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Öğe Atherogenic index of plasma: a useful marker for subclinical atherosclerosis in ankylosing spondylitis(Springer London Ltd, 2018) Cure, Erkan; Icli, Abdullah; Uslu, Ali Ugur; Sakiz, Davut; Cure, Medine Cumhur; Baykara, Rabia Aydogan; Yavuz, FatmaAnkylosing spondylitis (AS) is associated with an increased risk of atherosclerotic cardiovascular disease (ACD). The atherogenic index of plasma (AIP), which is the logarithmic transformation of the plasma triglyceride (TG) level to the high-density lipoprotein level (HDL) ratio, has been suggested to be a novel marker in the identification of atherosclerosis risk. Therefore, this study aims to determine if the AIP can act as an accurate marker for the detection of subclinical atherosclerosis. Fifty-two male patients with AS and 52 age-, gender-, and body mass index (BMI)-matched healthy control subjects were included in the study. For each patient, AIP and total cholesterol (TC)/HDL values were calculated and carotid artery intima-media thickness (cIMT) was measured. The mean (SD) cIMT and median (range) AIP values for AS patients were higher than that of the healthy control subjects (0.60 +/- 0.18 vs. 0.51 +/- 0.10, p = 0.003 and 0.23 [- 0.32 to 0.85] vs. 0.09 [- 0.53 to 0.49], p = 0.007, respectively). A positive correlation was found between the patients' cIMT and AIP values (r = 0.307, p = 0.002) and TC/HDL values (r = 0.241, p = 0.014). Regression analysis revealed an independent association between the subclinical atherosclerosis and AIP (beta [beta] = 0.309, p = 0.002). There were no independent correlations between subclinical atherosclerosis and TC (beta = 0.245, p = 0.065), TG (beta = 0.185, p = 0.515), HDL (beta = 0.198, p = 0.231), TC/HDL (beta = 0.032, p = 0.862), and low-density lipoprotein (LDL) (beta = 0.151, p = 0.246). A strong and independent correlation exists between AIP and cIMT values. Therefore, the AIP could serve as a better marker than the TC/HDL ratio for the detection of subclinical atherosclerosis in AS patients.Öğe Can emapalumab be life saving for refractory, recurrent, and progressive cytokine storm caused by COVID-19, which is resistant to anakinra, tocilizumab, and Janus kinase inhibitors(Wolters Kluwer Medknow Publications, 2021) Cure, Erkan; Kucuk, Adem; Cure, Medine CumhurAlthough many potent drugs have been used for cytokine storm, mortality is high for patients with coronavirus disease-2019 (COVID-19), which is followed up in the intensive care unit. Interferons (IFNs) are the major cytokines of the antiviral defense system released from many cell types. However, IFN-gamma plays a key role in both primary and secondary cytokine storms. If the cytokine storm is not treated urgently, it will be fatal; therefore, it should be treated immediately. Anakinra, an interleukin-1 (IL-1) antagonist, tocilizumab, an IL-6 antagonist, and Janus kinase (JAK) inhibitors are successfully used in cytokine storm caused by COVID-19. However, sometimes, despite these treatments, the patient's clinical course does not improve. Emapalumab (Eb) is the human immunoglobulin G1 monoclonal antibody and is a potent and noncompetitive antagonist of IFN-gamma. Eb can be life saving for cytokine storm caused by COVID-19, which is resistant to anakinra, tocilizumab, and JAK inhibitors.Öğe Comment on Smooth or Risky Revisit of an Old Malaria Drug for COVID-19?(Springer, 2020) Cure, Erkan; Cure, Medine Cumhur; Kucuk, Adem[Abstract Not Availabe]Öğe COVID-19 infection can cause chemotherapy resistance development in patients with breast cancer and tamoxifen may cause susceptibility to COVID-19 infection(Churchill Livingstone, 2020) Vatansev, Hulya; Kadiyoran, Cengiz; Cure, Medine Cumhur; Cure, ErkanBreast cancer is the most common cancer in women and is the second most common cause of death in women. Estrogen plays an important role in breast tumor etiopathogenesis. Tamoxifen and other anti-estrogen drugs are used in breast cancer patients who have a positive estrogen receptor (ER). While angiotensin II plays a key role in breast cancer etiology and causes tamoxifen resistance, angiotensin 1-7 has been reported to may reduce the spread and invasion of breast cancer. During the COVID-19 infection, the virus blocks ACE2, and angiotensin 1-7 production discontinued. Angiotensin III production may increase as angiotensin II destruction is reduced. Thus, aminopeptidase upregulation may occur. Increased aminopeptidase may develop resistance to chemotherapy in breast cancer patients receiving chemotherapy. Estrogen can have a protective effect against COVID-19. Estrogen increase causes ER-a upregulation in T lymphocytes. Thus, estrogen increases the release of interferon I and III from T lymphocytes. Increasing interferon I and III alleviates COVID-19 infection. Tamoxifen treatment causes down-regulation, mutation, or loss in estrogen receptors. In the long-term use of tamoxifen, its effects on estrogen receptors can be permanent. Thus, since estrogen receptors are damaged or downregulated, estrogen may not act by binding to these receptors. Tamoxifen is a P-glycoprotein inhibitor, independent of its effect on estrogen receptors. It suppresses T cell functions and interferon release. We think tamoxifen may increase the COVID-19 risk due to its antiestrogen and P-glycoprotein inhibitory effects.Öğe Endocan Levels and Subclinical Atherosclerosis in Patients With Systemic Lupus Erythematosus(Sage Publications Inc, 2016) Icli, Abdullah; Cure, Erkan; Cure, Medine Cumhur; Uslu, Ali Ugur; Balta, Sevket; Mikhailidis, Dimitri P.; Ozturk, CengizSystemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology. A major cause of morbidity and mortality in SLE is accelerated atherosclerosis. Endothelial-specific molecule 1 (endocan) is a potential predictor of vascular events and is expressed in response to inflammatory cytokines in endothelial cells. We investigated the relationship between endocan and carotid intima-media thickness (cIMT) as a marker of early atherosclerosis. We included 44 women with SLE and 44 healthy women as controls. Disease severity of SLE was evaluated using the SLE Disease Activity Index. Endocan, C-reactive protein, erythrocyte sedimentation rate (ESR), and lipid panel were measured. The cIMT was 0.70 (range: 0.45-1.20) mm in patients with SLE and 0.40 (0.25-0.60) mm in controls (P < .001). Endocan value was 1.6 +/- 0.9 ng/mL in controls and 2.2 +/- 1.0 ng/mL in patients with SLE (P = .014). Endocan levels were positively correlated with cIMT (r = .469, P < .001), body mass index (r = .373, P = .013), and ESR (r = .393, P = .008). Endocan level may be associated with subclinical atherosclerosis in SLE. Consequently, endocan levels may be a promising clinical tool for patients with SLE as a guide for preventive strategy.Öğe Evaluation of serum thiol/disulfide homeostasis in patients with ankylosing spondylitis by a novel method(Kare Publ, 2019) Baykara, Rabia Aydogan; Tuzcu, Ayca; Omma, Ahmet; Acet, Gunseli Karaca; Dogan, Erdal; Aydin, Almila; Cure, Medine CumhurOBJECTIVE: Increased reactive oxygen species may play an important role in Ankylosing spondylitis (AS) etiopathogenesis. The thiol group is a very potent antioxidant. In this study, we aimed to investigate the presence of oxidative stress in patients with AS by evaluating thiol/disulfide homeostasis. METHODS: In this study, a total of 66 AS patients (27 male, 39 female) and 66 healthy controls (21 male, 45 female) were enrolled. Recently, a novel method for the thiol measurement was found. Thiol and disulfide values were measured by the novel methods. RESULTS: Native thiol (NT) (p<0.001) and native thiol/total thiol (NTT) (p<0.001) levels of AS patients were significantly lower compared to the values of the healthy group. However, disulfide (p<0.001), disulfide/native thiol (DNT) (p<0.001) and disulfide/total thiol (DTT) levels of AS patients were a strongly higher control group. A negative correlation was found between BASFI and NTT. Also, a negative correlation was found between BASDAI and NT, NTT levels. A positive correlation was found between BASFI and disulfide, DNT and DTT levels. A positive correlation was found between BASFI and disulfide, DNT and DTT levels. CONCLUSION: The findings revealed that thiol-disulfide homeostasis deteriorated in patients with AS in favor of disulfide amounts. Thiol-disulfide homeostasis can play roles in the etiology and severity of AS.Öğe Evaluation of serum thiol/disulfide homeostasis in patients with ankylosing spondylitis by a novel method(Kare Publ, 2019) Baykara, Rabia Aydogan; Tuzcu, Ayca; Omma, Ahmet; Acet, Gunseli Karaca; Dogan, Erdal; Aydin, Almila; Cure, Medine CumhurOBJECTIVE: Increased reactive oxygen species may play an important role in Ankylosing spondylitis (AS) etiopathogenesis. The thiol group is a very potent antioxidant. In this study, we aimed to investigate the presence of oxidative stress in patients with AS by evaluating thiol/disulfide homeostasis. METHODS: In this study, a total of 66 AS patients (27 male, 39 female) and 66 healthy controls (21 male, 45 female) were enrolled. Recently, a novel method for the thiol measurement was found. Thiol and disulfide values were measured by the novel methods. RESULTS: Native thiol (NT) (p<0.001) and native thiol/total thiol (NTT) (p<0.001) levels of AS patients were significantly lower compared to the values of the healthy group. However, disulfide (p<0.001), disulfide/native thiol (DNT) (p<0.001) and disulfide/total thiol (DTT) levels of AS patients were a strongly higher control group. A negative correlation was found between BASFI and NTT. Also, a negative correlation was found between BASDAI and NT, NTT levels. A positive correlation was found between BASFI and disulfide, DNT and DTT levels. A positive correlation was found between BASFI and disulfide, DNT and DTT levels. CONCLUSION: The findings revealed that thiol-disulfide homeostasis deteriorated in patients with AS in favor of disulfide amounts. Thiol-disulfide homeostasis can play roles in the etiology and severity of AS.Öğe Novel myokine: irisin may be an independent predictor for subclinic atherosclerosis in Behcet's disease(Bmj Publishing Group, 2016) Icli, Abdullah; Cure, Erkan; Cure, Medine Cumhur; Uslu, Ali Ugur; Balta, Sevket; Arslan, Sevket; Sakiz, DavutBehcet's disease (BD) is a vasculitic and inflammatory disease causing endothelial dysfunction. Irisin is a metabolic hormone related to insulin resistance and endothelial functions. In this study, we investigated the relationship between irisin and carotid intima-media thickness (cIMT), which is a marker of atherosclerosis in patients with BD. 48 patients with BD and 50 healthy individuals were enrolled in the study. Disease severity was evaluated by BD current activity form. Irisin, glucose, insulin, C reactive protein, erythrocyte sedimentation rate and lipid panel were examined in all patients. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to calculate insulin resistance. A simple and inexpensive cIMT test was used as indicator of atherosclerosis. cIMT was 0.62 (0.45-1.05) mm in the patients, while it was 0.38 (0.25-0.65) mm in the control group (p<0.001). Irisin value was found to be 197.3 (24.8-834.2) ng/mL in the control group, while it was 85.4 (4.7-471.1) ng/mL in the patient group (p=0.007). There was a negative correlation between irisin level and cIMT (r=-0.511, p<0.001) and HOMA-IR (r=-0.371, p=0.009). Decreased irisin levels (OR 0.996, 95% CI 0.992 to 1.000, p=0.041), male gender (OR 7.634, 95% CI 1.415 to 41.191, p=0.018), and HOMA-IR (OR 2.596, 95% CI 1.451 to 4.643, p=0.001) are independent risk factors for cIMT in patients with BD. We detected a very strong relationship between cIMT, which is an indicator of subclinical atherosclerosis, and decreased irisin levels in patients with BD. BD is characterized by chronic inflammation, and low serum irisin levels in BD may be related to atherosclerosis.Öğe NSAIDs may increase the risk of thrombosis and acute renal failure in patients with COVID-19 infection(Elsevier, 2020) Cure, Medine Cumhur; Kucuk, Adem; Cure, Erkan[Abstract Not Availabe]Öğe The Relationship Between Atherogenic Index and Carotid Artery Atherosclerosis in Familial Mediterranean Fever: A Pilot Study(Sage Publications Inc, 2017) Icli, Abdullah; Cure, Erkan; Uslu, Ali Ugur; Sakiz, Davut; Cure, Medine Cumhur; Ozucan, Miyase; Baykara, Rabia AydoganFamilial Mediterranean fever (FMF) is a disease characterized by chronic inflammation. Atherogenic index of plasma (AIP) is a logarithmic value of the triglyceride to high-density lipoprotein cholesterol ratio and it is a good marker for atherosclerotic heart disease and cardiac risk. In this study, we investigated subclinical atherosclerosis and cardiac risks in patients with FMF. Patients with FMF (78 men and 84 women) and healthy controls (74 men and 82 women) were included in this study. The AIP values of the patients were calculated and carotid intima-media thicknesses (cIMTs) were measured. The cIMT (P < .001) and AIP (P < .001) values of patients with FMF were higher than the values of the control group. There was a positive correlation between cIMT and AIP values (r = .304, P < .001). In regression analysis, we detected an independent relationship between cIMT and AIP ( = .248, P = .001). Atherogenic index of plasma may be highly correlated with the subclinical atherosclerosis. Particularly, male patients with FMF may have a high cardiac risk.
