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Öğe The 6-month drug survival rate in patients with rheumatoid arthritis treated with tofacitinib(2021) Karatas, Ahmet; Gur, Burak; Oz, Burak; Piskin Sagir, Rabia; Hohluoglu, Abdulvahap; Gozel, Nevzat; Koca, Suleyman SerdarAim: Rheumatoid arthritis (RA) is a progressive, inflammatory, autoimmune disease that particularly affects the joints. Tofacitinib is the first oral Janus kinase inhibitor approved for RA treatment. We aimed to analyze the 6-month drug survival rate and factors affecting the discontinuation of tofacitinib in RA patients. Materials and Methods: Age, gender, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) levels, whether to continue treatment tofacitinib, if treatment is not continued what treatment is applied, use of biological agent before tofacitinib treatment were retrospectively recorded from the patient data. Results: 30 RA patients included in the study (29 female, 1 male) with a mean age of 50.5 ± 11.3 years. At the 6th month of treatment of tofacitinib, the drug survival rates were 50%. There was no significant difference between CCP positive and negative patients as well as between RF positive and negative patients in terms of drug survival rates (p = 0.92 and p = 0.90, respectively). The drug survival rates were alike in tofacitinib monotherapy and combined therapy of tofacitinib with any conventional DMARD (p = 0.36). The tofacitinib survival rates were similar in biologically naïve patients and in patients who had received at least one previous biological DMARD (p = 0.70). Conclusion: Half of the RA patients receiving tofacitinib treatment continue their treatment at the 6th month. The drug survival rate was not associated with co-treatment with conventional DMARD, auto-antibody positivities, and previously used biological DMARD therapy. These findings support that tofacitinib shows similar efficacy when used as combined or monotherapy, in seronegative or seropositive patients, and in biologic resistant or naive patients.Öğe Carotid artery stiffness in Behcet's disease(Aves, 2017) Yolbas, Servet; Gozel, Nevzat; Dagli, Mustafa Necati; Koca, Suleyman Serdar; Donder, EmirObjective: Increased carotid arterial stiffness (CAS) is a predictor of subclinical early atherosclerosis as well as carotid intima-media thickness (cIMT). We aimed to determine CAS and cIMT in Behcet's disease (BD). Material and Methods: BD (n= 49) and rheumatoid arthritis (RA) (n= 64) patients and healthy controls (HC) (n= 40) were included in the study. cIMT was measured. CAS indices, including arterial compliance (AC), arterial distensibility (AD), Young's elastic modulus (YEM), Peterson's elastic modulus (Ep), and beta stiffness index (beta SI) were measured based on the diameter-pressure relationship. Results: When compared to the HC group, the mean cIMT was significantly higher in the RA group (p= 0.033), but it was not higher in the BD group. The CAS indices, including AD, AC, Ep, and beta SI were not significantly different among the study groups. Moreover, the cIMT and CAS indices were not significantly different between active (n= 20) and inactive BD patients, and these indices were not correlated with the scores of disease activity. AD, AC and Ep were significantly lower in the BD patients with a positive pathergy reaction than in those with a negative reaction. Conclusion: These results suggest that BD does not directly lead to arterial stiffness or to an increase in cIMT.Öğe Detection of the regression on hydroxychloroquine retinopathy in optical coherence tomography(Springer, 2009) Turgut, Burak; Turkcuoglu, Peykan; Koca, Suleyman Serdar; Aydemir, OrhanHydroxychloroquine (HCQ) that is widely used in the treatment of the connective tissue disorders can cause retinopathy. The fundus examination of a patient with systemic lupus erythematosus receiving HCQ revealed left incomplete bull's eye and pigmentary changes in macula in the right eye. Repeated visual field tests showed the paracentral and peripheral defects in the right eye and the pericentral ring scotoma in the left eye. Optical coherence tomography (OCT) scans revealed the photoreceptor loss, retina pigment epithelium (RPE) irregularities, and a cyst-like hypo reflective space over RPE layer on the nasal perifoveal region in the left eye. On the ophthalmoscopic examination, the perifoveal pigmentation was not altered after the discontinuation of HCQ. However, the bilateral visual field defects were improved and the photoreceptor destruction and cyst-like hyporeflective space disappeared in the left eye. Mild RPE irregularities remained in both eyes as revealed by OCT scans. Even if OCT is used to evaluate the regression of HCQ retinopathy, it only shows advanced stage of retinopathy.Öğe Paricalcitol inhibits the wnt/beta-catenin signaling pathway and ameliorates experimentally inducedarthritis(Tubıtak scıentıfıc & technıcal research councıl turkey, ataturk bulvarı no 221, kavaklıdere, ankara, 00000, turkey, 2018) Yolbas, Servet; Yildirim, Ahmet; Tektemur, Ahmet; Celik, Zulfinaz Betul; Onalan Etem, Ebru; Ozercan, Ibrahim Hanifi; Akin, Mehmet Mustafa; Koca, Suleyman SerdarBackground/aim: The Wnt/beta-catenin pathway has important biological activities, including the differentiation of cells and joint formations. The aim of our study was to determine the effect of paricalcitol on experimentally induced arthritis. Materials and methods: Type II collagen combined with Freund's adjuvant was applied to induce arthritis in Wistar albino female rats. Paricalcitol (0.3 mu g/kg daily) was subcutaneously injected starting 1 day after collagen applications (prophylactic group) or 1 day after the onset of arthritis (therapeutic group), until day 29. Results: The 29th day arthritis scores were lower compared to the 13th day scores in the paricalcitol groups (P < 0.05), while they were higher in the arthritis group (P < 0.05). Marked cartilage-bone destruction and extensive perisynovial inflammation were detected in the arthritis group. Decreased cartilage-bone destruction and perisynovial inflammation in the paws were observed in the paricalcitol groups. The tissue mRNA levels of DKK1, Wnt5a, and axin-2 were higher in the arthritis group than in the control group. In the paricalcitol groups, mRNA expressions were lower than in the arthritis group. Conclusion: The present study shows that the Wnt/beta-catenin signaling pathway is active in arthritis. Moreover, paricalcitol ameliorates arthritis via inhibiting the Wnt/beta B-catenin pathway. Paricalcitol and the Wnt/beta-catenin pathway are candidates for research in human rheumatoid arthritis.Öğe The rs3768777-G allele of ITGAV gene is associated with rheumatoid arthritis(Springer Heidelberg, 2014) Koca, Suleyman Serdar; Kara, Murat; Ozgen, Metin; Dagli, Mustafa Necati; Gozel, Nevzat; Yolbas, Servet; Gundogdu, BarisIntegrin alpha v beta 3 (vitronectin receptor) plays a prominent role in angiogenesis, a key pathogenic feature of rheumatoid arthritis (RA). Moreover, integrin alpha(V) (ITGAV) subunit gene has been associated with a susceptibility to RA. The aim of the present study was to detect the potential association between ITGAV gene polymorphisms and a susceptibility to RA in a Turkish cohort. DNA samples were harvested from 160 patients with RA and 144 healthy controls (HC). Three single-nucleotide polymorphisms of ITGAV gene (rs3738919, rs3768777, and rs10174098) were genotyped using real-time PCR. Serum vitronectin levels were analyzed in 30 RA patients, 28 Beh double dagger et's disease (BD) patients, and 30 HC subjects. There was no significant difference between the RA and HC groups in terms of the genotypic and allelic distributions of rs3738919 and rs10174098 polymorphisms. However, the prevalence of rs3768777-G allele was higher in the RA group than in the HC group (OR 2.3, 95 % CI 1.6-3.2, p < 0.0001). Moreover, there was a significant association between RA and the genotypic distribution of rs3768777 (GG + AG vs. AA: OR 2.1, 95 % CI 1.3-3.4; GG vs. AG + AA: OR 4.1, 95 % CI 2.1-7.8). Serum vitronectin levels were lower in the RA and BD groups than in the HC group (p (ANOVA) = 0.002). The rs3738919 and rs10174098 polymorphisms of the ITGAV gene seem not to be associated with susceptibility to RA in Turkish patients. However, rs3768777 increases the risk of RA in this group. These results suggest that the ITGAV gene may be a candidate gene for the etiopathogenesis of RA.Öğe Serum IL-33 level and IL-33 gene polymorphisms in Behcet's disease(Springer Heidelberg, 2015) Koca, Suleyman Serdar; Kara, Murat; Deniz, Firat; Ozgen, Metin; Demir, Caner Feyzi; Ilhan, Nevin; Isik, AhmetBeh double dagger et's disease (BD) is a chronic inflammatory disease. Increased productions of cytokines including interleukin (IL)-1 beta and IL-18 are documented, and IL-1 alpha and beta gene polymorphisms are associated with susceptibility to the disease. IL-33 is a recently discovered member of IL-1 cytokine family. The aim of the study was to detect serum IL-33 level and IL-33 gene polymorphisms in a cohort of BD. Unrelated 117 patients with BD and 149 healthy controls (HC) were enrolled. Serum IL-33 levels were analyzed by enzyme-linked immunosorbent assay method. DNA samples were harvested using an appropriate commercial DNA isolation kit. Four single nucleotide polymorphisms of IL-33 gene (rs7044343, rs1157505, rs11792633 and rs1929992) were genotyped using the appropriate commercial primer/probe sets on real-time PCR. Serum IL-33 level was not significantly different in the BD and HC groups (p > 0.05). However, its level was lower in the active BD patients compared to the inactive ones and HC group (p = 0.044 and p = 0.037, respectively). There was no significant difference in terms of the genotypic and allelic distributions of rs1157505 and rs1929992 polymorphisms (p > 0.05 for all). However, the TT variants of rs7044343 and rs11792633 polymorphisms were very rare, and the T allele frequencies of these polymorphisms were lower, in the BD group compared to the HC group (p < 0.0001 for all). The rs7044343 and rs11792633 variants of IL-33 gene are associated with the decreased risk of BD in our cohort. Therefore, it may be concluded that IL-33 acts a protective role on the pathogenesis of BD.Öğe Serum salusin-? levels in systemic lupus erythematosus and systemic sclerosis(Aves, 2014) Koca, Suleyman Serdar; Ozgen, Metin; Isik, Bahar; Dagli, Mustafa Necati; Ustundag, Bilal; Isik, AhmetObjective: Systemic lupus erythematosus (SLE) and systemic sclerosis (SSc), chronic inflammatory diseases, demonstrate an increased incidence of cardiovascular manifestations and subclinical atherosclerotic disease. Salusin-alpha is a novel bioactive peptide that suppresses the formation of macrophage foam cells, and its serum level is significantly lower in patients with angiographically proven coronary artery disease. The aims of the study were to assess serum salusin-alpha level and its potential association with the predictors of atherosclerosis in SLE and SSc. Material and Methods: The study included 20 SLE and 22 SSc patients and 23 healthy controls (HC). All of the participants were female. Tumour necrosis factor-alpha (TNF-alpha), IL-6 and salusin-alpha levels, homeostasis model assessment for insulin resistance (HOMA-IR) index and common carotid intima-media thickness (IMT) were determined. Results: Salusin-alpha levels were lower and the IMTs were higher in the SLE and SSc groups than in the HC group. The salusin-alpha level was correlated with neither the disease activity scores nor cytokine levels and IMT in the SLE and SSc groups, although it was correlated with triglyceride level in the SLE group (r=-0.564, p=0.012), and with HOMA-IR index in the HC group (r=0.485, p=0.019). Conclusion: The present preliminary study may support the idea that SSc leads to subclinical atherosclerosis, as in SLE. Moreover, it can be concluded that the decreased salusin-a levels in SLE and SSc may contribute to subclinical atherosclerosis. However, further studies with larger sample size are needed to demonstrate this contribution in SLE and SSc.
