Person: ERGUN, SAFİYE ATLAS TÜLİN
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ERGUN
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SAFİYE ATLAS TÜLİN
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Publication Open Access Oligoclonal T cell expansions in patients with Behçet's disease(2001-12-24) DİRESKENELİ, RAFİ HANER; ERGUN, SAFİYE ATLAS TÜLİN; Direskeneli, H; Eksioglu-Demiralp, E; Kibaroglu, A; Yavuz, S; Ergun, T; Akoglu, TBehçet's disease (BD) is a multisystem disorder with oral and genital ulcers, mucocutaneous, ocular, joint, vascular and central nervous system involvement. In this study, the peripheral T cell repertoire was analysed in patients with BD with MoAbs against T cell receptor (TCR) Vβ gene products in CD4+ and CD8+ T cell compartments, and these were compared with rheumatoid arthritis (RA) patients and healthy controls (HC). In the CD4+ T cell compartment, oligoclonal TCR Vβ expression was observed in 56% of BD (10/18), 71% of RA (5/7) patients and 21% (3/14) of HC. In the CD8+ T cell group 50% of BD (9/18), 57% of RA patients and 28% of HC (4/14) had an oligoclonal TCR repertoire. An increase of TCR Vβ5.1 subset was observed in five BD patients among CD8+ T cells. Other elevations of TCR Vβ subsets were heterogeneously distributed with one to three different Vβ subsets. Our results suggest an antigen-driven oligoclonal increase of T cells in BD. There was no overall increase in any Vβ group to suggest a superantigen effect. Analysis of the responsible antigens causing the increase in T cell subsets may give insights into the aetiopathogenesis of BD and immunomodulation of these T cells may lead to new treatments.Publication Open Access Common femoral vein thickness measurement as a diagnostic test in incomplete behcet's disease(2022-06-01) ALİBAZ ÖNER, FATMA; ERGELEN, RABİA; ERGUN, SAFİYE ATLAS TÜLİN; DİRESKENELİ, RAFİ HANER; Alibaz-Oner F., Ergelen R., Temiz F., Agackiran S. K. , Soydemir E., Ergun T., DİRESKENELİ R. H.Publication Open Access Immune and inflammatory gene expressions are different in Behcet's disease compared to those in Familial Mediterranean Fever(AVES, 2017-01-11) DİRESKENELİ, RAFİ HANER; Ozdemir, Filiz Ture; Demiralp, Emel Eksioglu; Aydin, Sibel Z.; Atagunduz, Pamir; Ergun, Tulin; Direskeneli, HanerObjective: The immune classification of Behcet's disease (BD) is still controversial. In this study, we aimed to compare the immune/inflammatory gene expressions in BD with those in familial Mediterranean fever (FMF), an autoinflammatory disorder with innate immune activation. Material and Methods: CD4+ T cells and CD14+ monocytes were isolated from the peripheral blood mononuclear cells of Behcet's disease patients (n=10), FMF (n=6) patients, and healthy controls (n=4) with microbeads, and then, the mRNA was isolated. The expressions of 440 genes associated with immune and inflammatory responses were studied with a focused DNA microarray using a chemiluminescent tagging system. Changes above 1.5-fold and below 0.8-fold were accepted to be significant. Results: In BD patients, in the CD4+ T-lymphocyte subset, interleukin 18 receptor accessory protein (1.7-fold), IL-7 receptor (1.9-fold), and prokineticin 2 (2.5-fold) were all increased compared to those in FMF patients, whereas chemokine (C-X3-C motif) receptor-1 (CX3CR1) (0.7-fold) and endothelial cell growth factor-1 (0.6-fold) were decreased. In the CD14+ monocyte population, the V-fos FBJ murine osteosarcoma viral oncogene homolog (1.5-fold), Interleukin-8 (IL-8) (2.1-fold), and Tumor Necrosis Factor alpha (TNF-alpha) (1.8-fold) were all increased, whereas the chemokine (C-C motif) ligand 5 (CCL5) (0.6-fold), C-C chemokine receptor type 7 (0.6-fold), and CX3CR1 (0.7-fold) were decreased, again when compared to those in FMF. Compared to healthy controls in the CD4+ T-lymphocyte population, in both BD and FMF patients, pro-platelet basic protein and CD27 had elevated expression. In BD and FMF patients, 24 and 19 genes, respectively, were downregulated, with 15 overlapping genes between both disorders. In the CD14+ monocytes population, chemokine (C-C motif) receptor-1 (CCR1) was upregulated both in BD and FMF patients compared to that in the controls, whereas CCL5 was downregulated. Conclusion: Immune and inflammatory gene expressions seem to be variable in both the innate (CD14+) and adaptive (CD4+) immune responses in BD and FMF patients compared to those in controls, suggesting differences in immune regulation between the two disorders.Publication Open Access Atypical presentations of eosinophilic fasciitis(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) SALMAN, ANDAÇ; Ergun, Tulin; Seckin, Dilek; Salman, Andac; Ocak, Esra Sarac; Yucelten, Ayse Deniz; Direskeneli, Haner; Demirkesen, Cuyan; Ekinci, Gazanfer; Bayik, MahmutEosinophilic fasciitis is an uncommon connective tissue disease that may mimic and overlap with other sclerosing disorders such as morphea and lichen sclerosus. Herein, we report four patients (two men and two women, aged 16-64 yeas) with eosinophilic fasciitis. There was overlap with both morphea and lichen sclerosus in 2 patients and with morphoea alone in 1 patient. Magnetic resonance imaging (MRI) was used for diagnosis in three patients and for assessing treatment response in one patient. Eosinophilic fasciitis may co-exist with morhoea and lichen sclerosus. In view of the overlapping clinical and histopathological features of these disorders, MRI may be helful in delineating the conditions by detecting involvement of fascia.Publication Open Access Oral ulcer activity in Behcet's disease: Poor medication adherence is an underestimated risk factor(AVES, 2017-06-12) ALİBAZ ÖNER, FATMA; Mumcu, Gonca; Alibaz-Oner, Fatma; Oner, Sibel Yilmaz; Ozen, Gulsen; Atagunduz, Pamir; Inanc, Nevsun; Koksal, Leyla; Ergun, Tulin; Direskeneli, HanerObjective: The aim of this study was to evaluate the relationship between oral ulcer activity and medication adherence according to gender in Behcet's disease (BD) patients. Material and Methods: The study group included 330 BD patients (F/M: 167/163, mean age: 38.5 +/- 10.5 years). Oral ulcer activity and medication adherence were evaluated in the previous month. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8) having a score range of 0 to 8 with high scores indicating better adherence. Low adherence was defined as < 6 points on MMAS-8. Results: Over half of the group had active oral ulcers (n= 219, 66.4%) within the month preceding the visit. The number of oral ulcers was significantly higher in female patients with low medication adherence (2.39 +/- 3.24) than in the rest of the female group (1.28 +/- 2.05; p= 0.023). Although a similar trend was also observed in male patients (2.14 +/- 3.3 vs. 1.81 +/- 2.31), a significant relationship was not observed (p= 0.89). The frequency of medication intake per day was lower in patients with high medication adherence than in the rest of the study group (p= 0.04). Conclusion: Low medication adherence is a hidden risk factor in the management of BD. Poor adherence was associated with oral ulcer activity in female BD patients.Publication Open Access Earlier and more aggressive treatment of major organ involvement with biologics may prevent relapses or further new organ involvement in a subgroup of behcet's disease patients(2022-06-01) ERGUN, SAFİYE ATLAS TÜLİN; DİRESKENELİ, RAFİ HANER; ALİBAZ ÖNER, FATMA; Bozkurt T., Karabacak M., Karatas H., Agackiran S. K. , Ergun T., DİRESKENELİ R. H. , Alibaz-Oner F.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 Open Access Decreasing incidence and severity of Behcet's disease: a changing trend in epidemiological spectrum possibly associated with oral health(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY) ALİBAZ ÖNER, FATMA; Mumcu, Gonca; Alibaz Oner, Fatma; Ergun, Tulin; Direskeneli, HanerBehget's disease (BD) is a systemic and inflammatory disorder that is mainly present along the ancient Silk Road, from the Mediterranean Sea to East Asia. A wide range of prevalence figures (0.1-420/100,000) have been reported for BD, also among Turkish populations of similar genetic background living in different countries. Recently, a decline in the incidence of BD and a change of the disease spectrum to less-severe manifestations have been reported from Japan and Korea, two genetically homogenous, affluent populations with limited immigration. It was hypothesized that a decline in infectious diseases, especially dental/periodontal infections, associated with the improvement in oral health, could be a part of these changes in the disease expression. Further epidemiological studies in other populations might demonstrate whether there is a worldwide similar trend and may provide a better understanding of the triggering factors for the onset and course of BD.Publication Open Access Unilateral cutaneous vasculitis: An uncommon presentation and a possible explanation(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2015) SALMAN, ANDAÇ; Tekin, Burak; Salman, Andac; Tuglular, Serhan; Guler, Derya; Ozen, Gulsen; Direskeneil, Haner; Ayranci, Fatma Guicicek; Cinel, Leyla; Ergun, TullnPublication Open Access Oral health is impaired in Behcet's disease and is associated with disease severity(OXFORD UNIV PRESS, 2004-06-01) MUMCU, GONCA; Mumcu, G; Ergun, T; Inanc, N; Fresko, I; Atalay, T; Hayran, O; Direskeneli, HObjectives. This study aimed to investigate the oral health of Turkish patients with Behcet's disease (BD) and whether it is associated with the disease course. Methods. One hundred and twenty patients with BD, 35 patients with recurrent aphthous stomatitis (RAS) and 65 healthy Turkish controls (HC) were included in the study. Oral health was investigated by indices applied in a BD out-patient clinic. Results. The mean scores of plaque, sulcus bleeding and gingival indices, probing depth and the number of extracted teeth were observed to be higher in patients with BD and RAS compared to HC (P<0.05). In the linear regression analysis, plaque index score was associated with the presence of oral ulcers and male gender. An elevated plaque index score was observed to be a significant risk factor for increased severity score in patients with BD in the logistic regression analysis (P = 0.034). Conclusions. Oral health is impaired in BD and associated with disease severity. Improvement of the oral health of BD patients may affect their disease course, leading to a better prognosis.