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    Effects of vitamin E treatment on peroxisome proliferator-activated receptor-alpha expression and insulin resistance in patients with non-alcoholic steatohepatitis: results of a pilot study
    (Wiley, 2007) Yakaryilmaz, F.; Guliter, S.; Savaş, B.; Erdem, O.; Ersoy, R.; Erden, E.; Özenirler, S.
    Background: Insulin resistance (IR) is commonly associated with non-alcoholic steatohepatitis (NASH). Peroxisome proliferator-activated receptor-alpha (PPAR-alpha) may also play a role in the pathogenesis of NASH. A pivotal role in NASH pathogenesis depends on the hypothesis of increased oxidative stress. The aim of our study was to evaluate the effects of supplemental oral vitamin E, a potent antioxidant, on liver functions, PPAR-alpha expression and IR in patients with NASH. Methods: Nine patients with biopsy-proven NASH were given oral vitamin E 800 mg daily for 24 weeks. Liver functions, lipid parameters, IR index with homeostatic metabolic assessment and liver histology and PPAR-alpha staining index in biopsy specimens were detected before and after the treatment. Results: Seven patients (78%) had IR initially. After 6 months of therapy in nine patients, fasting insulin improved (P = 0.01), but serum cholesterol, triglyceride, fasting blood glucose levels and body mass index remained unchanged. Aspartate aminotransferase and alanine aminotransferase levels decreased (P = 0.01 and P = 0.01, respectively). IR index with homeostatic metabolic assessment resistance improved (P = 0.01), but PPAR-alpha staining index did not change (P = 0.37). Although the histological grade of steatosis decreased (P = 0.01), necroinflammation and fibrosis remained unchanged. In seven patients with IR, however, necroinflammation and PPAR-alpha staining index were improved (P = 0.04 and P = 0.02). Conclusion: Vitamin E treatment, in addition to its previously shown beneficial effect by suppressing oxidative stress, may also achieve improvement by reducing IR and PPAR-alpha expression in NASH.
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    Helicobacter pylori in allergic inflammation - Fact or fiction?
    (Elsevier Doyma Sl, 2008) Baccioglu, A.; Kalpaklioglu, F.; Guliter, S.; Yakaryilmaz, F.
    Background: Although it has been hypothised that infections may play a preventive role in allergic diseases, the role of Helicobacter pylori (H. pylori) is not clear. In this study we aimed to determine the association between H. pylori infection and allergic inflammation. Methods: H. pylori infection was assessed in gastric mucosa tissue by microscopy. Skin prick tests (SPT) were performed with a battery of common inhalant and certain food allergens. Serum samples were tested for total immunglobulin E (T.IgE). Predictive factors for H. pylori infection and atopy were examined by a questionnaire. Results: A total of 90 subjects suffering dyspeptic symptoms were enrolled into the study. SPT positivity was similar between H. pylori (+) and H. pylori (-) subjects. Among the possible factors examined: age; gender; educational status; pet at home; BMI, family size; number of children and siblings; monthly income; drinking water source; smoking; and serum T.IgE levels were not related with H. pylori infection. However, perennial allergic symptoms were significantly higher in the H. pylon (-) group, seasonal allergic symptoms were related with an increased risk for H. pylori infection. Conclusions: In this sample group from a developing country H. pylori infection was not shown to be associated with atopic diseases. Therefore, the eradication of H. pylori may not be assumed to have an effect on allergic inflammation.