Proteomic Identification of Allergenic Proteins of Morus alba L. Pollenexacerbation.

BACKGROUND: Tree pollens are well-known aeroallergens all over the world. Little is known about the allergenicity of Morus alba (white mulberry) pollen. OBJECIVE: We aimed to explore the potential allergens of this pollen and its clinical relevance in tree pollen allergic patients living in Istanbul, Turkey. METHODS: Twenty three seasonal allergic rhinitis patients with a confirmed tree pollen allergy and 5 healthy control subjects underwent skin prick and nasal provocation tests with M.alba pollen extract. The pollen extract was then resolved by gel electrophoresis, and immunoblotted with sera from patients/control individuals to detect the potential allergenic proteins. The prevalent IgE binding proteins from 1D-gel were analyzed by MALDI-TOF/TOF. RESULTS: Eleven out of 23 patients were reactive to the extract with skin prick tests. Seven of those patients also reacted positively to the nasal provocation tests. The most common IgE-binding pollen proteins were detected between 55-100 kDa, and also at molecular weights lower than 30 kDa for some patients. Mass spectrometry analyses revealed that the principal IgE-binding protein was methionine synthase (5-methyltetrahydropteroyltriglutamate homocysteine methyltransferase), which is then proposed as a novel allergen in M.alba pollen. CONCLUSION: This study provides the first detailed information for the potential allergens of Morus alba pollen of Istanbul. Methionine synthase with an apparent molecular weight of 80 to 85 kDa has been recognized as one of the allergens in Morus alba pollen for the first time.

A SOD2 Polymorphism is Associated with Abnormal Quantitative Sensory Testing in Type 2 Diabetic Patients.

INTRODUCTION: Diabetes mellitus (DM) affects peripheral nerves inducing diabetic polyneuropathy (DPN). Mitochondrial dysfunction and oxidative stress are potential causes of DPN. METHODS: Nerve conduction studies were performed in 20 type 2 DM patients (11 with DPN) and 15 healthy controls. Perception threshold values of cold, warm and vibration were measured by quantitative sensory testing. Variants of a superoxide dismutase 2 (SOD2) gene single nucleotide polymorphism (SNP) (rs5746136) were determined by polymerase chain reaction (PCR) and following NexteraXT DNA Library. RESULTS: DPN patients showed significantly increased threshold values. DM patients without DPN and healthy controls showed comparable values. TT variant of the SOD2 SNP was more prevalent in DM and DPN patients. DM patients with the TT variant displayed increased perception threshold values. CONCLUSIONS: Quantitative sensory testing is not superior to standard nerve conduction studies in DPN. Carriers of SOD2 SNP manifested increased sensory threshold levels which is important in further corroborating the link between oxidative stress and DPN.

The effects of home blood pressure monitoring on blood pressure control and treatment planning.

OBJECTIVES: Blood pressure monitoring is essential in hypertension, which is an important public health issue. Our objective was to compare the rates of blood pressure control and to investigate factors that affect blood pressure control in patients with hypertension. METHODS: The records of 1006 patients with hypertension were examined retrospectively. The blood pressure control rates of the 394 patients who measured their blood pressure at home (group 1) and those who did not (group 2) were compared. RESULTS: In group 1, the mean systolic and diastolic blood pressure was 123.91±12.63/78.64±8.92 mmHg measured at home, whereas it was 140.31±20.56/85.76±11.55 mmHg in the office setting (p<0.0001). In the total group (N=1006), the blood pressure control achievement rate was 56.1%. The number of cardiovascular events, hypertension duration, and the rate of being employed was higher in group 1 (p<0.0001, p<0.0001 and p=0.0001, respectively), while heart rate and grade 3-4 retinopathy was lower in group 1 (p<0.0001 for both) . Occupational status, geographical origin, BMI and the use of angiotensin converting enzyme (ACE) inhibitors were found to be the determinants of office BP control (p<0.05, p<0.05, p=0.001 and p<0.05, respectively), and BMI and grade 3-4 retinopathy findings were found to be the determinants of home BP control (p <0.05 for both). CONCLUSION: Home blood pressure monitoring is useful in preventing complications and achieving therapy compliance and is essential in diagnosis and treatment planning of hypertension.

Oral nickel exposure may induce Type I hypersensitivity reaction in nickel-sensitized subjects.

BACKGROUND: Little is known about the clinical and immunological changes in the nickel allergic patients with systemic symptoms. We aimed to evaluate T helper cell responses of patients with different clinical presentations due to nickel. METHODS: Patients having various allergic symptoms and positive patch test results to nickel and 20 controls underwent skin prick tests with nickel. IL-10, IL-4, IL-5 and IFN-gamma were measured in the culture supernatants of PBMC stimulated by nickel during lymphocyte proliferation test (LTT). RESULTS: 69 patients (56 female, mean age: 49.2 ± 13.1), 97% having nickel containing dental devices and 20 controls (8 female, mean age 34.9 ± 12.06) were evaluated. Skin prick tests with nickel were positive in 70% of the patients (p<0.001), being significantly higher in the patients with urticaria/angioedema (p=0.02). The LTT stimulation index (p<0.0001), IL-4 (p=0.002), IFN-gamma (p=0.01), IL-5 (p=0.04) and IL-10 (p=0.003) were higher in the patient group. LTT stimulation index, IL-4 and IL-10 were significantly elevated in patients having urticaria, angioedema and respiratory symptoms when compared to those who had only oral symptoms or systemic dermatitis (p=0.004, p=0.002 and p=0.01, respectively). CONCLUSION: This study suggests the presence of Type I hypersensitivity in addition to a Type IV immune reaction in patients with chronic systemic symptoms related to nickel. Nickel containing dental alloys and oral nickel intake seem to trigger systemic symptoms in previously nickel sensitized patients.

Enhanced nerve growth factor expression by mast cells does not differ significantly between idiopathic and allergic rhinitis.

BACKGROUND: The role of neurotrophins in allergic rhinitis (AR) has been well studied, but it has not been evaluated in idiopathic rhinitis (IR). OBJECTIVE: We aimed to evaluate the nasal ß-nerve growth factor (ß-NGF) expressions of mast cells in patients with AR and IR. METHODS: Seventeen patients with house dust mites-induced persistent moderate/severe allergic rhinitis (mean age: 29.7 ± 11.96), 14 patients with idiopathic rhinitis (mean age, 29.3 ± 10.62), and 16 healthy controls (29.9 ± 11.57) were included in the study. Nasal biopsy specimens were taken from the posterior part of the inferior turbinate from all of the study subjects. Nasal ß-nerve growth factor and its receptors, pan-neurotrophin receptor p75, and tyrosine kinase A (trkA) were assessed with an immunofluorescence assay. Mast cells were determined by both an immunofluorescence assay and immunohistochemistry as tryptase-positive cells. RESULTS: The ß-NGF, trkA, and p75 receptor counts were significantly higher in AR and IR patients than in the control group (P < .001, for each), but they were not different between AR and IR patients. Similarly, the ratio of ß-NGF+ mast cells/total mast cells and the ratio of ß-NGF+ mast cells/total ß-NGF+ cells in AR and IR patients was found to be elevated when compared with the control group (P < .001, P < .001, P < .001, and P = .046, respectively); furthermore, the 2 ratios were not statistically different between the 2 patient groups. CONCLUSION: The increase in ß-NGF-expressing mast cells does not differ between idiopathic and allergic rhinitis. Therefore, we propose that mast cells do play a role in the pathogenesis of IR as important as in that of AR.

Hypertensive retinopathy: incidence, risk factors, and comorbidities.

We aimed to determine the prevalence and risk factors of retinopathy in hypertensive outpatients. Demographic data, accompanying diseases, anthropometric measurements, and blood and urine biochemistry of 655 hypertensive patients were evaluated. Hypertensive retinopathy rate was 66.3% (grade 1, 33.6%; grade 2, 32.7%). Age, duration of hypertension, and systolic blood pressure levels were significant risk factors for retinopathy (P = .048, P = .035, and P = .012, respectively). Any correlations between retinopathy and gender, body mass index, biochemistry, and associated diseases were not found. This study shows that the degree and duration of hypertension increases the incidence of retinopathy. Low-grade retinopathy seems not to be associated with other cardiovascular risks.

The relationship between transforming growth factor-beta1, vascular endothelial growth factor, nitric oxide and Hashimoto's thyroiditis.

BACKGROUND: Hashimoto's thyroiditis (HT) is one of the autoimmune disorders of the thyroid gland. The pathogenesis of HT has not been clearly understood. This study was designed to investigate plasma transforming growth factor-beta1 (TGF-beta1), vascular endothelial growth factor (VEGF), and nitrate/nitrite (NOx - two end products of nitric oxide [NO] metabolism) in HT. METHODS: Forty patients diagnosed HT and 40 age- and sex-matched healthy controls were included in the study. TGF-beta1 and VEGF levels were measured by ELISA, NOx levels were measured spectrophotometrically. RESULTS: Plasma TGF-beta1 and VEGF were decreased, and NOx increased in HT patients in comparison with controls. There was a significant correlation between TGF-beta1 and VEGF, and weak but significant correlation between TGF-beta1 and NOx in HT. CONCLUSION: This study indicates that TGF-beta1, VEGF and NO probably have a role in the pathogenesis of Hashimoto's thyroiditis, and development of autoimmunity. Clearly, further studies are necessary to establish the exact mechanism of TGF-beta1, VEGF and NO interaction in Hashimoto's thyroiditis.

Neurotrophins: are they meaningful in chronic spontaneous urticaria?

Plasma neurotrophin levels are elevated in patients with allergic and autoimmune diseases. The present study was designed to investigate the serum neurotrophin levels in 42 patients displaying chronic spontaneous urticaria, as well as 22 healthy control subjects. Blood samples were obtained from subjects during their first visit to the clinic, and then again after one month of desloratadine therapy. No significant difference was found between patient and control groups in terms of basal serum neurotrophin levels. However, basal nerve growth factor levels in patients whose symptoms persisted despite treatment were significantly lower than those of the drug-responsive patients and the control group. In treatment-responsive patients, nerve growth factor increased after suppression of the symptoms. Our study suggests that chronic spontaneous urticaria is linked with changes serum nerve growth factor levels, and that the deregulation of neurotrophins may contribute to urticaria pathophysiology.

Acute-phase reactans in Hashimoto thyroiditis.

Hashimoto thyroiditis (HT) is one of the autoimmune diseases of the thyroid gland. It is characterized by diffuse lymphocytic infiltration of the thyroid gland and the elevated levels of the serum anti-thyroid antibodies. Recently Hashimoto thyroiditis has been proposed as a systemic disorder. Acute-phase reactans have been implicated for their involvement as pro-inflammatory molecules in various inflammatory diseases. The aim of the present study was to examine the blood concentrations of acute-phase proteins, namely C-reactive protein (CRP), serum amyloid A (SAA) and fibrinogen in the patients with Hashimoto thyroiditis. Two groups were enrolled: study group consisting from euthyroid patients with HT (n=30), and healthy control subjects (n=30). Blood samples were obtained from all the patients and control subjects and were analyzed for serum CRP, SAA, fibrinogen, and ESR. Mean ESR was found to be higher in HT patients than control group (p=0.024). The mean fibrinogen and SAA values in HT were also significantly higher than that of the control group (p=0.03, p=0.002). We therefore suggest that a low-grade systemic inflammation may exist in HT patients even if they were euthyroid.

Nigella sativa (black seed) oil does not affect the T-helper 1 and T-helper 2 type cytokine production from splenic mononuclear cells in allergen sensitized mice.

Nigella sativa Linn. (Ranunculaceae) is known to have beneficial effects on a wide range of diseases including asthma. However, the mechanism of action in asthma and other allergic diseases is not entirely clear. The present study was planned to evaluate the effects of Nigella sativa on cytokine production of splenic mononuclear cells in ova-sensitized mice. Nineteen two-month-old BALB/c mice were given 0.3 mL of Nigella sativa oil by oro-eosophageal cannula once a day for a month. The control group consisting of 10 mice took 0.3 mL of 0.9% saline solution by the same route for the same period. In the third week of the study, all mice were sensitized by means of intraperitoneal injections of 20 microg of ovalbumin (OVA-Grade VI, Sigma). Ova injections were repeated three times with 7-day intervals. After another week, all mice were sacrificed by means of cervical dislocation. Then the splenic mononuclear cells (MNCs) of mice were cultured with OVA or Concavalin A (Con-A). From the culture supernatants, IL-4, IL-10 and IFN-gamma were assessed by means of ELISA. The cytokine production of splenic MNCs of mice that were given Nigella sativa for 30 days was not significantly different than those who took saline solution instead. In conclusion, Nigella sativa oil seems not to have an immunomodulatory effect on Th1 and Th2 cell responsiveness to allergen stimulation.

Acute phase reactants in allergic airway disease.

Acute phase reactants have been implicated for their involvement as proinflammatory molecules in various inflammatory diseases. However, little is known regarding their role in the allergic airway disease. The aim of the present study was to examine the blood concentrations of three acute-phase proteins, namely C-reactive protein (CRP), serum amyloid A (SAA) and fibrinogen in patients with allergic rhinitis and asthma. Three study groups include: non-smoker allergic rhinitis (n = 50), non-smoker asthma (n = 20), and non-allergic, non-smoker healthy control subjects (n = 20). Patients who have had recent upper or lower respiratory tract infection and trauma, any rheumatological illnesses, malignancy or obesity were excluded. Blood samples were obtained from all the patients and control subjects and were analyzed for serum CRP, SAA and plasma fibrinogen. The mean CRP and fibrinogen values in the rhinitis and asthma groups were not significantly different when compared to the control group. However, the mean SAA levels of both groups were found to be significantly higher than those of the control group (p = 0.002 for rhinitis, p = 0.02 for asthma). There was no significant correlation between the FEV(1) values and the levels of the serum markers. This study demonstrates that acute phase reactant SAA rises in patients with allergic rhinitis and patients with asthma. We therefore suggest that SAA may have a role in the inflammatory airway disease.

Sister chromatid exchange and mitotic index in patients with cirrhosis related to hepatitis B and C viruses and in chronic carriers.

BACKGROUND/AIMS: It is controversial whether hepatitis B or C viruses induce liver cancer through non-specific mechanisms (inflammation and cell renewal) or direct genotoxicity. Considering that both viruses infect peripheral lymphocytes, studying sister chromatid exchange frequency and mitotic index in peripheral lymphocytes is a reasonable experimental approach to investigate their genotoxic potential separately. In the present study we investigated sister chromatid exchange frequency and mitotic index in the peripheral lymphocytes of patients with cirrhosis and chronic carriers with positive serology for HBV or HCV infections. METHODOLOGY: The study population consisted of 3 groups: group I involved 23 HBsAg positive chronic carriers; group II involved 30 HBsAg positive patients with cirrhosis and group III involved 9 HCV-positive patients with cirrhosis. The control group involved 30 healthy individuals. RESULTS: Sister chromatid exchange frequency was significantly higher in all the study groups than the control group (p < 0.05). The mitotic index was significantly lower in all the study groups than the control group (p < 0.05). CONCLUSIONS: The increased sister chromatid exchange frequency and low mitotic index may be reflecting a direct genotoxic effect of HBV and HCV in peripheral lymphocytes. We suggest that the same genotoxicity may also operate in the liver and contribute to hepatocarcinogenesis.