSIONS: Although immunogenicity was lower in IS patients, an acceptable response was obtained with both vaccines, and significantly higher anti-Spike IgG, anti-Spike IgA, and NAb activity levels were obtained with BNT162b2.

Optimization of the Cross-Sectional Geometry of Auxetic Dowels for Furniture Joints.

In this study, the aim was to optimize the cross-sectional geometry of auxetic dowels for furniture joints. For this purpose, two different sizes of auxetic dowels were chosen, one for frame- and the other for panel-type furniture joints for designing the cross-sectional geometry. Auxetic patterns that are created on the cross-sectional area cause deficiency of the materials, and this phenomenon decreases the modulus of elasticity (MOE) and increases the member stress. Accordingly, maximum MOE values and minimum Poisson's ratio levels were determined for the optimum strength-auxetic behavior relation by means of a Monte Carlo method. Furthermore, Poisson's ratio of the optimized dowel's cross-section was confirmed with experimental tests, numerical analyses and analytical calculations. As a result, Poisson's ratio values were obtained as negative values and confirmed, which means the dowels designed in this study had auxetic behavior. In conclusion, it could be said that studies should be conducted on the performance of auxetic dowels in both frame and panel furniture joints.

Endocan: a novel predictor of endothelial dysfunction in obstructive sleep apnea syndrome.

BACKGROUND AND AIMS: Obstructive sleep apnea syndrome (OSA) is an independent risk factor for endothelial dysfunction and cardiometabolic diseases. Plasma endocan levels are elevated in a large number of diseases, and is a novel surrogate endothelial cell dysfunction marker. We aimed to assess the role of serum endocan level as a potential mechanism of endothelial dysfunction in OSA patients. MATERIALS AND METHODS: This was a cohort study in which patients who had undergone a sleep study for diagnosis of OSA were recruited. Included patients were grouped according to apnea-hypopnea index (AHI) as mild, moderate and severe OSA. Patients with AHI < 5 served as control group. Endothelial function was evaluated with flow-mediated dilatation (FMD). Plasma endocan level was measured for all patients. RESULTS: One hundred twenty eight OSA patients included (15 controls, 22 with mild, 22 with moderate and 69 with severe OSA). The mean age was 51.6 ± 11.9 years and 43.8% (56/128) of the study population was female. As expected, the prevalence of hypertension, diabetes and cardiovascular disease increased as the severity of OSA increased. Endocan levels were significantly higher and FMD measurements were lower in patients with OSA compared to healthy controls. There was a positive correlation between AHI and serum endocan levels (rho = 0.826, P < 0.0001) and there was a negative correlation between AHI and FMD (rho = -0.686, P < 0.0001) In addition, we observed a strong negative correlation between serum endocan level and FMD (rho = -0.613, P < 0.0001). In linear regression analysis AHI was independently related both with endocan (P < 0.0001) and FMD (P = 0.011). CONCLUSION: Serum endocan level is strongly associated with the severity of OSA and endothelial dysfunction. Endocan might be a useful early novel marker for premature vascular endothelial system damage in OSA patients.

Obstructive sleep apnea is a risk factor for osteoarthritis.

INTRODUCTION: Obstructive sleep apnea (OSA) syndrome is closely associated with cardiovascular and metabolic disorders. Recent studies reported that osteoarthritis (OA) is associated with cardiovascular disease as well as inflammation defined as "metabolic disorder". Due to the strong association of metabolic disorders with both OA and OSA, we aimed to investigate the association between severity of OSA and osteoarthritis grade based on X-Ray. MATERIALS AND METHODS: Patients who underwent polysomnography due to suspicion of OSA were recruited in a cross-sectional study. Included patients were grouped according to apnea-hypopnea index (AHI) as mild (AHI between 5 and 14.9), moderately (AHI between 15 and 29.9), and severe OSA (AHI ≥ 30). Patients with AHI p< 5 served as the control group. Kellgren-Lawrence scoring system was used to express OA severity, which was graded as Grade 0, 1, 2, 3 and 4. RESULT: One hundred twenty patients were enrolled into the study. Mean age was 52.4 ± 11.5 years and 56% (68/120) of the patients were male. A strong correlation was present between severity of OSA and severity of OA. Among those with Grade 4 OA group (33 patients), all patients had severe OSA and this association was independent from body-mass index. In the Grade 1 OA group, none of the patients had severe OSA (p< 0.05). A positive correlation was also seen between severity of OSA, OA and hs-CRP. CONCLUSIONS: There is a strong association between OSA and OA. OSA might be a novel risk factor for the development OA. Further studies should evaluate the effect of OSA treatment on OA.

Two sisters with idiopathic pulmonary hemosiderosis.

Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of diffuse alveolar hemorrhage with unknown etiology. In the present report, the presentations of two sisters are described: one sister had IPH, eosinophilia and a high serum immunoglobulin E (IgE) level; and the other had IPH, pneumothorax, eosinophilia and a high serum IgE level. Both cases had quite unusual presentations. The first patient was 23 years of age, and had suffered from dry cough and progressive dyspnea for four years. Her hemoglobin level was 60 g/L, total serum IgE level was 900 U/mL and eosinophilia was 9%. Her chest radiography revealed diffuse infiltration. She died due to respiratory failure. The second patient was 18 years of age. She had also suffered from dry cough and gradually increasing dyspnea for two years. She had partial pneumothorax in the right lung and diffuse infiltration in other pulmonary fields on chest radiography. Her hemoglobin level was 99 g/L, total serum IgE level was 1200 U/mL and eosinophilia was 8%. IPH was diagnosed by open lung biopsy. All these findings suggested that familial or allergic factors, as well as immunological factors, might have contributed to the etiology of IPH.

Measurement of the total antioxidant potential in chronic obstructive pulmonary diseases with a novel automated method.

OBJECTIVE: To determine the oxidative and antioxidative status of plasma of patients with chronic obstructive pulmonary disease (COPD) and to compare these values with healthy smokers and healthy non-smokers control subjects using a more recently developed automated measurement method. METHODS: This study involved 40 COPD patients, 25 healthy smokers, and 25 healthy non-smokers who attended the Chest Diseases Outpatient Clinic in Harran University Research Hospital, Turkey during the period between March 2006 and June 2006. We calculated the total antioxidant potential (TAOP) to determine the antioxidative status of plasma, and we measured the total peroxide levels to determine the oxidative status of plasma. RESULTS: The TAOP of plasma was significantly lower in patients with COPD than in healthy smokers and healthy non-smokers (p<0.001). In contrast, the mean total peroxide level of plasma was significantly higher in COPD patients than in healthy smokers and healthy non-smokers (p<0.001). CONCLUSION: We found a decreased in TAOP COPD patients using a simple, rapid and reliably automated colorimetric assay, which may suitable for use in routine clinical biochemistry laboratory, and considerably facilitates the assessment of this useful clinical parameter. We suggest that this novel method may be used as a routine test to evaluate and follow-up the levels of oxidative stress in COPD.

Extraction of pins from the airway with flexible bronchoscopy.

BACKGROUND: Tracheobronchial foreign body aspiration is a worldwide health problem which often results in life threatening complications. Standard flexible bronchoscopy (FB) is used increasingly in the treatment of tracheobronchial foreign body aspiration in adults and older children, especially in the removal of aspirated foreign bodies which have entered into the peripheral bronchi. OBJECTIVES: In the present study, we discuss how to minimize complications and increase the success rate of FB in the aspiration of pins, and recommend techniques to facilitate the application. METHODS: The study was performed at a community hospital in Van, the Harran University Hospital in Sanliurfa and the Sutcuimam University Hospital in Kahramanmaras, Turkey. Between 2000 and 2005, 23 female patients between the ages of 12 and 23, who were admitted to the clinics and diagnosed as having tracheobronchial headscarf pin aspirations were included in our study to evaluate the efficiency of FB. Diagnosis of the patients was established by history, FB and radiological methods. All patients received transoral FB under local anesthesia. RESULTS: FB was successfully applied in all cases. During removal, the pins in 2 patients dropped at the proximal trachea and subglottic zone, and were ingested into the gastrointestinal track. In both cases, the pins were spontaneously excreted from the body in the stool within one day. No other complication was detected in the other patients during or following bronchoscopy. CONCLUSIONS: Our study suggests that FB is a safe, easy and successful method used in the removal of foreign bodies, such as pins, from the tracheobronchial trees. By employing FB, indications of thoracotomy and other invasive methods can be reduced especially in the cases of pins localized in distal airways and in the evaluation of suspected foreign bodies.

Nasal polyps and the severity of asthma.

BACKGROUND AND OBJECTIVES: Upper airway pathologies often accompany asthma. Because this represents a single airway, the diagnosis, follow up and treatment of both upper and lower respiratory diseases is essential. Samter Syndrome (SS) is known to be associated with more severe asthma. The presence of nasal polyps (NPs) is also associated with asthma. However, the incidence of NPs in asthma and the effect of NPs on asthma severity are not well documented. METHODS: Three hundred and forty-two asthma patients were evaluated by endoscopic nasal examination, pulmonary function test, skin prick tests and paranasal sinus tomography. RESULTS: Three hundred and eleven patients with asthma without NP, 19 asthma patients with NP and 12 patients with SS were included. It was found that 54.3% of patients without NPs, 63.2% with NP and 66.7% with SS were at step 3 on the Global Initiative for Asthma scale of severity, and 1.9%, 15.8% and 33.3% were at step 4, respectively. CONCLUSIONS: The presence of NPs in asthma patients is associated with an increase in asthma severity. In patients with asthma, the possibility of NPs should be investigated and treatment planned accordingly.

Helicobacter pylori seroprevalence in patients with chronic obstructive pulmonary disease and its relation to pulmonary function tests.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a slowly progressive condition characterized by poorly reversible airflow limitation that is associated with an abnormal inflammatory response of the lung. It has been shown that there is a seroepidemiological association of Helicobacter pylori (Hp) infection with many inflammatory conditions. OBJECTIVE: In this study, we aimed to investigate seroprevalence in Hp patients with COPD and to determine whether there is an association between Hp infection and COPD. METHODS: Forty-nine voluntary patients with COPD and 50 healthy control subjects of similar age and sex were included in the study. Hp-specific IgG was measured with a commercially available kit from venous blood samples. RESULTS: Serum levels of Hp-specific IgG and Hp IgG seropositivity were significantly higher in the patients with COPD than in the control subjects (p < 0.001 and p = 0.006, respectively). In addition, when the patients with COPD were grouped according to Hp IgG seropositivity, forced expiratory volume in 1 s (FEV(1)) values were lower in the seropositive patients compared to seronegative patients, and Hp serum IgG levels were correlated with FEV(1) values, which indicate the severity of COPD, in the COPD group (r = -0.306, p = 0.032). CONCLUSION: The results suggest that there is an association between Hp infection and COPD, and Hp IgG levels are correlated with the severity of COPD.

The effects of isothermic and hypothermic carbon dioxide pneumoperitoneum on respiratory function test results.

BACKGROUND/PURPOSE: This study investigated the effects of isothermic and hypothermic carbon dioxide, used for pneumoperitoneum during laparoscopic cholecystectomy, on respiratory function test results. METHODS: Thirty patients who underwent elective laparoscopic cholecystectomy were enrolled in this prospective randomized study. The patients were divided into two groups. Carbon dioxide at 37 degrees C (isothermic) was used in the isothermic group, and carbon dioxide at 21 degrees C (hypothermic) was used in the hypothermic group. Respiratory function tests were performed in the preoperative period and at 12 h after the operation. RESULTS: Mean forced vital capacity (FVC), forced expiratory volume (FEV1), maximum peak expiratory flow (PEF), and the FEV1/FVC ratio were significantly higher in the isothermic group than in the hypothermic group (P < 0.05). CONCLUSIONS: Using isothermic carbon dioxide for pneumoperitoneum has fewer negative effects than hypothermic carbon dioxide on respiratory function tests results. Isothermic carbon dioxide may be preferable for patients with respiratory problems.

Impact of bronchiectasis on right and left ventricular functions.

Diffuse systemic-pulmonary anastomoses and chronic hypoxemia may result in increase in ventricular work in bronchiectasis. We aimed to assess right ventricular (RV) and left ventricular (LV) functions in patients with bronchiectasis by using tissue Doppler-derived myocardial performance index (MPI), which is a novel and more sensitive parameter than conventional ventricular function parameters. To assess the possibility of RV and LV dysfunctions occurring in bronchiectasis, we studied 25 patients with bronchiectasis, and compared them with 22 age- and gender-matched control subjects. MPI, which is a combined index of both systolic and diastolic ventricular function, was calculated for both ventricles. RV and LV MPIs were also significantly different in patients and the controls. RV MPI was associated with the number of involved lobe, arterial blood oxygen pressure, and acceleration time/ejection time of pulmonary flow. LV MPI was not related to any clinical parameter, but it was correlated only with RV MPI. Ventricular functions are impaired in bronchiectasis. The impairment of RV function is related to involved lung lobe number, arterial oxygen pressure, and acceleration time/ejection time of pulmonary flow. LV dysfunction was correlated only with RV function.

Association of serum reactive oxygen metabolite levels with different histopathological types of lung cancer.

BACKGROUND: Oxygen is required for respiration and the energetic processes that enable aerobic life. Costs associated with oxygen use are free radical and reactive oxygen metabolite (ROM) formations, which create oxidative stress and contribute to various processes including aging, degenerative diseases and cancer. Additionally, they may have a role in the pathogenesis of lung cancer with different histopathological types. OBJECTIVES: In this study, we aimed to investigate the degree of oxidative stress in different types of carcinoma such as small cell carcinoma and non-small cell carcinoma, including epidermoid carcinoma and adenocarcinoma, and to find out whether the degree of oxidative stress shows any difference among them and whether it can be used as an index for their differential diagnosis. METHODS: Thirty-eight patients with lung cancer and 26 healthy persons were included in the study. Of the patients with lung cancer, 14 had epidermoid carcinoma, 12 adenocarcinoma and 12 small cell carcinoma. Serum ROM levels were detected by using an available commercial kit according to the manufacturer's instructions. RESULTS: The ROM levels were significantly lower in the controls than in the patients (p<0.001). Although all subtypes had significantly high ROM levels compared with the controls, the highest significance was found in the small cell carcinoma (p<0.001), and then in the adenocarcinoma and epidermoid carcinoma (p<0.01 and p<0.01, respectively). CONCLUSIONS: In the light of these data, it might be possible to conclude that the serum ROM levels increase in patients with different types of lung cancers and may be an index parameter for lung cancer. It could be thought that this increase, particularly in small cell carcinoma, may contribute to its poor progression.

Increased DNA damage in patients with chronic obstructive pulmonary disease who had once smoked or been exposed to biomass.

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is a slowly progressive condition characterised by poorly reversible airflow limitation associated with an abnormal inflammatory response of the lung. The main causal factors of COPD are chronic oxidative stress as a result of long-term smoking, use of biomass fuels, and air pollution. In this study, basal levels of DNA strand breaks were investigated together with some additional oxidative markers implicating oxidative damage on the other biomolecules such as proteins and lipids in patients with COPD who were exposed to smoking and biomass. MATERIAL AND METHODS: We detected DNA strand breaks in peripheral blood mononuclear leukocytes by using a Single Cell Gel Electrophoresis (also called Comet Assay), plasma protein carbonyl (PC) content by using Reznick and Parker's spectrophotometric method, and lipid peroxidation by measurement of malondialdehyde (MDA) as indexes of oxidative stress in 47 patients with smoking-related COPD and 25 patients with biomass-related COPD and 36 age-and-sex matched control participants. RESULTS: The mean values of DNA strand breaks, MDA and protein carbonyl levels were significantly higher in smoking- and biomass-related COPD groups than in the control group (ANOVA P<0.001, <0.05 and <0.05, respectively). DNA damage levels were also higher in smoking-related COPD group than in biomass-related COPD group (P<0.05). There was a positive relationship between DNA damage and MDA levels in smoking-related COPD group (P<0.05). CONCLUSION: Oxidative stress markers and DNA damage were strongly increased in both patient groups with smoking- and biomass-related COPD. However, DNA is more affected in smoking-related COPD patients than in biomass-related COPD. These data indicate that cigarette smoking is a more significant DNA damaging risk factor than biomass smoke.

Budesonide-formoterol (inhalation powder) in the treatment of COPD.

The budesonide-formoterol dry powder inhaler (Symbicort Turbuhaler 160/ 4.5-640/18 microg/day) contains the long-acting beta2-adrenoreceptor agonist formoterol and the inhaled corticosteroid budesonide. Two large, 12-month trials examined the effect of budesonide-formoterol 160/4.5 microg twice daily in COPD patients who met these criteria. The studies were identical, except one in which the patients had received oral prednisolone 30 mg/ day and had inhaled formoterol 4.5 microg twice daily for 2 weeks before randomization. In terms of the FEV1, budesonide-formoterol produced an effect greater than that of both budesonide alone and formoterol alone reported in previous studies. The combination was generally more effective than either of the components in terms of peak expiratory flow, symptoms, and exacerbations. These advantages of the combination over those of either budesonide alone or formoterol alone were quite consistent. Improving lung function and decreasing symptoms significantly, budesonide-formoterol combination therapy provides significant clinical improvements in COPD, despite the limited reversibility of impaired lung function in the disease.

Impact of chronic obstructive pulmonary disease with pulmonary hypertension on both left ventricular systolic and diastolic performance.

BACKGROUND: The effects of chronic obstructive pulmonary disease (COPD) on right ventricular (RV) systolic and diastolic functions and left ventricular (LV) diastolic function have been shown. Whereas LV myocardial performance index (LVMPI), which incorporates ejection and isovolumic relaxation and contraction times and is an index of global ventricular function, has not yet been evaluated in COPD. METHODS: Our study population consisted of 24 age-matched control subjects (group 1), 24 patients with COPD without pulmonary hypertension (group 2), and 20 patients with COPD with pulmonary hypertension (group 3). Pulmonary function tests, analyses of arterial blood gases, and transthoracic echocardiographic examination were performed. RV myocardial performance index (RVMPI) and LVMPI were obtained by pulsed wave Doppler tissue. RESULTS: RVMPI was higher in both group 2 (0.61 +/- 0.15) and group 3 (0.94 +/- 0.27) than group 1 (0.41 +/- 0.08) (P = .038 and P< .001, respectively), and was higher for group 3 than in group 2 (P = .018). LVMPI was higher for group 3 (0.77 +/- 0.25) than in both group 1 (0.49 +/- 0.08) and group 2 (0.59 +/- 0.10) (P = .001 and P = .037, respectively). However, difference between groups 1 and 2 was not significant (P > .05). For patients with COPD, LVMPI was positively correlated with age, heart rate, pulmonary arterial systolic pressure, RVMPI, and partial pressure of carbon dioxide, and negatively correlated with tricuspid annular plane systolic excursion, forced expiratory volume in 1 second, and partial pressure of oxygen. In multiple linear regression analysis (R2 = 0.676), LVMPI was independently associated with forced expiratory volume in 1 second (Beta = 0.549, P = .017), pulmonary arterial systolic pressure (Beta = 0.488, P = .014), and RVMPI (Beta = 0.278, P = .042). CONCLUSIONS: Both LV systolic and diastolic functions are impaired in COPD, especially in patients with pulmonary hypertension. This impairment is independently associated with pulmonary arterial systolic pressure, RVMPI, and forced expiratory volume in 1 second.

Leukocyte oxidant and antioxidant status in asthmatic patients.

BACKGROUND: Oxidative stress mediated by reactive oxygen species (ROS) is recognized to contribute significantly to the inflammatory process of bronchial asthma (BA). These species are released into the airway by activated inflammatory cells such as leukocytes. In this study, we aimed to determine whether the oxidant-antioxidant balance is changed in leukocytes of patients with BA. METHODS: Thirty eight patients (21 male, 17 female) aged 22-68 years and controls of 32 subjects (18 male, 14 female) aged 20-63 years were included in the study. A total of 10 mL venous blood was drawn, leukocytes were separated and lipid peroxidation (LPO), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and vitamin C levels were determined in both patients and controls. RESULTS: Leukocyte LPO and SOD activity in the patient group were higher than that of controls (p <0.001 and p <0.05, respectively). However, leukocyte GSH-Px and vitamin C levels in the patient group were lower than that of controls (p <0.01 and p <0.001, respectively). CONCLUSIONS: The results suggest that there are alterations in a wide array of oxidants and antioxidants with balance shifting toward increased oxidative stress in BA.

Clinical presentation of abdominal tuberculosis in HIV seronegative adults.

BACKGROUND: The accurate diagnosis of abdominal tuberculosis usually takes a long time and requires a high index of suspicion in clinic practice. Eighty-eight immune-competent patients with abdominal tuberculosis were grouped according to symptoms at presentation and followed prospectively in order to investigate the effect of symptomatic presentation on clinical diagnosis and prognosis. METHODS: Based upon the clinical presentation, the patients were divided into groups such as non-specific abdominal pain & less prominent in bowel habit, ascites, alteration in bowel habit, acute abdomen and others. Demographic, clinical and laboratory features, coexistence of pulmonary tuberculosis, diagnostic procedures, definitive diagnostic tests, need for surgical therapy, and response to treatment were assessed in each group. RESULTS: According to clinical presentation, five groups were constituted as non-specific abdominal pain (n = 24), ascites (n = 24), bowel habit alteration (n = 22), acute abdomen (n = 9) and others (n = 9). Patients presenting with acute abdomen had significantly higher white blood cell counts (p = 0.002) and abnormalities in abdominal plain radiographs (p = 0.014). Patients presenting with alteration in bowel habit were younger (p = 0.048). The frequency of colonoscopic abnormalities (7.5%), and need for therapeutic surgery (12.5%) were lower in patients with ascites, (p = 0.04) and (p = 0.001), respectively. There was no difference in gender, disease duration, diagnostic modalities, response to treatment, period to initial response, and mortality between groups (p > 0.05). Gastrointestinal tract alone was the most frequently involved part (38.5%), and this was associated with acid-fast bacteria in the sputum (p = 0.003). CONCLUSION: Gastrointestinal tract involvement is frequent in patients with active pulmonary tuberculosis. Although different clinical presentations of patients with abdominal tuberculosis determine diagnostic work up and need for therapeutic surgery, evidence based diagnosis and consequences of the disease does not change.

Evaluation of oxidative-antioxidative status and the L-arginine-nitric oxide pathway in asthmatic patients.

BACKGROUND: Reactive nitrogen, oxygen species and oxidative stress are related to many pulmonary diseases. Nitric oxide (NO) may be involved in either the protection against or the induction of oxidative stress within various tissues. It is derived from the amino acid L-arginine by the action of NO synthase (NOS). L-arginine can also be metabolized by arginase with the production of ornithine and urea. Because of the competition between NOS and arginase for the same substrate, their activities are regulated reciprocally. Therefore, the rate of NO generation associated with oxidative stress is dependent on the relative activities of both NOS and arginase. The objective of this study is to investigate the L-arginine-NO pathway, evaluate oxidative-antioxidative status in the patients with asthma and demonstrate their reciprocal regulation. METHODS: 30 voluntary asthmatic patients and 30 healthy control subjects with similar age range and sex were included in the study. A total of 10 ml venous blood was drawn, plasma and packed erythrocytes were prepared for the biochemical analyses. Plasma arginase activities and NO levels, and erythrocyte malondialdehyde and reduced glutathione levels were detected. RESULTS: Plasma malondialdehyde levels were significantly higher and glutathione levels were lower in patients with asthma than those of the control subjects (P < 0.001 and P < 0.01, respectively). Arginase activities were significantly lower and NO levels were higher in the patients than those of the controls (P < 0.001 for both). The negative correlation between arginase and NO levels in the patients was significant (r = -0.47; P < 0.01). There was also a positive correlation between malondialdehyde and NO levels in the patients (r = 0.51; P < 0.01). CONCLUSIONS: The results suggest that the L-arginine-NO pathway is involved in the pathophysiology of asthma; the arginase activities decrease which causes an increase in the L-arginine levels thereby up-regulation of NO production may contribute to the increase of oxidative stress in asthma.

A new parameter in the detection of tuberculosis activity: reactive oxygen metabolites.

BACKGROUND AND OBJECTIVES: In countries with a high frequency of tuberculosis, there are problems not only with active lung tuberculosis but also with past lung tuberculosis. Cases with sequel tuberculosis very frequently present with complaints like tuberculosis, and it is very hard to determine whether it is a sequel tuberculosis complication or reactivation of tuberculosis. In this study, we measured the serum reactive oxygen metabolite (ROM) levels of patients with active pulmonary tuberculosis and healthy controls, and investigated if these metabolites can be used as a criterion for differentiation between active pulmonary tuberculosis and sequel pulmonary tuberculosis. METHODS: 40 patients with active tuberculosis, 35 patients with sequel pulmonary tuberculosis and 30 healthy control subjects with a similar age range and sex distribution were included in the study. Serum total ROM levels were detected in the patients and control group. RESULTS: Mean serum ROM values were 994+/-236, 551+/-135 and 236+/-59 U/l among active lung tuberculosis cases, sequel lung tuberculosis cases and the healthy control group, respectively. As a result of these findings, serum ROM levels of active lung tuberculosis cases and sequel lung tuberculosis cases were significantly higher than those of the control group (both p<0.001). The serum ROM levels of active lung tuberculosis cases were also significantly higher than those of sequel lung tuberculosis cases (p<0.001). CONCLUSIONS: In the light of our findings, it may be assumed that serum total ROM values can be used as an activity criterion in the differentiation of active lung tuberculosis and sequel lung tuberculosis.