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    The effect of anti-tumor necrosis factor (TNF)-alpha therapy with etanercept on endothelial functions in patients with rheumatoid arthritis [Romatoid artrit'li hastalarda etanercept ile yapilan anti-tümör nekroz faktör (TNF)-alfa tedavisinin endotel fonksiyonlari üzerine etkisi]
    (2010) Tikiz H.; Arslan Ö.; Pirildar T.; Tikiz C.; Bayindir P.
    Objective: To investigate the effects of tumor necrosis factor (TNF)-< antagonism with etanercept (ENC) on endothelial functions in patients with active rheumatoid arthritis (RA). Methods: A total of 21 patients with RA were enrolled in this prospective study. Eleven of them (8 women, 3 men mean age 47.0±10.1 years) with high disease activity despite the conventional treatment were assigned to Group 1 and were given ENC treatment twice a week (25 mg SC injection) for 12 weeks. Ten patients with RA (8 women, 2 men mean age 55.0±6.4 years) under conventional methotrexate and prednisone therapy were assigned as Control group (Group 2). Endothelium-dependent and -independent vasodilator responses of the brachial artery were assessed by high-resolution ultrasound. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured at baseline and at the post treatment period. Mann-Whitney U and Wilcoxon tests were used to compare the data and correlation analysis was performed using Pearson correlation test. Results: Endothelium-dependent vasodilatation improved from 5.2±0.8% to 7.9±1.3% (p=0.04) in ENC group, while no significant change was observed in the control group (from 6.6±1.1% to 7.0±1.8% p=0.67). No significant changes were found in endothelium-independent vasodilatation and baseline brachial artery diameters in both groups. A significant reduction in ESR and CRP were observed in patients receiving ENC (from 16.2±6.8 to 9.2± 5.1 mm/h, p=0.003 and from 14.68±3.4 to 9.25± 3.7 mg/L, p=0.003, respectively). Conclusion: Treatment with ENC for 12 weeks significantly improved endothelial function in patients with active RA compared to those under conventional therapy. The findings of the present study support the hypothesis that the use of TNF-< blockers in patients with active RA may reduce the high incidence of cardiovascular complications. (Anadolu Kardiyol Derg 2010; 10: 98-103) © Copyright 2010 by AVES Yayincilik Ltd.
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    Manometric assessment of esophageal motility in patients with primary Sjögren's syndrome
    (Springer Verlag, 2005) Türk T.; Pirildar T.; Tunç E.; Bor S.; Doğanavşargil E.
    Objective: The aim of this study was to assess the esophageal motility by manometry in patients with primary Sjögren's syndrome. Methods: Esophageal manometry was carried out in 40 patients with primary Sjögren's syndrome (SS), 15 with rheumatoid arthritis (RA), 15 with RA and secondary SS, and 21 healthy volunteers. Results: We found that the mean lower esophageal sphincter (LES) pressures measured by station pull-through and rapid pull-through techniques were significantly higher in primary SS patients than with healthy controls and RA patients with or without SS (P<0.05). Our study did not show any major differences when comparing the three patient groups (P>0.05). However, peristaltic contraction velocity was lower and peristaltic contraction duration significantly higher at the middle and lower thirds of the esophagus in primary SS patients than in healthy controls (P<0.05). Conclusion: The results of our study support the view that various esophageal motility disorders can be found in patients with primary SS which could be related to an increase in LES pressure. We also found no correlation of the esophageal abnormalities with other factors studied, suggesting that the cause of dysphagia is multifactorial in nature. © Springer-Verlag 2004.
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    Platelet-activating factor and P-selectin activities in thrombotic and nonthrombotic Behçet's patients
    (2005) Tunc S.E.; Aksu K.; Keser G.; Oksel F.; Doganavsargil E.; Pirildar T.; Turk T.; Terzioglu E.; Huseyinov A.
    Objective: The aim of this study was to compare plasma Platelet-activating factor (PAF) and P-selectin (CD62P) activities in Behçet's disease patients with and without thrombosis. Methods: In this cross-sectional and descriptive study, 30 consecutive Behçet's patients were included, 15 of them with venous thrombosis. All patients were also divided into two subgroups according to the presence or absence of clinical activity. Plasma PAF levels, basal and Ca++ ionophore (A23187)-induced leukocyte (cellular) PAF activities, and platelet-rich plasma ?CD62P activity (the mean fluorescent density difference between CD62P phycoerythrin-positive and -negative stains) were evaluated. Results: In the thrombotic group, plasma PAF (P=0.001), basal leukocyte PAF (P=0.017), induced leukocyte PAF (P=0.024), and ?CD62P (P=0.023) levels were significantly higher than in the nonthrombotic group. In the whole group of Behçet's patients, there was a positive correlation between plasma PAF and ?CD62P levels (r=0.533, P=0.002). When we compared clinically active and inactive patients with respect to the above parameters, there was no significant difference, irrespective of thrombosis. Plasma PAF (P=0.001), basal leukocyte PAF (P=0.004), and ?CD62P (P=0.038) levels were significantly higher in the presence of both clinical activity and thrombosis than of clinical activity alone. Conclusion: Platelet-activating factor and CD62P may contribute to endothelial injury and thrombosis development in Behçet's disease. These two parameters seem related to the presence of thrombosis rather than clinical activity. © Springer-Verlag 2004.