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Öğe 25-Hydroxyvitamin D3 deficiency: Prevalance and its impact on disease activity in small-medium vessel vasculitis(BMJ Publishing Group, 2016) Korkmaz, Fatma Nur; Özen, Gülşen; Ünal, Ali Uğur; Can, Meryem; Tuğlular, Serhan; Direskeneli, Haner[Abstract Not Available]Öğe Elevated serum TREM-1 is associated with periodontitis and disease activity in rheumatoid arthritis(Nature Research, 2021) İnanç, Nevsun; Mumcu, Gonca; Can, Meryem; Yay, Meral; Silbereisen, Angelika; Manoil, Daniel; Direskeneli, Haner; Bostancı, NagihanThe triggering receptor expressed on myeloid cells 1 (TREM-1) and peptidoglycan recognition protein 1 (PGLYRP1) are involved in the propagation of inflammatory responses. This study investigated whether serum levels of TREM-1 and PGLYRP1 correlate with periodontitis in rheumatoid arthritis (RA) patients. A total of 154 non-smoking participants with RA (n = 55, F/M: 41/14), Behçet´s disease (BD, n = 41, F/M: 30/11) and healthy controls (HC, n = 58, F/M: 40/18) were recruited. Serum and saliva were collected, the 28-joint disease activity score (DAS-28) was calculated and dental/periodontal measurements were recorded. Serum TREM-1 and PGLYRP1 levels were measured by ELISA and salivary bacterial DNA counts by quantitative polymerase chain reaction. TREM-1 and PGLYRP1 levels were higher in RA (166.3 ± 94.3; 155.5 ± 226.9 pg/ml) than BD (102.3 ± 42.8; 52.5 ± 26.3 pg/ml) and HCs (89.8 ± 55.7; 67.4 ± 37.3 pg/ml) (p < 0.05). In RA, periodontitis was associated with increased TREM-1 and PGLYRP1 levels (p < 0.05), yet in patients under methotrexate TREM-1 levels were lower. TREM-1 correlated with C-reactive protein (CRP) levels, DAS-28 and erythrocyte sedimentation rate, whereas PGLYRP1 positively correlated with CRP. RA patients displayed 3.5-fold higher salivary bacterial DNA counts than HCs. Increased serum TREM-1 levels correlated with PGLYRP1, CRP and DAS-28-ESR in RA patients with periodontitis.Öğe Elevated serum trem-1 levels are associated with das28 and periodontitis in rheumatoid arthritis(BMJ Publishing Group, 2019) İnanç, Nevsun; Mumcu, Gonca; Can, Meryem; Direskeneli, Haner; Bostancı, NagihanBackground: The Triggering Receptor Expressed on Myeloid cells 1(TREM-1) along with its putative ligand peptidoglycan recognition protein1 (PGLYRP1) are involved in the propagation of the inflammatoryresponse to microbial exposure(1). Periodontal disease (PD) has beensuggested as an environmental risk factor for rheumatoid arthritis (RA),yet further studies are required to dissect the mechanisms underlying theassociation between the two(2).Öğe Low relapse rate in patients with giant cell arteritis in a multi-centre retrospective Turkish Registry(2024) Alibaz Öner, Fatma; Keleşoğlu, Bahar; Balcı, Mehmet Ali; Yardımcı, Gözde Kübra; Armağan, Berkan; Kılıç, Levent; Karakaş, Özlem; Erden, Abdulsamet; Yaşar Bilge, Şule; Kardaş, Rıza Can; Küçük, Hamit; Zengin, Orhan; Taşçı, Murat; Kocaer, Sinem Burcu; Yavuz, Şule; Doğru, Atalay; Şahin, Mehmet; Bayındır, Özün; Sevik, Gizem; Ertürk, Zeynep; Alpay Kanıtez, Nilüfer; Göğebakan, Hasan; Tezcan, Mehmet Engin; Öksüz, Mustafa Ferhat; Çefle, Ayşe; Küçükşahin, Orhan; Yazıcı, Ayten; Kasapoğlu, Esen; Beş, Cemal; Ünal, Ali Uğur; Dalkılıç, Ediz; Yıldırım Çetin, Gözde; Aksu, Kenan; Keser, Gökhan; Önen, Fatoş; Çobankara, Veli; Kısacık, Bünyamin; Onat, Ahmet Mesut; Öztürk, Mehmet Akif; Kaşifoğlu, Timuçin; Omma, Ahmet; Karadağ, Ömer; Ateş, Aşkın; Direskeneli, HanerObjective Glucocorticoids (GC) are widely accepted as the standard first-line treatment for giant cell arteritis (GCA). However, relapse rates are reported up to 80% on GC-only protocol arms in controlled trials of tocilizumab and abatacept in 12-24 months. Herein, we aimed to assess the real-life relapse rates retrospectively in patients with GCA from Turkey. Methods We assembled a retrospective cohort of patients with GCA diagnosed according to ACR 1990 criteria from tertiary rheumatology centres in Turkey. All clinical data were abstracted from medical records. Relapse was defined as any new manifestation or increased acute-phase response leading to the change of the GC dose or use of a new therapeutic agent by the treating physician. Results The study included 330 (F/M: 196/134) patients with GCA. The mean age at disease onset was 68.9±9 years. The most frequent symptom was headache. Polymyalgia rheumatica was also present in 81 (24.5%) patients. Elevation of acute phase reactants (ESR>50 mm/h or CRP>5 mg/l) was absent in 25 (7.6%) patients at diagnosis. Temporal artery biopsy was available in 241 (73%) patients, and 180 of them had positive histopathological findings for GCA. For remission induction, GC pulses (250-1000 methylprednisolone mg/3-7 days) were given to 69 (20.9%) patients, with further 0.5-1 mg/kg/day prednisolone continued in the whole group. Immunosuppressives as GC-sparing agents were used in 252 (76.4%) patients. During a follow-up of a median 26.5 (6-190) months, relapses occurred in 49 (18.8%) patients. No confounding factor was observed in relapse rates. GC treatment could be stopped in only 62 (23.8%) patients. Additionally, GC-related side effects developed in 64 (24.6%) patients, and 141 (66.2%) had at least one Vasculitis Damage Index (VDI) damage item present during follow-up. Conclusion In this first multi-centre series of GCA from Turkey, we observed that only one-fifth of patients had relapses during a mean follow-up of 26 months, with 76.4% given a GC-sparing IS agent at diagnosis. At the end of follow-up, GC-related side effects developed in one-fourth of patients. Our results suggest that patients with GCA had a low relapse rate in real-life experience of a multi-centre retrospective Turkish registry, however with a significant presence of GC-associated side effects during follow-up.Öğe Novel and known periodontal pathogens residing in gingival crevicular fluid are associated with rheumatoid arthritis(Wiley, 2021) Manoil, Daniel; Bostancı, Nagihan; Mumcu, Gonca; İnanç, Nevsun; Can, Meryem; Direskeneli, Haner; Belibasakis, Georgios N.Background Periodontitis is a suspected environmental risk factor for the development of rheumatoid arthritis (RA). However, correlation mechanisms between the two pathologies remain elusive. This study examined potential correlations between detached subgingival bacteria collected in gingival crevicular fluid (GCF) and RA parameters. Methods RA patients (n = 52, F:M = 40:12), patients with Behcet's disease (BD,n = 40, F:M = 29:11) as another systemic inflammatory disease were studied along with a systemically healthy control group (HC,n = 57, F:M = 40:17). All participants were non-smokers. Full mouth periodontal parameters were recorded. RA activity was assessed using the 28-joint Disease Activity Score (DAS-28). Rheumatoid factors (RFs)-IgM and -IgA were measured by ELISA. GCF samples were investigated by means of fluorescent in situ hybridization for 10 different bacterial taxa. Results The taxa TM7,Synergistetescluster B,Leptotrichia, Megasphaera,Anaeroglobus geminatus, andTannerella forsythiadisplayed significantly differential abundances between the groups. Whereas abundances ofMegasphaeraandA. geminatuswere significantly increased in the RA group, onlyPorphyromonas gingivalisdisplayed significant correlations with plaque scores, bleeding on probing, and RF-IgA. RA patients displaying RF-IgA levels >75 IU/mL exhibited five-fold more abundantP. gingivalislevels than patients below the threshold. This association with RF-IgA levels appeared even more pronounced, by six-fold moreP. gingivalis(P = 0.025), in patients with a DAS-28 score >3.2, indicative of moderate/very active RA. Conclusions Unattached GCF bacteria may mediate the association between periodontitis and RA, and monitoring the bacterial composition of GCF might inform on RA activity. The role of newly identified bacterial taxa in RA warrants further investigations.Öğe Vitamin D levels in patients with small and medium vessel vasculitis(Elsevier Espana Slu, 2022) Korkmaz, Fatma Nur; Özen, Gülşen; Ünal, Ali Uğur; Odabaşı, Aslı; Can, Meryem; Aşıcıoğlu, Ebru; Tuğlular, Serhan; Direskeneli, HanerObjectives: To determine the prevalence of vitamin D deficiency in patients with small and medium vessel systemic vasculitis.& nbsp;Methods: In this cross-sectional study, 25-hydroxy (OH) vitamin D3 levels were measured in adult patients with systemic small and medium vessel vasculitis including antineutrophil cytoplasmic antibody-associated vasculitis (AAV), cryoglobulinaemic vasculitis (CryV), IgA vasculitis (IgAV) and pol-yarteritis nodosa (PAN), and age- and sex-matched healthy subjects (HS) and patients with rheumatoid arthritis (RA) as control groups. 25OH vitamin D3 levels < 30 ng/ml and < 20 ng/ml were regarded as insufficiency and deficiency, respectively.& nbsp;Results: Fifty-seven patients (42 AAV, 2 CryV, 8 IgA vasculitis, 5 PAN) with systemic vasculitis, 101 HS, and 111 RA patients were included. The mean 25OH vitamin D3 level was 21.8 +/- 14.2 ng/mL in patients with vasculitis, 42.7 & nbsp;+/- 27.6 ng/mL in HS (p < .001) and 20.1 +/- 18.47 ng/mL in patients with RA (p = .54). Vitamin D insufficiency and deficiency were significantly higher in patients with systemic vasculitis compared to HS (75.4% vs 33.7%, p < .001; %50 vs 21.8%, p < .001, respectively). Vitamin D status was not different in patients with systemic vasculitis compared to RA. There was a negative correlation between vitamin D status and CRP levels (=-.364, p = .007). The multivariate logistic regression analysis showed that renal involvement was significantly associated with vitamin D deficiency/insufficiency in patients with vasculitis (OR 22.5 [95% CI 1.6-128.9].& nbsp;Conclusion: Vitamin D deficiency and insufficiency are more frequent in patients with systemic small and medium vessel vasculitis and RA than HS. Renal involvement is one of the factors associated with vitamin D deficiency/insufficiency in patients with vasculitis.
