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    Characteristics of sensitization to cockroaches in patients with respiratory allergy in Izmir, Turkey
    (2004) Gulbahar O.; Mete N.; Ardeniz O.; Kokuludag A.; Sin A.; Sebik F.
    Cockroach (CR) infestation is an important cause of sensitization in allergic individuals. We investigated the prevalence and the characteristics of sensitivity to CRs in patients with respiratory allergy in Izmir. Three hundred and fifty-four patients with allergic rhinitis and/or asthma responded to a questionnaire and were prick tested with CR extract as well as with extracts of other household allergens. One hundred and twenty-eight of these patients (36.2%) were sensitized to CRs; sensitivity was 1.4 times more frequent among men compared to women. The prevalence of asthma was 39.1% in the group of individuals sensitized to CRs and 28.8% in the non-sensitized group (95% confidence intervals (CI) 1.005-2.508; P = 0.047). Moderate, persistent asthma was reported more often in patients sensitized compared to patients not sensitized to CRs (30% versus 18%). In patients with allergic rhinitis, the mean time before they became asthmatic was less in the group sensitized compared to those not sensitized to CRs (2.8 ± 3.4 versus 4.5 ± 5.2 years, P = 0.045). More than half the patients sensitized to CRs were also sensitized to cats (68.9%), to dog dander (62.1%) and to Dermatophagoides pteronyssinus (59.8%). We conclude that allergy to CRs is present in a large number of atopic individuals in Izmir. The existence of allergy to CRs seems to shorten the delay in the onset of asthma in patients with allergic rhinitis. © 2004 Elsevier SAS. All rights reserved.
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    Clinical and immunological analysis of 23 adult patients with common variable immunodeficiency
    (2010) Ardeniz O.; Başoglu O.K.; Günşar F.; Ünsel M.; Bayraktaroglu S.; Mete N.; Gülbahar O.; Sin A.
    Background: Common variable immunodeficiency (CVID) is characterized by hypogammaglobulinemia, defective antibody production, and recurrent upper and lower airway tract infections. Objectives: To reveal the clinical heterogeneity of this condition, analyze the high frequency of respiratory and gastrointestinal complications despite satisfactory trough immunoglobulin (Ig) G levels, and determine the main difficulties in management and treatment. Methods: We performed a retrospective analysis of 23 patients (13 male and 10 female) diagnosed with CVID between 2001 and 2008. Results: The median diagnostic delay for females and males was 15 years (range, 1-32 years) and 8 years (range, 1-31 years), respectively. Restrictive, obstructive, and combined pulmonary function defects were determined in 23%, 27%, and 14% of patients, respectively. The most frequent findings on the thoracic computed tomography scan were bronchiectasis, mediastinal lymphadenopathy, fibrosis, ground-glass patterns, mosaic oligemia, peribronchial cuffing, and parenchymal nodules. Giardiasis and duodenal lymphoid hyperplasia were detected in 52% and 42% of the patients, respectively, and Helicobacter pylori in 42%. Vitamin A levels were normal, although B-carotene and/or vitamin E levels were decreased in patients presenting malabsorption-related symptoms. Malignancy was documented in 3 patients and decreased bone mineral density in 9 patients (3 had osteoporosis and 3 had osteomalacia). Conclusion: CVID is a multisystemic disease that should be managed by a multidisciplinary team. Intravenous immunoglobulin therapy and antibiotics do not seem to have a suppressive effect on granulomatous or inflammatory manifestations. More comprehensive studies based not only on peripheral blood but also on immunohistological analysis are necessary to shed light on the pathogenesis of these life-threatening complications. © 2010 Esmon Publicidad.
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    Desensitization effect of preseasonal seven-injection allergoid immunotherapy with olive pollen on basophil activation: The efficacy of olive pollen-specific preseasonal allergoid immunotherapy on basophils
    (2012) Gokmen N.M.; Ersoy R.; Gulbahar O.; Ardeniz O.; Sin A.; Unsel M.; Kokuludag A.
    Background: It has previously been demonstrated that subcutaneous immunotherapy with allergoids positively affects clinical and immunological parameters even after 7 preseasonal injections. However, its effect on basophil activation remains unclear. We investigated the effect of preseasonal allergoid immunotherapy on basophils and concomitantly assessed its clinical and immunological efficacy in olive pollen-monosensitized patients. Methods: This study enrolled 437 consecutive patients with respiratory allergy and positive skin prick tests (SPTs); 212 (48.5%) patients were sensitized to olive pollen, and 33 (7.5%) patients were sensitized to olive pollen only. Of these patients, 23 received preseasonal immunotherapy with an olive pollen allergoid. The olive pollen-specific basophil activation, the titrated nasal provocation test, the nasal symptom score, and olive pollen-specific IgE, IgG1 and IgG4 levels were evaluated before immunotherapy and 8 months after the end of immunotherapy in the follow-up visit. Results: In comparison to baseline evaluation, 7 preseasonal injections of an allergoid resulted in a significant decrease in the percentage of basophils expressing CD63 (29 vs. 7%, respectively, p < 0.0001) and a significant increase in the titrated nasal provocative dose (1/10 vs. 1/1, respectively, p < 0.01). SPT induration diameters caused by an olive pollen extract decreased (12 mm at baseline vs. 5.5 mm at follow-up, p < 0.005), as did nasal symptom score (7 at baseline vs. 3 at follow-up, p < 0.01). Olive pollen-specific IgE (17.5 vs. 50 kU/l, p < 0.012), IgG1 (0.16 vs. 2.9 µg/ml, p < 0.0001) and IgG4 (0.07 vs. 1.92 µg/ml, p < 0.0001) levels significantly increased. Conclusions: Immunotherapy with 7 preseasonal injections of an olive pollen allergoid decreases olive pollen-specific basophil activation over 8 months, an effect observed in vitro and in vivo. Copyright © 2012 S. Karger AG, Basel.
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    An important source for cat and house dust mite allergens: Day-care centers [Kedi ve ev tozu akan allerjenleri igin önemli bir kaynak: Anaokullan]
    (Turkiye Klinikleri, 2012) Gülbahar O.; Korkmaz M.; Erdem N.; Gökmen N.M.; Sin A.Z.; Ardeniz O.; Uluer H.; Kokuludag A.
    Objective: Exposure to indoor allergens during childhood has been associated with an increased risk of sensitization. There is no data about indoor allergen levels in day-care centers in Turkey. We hypothesized that day-care centers (DC) would be relevant sources of cat and mite allergens. Material and Methods: Fifty-seven dust samples were collected from 19 DCs in Izmir, their gardens, and classrooms of the primary schools where the DCs are located in. A questionnaire about characteristics of DCs was completed. Feld 1, Der p 1 and Der f 1 allergen levels were quantitated by enzyme-linked immunoassay. Results: Feld 1 was detected in all, and mite allergens in 94.7% of the samples. Levels exceeding sensitization threshold level for cat and mite allergens were present in 73.7%, and 21.1% of DCs, respectively. Feld 1 levels exceeding threshold level that might cause asthma exacerbation was detected in 21% of DCs. Feld 1 levels in DCs and their gardens were higher than the classrooms of the same school. Der f 1 levels were identical in DCs, gardens and classrooms. Der p 1 concentration was higher in DCs with air-conditioning, than DCs without a ventilation system. Although there was no difference for Feld 1 levels in DCs with or without carpeted floor, Feld 1 concentrations in DCs with carpet were significantly higher than in classrooms with no carpet. Conclusion: Day-care centers in Izmir are important sources of indoor allergens that could cause sensitization or even allergic symptoms in children and their staff. © 2012 by Türkiye Klinikleri.
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    Phagocytic and oxidative burst activity of neutrophils in patients with spinal cord injury
    (2013) Kanyilmaz S.; Hepguler S.; Atamaz F.C.; Gokmen N.M.; Ardeniz O.; Sin A.
    Objective: To evaluate phagocytic activity and neutrophil oxidative burst functions in patients with spinal cord injury (SCI) because alterations in neutrophil metabolic activity can be one of the causes of immune mechanism damage contributing to repeated bacterial infections. Design: A controlled and cross-sectional study. Setting: Departments of physical medicine and rehabilitation and immunology. Participants: Patients with SCI (N=34) and 28 healthy controls. Interventions: Phagocytosis and oxidative burst in whole-blood neutrophils were assessed by flow cytometry. The percentage of phagocytizing cells after in vitro incubation with Escherichia coli, phagocytic activity (mean intensity of fluorescence [MIF]) and the percentage of neutrophiloxidative burst, and the MIF value of the production of reactive oxygen intermediates (ROIs) were analyzed. In addition, clinical assessment including the level of injury, American Spinal Injury Association scores, and functional status were carried out. Main Outcome Measures: Not applicable. Results: Although the percentage of E. coli phagocytizing neutrophils was not different between groups, the MIF value of absorbed E. coli was significantly lower in patients with SCI than in controls (P<.05). The MIF value of ROI production by neutrophils with both stimulator of phorbol 12-myristate 13-acetate and E. coli was significantly higher in patients with SCI (P<.05). Conclusions: In patients with SCI, decreased phagocytic activity of neutrophils may be a result of a regulatory mechanism to minimize the deleterious effects of increased neutrophil burst activity. © 2013 American Congress of Rehabilitation Medicine.