Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Identifying future risk factors of uncontrolled asthma control: the TAAR study perspective(Başkent Üniversitesi Tıp Fakültesi, 2025) Erdogan, Tuba; 41305966Objective: Risk factors associated with asthma symptom control is crucial for disease management. This study aimed to determine the risk factors of patients with uncontrolled asthma and to examine the relationship with their geographical patterns. Methods: This cross-sectional study was conducted at 36 centers across Turkey. Future risk factors (FRFs) such as exposure to triggers/allergens and inadequate or poor inhalation technique, etc., were identified based on the Global Initiative for Asthma (GINA) guidelines. The associations between FRFs and demographic and clinical characteristics, geographical regions, and levels of asthma control were analyzed. Results: The study included 2,053 adult asthma patients. At least one FRF was identified in 1576(76.8%) patients. The most common FRFs were exposure to allergens/triggers (n: 664; 32.3%), impaired asthma symptom control (n: 540; 26.3%), and eosinophilia (n: 526; 25.6%). Regarding regional differences, the most prevalent FRFs in the Marmara region were exposure to allergens/triggers and frequent use of short-acting beta-2 agonists (>3 boxes/year). In contrast, eosinophilia was more common in the Southeastern region, while inadequate or poor inhalation technique, noncompliance with treatment, and psychosocial or socioeconomic problems were more frequently observed in the Eastern Anatolia region. Asthma control was achieved in 79.5% of patients without any FRFs; however, this rate decreased significantly to 25% among patients with more than four FRFs. Conclusions: This study demonstrates that FRFs in asthma vary according to demographic and disease characteristics, as well as geographical distribution. An increased number of FRFs was associated with asthma control. However, an individualized approach remains essential for achieving optimal asthma management.Item Investigation of The Relationship Between Asthma and Subclinical Atherosclerosis by Carotid/Femoral Intima Media and Epicardial Fat Thickness Measurement(2018) Yilmaz, Mustafa; Yilmaz, Hatice Eylul Bozkurt; Sen, Nazan; Altin, Cihan; Tekin, Abdullah; Muderrisoglu, Haldun; https://orcid.org/0000-0002-2557-9579; https://orcid.org/0000-0002-4171-7484; https://orcid.org/0000-0002-5658-870X; https://orcid.org/0000-0002-9635-6313; 28453377; S-6973-2016; AAI-8947-2021; ABD-7304-2021; AAG-8233-2020Objective: Since asthma and atherosclerosis may share similar pathophysiological mechanism, this study is planned to investigate whether epicardial fat thickness (EFT), carotid and femoral intima media thicknesses, which are markers of subclinical atherosclerosis, are increased in patients with asthma. Methods: The study was designed as a cross-sectional study. A total of 154 participants (83 patients with asthma and 71 healthy volunteers) were enrolled into the study. Epicardial fat, carotid, and femoral intima media thicknesses were measured and recorded in both groups. The statistical difference between the two groups was examined. Results: Both carotid and femoral intima media thicknesses were significantly higher in patients with asthma compared to control group (5.52 +/- 0.4 mm vs. 5.36 +/- 0.4 mm; p = 0.038 and 5.64 +/- 0.4 mm vs. 5.46 +/- 0.5 mm; p = 0.036, respectively). However, there was not a significant difference in EFT between the groups [5.9 mm (5.3-6.6; IQR = 1.3) vs. 5.6 mm (4.7-6.5; IQR = 1.8); p = 0.1]. On comparison of control group and asthma subgroups (mild, moderate, and severe), there was a statistically significant difference among these four groups in terms of carotid and femoral intima media thicknesses (p = 0.002 and p < 0.001, respectively). Subgroup analyses showed that this difference was mainly due to patients with severe asthma. Conclusions: Carotid and femoral intima media thicknesses in asthmatic patients were found to be increased compared to the normal population. As a result, the risk of subclinical atherosclerosis in asthmatic patients may be high.Item Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk in Patients With Asthma By P Wave/Corrected QT Interval Dispersion(2018) Yilmaz, H. E. Bozkurt; Yilmaz, M.; Sen, N.; Altin, C.; Unsal, Z. E.; Tekin, A.; Akcay, S.; https://orcid.org/0000-0002-4171-7484; https://orcid.org/0000-0003-3225-2686; https://orcid.org/0000-0002-5658-870X; https://orcid.org/0000-0002-8360-6459; 29461607; AAI-8947-2021; AAD-5602-2021; ABD-7304-2021; AAB-5175-2021OBJECTIVE: Although the relationship between obesity-asthma, obesity-atrial fibrillation (AF) and obesity-sudden cardiac death is clearly known, the risk of AF and ventricular arrhythmia has not been clearly determined in asthmatic patients. The aim of this study was to investigate whether AF, ventricular arrhythmia, and sudden cardiac death risk were increased in asthmatic patients using P wave dispersion (PWD) and corrected QT interval dispersion (CQTD). PATIENTS AND METHODS: The study was designed as a cross-sectional study. A total of 164 participants (88 patients with asthma and 76 healthy. volunteers) were enrolled into the study. PWD and CQTD were measured and recorded in both groups. The statistical difference between the two groups was examined. RESULTS: PWD was higher in the asthma patients than in control subjects (31.53 +/- 3.18 vs. 30.33 +/- 3.53, p = 0.023). However, there was no statistically difference between the groups in terms of CQTD measurement (43.9 +/- 1.84 vs. 43.63 +/- 2.06, p = 0.385). In comparison between control group and asthma subgroups (mild, moderate and severe), there was a statistically significant difference among these four groups in terms of PWD (p = 0.017). Subgroup analyses showed that this difference was mainly due to patients with severe asthma. CONCLUSIONS: PWD value was elevated in asthmatic compared to the control group. The CQTD was not statistically significant between the groups. These results indicate that the risk of developing AF in asthmatic patients might be higher than in the normal population. Ventricular arrhythmia and sudden cardiac death risk may not be high in asthmatic patients.Item Intraperitoneal Mesenchymal Stem Cell Administration Ameliorates Allergic Rhinitis in The Murine Model(2017) Isik, Sakine; Karaman, Meral; Adan, Aysun; Kiray, Muge; Bagriyanik, Husnu Alper; Sozmen, Sule Caglayan; Kozanoglu, Ilknur; Karaman, Ozkan; Baran, Yusuf; Uzuner, Nevin; https://orcid.org/0000-0002-5268-1210; 27380271; AAE-1241-2021Previous studies showed that bone marrow-derived mesenchymal stem cells (BMSCs) could ameliorate a variety of immune-mediated and inflammatory diseases due to their immunomodulatory and anti-inflammatory effects. In this study, we developed a mouse model of ovalbumin (OVA) induced allergic inflammation in the upper airways and evaluated the effects of the intraperitoneal administration of BMSCs on allergic inflammation. Twenty-five BALB/c mice were divided into five groups; group I (control group), group II (sensitized and challenged with OVA and treated with saline-placebo group), group III (sensitized and challenged with OVA and treated with 1 x 10(6) BMSCs), group IV (sensitized and challenged with OVA and treated with 2 x 10(6) BMSCs), and group V (sensitized and challenged with phosphate buffered saline (PBS) and treated with 1 x 10(6) BMSCs). Histopathological features (number of goblet cells, eosinophils and mast cells, basement membrane, epithelium thickness, and subepithelial smooth muscle thickness) of the upper and lower airways and BMSCs migration to nasal and lung tissue were evaluated using light and confocal microscopes. Levels of cytokines in the nasal lavage fluid and lung tissue supernatants were measured using enzyme-linked immunosorbent assay (ELISA). Confocal microscopic analysis showed that there was no significant amount of BMSCs in the nasal and lung tissues of group V. However, significant amount of BMSCs were observed in group III and IV. In OVA-induced AR groups (group II, III, and IV), histopathological findings of chronic asthma, such as elevated subepithelial smooth muscle thickness, epithelium thickness, and number of goblet and mast cells, were determined. Furthermore, the number of nasal goblet and eosinophil cells, histopathological findings of chronic asthma, and IL-4, IL-5, IL-13, and NO levels was significantly lower in both BMSCs-treated groups compared to the placebo group. Our findings indicated that histopathological findings of chronic asthma were also observed in mice upon AR induction. BMSCs migrated to the nasal and lung tissues following intraperitoneal delivery and ameliorated to the airway remodeling and airway inflammation both in the upper and lower airways via the inhibition of T helper (Th) 2 immune response in the murine model of AR.Item Thrombin lag time is increased in children with mild asthma(2019) Koksal, B.T.; Eker, I.; Ozbek, N.Y.; Dogan, I.; Ozbek, O.Y.; 0000-0001-9580-7656; 30262412Background: Inflammation and coagulation are closely linked events. Thrombin is the key enzyme in coagulation system and also has roles in inflammation. Objective: The aim of our study was to evaluate thrombin generation in children with mild asthma. Methods: Forty-two children with mild asthma and 49 healthy children were included in the study. All patients performed spirometry. Thrombin generation tests (TGT) were performed with a calibrated automated thrombogram (CAT) in children without asthma exacerbation during the last six months. During CAT assay thrombogram curves were obtained. The area under the curve showed endogenous thrombin potentials and indicated the total amount of endogenous thrombin generated; the peak height showed the highest thrombin value, thrombin lag time and time to thrombin peak were measured. Results: Thrombin lag time was significantly longer in children with asthma (3.98 1.2 min) compared to those in the control group (3.29 +/- 0.6 min) (p < 0.01). Children with asthma also had longer thrombin tail time compared to the control group (19.5 +/- 8.9 min vs. 16.7 +/- 2.9 min, p= 0.02). Thrombin peak was inversely correlated with FEF 25-75 (r =-0.41, p < 0.01). Thrombin lag time was inversely correlated with FEF 25-75 (r=-0.39, p<0.01). Conclusion: Inflammation in mild asthma seems to disturb coagulation but this disturbance may not be so strong as to increase thrombin levels and may only affect the initiation phase of thrombin generation. (C) 2018 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.Item Misdiagnosis of Asthma May Delay the Post Infectious Bronchiolitis Obliterans Diagnosis(2019) Onay, Zeynep Reyhan; Gursoy, Tugba Ramasli; Aslan, Ayse Tana; Eyubolgu, Tugba Sismanlar; Kibar, Busra Sultan; Pekcan, Sevgi; Hangu, Melih; Kose, Mehmet; Budakoglu, Isil Irem; Gokturk, BaharItem Angiopoietin-1, Angiopoietin-2, and Periostin Levels in Children with Recurrent Wheeze(2018) Koksal, Burcu Tahire; Aydin, Beril Ozdemir; Tekindal, Agah; Ozbek, Ozlem YilmazBackground: Recurrent wheeze (RW) is frequent in preschool children. Wheezing phenotypes, asthma predictive index (API), and modified API (mAPI) have been described for clinical purposes. Our aim was to examine whether inflammatory markers including serum angiopoietin (Ang)-1, Ang-2, and periostin levels differ according to wheezing phenotypes and mAPI. Materials and Methods: Ninety-eight children who were <4 years of age with history of at least 4 episodes of wheezing during the past 12 months and 51 age-matched healthy controls were included in the study. Children with RW were classified according to wheezing phenotypes as episodic viral wheeze or multitrigger wheeze, and positive or negative mAPI. Blood for Ang-1, Ang-2, and periostin levels was drawn during wheezing episode-free periods. Results: Atopic children with RW (31.4 +/- 34.4 ng/mL) demonstrated higher serum Ang-1 levels than nonatopic children (16.5 +/- 13.8 ng/mL) with RW (P = 0.03). When we compared children according to wheezing phenotypes, we could not find any difference in serum Ang-1, Ang-2, and periostin levels between groups. Children with positive mAPI showed similar Ang-1, Ang-2, and periostin levels with children having negative API and healthy children. Conclusions: We have found higher serum Ang-1 levels in atopic children with RW, and this result might be explained by increased inflammation. The evidence was not strong enough to associate serum Ang-1, Ang-2, or periostin and asthma in preschool children with RW. However, Ang-1 can be a candidate for investigating its role in predicting atopic children and diagnosing atopic childhood asthma.