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Nanoparticles (NPs) have been widely used to improve the pharmacokinetic properties and tissue distribution of small molecules such as targeting to a specific tissue of interest, enhancing their systemic circulation, and enlarging their therapeutic properties. NPs have unique and complicated in vivo disposition properties compared to small molecule drugs due to their complex multifunctionality. Physiologically based pharmacokinetic (PBPK) modeling has been a powerful tool in the simulation of the absorption, distribution, metabolism, and elimination (ADME) characteristics of the materials, and it can be used in the characterization and prediction of the systemic disposition, toxicity, efficacy, and target exposure of various types of nanoparticles. In this review, recent advances in PBPK model applications related to the nanoparticles with unique properties, and dispositional features in the biological systems, ADME characteristics, the description of transport processes of nanoparticles in the PBPK model, and the challenges in PBPK model development of nanoparticles are delineated and juxtaposed with those encountered in small molecule models. Nanoparticle related, non-nanoparticle-related, and interspecies-scaling methods applied in PBPK modeling are reviewed. In vitro to in vivo extrapolation (IVIVE) methods being a promising computational tool to provide in vivo predictions from the results of in vitro and in silico studies are discussed. Finally, as a recent advancement ML/AI-based approaches and challenges in PBPK modeling in the estimation of ADME parameters and pharmacokinetic (PK) analysis results are introduced.
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BACKGROUND: We aimed to examine the effects of COVID-19 infection versus vaccination within the month prior to acute coronary syndrome (ACS) diagnosis with respect to their impact on the development of mortality or major adverse cardiovascular events (MACE). METHODS: This retrospective cohort study included patients hospitalized with a diagnosis of ACS between June 2020 and December 2022. Patients diagnosed with ACS were grouped according to the presence of COVID-19 infection (post-COVID), vaccination (post-vaccine), or non-exposure during the month prior to ACS diagnosis. Patients with and without MACE were also compared separately. RESULTS: We analyzed 1890 ACS patients (mean age 57.43 ± 11.53 years, 79.15% males). Of these, 319 (16.88%) were in the post-vaccine group, and 334 (17.67%) were in the post-COVID group. Major adverse cardiovascular events occurred in 569 (30.11%) patients. Mortality was recorded in 271 (14.34%) patients. In the post-COVID group, the frequencies of MACE and mortality and length of stay in hospital were significantly higher (vs. post-vaccine and vs. non-exposure groups; both P <.001). High age, ST-elevation myocardial infarction, having suffered from Post-COVID ACS, and high glucose were independently associated with increased MACE risk; whereas, hyperlipidemia, 3 or more COVID vaccinations, receipt of the Biontech vaccine, and high estimated glomerular filtration rate were independently associated with decreased MACE risk. CONCLUSION: Acute coronary syndrome patients who have recently had COVID-19 infection may have a worse prognostic course compared to those with recent vaccination, necessitating continuing care for pandemic-related risk factors as well as previously known factors impacting MACE and prognosis.
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BACKGROUND: Food protein-induced allergic proctocolitis (FPIAP) is a nonimmunoglobulin (IgE)-mediated food hypersensitivity and the exact mechanisms that cause FPIAP are unknown. Chemokines play crucial roles in the development of allergic diseases. OBJECTIVE: To examine serum levels of a group of chemokines in infants with FPIAP. METHODS: In 67 infants with FPIAP and 65 healthy infants, we measured serum levels of mucosa-associated epithelial chemokine (MEC/CCL28), thymus-expressed chemokine (TECK/CCL25), CX3CL1 and macrophage inflammatory protein (MIP)-3a/CCL20. RESULTS: Infants with FPIAP had a lower median value of MIP3a/CCL20 than healthy infants [0.7 (0-222) vs. 4 (0-249) pg/mL, respectively] (p < 0.001). Infants with MIP3a/CCL20 levels ≤0.95 pg/mL have 13.93 times more risk of developing FPIAP than infants with MIP3a/CCL20 levels >0.95 pg/mL. Serum MEC/CCL28, TECK/CCL25, and CX3CL1 levels were similar between the infants with FPIAP and the control group. CONCLUSION: MIP3a/CCL20 serum levels were reduced in infants with FPIAP compared with healthy controls. Whether this finding has a role in pathogenesis remains to be determined.
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Quimiocina CCL20 , Hipersensibilidade Alimentar , Proctocolite , Humanos , Lactente , Hipersensibilidade Alimentar/complicações , Proteínas Inflamatórias de Macrófagos , Mucosa , Quimiocina CCL20/sangue , Quimiocina CCL20/químicaRESUMO
The discovery of new strategies and novel therapeutic agents is crucial to improving the current treatment methods and increasing the efficacy of cancer therapy. Phytochemicals, naturally occurring bioactive constituents derived from plants, have great potential in preventing and treating various diseases, including cancer. This study reviewed 74 literature studies published between 2006 and 2022 that conducted in vitro cytotoxicity and cell apoptosis analyses of the different concentrations of phytochemicals and their combinations with conventional drugs or supplementary phytochemicals on human pancreatic cell lines. From 34 plant-derived phytochemicals on 20 human pancreatic cancer cell lines, a total of 11 input and 2 output variables have been used to construct the data set that contained 2161 different instances. The machine learning approach has been implemented using random forest for regression, whereas association rule mining has been used to determine the effects of individual phytochemicals. The random forest models developed are generally good, indicating that the phytochemical type, its concentration, and the type of cell line are the most important descriptors for predicting the cell viability. However, for predicting cell apoptosis the primary phytochemical type is the most significant descriptor . Among the studied phytochemicals, catechin and indole-3-carbinol were found to be non-cytotoxic at all concentrations irrespective of the treatment time. On the other hand, berbamine and resveratrol were strongly cytotoxic with cell viabilities of less than 40% at a concentration range between 10 and 100 µM and above 100 µM, respectively, which brings them forward as potential therapeutic agents in the treatment of pancreatic cancer.
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This research has been conducted to determine the effect of tourists' beliefs of climate change on the NEP and ecotourism attitudes. In addition to this purpose, the moderator role of green self-identity in the effect of the NEP on ecological attitudes has also been examined. The research data were obtained from the tourists visiting the Alanya destination, which is one of the centers that attract the most tourists in Turkey. When the results of the research were examined, it could be determined that the belief in climate change is effective on all dimensions of the NEP, and similarly, all dimensions of the NEP have also affected the tourists' ecological attitude. Further, green self-identity has a moderator role in the effect of ecocentric and anthropocentric sub-dimensions on eco-tourism attitudes. As a consequence of the findings, a number of theoretical and practical implications have been developed for sector managers, destination management organizations, and academicians.
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Turismo Médico , Turismo , Mudança Climática , Atitude , TurquiaRESUMO
PURPOSE: We aimed to evaluate and compare the efficacy and complications of three consecutive prone positions (PP) in COVID-19 ICU. MATERIALS AND METHOD: Patients with ARDS and placed in PP for 3 times (PP1, PP2, PP3) consecutively were included. Arterial blood gases (ABG), partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) ratios, partial pressure of carbondioxide (PaCO2), PEEP, and FiO2 were recorded before (bPP), during (dPP), and after (aPP) every prone positioning. Eye, skin, nerve, and tube complications related to PP were collected. RESULTS: In all positions, PaO2 value during PP was significantly higher than PaO2 before and after prone position (p = 0.001). PaO2 values were similar in all (PP1, PP2, PP3) bPP arterial blood gases. We found difference in PaO2 values during prone position between the first (PP1) and second proning (PP2). When each prone was evaluated within itself, PaO2/FiO2 increases after proning compared to before proning. PaO2/FiO2 during PP were higher compared to before proning ones. PaO2/FiO2 during PP1 was significantly higher compared to during PP3 (p = 0.005). In PP3, PEEP values bPP, dPP, and aPP were significantly higher than PEEP values after the second prone (p = 0.02, p = 0.001, p = 0.01). In the third prone, PaCO2 levels were higher than in PP1 and PP2. There were eye complications in 13, tube-related complications in 10, skin complications in 30, and nerve damage in 1 patient. CONCLUSION: We believe that a more careful decision should be made after the second prone position in patients who have to be placed in sequential prone position.
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COVID-19 , Síndrome do Desconforto Respiratório , Humanos , Estudos Retrospectivos , COVID-19/complicações , Síndrome do Desconforto Respiratório/etiologia , Oxigênio , Unidades de Terapia IntensivaRESUMO
BACKGROUND: The aim of this study is to investigate the antimicrobial activities of the species belonging to the genera Origanum L., Thymus L., and Thymbra L. in the Lamiaceae family and molecular characterization using ISSR markers and to determine the correlations between anti-microbial activities of the plant extracts and ISSR loci. METHODS AND RESULTS: Anti-microbial active extracts were obtained after 24-hours extraction using either of the three different solvents (ethanol, hexane, and chloroform) from the plants using the Soxhlet device. The effects of extracts on the bacterial strains (Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis) were determined using the disc-diffusion method. The species Thymbra spicata var. spicata L., Thymus vulgaris L., Thymus citriodorus, Thymus cilicicus, Origanum syriacum L., and Origanum vulgare L. subsp. hirtum displayed significant anti-microbial activities, while the Origanum minutiflorum, Origanum onites L., Origanum saccatum and Origanum vulgare L. ssp. gracile displayed less activities on the bacterial strains. The plant species under study had a high level of genetic diversity. Significant correlations were determined between the anti-microbial activities of the plant species and the ISSR loci. CONCLUSION: Staphylococcus aureus was the most sensitive and Pseudomonas aeruginosa was the least sensitive strain. The ethanol and chloroform extracts were the most effective solvents. ISSR markers were successful for determining high levels of genetic diversity and clustering the species belonging to the genera Origanum, Thymus, and Thymbra. Conducting molecular marker analyses facilitated in distinguishing the species correctly for molecular breeding studies. The studies identified the antimicrobial activities of the plants against the bacteria used in the study and suggested their potential role in the pharmaceutical industry.
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Anti-Infecciosos , Lamiaceae , Óleos Voláteis , Origanum , Thymus (Planta) , Clorofórmio , Extratos Vegetais/farmacologia , Solventes , Etanol , Escherichia coli , Staphylococcus aureus , Pseudomonas aeruginosa/genética , Bactérias , Anti-Infecciosos/farmacologia , Óleos Voláteis/farmacologia , Antibacterianos/farmacologiaRESUMO
Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease. Skin and gut are the organs that first encounter antigens and environmental triggers. The mechanisms behind the relation between skin and gut immune responses in AD have not been identified yet. Aims and Objectives: To investigate mucosa-associated epithelial chemokine (MEC/CCL28), thymus-expressed chemokine (TECK/CCL25), periostin and zonulin levels in infants with AD. Materials and Methods: Children under one year old participated in the study. We used a propensity matching score. We included 39 infants who had active AD lesions at the time of evaluation. Serum MEC/CCL28, TECK/CCL25, periostin and zonulin levels were measured. Results: We examined age and sex matched 39 infants with AD and 39 healthy infants. Median value of zonulin was lower in infants with AD [49.2 (27.1-71.8) ng/mL] compared to healthy controls [58.5 (27.3-80.8) ng/mL] (P < 0.001). Infants with zonulin levels ≤55.15 ng/mL had 11.64 times more risk of developing AD than the infants with zonulin levels >55.15 ng/mL. Infants whose MEC/CCL28 levels were ≥8.3 ng/mL had 5.83 times more risk of developing AD than the infants with MEC levels <8.3 ng/mL. Duration of AD and SCORAD index score did not show correlation with MEC/CCL28, TECK/CCL25, periostin and zonulin levels. Conclusion: Low zonulin levels and high MEC/CCL28 levels in infants may show an increased association with AD.
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Polystyrene latex (PSL) nanoparticles (NPs), 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) liposomes, and hybrid NPs that have different concentrations, sizes, surface charges, and functional groups were used to determine their toxicity to Saccharomyces cerevisiae cells. The size, charge, and morphology of the nanoparticles were characterized by dynamic light scattering, electrophoretic light scattering, scanning transmission electron microscopy, and transmission electron microscopy analysis. The cell viabilities were determined by colony forming unit analysis and confocal laser scanning microscopy imaging. Uptake inhibition studies were performed to determine the internalization mechanism of PSL NPs. At 50 mg/L, both positively and negatively charged NPs were slightly toxic. With increasing concentration, however, full toxicities were observed with positively charged PSL NPs, while a marginal increase in toxicity was obtained with negatively charged PSL NPs. For negatively charged and carboxyl-functionalized NPs, an increase in size induced toxicity, whereas for positively charged and amine-functionalized NPs, smaller-sized NPs were more toxic to yeast cells. Negatively charged NPs were internalized by the yeast cells, but they showed toxicity when they entered the cell vacuole. Positively charged NPs, however, accumulated on the cell surface and caused toxicity. When coated with DOPC liposomes, positively charged NPs became significantly less toxic. We attribute this reduction to the larger-diameter and/or more-agglomerated NPs in the extracellular environment, which resulted in lower interactions with the cell. In addition to endocytosis, it is possible that the negatively charged NPs (30-C-n) were internalized by the cells, partly via direct permeation, which is preferred for high drug delivery efficiency. Negatively charged PSL NP exposure to the yeast cells at low-to-moderate concentrations resulted in low toxicities in the long term. Our results indicate that negatively charged PSL NPs provide safer alternatives as cargo carriers in drug delivery applications. Moreover, the variations in NP size, concentration, and exposure time, along with the use of hybrid systems, have significant roles in nanoparticle-based drug delivery applications in terms of their effects on living organisms.
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Nanopartículas/toxicidade , Poliestirenos/toxicidade , Saccharomyces cerevisiae/efeitos dos fármacos , Nanopartículas/química , Tamanho da Partícula , Poliestirenos/química , Saccharomyces cerevisiae/citologia , Propriedades de SuperfícieRESUMO
Incidence of food allergy (FA) during nursing period is 6-8% globally and It is reported %5,7 in Turkey. In our study, the aim is to determine whether the prevalence of food allergy (FA) increases in children vaccinated against rotavirus. The files of 681 infants who are still followed-up were retrospectively evaluated. Children who did not come to our clinic for all of their well-child follow-up visits were excluded from the study. Moreover, children diagnosed with allergy before vaccination and children with known gastrointestinal system disease were excluded from the study. The number of patients diagnosed with food allergy after being vaccinated against rotavirus was 12 (1.76%). Three children had a family history of allergy. Of 12 patients who were diagnosed after vaccination, 3 (n:104) were vaccinated with pentavalent vaccine and 9 (n:507) with monovalent vaccine. In the monovalent vaccination group, food allergy was found in 9 children (1.55%), and in the pentavalent vaccination group, food allergy was found in 3 children (2.88%). The difference between the two vaccination groups in terms of food allergy prevalence was not significant (p > .05). Although it is believed that food allergy, and even cow's milk protein allergy (CMPA) prevalence increases in infants vaccinated against rotavirus, in this study, no significant increase was observed in the prevalence of food allergy after rotavirus vaccination. Both types of vaccine had similar rates to each other.
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Hipersensibilidade Alimentar , Hipersensibilidade a Leite , Vacinas contra Rotavirus , Animais , Bovinos , Criança , Feminino , Hipersensibilidade Alimentar/epidemiologia , Humanos , Lactente , Prevalência , Estudos Retrospectivos , Turquia/epidemiologiaRESUMO
Food allergies often develop after liver transplant, especially in young children. However, data are scarce on clinical characteristics and patient outcomes. When we evaluated our pediatric liver transplant patients over a 16-year period, food allergy incidence was 8% (19/236 patients). All patients with food allergies were <18 months old, with incidence in this age group of 19.2% (19/99). Two patients had a single food and 17 had multiple food allergies. Five patients showed only non-IgE-mediated food allergies. Eggs, milk, nuts, and wheat were the most common allergens. Presenting symptoms included diarrhea, flushing, angioedema attacks, wheezing/chronic cough, and vomiting. Seven patients had EBV, and two patients had CMV infections at time of food allergy diagnosis. Twelve patients had eosinophilia. Seven patients (36.8%) were able to regain tolerance to all food allergens. However, one patient with single nut allergy and three with multiple food allergies were still on allergen-eliminated diets. Eight patients with multiple food allergies gained tolerance to some of the food allergens. In conclusion, food allergies in our patients were mainly against multiple foods and IgE mediated. Infections like EBV and CMV may play a role in food allergies after liver transplant, especially in pretransplant-naive patients.
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Doença Hepática Terminal/complicações , Hipersensibilidade Alimentar/complicações , Transplante de Fígado/efeitos adversos , Alérgenos , Angioedema/complicações , Animais , Pré-Escolar , Tosse/complicações , Diarreia/complicações , Ovos , Eosinofilia/complicações , Feminino , Hipersensibilidade Alimentar/epidemiologia , Humanos , Imunoglobulina E , Incidência , Lactente , Masculino , Leite , Nozes , Sons Respiratórios , Estudos Retrospectivos , Resultado do Tratamento , Triticum , Vômito/complicaçõesRESUMO
BACKGROUND/AIMS: We evaluated our 16-year single-center experience of pediatric post-transplant lymphoproliferative disorder (PTLD) cases who underwent liver transplantation between 2001 and 2017. MATERIALS AND METHODS: Of the 236 pediatric patients who underwent liver transplantation between 2001 and 2017, the clinical and laboratory data of eight patients diagnosed with PTLD were reviewed. The pre-transplant Epstein-Barr virus (EBV) status of 172 patients was also recorded. RESULTS: The total incidence of PTLD was 3.4%. The incidence of PTLD was 10% in pre-transplant EBV immunoglobulin G (IgG)-seronegative patients and 0.8% in pre-transplant EBV IgG-seropositive patients. The mean age of the patients at liver transplantation was 2.71±3.21 years, and four patients were aged below 1 year at the time of transplantation. PTLD was diagnosed at 21.81±18.1 months after transplantation. The primary site of involvement was variable among patients: peripheral and mediastinal lymph nodes, stomach and intestine, transplanted graft, bone marrow, and nasopharynx. The eosinophil count varied greatly among patients, with a mean value of 524.62±679/mm3. Three patients had a food allergy and were administered an elimination diet at the time of PTLD diagnosis. Six patients had PTLD of B-cell origin. One patient died due to neutropenic sepsis during chemotherapy, whereas seven patients were followed up in full remission for 7.75±4 years. CONCLUSION: PTLD is a life-threatening complication of solid-organ transplantation with a heterogeneous clinical spectrum. Food allergy had a close association with PTLD. A close follow-up of patients with risk factors and an early diagnosis with appropriate treatment may lead to a better outcome.
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Hipersensibilidade Alimentar/epidemiologia , Transplante de Fígado/efeitos adversos , Transtornos Linfoproliferativos/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Criança , Pré-Escolar , Eosinófilos , Infecções por Vírus Epstein-Barr/sangue , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/epidemiologia , Feminino , Seguimentos , Hipersensibilidade Alimentar/etiologia , Hipersensibilidade Alimentar/virologia , Herpesvirus Humano 4 , Humanos , Incidência , Lactente , Contagem de Leucócitos , Transtornos Linfoproliferativos/etiologia , Transtornos Linfoproliferativos/virologia , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/virologia , Período Pós-Operatório , Período Pré-Operatório , Fatores de RiscoRESUMO
Background/aim: Allergic rhinitis (AR) is a respiratory disease caused by inflammation of the nasal mucosa. Intranasal corticosteroids (ICs) are an effective treatment for AR; however, their use has been associated with atrophy in nasal mucosae. Because DNA damage has been linked to several chronic diseases, we hypothesize that use of ICs could cause DNA damage in nasal mucosa cells, leading to mucosal atrophy and septal perforation. Materials and methods: Sixty patients with moderate or severe AR were divided randomly into two groups. Mometasone furoate (MF) and antihistamine tablets (desloratadine) were given to the study (IC) group. Physiologic saline and desloratadine were given to the control ((serum physiologic (SP)) group. Nasal irrigation fluid was taken from patients before study commencement and after 4 weeks of treatment. The comet assay was applied to detect DNA damage in nasal mucosa cells. Results: Nineteen patients were excluded, leaving a study population of 41 patients (IC group: 17 patients; SP group: 24 patients). Genotoxic damage was evaluated by comet assay. Conclusion: Treatment with MF spray for 4 weeks does not cause DNA breaks within cells in the nasal mucosa. These results could form the basis of clinical trials involving treatment with different ICs over longer treatment periods.
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OBJECTIVES: To evaluate serum vitamin D levels in cases of recurrent respiratory infections and chronic cough and to investigate the effect of vitamin D therapy on recurrence of the diseases. METHODS: This prospective observational study was performed by comparing serum vitamin D levels in children with recurrent respiratory infections, chronic cough and healthy children. One-hundred-one children with chronic cough, ninety-eight children with recurrent respiratory infections and one-hundred-twenty-four healthy children were enrolled in the study. A structured questionnaire was completed to collect data on demography, diet, duration of breastfeeding, vitamin D supplementation and family history for allergic diseases. In patients with low serum vitamin D levels (<20 ng/ml), vitamin D therapy was administered in addition to conventional treatment for the diseases. Patients were followed up for 6 mo and their complaints were evaluated. RESULTS: Mean serum 25(OH) vitamin D level in the recurrent respiratory infections group was 11.97 ± 4.04 ng/ml, chronic cough group was 13.76 ± 4.81 ng/ml and control group was 31.91 ± 18.79 ng/ml. Comparison of serum 25(OH) vitamin D levels between the study groups revealed a statistically significant difference (p < 0.05). 25(OH)D deficiency in children was associated with increased frequency of recurrent respiratory infections and chronic cough. CONCLUSIONS: To conclude, administration of supplementary vitamin D may be useful in the treatment and preventation of recurrent respiratory infections and chronic cough.
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Tosse/congênito , Infecções Respiratórias/complicações , Deficiência de Vitamina D/complicações , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Prospectivos , Vitamina DRESUMO
BACKGROUND: The scar tissue formed by episiotomy during vaginal delivery, and the related pain, is very frequent. The change in the normal anatomy can cause cosmetic and physiologic problems. It can affect and cause deterioration in sexual functions. Therefore, making the right diagnosis and applying the right surgical procedures are very important. AIMS: Our aim was to examine the effect of the perineoplasty operation on the sexual dysfunctions that present due to vaginal delivery. STUDY DESIGN: Self-controlled study. METHODS: Forty patients, who attended our clinic between April 2012 and May 2013, and who were between the ages of 20 and 50 years, were included in the study. The patients had complaints of scar tissue in the perineum and various sexual dysfunctions after vaginal delivery, and they were suitable for perineoplasty. The Female Sexual Function Index (FSFI) questionnaire was applied to the patients before and 6 months after the operation, and the results were compared. RESULTS: After the perineoplasty operation, there was a statistically significant improvement in the patients in the domains of sexual desire, arousal, lubrication, orgasm, and sexual satisfaction (p<0.005). However, there was no significant improvement in the feeling of pain during sexual intercourse (p=0.184). The mean±SD total FSFI score increased significantly after the operation (p<0.005). CONCLUSION: The sexual dysfunctions that develop due to perineal damage during vaginal delivery can benefit significantly from the perineoplasty operation if the indications are correct. However, vaginal perineoplasty did not provide an improvement in dyspareunia.
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Hipersensibilidade Alimentar/etiologia , Falência Hepática/cirurgia , Transplante de Fígado/efeitos adversos , Fatores Etários , Criança , Pré-Escolar , Ciclosporina/efeitos adversos , Feminino , Seguimentos , Hipersensibilidade Alimentar/complicações , Humanos , Imunoglobulina E/imunologia , Lactente , Falência Hepática/complicações , Masculino , Prognóstico , Sirolimo/efeitos adversos , Tacrolimo/efeitos adversos , Fatores de TempoRESUMO
Asthma is characterized by chronic airway inflammation that is associated with structural changes termed airway remodeling. Recently, cytokines/mediators that augment inflammation have been attracting attention in this field. The aim of this study was to evaluate serum angiopoietin (Ang)-1, Ang-2, vascular endothelial growth factor (VEGF), and tumor necrosis factor (TNF) alpha values, which have important roles in inflammation, angiogenesis, and remodeling in asthmatic children. We also documented correlations between demographic features, duration of asthma, and pulmonary function test (PFT) parameters. Randomly selected 40 children (20 male and 20 female children, aged 6-16 years) with mild or moderate persistent asthma and 32 healthy children (15 male and 17 female children, aged 6-16 years) enrolled in the study. All asthmatic children had been using inhaled corticosteroids at least for the last 3 months. Serum Ang-1 levels were significantly lower in asthmatic children than those in normal controls. The Ang-1/Ang-2 ratio was also significantly lower in asthmatic children compared with those in normal controls (p < 0.01). However, serum Ang-2, VEGF, and TNF-alpha levels were similar in the two groups. A significant positive correlation was found between VEGF and duration of asthma. No correlation between serum Ang-1, Ang-2, VEGF values, and PFT parameters was obtained. On the other hand, significant negative correlation was detected between serum TNF-alpha and forced expiratory volume in 1 second. We have shown that serum Ang-1 levels and Ang-1/Ang-2 ratio were significantly reduced and balance was toward Ang-2 in asthmatics children. This process may lead to inflammation, destabilization of blood vessels, and trigger remodeling.