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Öğe Allergy as an etiologic factor in nasal polyposis(J R Prous Sa, 1997) Sin, A; Terzioglu, E; Kokuludag, A; Veral, A; Sebik, F; Karci, B; Kabakci, TAllergy has been reported as an important factor in the etiology of nasal polyposis. Asthma, chronic sinusitis and aspirin hypersensitivity are frequently found together with nasal polyposis. Total IgE, RAST for specific IgE and skin prick test were used to investigate the incidence of allergy in 95 patients with nasal polyposis. In addition, histopathologic appearance of polyp tissue was examined in 21 patients after polypectomy and compared in allergic and nonallergic groups. IgG subclass levels were also measured to detect if there were any changes. Mean serum IgE level was found to be higher in the patient group and the skin prick test (SPT) was positive in 66.3% of patients. On the basis of positive SPT and serum RAST results, 45.2% of all patients with nasal polyposis were defined as allergic. Both total IgE and IgG, were detected at increased levels in the SPT-positive group. These findings suggest that an IgE-mediated mechanism may be present in a subpopulation of patients with nasal polyposis.Öğe Allopurinol hypersensitivity syndrome as a cause of hepatic centrilobular hemorrhagic necrosis(Hogrefe & Huber Publishers, 2003) Mete, N; Yilmaz, F; Gulbahar, O; Aydin, A; Sin, A; Kokuludag, A; Yuce, G; Sebik, FExtensive and severe hepatic centrilobular hemorrhagic necrosis is a common finding in hepatic vein obstruction and Budd-Chiari syndrome. Some drugs, including allopurinol, can also cause this histopathologic appearance but to our knowledge in this setting the lesions are not so massive. Here we report a case of a 41-year-old female who developed fever, pruritic skin rash, jaundice, eosinophilia, abnormal liver function tests, and acute renal failure 3 weeks after the beginning of allopurinol treatment, complicated with severe hepatocyte necrosis around most terminal hepatic venules suggesting Budd-Chiari syndrome.Öğe B12 deficiency in chronic idiopathic urticaria: complication of Helicobacter pylori infection or reflection of an autoimmune process?(Blackwell Munksgaard, 2002) Mete, N; Gulbahar, O; Aydin, A; Sin, AZ; Sebik, FÖğe The effect of inhaled corticosteroids on bronchoalveolar lavage cells and IL-8 levels in stable COPD patients(W B Saunders Co Ltd, 2005) Ozol, D; Aysan, T; Solak, ZA; Mogulkoc, N; Veral, A; Sebik, FChronic obstructive pulmonary disease (COPD) is characterised by a chronic inflammatory process in the large and small airways, as well as in the lung parenchyma. Although the rote of oral corticosteroids in the management of acute exacerbations of COPD is well documented, its rote in stable COPD is not clear. We examined the anti-inflammatory effect of inhaled budesonide on the percentage of neutrophils and on interleukin-8 (IL-8) levels in bronchoalveolar lavage (BAL) and their correlation with spirometry and symptom scores. Twenty-six patients with stable COPD were randomised, in a double-blinded, placebo-controlled trial with either 800 mu g of inhaled budesonide or placebo for a 6-month period. The budesonide-treated subjects had significant reductions in IL-8 levels in the BAL after therapy (mean +/- SEM, 1.53 +/- 0.72 at baseline vs. 0.70 +/- 0.48 ng/ml at 6 months, P = 0.004) and a reduction in the mean percentages of neutrophils (17.16 +/- 2.67% vs. 13.25 +/- 2.28% P = 0.002). The improvement in sputum production was of borderline (P = 0.058) significance but there was no improvement in lung function. In stable patients with COPD, treatment with inhaled budesonide for a period of 6 months has a positive effect on markers of lung inflammation, as assessed by reduction in percentage neutrophils and IL-8 concentration in BAL. (c) 2005 Elsevier Ltd. All rights reserved.Öğe Elevation of serum eosinophil cationic protein, soluble tumor necrosis factor receptors and soluble intercellular adhesion molecule-1 levels in acute bronchial asthma(Esmon Publicidad S A, Dept Allergy & Clin Immunol, Clin Univ Navarra, 2002) Kokuludag, A; Sin, A; Terzioglu, E; Saydam, G.; Sebik, FAsthma is a disease characterized by chronic airway inflammation. Many inflammatory cells and molecules contribute to its pathogenesis. Soluble tumor necrosis factor receptors (sTNFRs) and soluble intercellular adhesion molecule-1 (sICAM-1) play regulatory roles in the inflammation. But their roles in the inflammation of asthma have not been well defined. This study was done to examine the changes in serum levels of these molecules in acute asthmatic patients. The concentrations of eosinophilic cationic protein (ECP), sTNF-RI, sTNF-RII, and sICAM-1 were measured in sera of 24 asthmatic patients during acute attack, in 18 patients at 24 h, and in 10 patients at 7 days after attack and in era of 14 healthy control subjects by ELISA method. Serum levels of ECP, sTNF-RI, sTNF-RII and sICAM-1 in the patients with asthma during attack were significantly higher than those of the controls (p < 0.001, p < 0.01, p < 0.05 respectively) and stayed high up to the 7th day. In conclusion, high serum levels of sTNF-RI, sTNF-RII and sICAM-1 suggest that these molecules may contribute to the regulation of allergic inflammation and may reflect the severity of inflammation in the airway of asthmatic patients.Öğe Eosinophil infiltration of the oesophageal mucosa in patients with pollen allergy during the season(Wiley, 2005) Onbasi, K; Sin, AZ; Doganavsargil, B; Onder, GF; Bor, S; Sebik, FBackground The oesophagus is normally devoid of eosinophils. There are some disorders accompanying with eosinophil infiltration. Food allergy has been reported as a common reason, especially in children but some other studies have also indicated that aeroallergens might have a role in oesophageal eosinophil accumulation. Objective In this study we investigated whether there is any eosinophil recruitment in the oesophagus of pollen-allergic patients who had respiratory symptoms during the season. Methods Thirty-eight symptomatic patients (allergic rhinitis (AR) with or without asthma) who had sensitization to grass pollen were included in the study during the pollen season. Controls were composed of 25 healthy non-atopics and 24 patients diagnosed as having gastro-oesophageal reflux disease. Reflux was excluded in allergic and non-atopic groups, whereas the presence of allergy was eliminated in control groups. Gastrointestinal endoscopy was performed in all participants, and biopsy specimens were taken from both the proximal and the distal oesophagus to evaluate eosinophil accumulation. At the same time, blood eosinophil numbers were counted. Results Oesophageal eosinophil accumulation was found in 10 allergic patients (26%) and in five patients (21%) with gastro-oesophageal reflux disease but none of the healthy controls had eosinophils (0%) (P < 0.05). Blood eosinophils were higher in these 10 patients than the rest of the 28 patients without infiltration. In this group, blood eosinophils were also correlated with the number of accumulated eosinophils in the oesophagus (P < 0.001). There was more intense eosinophil infiltration at the distal part of the oesophagus in the reflux group when compared with the allergic group (mean 7.6 +/- 5.6 vs. 3.2 +/- 3.7). Nevertheless, eosinophils were found to be concentrated (mean 5.5 +/- 7.3) in the proximal oesophagus of allergic patients, although it was 1.7 +/- 1.5 in reflux patients (P > 0.05). Conclusion Our results showed that eosinophil infiltration might be observed in oesophageal tissue of patients with respiratory tract allergy during the symptomatic period. This finding may possibly reflect the systemic and common mucosal aspects of allergic inflammation.Öğe Food Allergy İn the İnflammatory Bowel Disease(Monduzzi Editore, 1995) Kokuludag, A; Yuceyar, H; Terzioglu, E; Sin, A; Sebik, F; Kabakci, T; Basomba, A; Hernandez, MDÖğe House dust mite allergens in Turkish homes(Blackwell Munksgaard, 2004) Gulbahar, O; Mete, N; Kokuludag, A; Sin, A; Sebik, FÖğe Igg Subclass Levels İn Patients With Seasonal Allergic Rhinitis(Monduzzi Editore, 1995) Sin, A; Toz, H; Kokuludag, A; Terzioglu, E; Kose, S; Sebik, F; Kabakci, T; Basomba, A; Hernandez, MDÖğe Laryngeal edema due to European bee-eater (Merops apiaster) in a patient allergic to honeybee(Blackwell Munksgaard, 2003) Gulbahar, O; Mete, N; Ardeniz, O; Onbasi, K; Kokuludag, A; Sin, A; Sebik, FÖğe Laryngeal edema due to European bee-eater (Merops apiaster) in a patient allergic to honeybee(Blackwell Munksgaard, 2003) Gulbahar, O; Mete, N; Ardeniz, O; Onbasi, K; Kokuludag, A; Sin, A; Sebik, FÖğe Latex allergy and associated risk factors in a group of Turkish patients with spina bifida(Turkish J Pediatrics, 2004) Gulbahar, O; Demir, E; Mete, N; Ulman, I; Can, D; Sin, A; Gulen, F; Kokuludag, A; Tanac, R; Sebik, FAllergic reactions to latex are common in patients with spina. bifida. Its incidence varies between 28% and 67%. The aim of this study was to investigate the incidence of latex allergy and its risk factors in patients with spina bifida in Izmir, Turkey. Forty-six patients (24 male, mean age 10 years) were included in the study. A questionnaire was completed and skin prick tests with latex solution and cross-reacting foods were performed. Total IgE levels, specific IgE to common aeroallergens (Phadiotop), and latex specific IgE levels were measured. Patients with positive skin test reaction and/or who had specific IgE to latex without clinical symptoms were considered as sensitive to latex. The patients who also had clinical symptoms with latex exposure were diagnosed as allergic to latex. Latex sensitivity was found in 5/46 patients (10.8%). Only two patients had latex allergy (4.3%). Total IgE levels were higher (median 157 vs. 40 kU/L, p=0.012) and the duration of clean intermittent catheterization was longer insensitized patients when compared to non-sensitized patients (median 8 vs. 3 years, p=0.015). Specific IgE to common aeroallergens and positive skin prick test to cross-reacting foods were more prevalent in sensitized than in nonsensitized patients (p=0.02 and 0.015, respectively). The incidence of latex allergy in our group was lower than reported in the literature. This result may be due to the low number of surgical interventions. High levels of total IgE, positive Phadiotop, positive skin prick test to crossreacting foods and the duration of clean intermittent catheterization are the risk factors for latex sensitivity in patients with spina bifida.Öğe Latex allergy in Turkish patients with Spina bifida(Blackwell Munksgaard, 2002) Gulbahar, O; Demir, E; Sin, AZ; Ulman, I; Can, D; Mete, N; Gulen, F; Kokuludag, A; Tanac, R; Sebik, FÖğe Low B-12 levels in chronic idiopathic urticaria(Hogrefe & Huber Publishers, 2004) Mete, N; Gulbahar, O; Aydin, A; Sin, AZ; Kokuludag, A; Sebik, FRecent studies suggest that autoimmune mechanisms may be involved in the etiology of chronic idiopathic urticaria (CIU). There is a higher prevalence of B-12 deficiency in autoimmune diseases and possibly in gastric Helicobacter pylori (H. pylori) infection. The frequency of B-12 deficiency in CIU is unknown. Our objective in this study was to determine the prevalence of B-12 deficiency in patients with CIU and also its relationship to gastric H. pylori infection and serologic markers of autoimmunity in these groups. Thirty-three patients with CIU and 27 healthy controls were included in the study. Serum vitamin B-12 levels, H. pylori infection and serological markers of autoimmunity (anti-thyroglobulin, thyroid microsomal, gastric parietal cell and antinuclear autoantibodies) were investigated. H. pylori infection was determined according to serology and gastric biopsy in 19 patients, serology and urea breath test in 4 patients and serology alone in the remaining 10 patients. Serum B-12 levels were below the normal reference range in 11 /33 (33.3%) patients with CIU. The mean serum B-12 levels among patients with CIU and the controls were 281+/-127.5 pg/ml and 465.1+/-140.3 pg/ml (p=0.0001), respectively. Anti-thyroid antibodies were positive in 6 of 11 patients (54.5%) with low B, levels, but only in 4 of 27 (14.8%) healthy controls (p=0.019). Anti-GPC antibodies were positive in 4 of 11 (36.4%) patients with CIU and low B, levels, but only in 2 of 27 (7.4%) healthy controls (p=0.047). In CIU patients, there was no difference in the frequency of IgG H. pylori antibodies between those with low B-12 levels and normal B-12 levels. Among the 19 patients who had been performed gastric endoscopy, 15 patients (78.9%) had chronic antral gastritis, 2 patients (10.5%) had atrophic gastritis and there were normal findings in 2 patients (10.5%). In conclusion, serum B-12 levels were found to be below the normal reference range in 33% of the patients with CIU. An association between low B-12 levels and H. pylori could not be shown. The higher frequency of antithyroid and anti-GPC antibodies in patients with low B-12 levels suggest that low B-12 levels in CIU may be autoimmune in nature.Öğe Selective IgA deficiency and ankylosing spondylitis(Prous Science, Sa, 1997) Terzioglu, E; Kokuludag, A; Sin, A; Kirmaz, C; Yalcin, M; Sebik, F; Kabakci, Tdeficiency is described. There have been several reports in the literature indicating coexistence of AS with selective IgA deficiency. As it is suggested in the literature, we believe that selective IgA deficiency is a poor prognostic factor in AS.Öğe Sensitivity to Parietaria pollen in Izmir, Turkey as determined by skin prick and serum specific IgE values(Prous Science, Sa, 1998) Terzioglu, E; Sin, A; Kokuludag, A; Kirmaz, C; Erdem, N; Sebik, F; Kabakci, TAs the first study of its kind in the Aegean region of Turkey, we examined the incidence of sensitivity to Parietaria pollen in patients with allergic rhinitis and/or asthma living in the Mediterranean climate of the Aegean coast On the Mediterranean, there are characteristic climatic conditions (mild winters, dry summers, etc.) which facilitate the growth of a typical vegetation and the production of allergenic pollen, such as that from Parietaria. These pollen types differ greatly from those of central and northern Europe. We skin tested 132 patients with a clinical history of seasonal rhinitis and/or asthma symptoms. Each patient was skin tested with extracts of grass, weed, tree and cereal pollens, and serum samples were collected for specific IgE assays for Parietaria. Sixty-nine of the 132 patients (52%) showed skin reactivity to Parietaria; seven of these (10%) had monosensitization to Parietaria. Fifty-six out of 69 patients (81%) had specific IgE in their serum to Parietaria pollen. Based on skin test reactions, we concluded that Parietaria is important in terms of clinical symptoms and that it is the most common weed pollen in the Aegean region in Turkey.Öğe Sensitization to cat allergens in non-cat owner patients with respiratory allergy(Amer Coll Allergy Asthma Immunology, 2003) Gulbahar, O; Sin, A; Mete, N; Kokuludag, A; Kirmaz, C; Sebik, FBackground: Cats represent one of the most important sources of indoor allergens. The sensitization rate can reach up to 60% in western countries. Keeping cats indoors is uncommon in big cities in Turkey, but cats living in the streets are common. Objective: To investigate the prevalence of sensitization to cats in patients with respiratory allergy from Izmir, Turkey, and its relationship to home cat allergen levels. Methods: A total of 387 patients (70.8% female; mean age, 34.3 years) with respiratory allergic diseases (rhinitis and/or asthma) were included in this study. Skin prick test to cat was performed. House dust samples were collected from the living room of 25 patients and 14 healthy subjects. The major cat allergen (Fel d 1) levels were measured by Dustscreen. Fel d 1 levels given by the manufacturer were as follows: 0.05, 0.13, 0.40, 1. 1, and 6.2 mU/mL. Results: ne prevalence of cat sensitivity was 44.7% (n = 173). Only 6 patients (1.6%) had a history of feeding a cat in their houses. Thirty-six (92%) of 39 houses had detectable levels of cat allergen (mean Fel d 1 level, 2.24 +/- 2.69 mU/mL). The mean Fel d I levels were 1.58 +/- 2.51 mU/mL in the healthy group, 1.91 +/- 2.61 mU/mL in the asthmatic group, and 3.26 +/- 2.85 mU/mL in the group with allergic rhinitis (P = 0.12). The prevalence of cat sensitivity in patients who had 1. 1 mU/mL of Fel d I in their homes was 57.1%. This rate was five times lower (11.1%) in patients who had the highest Fel d I level (6.2 mU/mL) in their homes. Conclusions: The prevalence of cat sensitivity in Izmir, where cats are generally not kept within homes, is as high as in western countries. The sampled houses have measurable levels of Fel d 1 even in the absence of indoor cats. High prevalence of cat sensitivity in Izmir is probably due to indirect exposure.Öğe Sensitization to cat allergens in non-cat owner patients with respiratory allergy(Amer Coll Allergy Asthma Immunology, 2003) Gulbahar, O; Sin, A; Mete, N; Kokuludag, A; Kirmaz, C; Sebik, FBackground: Cats represent one of the most important sources of indoor allergens. The sensitization rate can reach up to 60% in western countries. Keeping cats indoors is uncommon in big cities in Turkey, but cats living in the streets are common. Objective: To investigate the prevalence of sensitization to cats in patients with respiratory allergy from Izmir, Turkey, and its relationship to home cat allergen levels. Methods: A total of 387 patients (70.8% female; mean age, 34.3 years) with respiratory allergic diseases (rhinitis and/or asthma) were included in this study. Skin prick test to cat was performed. House dust samples were collected from the living room of 25 patients and 14 healthy subjects. The major cat allergen (Fel d 1) levels were measured by Dustscreen. Fel d 1 levels given by the manufacturer were as follows: 0.05, 0.13, 0.40, 1. 1, and 6.2 mU/mL. Results: ne prevalence of cat sensitivity was 44.7% (n = 173). Only 6 patients (1.6%) had a history of feeding a cat in their houses. Thirty-six (92%) of 39 houses had detectable levels of cat allergen (mean Fel d 1 level, 2.24 +/- 2.69 mU/mL). The mean Fel d I levels were 1.58 +/- 2.51 mU/mL in the healthy group, 1.91 +/- 2.61 mU/mL in the asthmatic group, and 3.26 +/- 2.85 mU/mL in the group with allergic rhinitis (P = 0.12). The prevalence of cat sensitivity in patients who had 1. 1 mU/mL of Fel d I in their homes was 57.1%. This rate was five times lower (11.1%) in patients who had the highest Fel d I level (6.2 mU/mL) in their homes. Conclusions: The prevalence of cat sensitivity in Izmir, where cats are generally not kept within homes, is as high as in western countries. The sampled houses have measurable levels of Fel d 1 even in the absence of indoor cats. High prevalence of cat sensitivity in Izmir is probably due to indirect exposure.Öğe Sensitization to cat allergens in non-cat owner patients with respiratory allergy(Blackwell Munksgaard, 2002) Gulbahar, O; Sin, AZ; Mete, N; Kokuludag, A; Kirmaz, C; Sebik, FÖğe Serum eosinophil cationic protein (ECP) levels in patients with seasonal allergic rhinitis and allergic asthma(Ocean Side Publications Inc, 1998) Sin, A; Terzioglu, E; Kokuludag, A; Sebik, F; Kabakci, TWe studied serum ECP levels in 21 seasonal allergic patients (16 patients with rhinitis; 5 with rhinits and asthma) diagnosed by history skin tests, and PAST Seventeen healthy subjects were selected as a control group. None of the patients had received medications. Total IgE levels were also measured and correlated with ECP levels. Mean IgE level was found to be higher in patients than controls (p < 0.05). Patients with asthma and rhinitis had higher IgE values than those with rhinitis alone (p < 0.05). Serum ECP levels in the patient group were significantly higher than those in the control group (p < 0.05). No statistically significant difference was found between ECP levels in patients with rhinitis and rhinitis plus asthma groups, although mean ECP was higher level in the later group. Total IgE and ECP levels were correlated positively in the patients (r = 0.630, p < 0.05). We conclude that the extent of allergic inflammation in mucosal surfaces such as allergic rhinitis plus asthma, might influence serum ECP levels.
