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Öğe Antileukotrienes in adenotonsillar hypertrophy: a review of the literature(Springer, 2016) Kar, Murat; Altintoprak, Niyazi; Muluk, Nuray Bayar; Ulusoy, Seckin; Bafaqeeh, Sameer Ali; Cingi, CemalWe assessed the use of antileukotrienes for treating adenotonsillar hypertrophy. We reviewed the current literature on the anatomy of adenotonsillar tissue, adenotonsillar hypertrophy/hyperplasia (and the associated pathophysiology and symptoms), and the effects of antileukotrienes used to treat adenotonsillar hypertrophy. Leukotrienes (LTs) are inflammatory mediators produced by a number of cell types, including mast cells, eosinophils, basophils, macrophages, and monocytes. There are several types (e.g., LTA4, LTB4, LTC4, LTD4, and LTE4). By competitive binding to the cysLT1 receptor, LT-receptor antagonist drugs such as montelukast, zafirlukast, and pranlukast block the effects of cySHLTs, improving the symptoms of some chronic respiratory diseases. High numbers of LT receptors have been found in the tonsils of children with obstructive sleep apnea. Antileukotrienes reduce the apnea-hypopnea index and adenotonsillar inflammation. Antileukotrienes may be useful for children with adenotonsillar hypertrophy due to their anti-inflammatory effects, which help to reduce adenotonsillar inflammation.Öğe Antioxidant activities of curcumin in allergic rhinitis(Springer, 2016) Altintoprak, Niyazi; Kar, Murat; Acar, Mustafa; Berkoz, Mehmet; Muluk, Nuray Bayar; Cingi, CemalWe investigated the antioxidant effects of curcumin in an experimental rat model of allergic rhinitis (AR). Female Wistar albino rats (n = 34) were divided randomly into four groups: healthy rats (control group, n = 8), AR with no treatment (AR + NoTr group, n = 10), AR with azelastine HCl treatment (AR + Aze group, n = 8), and AR with curcumin treatment (AR + Curc group, n = 8). On day 28, total blood IgE levels were measured. For measurement of antioxidant activity, the glutathione (GSH) level and catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activities were measured in both inferior turbinate tissue and serum. Malondialdehyde (MDA) levels were measured only in inferior turbinate tissue, and paraoxonase (PON) and arylesterase (ARE) activities were measured only in serum. Statistically significant differences were found for all antioxidant measurements (GSH levels and CAT, SOD, GSH-Px activities in the serum and tissue, MDA levels in the tissue, and PON and ARE activities in the serum) between the four groups. In the curcumin group, serum SOD, ARE, and PON and tissue GSH values were higher than the control group. Moreover, tissue GSH levels and serum GSH-Px activities in the curcumin group were higher than in the AR + NoTr group. In the azelastine group, except MDA, antioxidant measurement values were lower than in the other groups. Curcumin may help to increase antioxidant enzymes and decrease oxidative stress in allergic rhinitis. We recommend curcumin to decrease oxidative stress in allergic rhinitis.Öğe Do probiotics have a role in the treatment of allergic rhinitis? A comprehensive systematic review and meta-analysis(Sage Publications Inc, 2016) Guvenc, Isil Adadan; Muluk, Nuray Bayar; Mutlu, Fezan Sahin; Eski, Erkan; Altintoprak, Niyazi; Oktemer, Tugba; Cingi, CemalObjective: To investigate clinical evidence for the efficacy of probiotics in the treatment of allergic rhinitis (AR). Methods: A systematic search was conducted to review the results of all randomized, double-blind, placebo-controlled trials by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Primary outcome measurements were total nasal and ocular symptom scores (SS) and quality of life (QoL) questionnaires. Secondary outcome measurements were individual nasal SS and immunologic parameters. Results: Twenty-two randomized, double-blind, placebo-controlled studies were included. Seventeen trials showed significant benefit of probiotics clinically, whereas eight trials showed significant improvement in immunologic parameters compared with placebo. All five studies with Lactobacillus paracasei (LP) strains demonstrated clinically significant improvements compared with placebo. Probiotics showed significant reduction in nasal and ocular SS (standardized mean difference [SMD], -1.23, p < 0.001; and SMD, -1.84, p < 0.001; respectively), total, nasal, and ocular QoL scores compared with placebo (SMD, -1.84, p < 0.001; SMD, -2.30, p = 0.006; and SMD, -3.11, p = 0.005; respectively). Although heterogeneity was high, in subgroup analysis, SMD for total nasal and ocular symptoms with patients with seasonal AR and for nasal QoL scores for studies with LP-33 strain were significant and homogenous. Scores of nasal blockage, rhinorrhea, and nasal itching were significantly lower in the probiotic group compared with placebo. The meta-analysis studies SS the Japanese guidelines revealed a significant, homogenous SMD score of -0.34 for individual nasal SS, above the minimal important clinical difference value of 0.3. The T-helper 1 to T-helper 2 ratio was significantly lower in the probiotic group compared with placebo (SMD, -0.78; p = 0.045). Conclusion: Despite high variability among the studies, synthesis of available data provided significant evidence of beneficial clinical and immunologic effects of probiotics in the treatment of AR, especially with seasonal AR and LP-33 strains. With the rising pool of studies, the most promising strains in specific allergies can be revealed and adjuvant therapy with probiotics can be recommended for the treatment of AR.Öğe GSTP1 Levels in Cisplatin-induced Rat Cochlea after Alpha Lipoic Acid and Oxytocin Treatment(Medknow Publications & Media Pvt Ltd, 2017) Aydin, Sedat; Demir, Mehmet Gokhan; Oguztuzun, Serpil; Altintoprak, Niyazi; Bilmez, Eda Bekmez; Gul, Aylin Ege; Kocdogan, Arzu KayaIntroduction: Cisplatin is a well-known chemotherapeutic agent used in many cancer treatments. Several antioxidant agents are used for diminishing the toxic side effects of the cisplatin therapy. Alpha-lipoic acid (alpha-LA) and oxytocin (OT) are antioxidant agents that can be used in toxicity. Our aim is to investigate the effect of these antioxidants in cisplatin-induced ototoxicity in tissue level. Materials and Methods: Forty Wistar albino rats divided into five groups as control, cisplatin, cisplatin + intraperitoneal (IP) OT, cisplatin + intratympanic (IT) OT, and cisplatin + IT alpha-LA. The drug administration is applied for 4 days, and at the end of the procedure, the cochleas are harvested. After tissue preparation, GSTP1 levels are investigated and the intensity of the reaction is scored as negative (-), weak (1+), moderate (2+), or strong (3+). Results: Group 4 has a moderate staining which can be interpreted as high immunoreaction. When we compare with Group 1, this staining difference is statistically significant (P < 0.02). When we observe the Group 3, we cannot detect any difference with Group 1 in immunoreactivity. Conclusion: alpha-LA and OT are antioxidants effective against cisplatin ototoxicity. The expression of GSTP1 isozyme is increased in antioxidant-treated groups. Increased levels of these isozymes proved the increased healing response in tissue levels. Antioxidant agents can be used for adverse effects during cisplatin treatment. IT route is effective as IP systemic route.Öğe Is resveratrol therapeutic when used to treat allergic rhinitisinitis in rats?(Canadian Soc Clinical Investigation, 2016) Bozdemir, Kazim; Sahin, Ethem; Altintoprak, Niyazi; Muluk, Nuray B.; Cengiz, Betul P.; Acar, Mustafa; Cingi, CemalPurpose: Resveratrol has anti-infective, anti-inflammatory and antioxidant activities. The purpose of this study was to determine the effect of resveratrol in a rat experimental model of allergic rhinitis (AR). Methods: Wistar albino rats were divided into three groups: control (n=7), AR with no treatment (AR+NoTr, n=7) and AR with resveratrol treatment (AR+Res, n=7). For AR+Res, AR was induced and resveratrol given on days 21-28. On day 28, the total blood IgE levels were measured. Allergic symptoms (sneezing, nose-rubbing, eye lacrimation and nasal congestion) were scored on a 0-3 point scale, and histopathological changes in the nasal mucosa were evaluated. Results: Allergic symptom score of AR+NoTr was higher than the other two groups and the score of AR+Res was higher than the control group. Histopathologically, neither ciliary loss nor chondrocyte hypertrophy differed among the three groups; however, vascular congestion, inflammatory and plasma cell numbers, eosinophil and mast cell infiltration and goblet cell numbers were higher and mast cell infiltration was more prominent in AR+NoTr than in AR+Res and control. AR+Res and control did not differ significantly in any histological parameter. In AR+NoTr, nasal mucosa exhibited ciliary loss, squamous epithelial metaplasia, inflammatory cell infiltration, vascular congestion of the lamina propria and goblet cell epithelial metaplasia. In AR+Res, goblet cell metaplasia was focal or absent and infiltration of the lamina propria by inflammatory cells, eosinophils, and plasma cells was reduced relative to AR+NoTr. Conclusion: Allergic symptoms and tissue reactions were reduced by resveratrol treatment in rats with experimentally-induced AR.Öğe Managing anaphylaxis in the office setting(Sage Publications Inc, 2016) Cingi, Cemal; Wallace, Dana; Muluk, Nuray Bayar; Ebisawa, Motohiro; Castells, Mariana; Sahin, Ethem; Altintoprak, NiyaziBackground: Although the definition of anaphylaxis for clinical use may vary by professional health care organizations and individuals, the definition consistently includes the concepts of a serious, generalized or systemic, allergic or hypersensitivity reaction that can be life-threatening or even fatal. Methods: In this review, we presented the important topics in the treatment of anaphylaxis in the office setting. This review will discuss triggers and risk factors, clinical diagnosis, and management of anaphylaxis in the office setting. Results: Anaphylaxis in the office setting is a medical emergency. It, therefore, is important to prepare for it, to have a posted, written anaphylaxis emergency protocol, and to rehearse the plan regularly. In this review, we presented the important steps in managing anaphylaxis in the office. Treatment of anaphylaxis should start with epinephrine administered intramuscularly at the first sign of anaphylaxis. Oxygen and intravenous fluids may be needed for moderate-to-severe anaphylaxis or anaphylaxis that is quickly developing or if the patient is unresponsive to the first injection of epinephrine. Antihistamine therapy is considered adjunctive to epinephrine, which mainly relieves itching and urticaria. Corticosteroids, with an onset of action of 4-6 hours, have no immediate effect on anaphylaxis. Conclusion: To prevent near-fatal and fatal reactions from anaphylaxis, the patient, the family, and the physician must remember to follow the necessary steps when treating anaphylaxis. In anaphylaxis, there is no absolute contraindication for epinephrine.Öğe The possible mechanisms of the human microbiome in allergic diseases(Springer, 2017) Ipci, Kagan; Altintoprak, Niyazi; Muluk, Nuray Bayar; Senturk, Mehmet; Cingi, CemalIn the present paper, we discuss the importance of the microbiome in allergic disease. In this review paper, the data from the Medline (PubMed) and search engine of Kirikkale University were systematically searched for all relevant articles in June 15th, 2015 for the past 30 years. The keywords of "microbiome'', "dysbiosis'', "allergy'', "allergic rhinitis'', "allergic disease'', "mechanisms'' and "treatment'' were used alone or together. In this paper, microbiomes were presented in terms of "Definition'', "Influence of \the human microbiome on health'', "The microbiome and allergic diseases'', and "Modulation of the gut microbiota in terms of treatment and prevention''. Microbiological dysbiosis is also reviewed. The microbiome is the genetic material of all microbes (bacteria, fungi, protozoa, and viruses) that live on or in the human body. Microbes outnumber human cells in a 10: 1 ratio. Most microbes live in the gut, particularly the large intestine. Changes in the immune function of the respiratory tract are (at least in theory) linked to the immunomodulatory activity of the gut microbiota via the concept of a "common mucosal response''. The gut microbiota shapes systemic immunity, thus affecting the lung mucosa. Alternatively, changes in the gut microbiota may reflect alterations in the oropharyngeal microbiota, which may in turn directly affect the lung microbiota and host immune responses via microaspiration. Dysbiosis is defined as qualitative and quantitative changes in the intestinal flora; and modern diet and lifestyle, antibiotics, psychological and physical stress result in alterations in bacterial metabolism, as well as the overgrowth of potentially pathogenic microorganisms. All immune system components are directly or indirectly regulated by the microbiota. The nature of microbial exposure early in life appears to be important for the development of robust immune regulation; disruption of either the microbiota or the host response can trigger chronic inflammation. Dysbiosis is also an important clinical entity. Antibiotics, psychological and physical stress, and dietary factors contribute to intestinal dysbiosis.Öğe Update on local allergic rhinitis(Elsevier Ireland Ltd, 2016) Altintoprak, Niyazi; Kar, Murat; Muluk, Nuray Bayar; Oktemer, Tugba; Ipci, Kagan; Birdane, Leman; Cingi, CemalWe here provide an update on the literature regarding local allergic rhinitis (LAR). In reviewing LAR, we have included an updated definition, classifications, mechanisms, comorbidities, and recommendations for diagnosis and treatment for LAR, as well as the defined research areas for future evidence-based studies. LAR is a localised nasal allergic response in the absence of systemic atopy characterised by local production of specific IgE (sIgE) antibodies, a TH2 pattern of mucosal cell infiltration during natural exposure to aeroallergens, and a positive nasal allergen provocation test response, with the release of inflammatory mediators. The localised allergic response of LAR is an important topic for the study of allergies. This review provides an update on the current knowledge of LAR. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
