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Öğe Alternative products to treat allergic rhinitis and alternative routes for allergy immunotherapy(OceanSide Publications Inc., 2016) Ipci K.; Oktemer T.; Muluk N.B.; Şahin E.; Altintoprak N.; Bafaqeeh S.A.; Cingi C.Background: Some alternative products instead of immunotherapy are used in patients with allergic rhinitis (AR). Methods: In this paper, alternative products to treat allergic rhinitis and alternative routes for allergy immunotherapy are reviewed. Results: Alternative products and methods used instead of immunotherapy are tea therapy, acupuncture, Nigella sativa, cinnamon bark, Spanish needle, acerola, capsaicin (Capsicum annum), allergen-absorbing ointment, and cellulose powder. N. sativa has been used in AR treatment due to its anti-inflammatory effects. N. sativa oil also inhibits the cyclooxygenase and 5-lipoxygenase pathways of arachidonic acid metabolism. The beneficial effects of N. sativa seed supplementation on the symptoms of AR may be due to its antihistaminic properties. To improve the efficacy of immunotherapy, some measures are taken regarding known immunotherapy applications and alternative routes of intralymphatic immunotherapy and epicutaneous immunotherapy are used. Conclusion: There are alternative routes and products to improve the efficacy of immunotherapy. Copyright © 2016, OceanSide Publications, Inc., U.S.A.Öğe Chronic Rhinosinusitis—Could Phenotyping or Endotyping Aid Therapy?(SAGE Publications Inc., 2019) Bayar Muluk N.; Cingi C.; Scadding G.K.; Scadding G.Objectives: We reviewed the phenotyping and endotyping of chronic rhinosinusitis (CRS) and treatment options. Methods: We searched PubMed, Google, Google Scholar, and the Proquest Central Database of the Kırıkkale University Library. Results: Phenotypes are observable properties of an organism produced by the environment acting upon the genotype, that is, patients with a particular disorder are subgrouped according to common characteristics. Currently, CRS is usually phenotyped as being with (CRSwNP) or without (CRSsNP) nasal polyps. However, this is not immutable as some individuals progress from nonpolyp to polypoid CRS over time. Phenotypes of CRS are also based on inflammatory patterns, generally CRSwNP is eosinophilic, CRSsNP neutrophilic; but there is a spectrum, rather than a clear-cut division into 2 types. An endotype is a subtype of a condition defined by a distinct functional or pathobiological mechanism. Endotypes of CRS can be (1) nontype Th2, (2) moderate type Th2, and (3) severe type Th2 immune reactions, based on cytokines and mediators such as IL4, 5, 13. CRS endotyping can also include a (1) type 2 cytokine-based approach, (2) eosinophil-mediated approach, (3) immunoglobulin E-based approach, and (4) cysteinyl leukotriene-based approach. Subdivisions of CRSwNP can be made into nonsteroidal anti-inflammatory drug-exacerbated respiratory disease, allergic fungal sinusitis, and eosinophil pauci-granulomatous arteritis by testing. General treatment for all CRS is nasal douching. The place of surgery needs careful reconsideration. Endotype-directed therapies include glucocorticosteroids, antibiotics, aspirin, antifungals, anticytokines, and immunoglobulin replacement. The recognition of united airways and the co-occurrence of CRSwNPs and severe asthma should lead to common endotyping of both upper and lower airways in order to better direct therapy. Conclusion: Endotyping can allow for the identification of groups of patients with CRS with a high likelihood of successful treatment, such as patients with a moderate type 2 immune reaction or those with acquired immune deficiency. © The Author(s) 2018.Öğe Clinical efficacy of immunotherapy in allergic rhinitis(OceanSide Publications Inc., 2016) Oktemer T.; Altintoprak N.; Muluk N.B.; Senturk M.; Kar M.; Bafaqeeh S.A.; Cingi C.Background: Aeroallergen immunotherapy (AIT) should be considered for patients who exhibit symptoms of allergic rhinitis (AR), rhinoconjunctivitis, and/or asthma after natural exposure to allergens and who also demonstrate specific immunoglobulin E antibodies against relevant allergens. Methods: In this paper, clinical efficacy of immunotherapy in allergic rhinitis is reviewed. Result: Subcutaneous allergen immunotherapy (SCIT) is effective for seasonal and perennial AR. Sustained effectiveness requires several years of treatment. SCIT may prevent the development of allergic asthma in children with AR. Sublingual allergen immunotherapy (SLIT) is currently considered an alternative treatment to the subcutaneous route. The use of SLIT has been included in international guidelines for the treatment of AR with or without conjunctivitis. Conclusion: Patients treated with SCIT are at risk of both local and systemic adverse reactions; however, in most cases, symptoms are readily reversible if they are recognized early and treated promptly. The safety profile of SLIT is good; therefore, SLIT can be self-administered by patients in their homes. In this article, we reviewed the efficacy and safety of allergen immunotherapy. Copyright © 2016, OceanSide Publications, Inc.Öğe Evaluation of the efficacy of curcumin in experimentally induced acute sinusitis in rats(Medquest Communications LLC, 2016) Birdane L.; Cingi C.; Muluk N.B.; San T.; Burukoglu D.We investigated the possible beneficial effects of curcumin (CMN) in the treatment of sinusitis. An experimentally induced sinusitis model was created in rats, and the results were evaluated histologically. Thirty-two healthy, female Sprague Dawley rats weighing 270 to 310 g each, were randomly divided into four groups. Group 1 was the control group. In Groups 2 to 4, experimentally induced acute sinusitis was developed, and the rats in those groups were given saline, sulbactam-ampicillin, and CMN, respectively, for 10 days. Then all rats were dissected, and samples of sinus mucosa were taken. Histologic examination was performed via light microscopy. In the sinusitis + antibiotic group, values of inflammation, vascular congestion, vascular dilatation, and subepithelial glandular atrophy were significantly higher; and values of mucosal damage and cilia loss, and hyperplasia of goblet cells, were not significantly different from those in the control group. In the sinusitis + CMN group, values of inflammation, vascular congestion, and vascular dilatation were significantly higher; and values of mucosal damage and cilia loss, hyperplasia of goblet cells, and subepithelial glandular atrophy were not significantly different from those of the control group. Histologic examination revealed that in the sinusitis + CMN group, a nearly normal appearance of the epithelial tissue and reduced cellular inflammation in connective tissue were observed. Minimal vascular congestion in connective tissue remained. The efficacy of CMN in acute sinusitis may be related to its potent anti-inflammatory effects on modulation of various inflammatory cytokines. When low side effects are taken into account, CMN therapy may be a promising option in the treatment of acute sinusitis. © 2016 Vendome Group, LLC All rights reserved.Öğe Is there a correlation between body proportion and choice of profession?(Walter de Gruyter GmbH, 2016) Cingi C.C.; Muluk N.B.; Hanci D.; Güngör E.O.; Cingi C.Objective: We made anthropometric measurements to compare body proportions of university students and to investigate the tendency of the students with more developed bodies in choosing profession for university education. Methods: A total of 204 male students [group 1: students of School of Physical Education and Sports" (SPESp) (n=88), group 2: students of Faculty of Fine Arts (FFArts) (n=59), and group 3: students of Faculty of Medicine (FMed) (n=57)] were included, and anthropometric measurements were performed. Results: "Height"; "chest circumference"; "difference of inspiration and expiration of chest circumference" values of the SPESp students were higher than the others (FFArts and FMed). In the SPESp students, chest circumference and chest expansion capacity by inspiration developed more. This shows the positive impact of sport on respiratory functions. Additionally, the legs are longer in students engaged in regular sports. Conclusion: Exercise is important for all subjects in terms of body development, growth, and oxygenization and to decrease cardiovascular risk factors. For the development of the ideal body anthropometric rates, obesity prevention, and for the growth of healthy generations, governments should give importance to sports and take incentive measures to increase children and young people's interest in the sport. © 2016 by De Gruyter 2016.Öğe Mechanism of action of allergen immunotherapy(OceanSide Publications Inc., 2016) Şahin E.; Bafaqeeh S.A.; Güven S.G.; Çetinkaya E.A.; Muluk N.B.; Coşkun Z.O.; Cingi C.Background: Allergen immunotherapy (AIT) leads to the production of antiallergen immunoglobulin (IgG) or "blocking antibody" in the serum and an increase in antiallergen IgG and IgA in nasal secretions. There is also a decrease in the usual rise in antiallergen IgE that occurs after the pollen season. Methods: In this paper, mechanisms of action of allergen immunotherapy is reviewed. Results: Regulatory T (Treg) cells and their cytokines, primarily interleukin (IL) 10 and transforming growth factor beta, suppress T-helper type 2 immune responses and control allergic diseases in many ways. AIT induces a shift in the proportion of IL-4-secreting T-helper type 2 cells in favor of IL-10-secreting inducible Treg cells specific for the same allergenic epitope that increases in number and function. Different types of inducible Treg control several facets of allergic inflammation. There are two main types of immunotherapy: subcutaneous immunotherapy and sublingual immunotherapy. Subcutaneous immunotherapy is efficacious and is indicated for the reduction of seasonal symptoms. Sublingual immunotherapy involves the regular self-administration and retention of allergen extract under the tongue for 1-2 minutes before the extract is swallowed. The allergens cross the mucosa in 15-30 minutes and are then captured by tolerogenic dendritic cells and processed as small peptides. Next, via the lymphatic system, a systemic immune response is created to produce an early decrease in mast cell and basophil degranulation. Conclusion: AIT is indicated for the treatment of moderate-to-severe intermittent or persistent symptoms of allergic rhinitis. AIT can be administered to those >5 years of age and has been shown to be safe in children as young as 3 years of age. In this article, AIT and other types of immunotherapies were discussed as well as the indications for immunotherapy. Copyright © 2016, OceanSide Publications, Inc.