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    Characteristics of nonallergic rhinitis
    (Bilimsel Tip Yayinevi, 2012) Kavut, Ayse Baccioglu; Kalpaklioglu, Fusun
    Nonallergic rhinitis (NAR) is a type of rhinitis with perennial symptoms, unknown aetiology, and no clear treatment suggestions. Even though NAR has similarities with allergic rhinitis with regards to its prevalence, symptoms and impairment on quality of life, its importance is underestimated in clinical practice. There is no single valid test for the diagnosis of NAR as typical rhinitis symptoms, negativity in allergy skin tests and/or specific IgE, and exclusion of nonallergic rhinitis types with known aetiology are required. Pathophysiology of NAR is poorly understood, but a key component involves activation of neurogenic or allergic pathways. The aim of this review was to describe the characteristics, diagnostic methods, prevalence, pathophysiology, and treatment of NAR in the light of recent publications.
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    Comparison of azelastine versus triamcinolone nasal spray in allergic and nonallergic rhinitis
    (Sage Publications Inc, 2010) Kalpaklioglu, Ayse Fusun; Kavut, Ayse Baccioglu
    Background: Intranasal antihistamine has not been thoroughly studied in the treatment of rhinitis of different etiologies. This study was designed to show the comparative efficacy of nasal antihistamine and nasal corticosteroid in patients with allergic rhinitis (AR) and nonallergic rhinitis (NAR). Methods: A comparison of the efficacy of azelastine nasal spray (AZENS) versus triamcinolone acetonide nasal spray (TANS) on total nasal symptom scores (TNSS), nasal peak inspiratory flow rate (nPIFR), and nasal cytology was studied in a 2-week randomized parallel-group trial. The Epworth Sleepiness Scale (ESS) and health-related quality of life (HRQoL) were also analyzed. Results: The study group consisted of 132 patients (100 women and 32 men) with a mean age of 33.14 +/- 12.52 years, Sixty-nine patients had AR and 63 had NAR. Although TNSS including sneezing, itching, rhinorrhea, congestion-but not anosmia-significantly improved in both groups, intranasal azelastine reduced ocular symptoms greatly compared with intranasal triamcinolone (p = 0.05). Patients with NAR seemed to respond more to TANS, whereas AZENS was more useful in AR. The nPIFR improved in AR and NAR, with no significant difference between the treatment groups. Neither intranasal azelastine nor intranasal triamcinolone changed cytology in nasal lavage. Both medications were well tolerated, but AZENS led to more adverse events than TANS (56.9 and 19%, respectively; p = 0.001), mainly because of bitter taste. Scores on each domain of generic HRQoL (36-Item Short-Form Health Survey) and mini-rhinitis QoL questionnaires, as well as ESS score, significantly improved in both groups, irrespective of rhinitis etiology. Conclusion: In this first comparative demonstration, AZENS appears to be as effective as triamcinolone in symptom scores, nPIFR, ESS, and HRQoL, equally in AR and NAR. (Am J Rhinol Allergy 24, 29-33, 2010; doi: 10.2500/ajra.2010.24.3423)
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    Contribution of Neurogenic and Allergic Ways to the Pathophysiology of Nonallergic Rhinitis
    (Karger, 2013) Kavut, Ayse Baccioglu; Kalpaklioglu, Fusun; Atasoy, Pinar
    Background: A neuroallergic interaction was reported in the pathogenesis of allergic rhinitis (AR), but the pathophysiology of nonallergic rhinitis (NAR) is poorly understood. We aimed to explore the contribution of neuroallergic mechanisms to the pathogenesis of NAR. Methods: Subjects were divided into three groups - NAR patients (n = 25), AR patients (n = 16) and the control group (n = 10) - and were assessed using the nasal provocation test (NPT) with house dust mite. Total symptom scores, nasal inspiratory peak flow and nasal lavage were performed before and after NPT. Nasal brushing and scraping was done after NPT. Results: NPT was positive in NAR (52%) and AR (100%) patients and negative in all controls. After NPT, total symptom scores increased in both rhinitis groups. Post-NPT values of nasal inspiratory peak flow decreased only in AR patients. NAR patients showed a similar inflammatory cell profile in the nasal smears to AR patients which was different in controls. There were more tryptase- and immunoglobulin E (IgE)-positive cells in the nasal mucosa of AR patients, and more substance-p-positive cells were observed in NAR patients compared with controls. However, IgE- and tryptase-positive cells in NAR patients and substance-p-positive cells in AR patients were detectable in nasal mucosa, but rarely in the controls. Comparing the values before and after NPT, tryptase significantly increased in the nasal lavages of AR and NAR patients, while house dust mite-specific IgE did not change. Conclusions: We showed the existence of a common pathophysiological mechanism with different contributions in AR and NAR. We conclude that the difference in dominance of neuroallergic ways may determine the major phenotype of rhinitis. Copyright (C) 2012 S. Karger AG, Basel
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    Desensitization in Interferon-beta 1a Allergy: A Case Report
    (Karger, 2009) Kalpaklioglu, Ayse Fusun; Kavut, Ayse Baccioglu; Erdemoglu, Ali Kemal
    We report a 41-year-old patient with multiple sclerosis (MS) who was successfully desensitized after she developed non-injection-site urticaria and angioedema due to interferon (IFN)-beta 1a. Although a few cases of urticaria and anaphylaxis have been reported in the literature, to our knowledge this is the first report of a successful desensitization with IFN-beta 1a. Desensitization with IFN-beta 1a allowed us to continue with the administration of interferon-beta, which is a mainstay in treatment for MS. Copyright (C) 2009 S. Karger AG, Basel
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    Diagnostic tools for allergic rhinitis and asthma
    (Dergipark Akad, 2012) Kavut, Ayse Baccioglu; Kalpaklioglu, Fusun
    The diagnosis of allergic airway diseases is based on symptoms, and the laboratory tests help us to classify the types. A correct diagnose is important, since the treatment will change in different types of diseases. For example, untreated rhinitis may result in other diseases like asthma, and deteriorate the quality of life. Therefore, early diagnosis of allergic airway diseases is important before the disease progresses. This review summarizes the currently known diagnostic tools which can be useful in daily practical life and researches, including assessment of symptoms, physical examination, allergy skin tests, total and specific IgE, nasal provocation test and assessment parameters (symptoms, nasal flow and secretions), nasal mucosal sampling, and pulmonary function test.
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    The role of CD14 gene promoter polymorphism in tuberculosis susceptibility
    (Elsevier Taiwan, 2013) Ayaslioglu, Ergin; Kalpaklioglu, Fusun; Kavut, Ayse Baccioglu; Erturk, Arzu; Capan, Nermin; Birben, Esra
    Background: CD14 is expressed principally by cells of monocyte/macrophage lineage and plays a pivotal role in the innate immunity to intracellular infections. Recent research findings have revealed an association between the CD14 gene promoter polymorphism and several major infectious diseases. Objective: The aim of the present study was to investigate the association between the CD14-159C/T polymorphism and tuberculosis in a Turkish population. Methods: For this purpose, 88 consecutive patients with tuberculosis (63 pulmonary, 25 extra-pulmonary) and 116 control subjects were enrolled into a prospective study. We determined CD14-159 genotypes by polymerase chain reaction - restriction fragment length polymorphism analysis and also measured serum concentrations of soluble CD14 (sCD14) by using a quantitative sandwich enzyme immunoassay technique. Results: There was no significant difference in terms of genotype distribution between patients with tuberculosis (CC 18.2%, CT 48.9%, TT 33.0%) and controls (CC 12.9%, CT 50.9%, TT 36.2%) or between patients with pulmonary and extrapulmonary tuberculosis. Serum levels of sCD14 were significantly increased in patients with active tuberculosis compared to those with inactive tuberculosis and healthy controls (p < 0.001). However, levels of sCD14 were not associated with any genotypes of CD14-159. Conclusion: The genotyping findings of the present study do not support a role for the CD14-159C/T polymorphism in the development of tuberculosis, at least in the geographical region of central Anatolia. Significantly elevated serum sCD14 levels in patients with active disease reflect the importance of the mononuclear phagocytic system activation in tuberculosis. Copyright (C) 2012, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. All rights reserved.