Person: MUMCU, GONCA
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MUMCU
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GONCA
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Publication Metadata only Salivary levels of antimicrobial peptides Hnp 1-3, Ll-37 and S100 in Behcet's disease(PERGAMON-ELSEVIER SCIENCE LTD, 2012) MUMCU, GONCA; Mumcu, Gonca; Cimilli, Hale; Karacayli, Umit; Inanc, Nevsun; Ture-Ozdemir, Filiz; Eksioglu-Demiralp, Emel; Ergun, Tulin; Direskeneli, HanerBackground: Oral ulcer is the cardinal clinical sign and increased neutrophilic activity is a part of the pathogenesis in Behcet's disease (BD). Saliva, as a part of the innate immune response, contains antimicrobial peptides (AMPs) that are derived from both oral epithelial cells and neutrophils. The aim of this study was to investigate the associations between salivary levels of AMPs HNP 1-3, LL-37 and S100 and disease course in patients with Behcet's disease (BD). Methods: Fifty-three patients with BD and 44 healthy controls (HC) were included in the study. Disease severity score reflecting organ involvement was calculated. Salivary HNP 1-3, LL-37 and S100 levels were measured in unstimulated saliva samples by ELISA. Results: Salivary HNP 1-3 and S100 levels in BD patients (2715.2 +/- 1333.4 mu g/ml and 430.6 +/- 203.9 mu g/ml) were significantly higher compared to HC (1780.6 +/- 933.2 mu g/ml and 365.3 +/- 84.7 mu g/ml) (p = 0.000 and p = 0.004, respectively). Although LL-37 levels were also higher in BD than HC (190.9 +/- 189.1 vs 143.1 +/- 128.9 ng/ml), no significant difference was observed (p = 0.53). Salivary HNP 1-3 and LL-37 levels were associated with the severity of BD (mild disease: 1975.1 +/- 1174.2 mu g/ml and 115.9 +/- 109.4 ng/ml vs severe disease: 2955.7 +/- 1305.6 mu g/ml and 215.3 +/- 203.8 ng/ml, p = 0.020 and p = 0.031, respectively). Salivary LL-37 levels also correlated with the number of monthly oral ulcers (r = 0.5 p = 0.000). Conclusion: An increase in salivary HNP 1-3 and S100 levels might be associated with enhanced local and systemic innate responses in BD. (C) 2011 Elsevier Ltd. All rights reserved.Publication Metadata only Does illness perception associate with disease symptoms in Behcet's disease?(SPRINGER-VERLAG ITALIA SRL, 2019) ALİBAZ ÖNER, FATMA; Mumcu, Gonca; Yagar, Fedayi; Alibaz-Oner, Fatma; Inanc, Nevsun; Direskeneli, Haner; Ergun, TulinThis study aims to assess the relationship between illness perception and disease course and symptoms in Behcet disease (BD). One hundred ten consecutive BD patients (F/M 50/60, mean age 38.5 +/- 9.88years) and 57 patients with Psoriasis as a disease control group (F/M 28/29, mean age 48.12 +/- 15.52) are included in this cross-sectional study. Illness perception is evaluated using a revised version of the Illness Perception Questionnaire (IPQ-R). In IPQ-R, the identity score reflecting the number of symptoms is higher in BD patients with musculoskeletal involvement than the others (6.77 +/- 2.91 vs. 5.08 +/- 3.3, respectively, p=0.007). The consequences score for musculoskeletal involvement (19.52 +/- 7.03) and timeline (acute/chronic) score for eye involvement (26.67 +/- 4.32) are also higher compared to patients without them (16.37 +/- 5.82 and 22.09 +/- 8.68) (p=0.011 and p=0.038), reflecting negative beliefs about the illness. The score of psychological attribution is higher in patients with psoriasis than BD (p=0.039), whereas the other subgroup scores are lower in patients with psoriasis compared to those of BD (p<0.05). This study provides a patient's perspective in the disease management process of BD using the IPQ-R questionnaire. A patient's own personal beliefs and emotional responses to their symptoms might affect the outcome measures, especially with musculoskeletal symptoms and eye involvement in BD. However, psychological attribution is found to be a prominent issue in psoriasis.Publication Metadata only Moderation analysis exploring associations between age and mucocutaneous activity in Behcet's syndrome: A multicenter study from Turkey(WILEY, 2020) AKSOY, AYSUN; Mumcu, Gonca; Yay, Meral; Karacayli, Umit; Aksoy, Aysun; Tas, Mehmet Nedim; Armagan, Berkan; Sari, Alper; Bozca, Burcin Cansu; Tekgoz, Emre; Temiz Karadag, Duygu; Badak, Suade ozlem; Tecer, Duygu; Yildirim, Alper; Bes, Cemal; Sahin, Ali; Erken, Eren; Cefle, Ayse; Cinar, Muhammet; Yilmaz, Sedat; Alpsoy, Erkan; Boyvat, Ayse; Senel, Soner; Bilge, Sule Yasar; Kasifoglu, Timucin; Karadag, Omer; Aksu, Kenan; Keser, Gokhan; Alibaz-oner, Fatma; Inanc, Nevsun; Ergun, Tulin; Direskeneli, HanerThe aim of the present study was to examine the effects of age on mucocutaneous activity by using moderation analysis in Behcet's syndrome (BS). In this cross-sectional study, 887 BS patients (female : male, 481:406; mean age, 38.4 +/- 10.9 years) followed in 13 tertiary centers in Turkey were included. Mucocutaneous activity was evaluated by using the Mucocutaneous Index (MI) according to sex and disease course. Moderation analysis was performed to test the effect of age on mucocutaneous activity. A moderator variable is a third variable and affects the relationship between independent and outcome variables. Age was chosen as a potential moderator variable (interaction effect), MI score as the outcome variable and sex as an independent variable in the analysis. The moderation analysis tested the effects of age in three steps: whole BS patient group, patients without systemic involvement and those with systemic involvement. The moderation model was only significant in BS patients with systemic involvement (P = 0.0351), and a significant relationship was observed between female sex and MI score (P = 0.0156). In addition, the interaction plot showed that female patients had increased MI scores compared with male patients, especially in the 28-year-old age group (P = 0.0067). Moreover, major organ involvement was newly diagnosed in the majority of these young female BS patients. Our results suggest that the relationship between sex and mucocutaneous activity was moderated by age in the systemic involvement group. Also, increased mucocutaneous activity may be associated with new major organ involvement in young female BS patients with systemic involvement.Publication Open Access The close association between dental and periodontal treatments and oral ulcer course in behcet's disease: a prospective clinical study(WILEY-BLACKWELL PUBLISHING, INC, 2009-03-05) MUMCU, GONCA; Karacayli, Umit; Mumcu, Gonca; Simsek, Ismail; Pay, Salih; Kose, Osman; Erdem, Hakan; Direskeneli, Haner; Gunaydin, Yilmaz; Dinc, AyhanThe aim of the study was to evaluate the influence of dental and periodontal treatments to the course of oral ulcers in patients with Behcet's disease (BD). Fifty-eight consecutive BD patients with oral ulcers were studied. Twenty-nine patients were in the intervention group (F/M: 15/14, mean age: 39.6 +/- 6.9 years) and 29 (F/M: 15/14, 39.4 +/- 10.6 years) were followed with a conventional treatment approach. In addition to oral hygiene education, dental and periodontal treatments were carried out in the intervention group, whereas the control group was only given oral hygiene education. Patients were evaluated in the pre-treatment observation period (1 month), treatment period (1 month) and 6 months after treatment. An increase in the number of new oral ulcers (4.1 +/- 3.5) was observed within 2 days during the treatment compared with 3-30 days during treatment month (2.3 +/- 1.2) (P = 0.002). However, 6 months after the treatment, the number of oral ulcers (1.9 +/- 1.5) was significantly lower compared with the pre-treatment observation (4.8 +/- 3.2) (P = 0.000) and treatment periods (6.4 +/- 2.3) in the intervention group (P = 0.05), whereas a similar oral ulcer presence was observed in the control group (2.8 +/- 2.4, 3.7 +/- 2.3 and 4.8 +/- 4.3, respectively) (P > 0.05). Dental and periodontal indices were also better in the intervention group during the 6-month follow-up. Our results suggest that, in BD patients, dental and periodontal therapies could be associated with a flare-up of oral ulcers in the short term, but may decrease their number in longer follow-up. They also lead to a better oral health.Publication Open Access The assessment of contributing factors to oral ulcer presence in Behcet's disease: Dietary and non-dietary factors(AVES, 2018-11-27) AKSOY, AYSUN; Iris, Merve; Ozcikmak, Ezgi; Aksoy, Aysun; Alibaz-Oner, Fatma; Inanc, Nevsun; Ergun, Tulin; Direskeneli, Haner; Mumcu, GoncaObjective: The aim of this study was to assess the contributing factors for oral ulcer activity in Behcet's disease (BD). Methods: Ninety-two patients with BD (F/M: 42/50, mean age: 38.7 +/- 10.02 years) participated in this cross-sectional study. Data regarding disease-related factors, smoking patterns, and self-reported dietary/non-dietary triggering factors for oral ulcer activity were collected by a questionnaire. Treatment protocol was categorized as mild and intensive groups associated with organ involvements. Results: A mild treatment protocol was more common in females (52.4% vs 20%) than in males (p=0.002). During the last three months, the number of oral ulcers in female patients was higher in the mild treatment group (6.4 +/- 6.5) than in the intensive treatment group (3.3 +/- 4.9) (p=0.045). In patients with active oral ulcers (n=63), rate of being a non-smoker was also higher in females (86.7% vs 63.6%) than in males. Daily frequency of tooth brushing was 1.2 +/- 0.8 in patients with BD, and was higher in females (1.5 +/- 0.9 vs 0.9 +/- 0.6) (p=0.001). Stress and fatigue (78.3%) were reported as the most frequent triggering factors for oral ulcer presence in patients with BD. A total of 148 different dietary factors associated with oral ulcer presence were reported in the study. Conclusion: A mild treatment protocol and being a non-smoker were found to be the contributing factors associated with oral ulcer activity in patients with BD. Being motivated for oral hygiene and being non-smokers were positive health behaviors observed in females. Irrespective of gender, stress and fatigue were defined as the most common self-reported triggering factors for oral ulcer presence in BD. In addition, the roles of some dietary factors were also reported.Publication Metadata only Salivary levels of HNP 1-3 are related to oral ulcer activity in Behcet's disease(WILEY, 2013) MUMCU, GONCA; Mumcu, Gonca; Cimilli, Hale; Karacayli, Umit; Inanc, Nevsun; Ture-Ozdemir, Filiz; Eksioglu-Demiralp, Emel; Ergun, Tulin; Direskeneli, HanerBackground Saliva contains antimicrobial peptides derived from oral epithelium as well as neutrophils in the innate immune response. The aim of this study was to examine the association between salivary human neutrophil peptide (HNP) 1-3 levels originating from neutrophils and oral ulcers in patients with Behcet's disease (BD). Methods Ninety-five patients with BD (F/M: 39/56; mean age: 38.711.9years) and 53 healthy controls (HC; F/M: 23/30; mean age: 35.210.1years) were included in the study. The disease control group (F/M: 20/33; mean age: 33.7 +/- 10.7years) was comprised of patients with oral infection regarding endodontic infection (n=32) and pericoronitis (n=21). Salivary HNP 1-3 levels of groups were measured in unstimulated samples by ELISA (Hycult, the Netherlands). Results A statistically significant increase was found in salivary HNP 1-3 levels of patients with BD (2268.28 +/- 1216.38g/ml) compared with HC (1836.49 +/- 857.76g/ml), patients with endodontic infection (849.9 +/- 376.1g/ml), and patients with pericoronitis (824.3 +/- 284.02g/ml; P=0.024, 0.000 and 0.000, respectively). The ratio of active oral ulcer (100%, n=14) was higher in low HNP 1-3 levels (1000g/ml) than the others (66.7%, n=54) in active patients with BD (P=0.008). Moreover, salivary HNP 1-3 levels were significantly lower in patients with endodontic infection and patients with pericoronitis compared with those in the HC group and patients with BD (P=0.000). Conclusion A decrease in salivary HNP 1-3 levels might be a biological factor for predisposition to oral ulcers in patients with BD and oral infection in healthy patients.Publication Metadata only A composite index for determining the impact of oral ulcer activity in Behcet's disease and recurrent aphthous stomatitis(WILEY-BLACKWELL PUBLISHING, INC, 2009) MUMCU, GONCA; Mumcu, G.; Sur, H.; Inanc, N.; Karacayli, U.; Cimilli, H.; Sisman, N.; Ergun, T.; Direskeneli, H.Background: Although number, frequency and healing time of oral ulcers and pain are generally used for clinical practice and studies in Behcet's disease (BD) and recurrent aphthous stomatitis (RAS), no standardized activity index is currently present to monitor clinical manifestations associated with oral ulcers. The aim of this study was to develop a standardized composite index (CI) to assess oral ulcer activity in BD and RAS. Methods: In this cross-sectional study, 121 patients with BD and 45 patients with RAS were included. Sixty-five percentage of BD and 68.9% of RAS patients were in active stage during the previous 3 months. The developed CI included the presence of oral ulcers, ulcer-related pain and functional status and was evaluated in patients with both active and inactive disease for content validity. Results: Composite index score was observed to be higher in active patients with RAS (6.94 +/- 2.19) compared with active BD patients (6.01 +/- 2.04) (P = 0.04). The number of oral ulcers and healing time of oral ulcers were significantly higher in RAS compared with BD (P = 0.018, P = 0.001 respectively). CI score correlated with the number of oral ulcers in both BD and RAS (P = 0.000, P = 0.002 respectively). CI score was '0' for inactive patients without oral ulcer in BD and RAS. Conclusions: The presented CI as an oral ulcer activity index seems to be a reliable and suitable tool for evaluating the clinical impact and disease-specific problems in BD and RAS.Publication Metadata only The assessment of work productivity and activity impairment in Behcet's disease(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2017) ALİBAZ ÖNER, FATMA; Mumcu, Gonca; Lehimci, Fadime; Fidan, Ozlem; Guk, Hulya; Alpar, Ugur; Unal, Ali Ugur; Erturk, Zeynep; Alibaz Oner, Fatma; Inanc, Guzide Nevsun; Ergun, Safiye Atlas Tulin; Direskeneli, Rafi HanerBackground/aim: The aim of this study was to assess the relationships between the course of Behcet's disease (BD), disease-specific fears, and work productivity and activity impairment. Materials and methods: In this cross-sectional study, 110 consecutive BD patients were included. The Work Productivity and Activity Impairment questionnaire was used. Results: In the group of employed patients, 30.41% had missed work during the previous week. The mean percentages of daily activity impairment were higher in patients with musculoskeletal involvement (39.81 +/- 33.61%) compared to those without (23.48 +/- 32.45%) (P = 0.008). A greater decrease in working hours was observed in patients with eye involvement (45.52 +/- 15.29 h) compared to those without (54.15 +/- 15.29 h) (P = 0.007). More of the male patients (67.8%) were afraid of losing their jobs compared to females (30%) (P = 0.000). Conclusion: The highest levels of lost productivity and the most severe effects on daily life are consequences of eye and musculoskeletal involvement in the study population. More effective therapeutic approaches are required to improve the working lives of patients with BD. Moreover, male patients had a higher fear of losing their jobs, suggesting a match between the expected clinical course and the predictions of BD patients.Publication Metadata only Sequencing of 16S rRNA reveals a distinct salivary microbiome signature in Behcet's disease(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2016) MUMCU, GONCA; Coit, Patrick; Mumcu, Gonca; Ture-Ozdemir, Filiz; Unal, Ali Ugur; Alpar, Ugur; Bostanci, Nagihan; Ergun, Tulin; Direskeneli, Haner; Sawalha, Amr H.Behcet's disease (BD) is characterized by recurrent oro-genital ulcers, mucocutaneous lesions, and serious organ involvement. We investigated the salivary microbiome in BD using high-throughput sequencing of the 16S rRNA V4 region. Stimulated saliva samples were collected from 31 BD patients and 15 healthy controls, and in 9 BD patients, a second saliva sample was collected following dental and periodontal treatment. Sequence analysis identified a total of 908 operational taxonomic units (OTUs) present across all samples. Patients had a microbial community structure that is significantly less diverse than healthy controls. The most overabundant species in BD was Haemophilus parainfluenzae, while the most depleted included Alloprevotella rava and species in the genus Leptotrichia. Periodontal treatment improved oral health indices in BD but had no short-term effect on bacterial community structure. Neither the BD-associated genetic risk locus within the HLA-B/MICA region nor being on immunosuppressive medications explained the differences between patients and controls. (C) 2016 Elsevier Inc. All rights reserved.