Person: ATAGÜNDÜZ, MEHMET PAMİR
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ATAGÜNDÜZ
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MEHMET PAMİR
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Publication Open Access Exosomes' profile in ankylosing spondylitis: A preliminary study(2023-01-01) ABACAR, KEREM YİĞİT; ATAGÜNDÜZ, MEHMET PAMİR; ERZİK, CAN; Karakaya E., Deniz R., ABACAR K. Y., ATAGÜNDÜZ M. P., ERZİK C.Objective: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that leads to structural and functional im-pairments and reduced quality of life, with heterogeneous manifestations. The origin and possible role of extracellular vesicles represented by exosomes (EVexo) in the pathogenesis of AS were examined in this study. Materials and Methods: Extracellular vesicles (EVs) were isolated from serum from ten AS patients and ten healthy controls through Izon qEV2/35 nm columns. After assessing the isolate purity by bicinchoninic acid assay (BCA) and Enzyme-Linked ImmunoSorbent Assay (ELISA), the relationship between EVexo concentration and AS was tested by the BCA method. The EVexo surface markers were analyzed by flow cytometry (FC) to verify EVexo presence and reveal its origin. Results: In FC analysis, CD86+TSG101+ and CD3+TSG101+ exosome percentages of AS group were significantly higher than the control group (p<0.05). A significant difference was found between the AS and control groups in terms of CD3+IL17+ and CD3+IFNg+ and CD86+TNF alpha+ and CD86+IL12(p35)+ exosome percentages (p<0.01). Conclusion: The exosomes whose ratio increased in the AS process were derived from T cells expressing increased levels of IL-17A and IFNg in their membranes, and macrophages expressing increased levels of TNF alpha and IL-12(p35) in their membranes. The EVexo profile did not change according to the AS course.Publication Metadata only The evaluation of the static and dynamic balance disorders in patients with psoriatic arthritis(SPRINGER HEIDELBERG, 2018) ŞANAL TOPRAK, CANAN; Duruoz, Mehmet Tuncay; Baklacioglu, Hatice Sule; Toprak, Canan Sanal; Atalay, Kardelen Gencer; Atagunduz, Mehmet PamirTo evaluate the static and dynamic balances in psoriatic arthritis (PsA) and to investigate their relationship with clinical and functional parameters. Patients diagnosed with PsA and healthy controls were recruited consecutively into the study. The demographic variables such as age, sex, body mass index of the subjects were noted. Radiographic images were examined for the detection of foot deformities. Foot and Ankle Outcome Score' (FAOS) was used to assess foot function. The dynamic and static balance of the patients was evaluated by Berg Balance Scale' (BBS) and Neurocom Balance Master' device. The fatigue (Multidimensional Assessment of Fatigue: MAF), depression (Beck Depression Inventory: BDI) and sleep disorders (Pittsburgh Sleep Quality Index: PSQI) of all patients were evaluated. This study included 50 PsA patients and 50 healthy controls with mean ages of 45.02 (SD 12.81) and 45.12 (SD 10.56), respectively. Demographic data of both groups were similar. Concerning the balance tests, there were significant differences (p<0.05) between patient and control groups about the all tests of sway velocity (except on foam surface eyes closed test), end sway of tandem walk test, movement time of bilateral step up over test and lift up index of left step up over test. There was no significant correlation between static and dynamic balance parameters with MAF, BDI, PSQI, foot deformities and FAOS. The static and dynamic balance impairments are seen in PsA. As the balance parameters had no significant correlation with functional and clinical data, they are acceptable as independent parameters during the course of the disease.Publication Metadata only Hpr prevalence of inflammatory back pain in primary sjogren’s syndrome is increased and associated with acute and structural changes of the sacroiliac joint(2023-06-15) BIYIKLI, ERHAN; BUĞDAYCI, ONUR; ATAGÜNDÜZ, MEHMET PAMİR; ABACAR K. Y., ÇOLAKOĞLU ÖZKAYA Ş., BIYIKLI E., BUĞDAYCI O., ATAGÜNDÜZ M. P., SELÇUK Z. D.Publication Open Access COMPARISON OF LONG TERM ANTI-TNF SURVIVAL IN PATIENTS WITH ANKYLOSING SPONDYLITIS AND NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS; DATA FROM TURKBIO REGISTRY(BMJ PUBLISHING GROUP, 2018-06) İNANÇ, GÜZİDE NEVSUN; Can, G.; Dalkilic, E.; Pehlivan, Y.; Senel, S.; Akar, S.; Solmaz, D.; Koca, S. S.; Inanc, N.; Atagunduz, P.; Yazici, A.; Cefle, A.; Goker, B.; Zengin, B.; Uslu, S.; Akkoc, N.; Onen, F.Publication Metadata only Validation of ultrasound imaging for Achilles entheseal fibrocartilage in bovines and description of changes in humans with spondyloarthritis(B M J PUBLISHING GROUP, 2010) ÇELİKEL, ÇİĞDEM; Aydin, Sibel Zehra; Bas, Emine; Basci, Onur; Filippucci, Emilio; Wakefield, Richard J.; Celikel, Cigdem; Karahan, Mustafa; Atagunduz, Pamir; Benjamin, Mike; Direskeneli, Haner; McGonagle, DennisBackground Entheseal fibrocartilage (EF) derangement is hypothesised to be pivotal to the pathogenesis of spondyloarthritis. Ultrasound is useful for visualisation of the enthesis but its role in EF visualisation is uncertain. This work aimed to demonstrate face and content validity of ultrasound for EF visualisation both by bovine histological evaluation and EF imaging in spondyloarthritis. Methods Achilles enthesis of 18 bovine hindfeet was visualised using a MyLab 70 ultrasound machine. The presence of tissue with EF characteristics was documented and histological confirmation was performed on five randomly selected sections using Masson trichrome staining. Ultrasound of the Achilles tendon (AT) was performed in 19 patients with spondyloarthritis and 21 healthy controls (HC). Results The bovine EF could be visualised in all cases and seen as a thin, uncompressible, well-defined, anechoic layer between the hyperechoic bone and the hyperechoic fibrils of the enthesis both in longitudinal and transverse scans. This region corresponded to EF on histological examination. The same pattern of low signal corresponding to EF location was seen in 17/19 patients and all HC. Discontinuities of the anechoic layer around the erosions and enthesophytes were observed in the spondyloarthritis group. The thickness of the anechoic layer was not significantly different in spondyloarthritis and HC (0.5 +/- 0.1 vs 0.5 +/- 0.2 mm, p=0.9) whereas the thickness of the EF was greater in men (0.6 +/- 0.2 vs 0.5 +/- 0.1 mm; p=0.009) compared with women. Conclusion Ultrasound can visualise EF of the AT insertion, which can be abnormal in cases of spondyloarthritis. This has implications for a better understanding of enthesopathy.Publication Open Access The intensity or duration of inflammatory back pain has no impact on the detection of sacroiliitis by magnetic resonance imaging in axial spondyloarthritis(2023-06-15) BIYIKLI, ERHAN; BUĞDAYCI, ONUR; KUTLUĞ AĞAÇKIRAN, SEDA; ATAGÜNDÜZ, MEHMET PAMİR; SEVİK G., BIYIKLI E., BUĞDAYCI O., ABACAR K. Y., KUTLUĞ AĞAÇKIRAN S., ÇOLAKOĞLU ÖZKAYA Ş., EKİNCİ G., ATAGÜNDÜZ M. P.Background: Sacroiliac joint (SIJ) magnetic resonance imaging (MRI) is an established tool in the evaluation of patients with axial spondyloarthritis (axSpA). In the validation study of the ASAS classification criteria for axSpA, only 63.1% of patients had sacroiliitis on the SIJ-MRI.[1] Studies that enrolled patients with axSpA based on expert opinion reported the sensitivity of MRI between 35 to 42% in detecting sacroiliitis.[2,3] Objectives: This study aimed to evaluate the temporal relationship between ASAS defined positive MRI and the characteristics of low back pain (LBP) in axSpA. Methods: Following axSpA groups were enrolled in the study whenever an attending physician ordered an SIJ-MRI. Patients fulfilling both the Rudwaleit criteria for inflammatory back pain (IBP) and Amor criteria, patients with a previous classification with either modified New York or ASAS classification criteria.[1] A blinded rheumatologist (GS) recorded the intensity and duration of IBP using a questionnaire before SIJ-MRI. MRI appointments were based on availability. Therefore some patients did not have IBP at acquisition. Two radiologists assessed SIJ-MRIs using the ASAS/OMERACT MRI group definition of active sacroiliitis.[4] In case of discrepant reporting, a third experienced radiologist (GE) adjudicated the SIJ-MRIs. The probability of axSpA is estimated using sum scores for SpA features excluding the SIJ-MRI.[5] The correlation between an ASAS-defined positive MRI and LBP characteristics was analyzed. Results: Fifty-nine patients (32 F/27M) were included. Patient characteristics are given in Table 1. Overall, 28 of 59 patients (47.5%) had a positive SIJ-MRI defined by ASAS. The median duration of LBP was 15 (43) days and the highest intensity of LBP was felt 6.5 ± 1.2 days before the MRI appointment. At acqusition, 13 (22.0%) patients reported no LBP. There was no significant difference between the presence of LBP within 10 days prior to MRI and sacroiliitis on MRI. (p=0.6) (Sacroiliitis in 45.7% with, and 53.8% without LBP) In LBP reporting patients, pain duration and pain VAS score were 3.3 ±2.3 and 7.1 ±1.9 in patients with sacroiliitis, and 8.7 ±3.6 and 6.8 ±1.7 in patients without sacroiliitis on MRI, respectively. (p=0.48, p=0.10) Age, sex, BASDAI, CRP and calculated probability of axSpA had no correlation with the presence of sacroiliitis on MRI. Adding sacroiliitis on SIJ-MRI to axSpA probability score increased the rate of patients with a probability of >90% for axSpA from 71.2 to 83.1% but the rate of sacroiliitis on MRI was similar in all probability groups. Conclusion: These results suggest that the presence of LBP and the duration of intense pain do not affect the detected rate of sacroiliitis on SIJ-MRI in axSPA. The low prevalence of sacroiliitis in this study population implies its value as a classification tool. Further studies with larger sample sizes are needed to clarify the factors affecting the SIJ-MRI findings in axSpA patients.Publication Metadata only Methodology of a new inflammatory arthritis registry: TReasure(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2018) AKSOY, AYSUN; Kalyoncu, Umut; Tascilar, Etem Koray; Ertenli, Ali Ihsan; Dalkilic, Huseyin Ediz; Bes, Cemal; Kucuksahin, Orhan; Kasifoglu, Timucin; Alpay Kanitez, Nilufer; Emmungil, Hakan; Kimyon, Gezmis; Yasar Bilge, Nazife Sule; Akar, Servet; Atagunduz, Mehmet Pamir; Koca, Suleyman Serdar; Ates, Askin; Yazisiz, Veli; Terzioglu, Ender; Ersozlu, Emine Duygu; Tufan, Muge Aydin; Cinar, Muhammet; Mercan, Ridvan; Sahin, Ali; Erten, SUkran; Pehlivan, Yavuz; Yilmaz, Sedat; Kelesoglu Dincer, Ayse Bahar; Gercik, Onay; Coskun, Belkis Nihan; Yagiz, Burcu; Kaymaz Tahra, Sema; Aksoy, Aysun; Karadag, Omer; Kilic, Levent; Kiraz, SedatBackground/aim: The TReasure registry, created in 2017, is an observational multicenter cohort that includes inflammatory arthritis patients. This article reviews the methodology and objectives of the TReasure registry established to collect data from rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients. Methodology: Fifteen rheumatology centers in Turkey will contribute data to the TReasure database. The actual proprietor of the database is the Hacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises. Pharmaceutical companies that operate in Turkey (in alphabetical or er), Abbvie, Amgen, BMS, Celltrion Healthcare, Novartis, Pfizer, Roche, and UCB, support the TReasure registry. TReasure is a web-based database to which users connect through a URL (https://www.trials-network.org/treasure) with their unique identifier and passwords provided for data entry and access. TReasure records demographic and clinical features, comorbidities, radiology and laboratory results, measures of disease activity, and treatment data. Discussion: TReasure will provide us with various types of data, such as a cross-sectional view of the current nationwide status of the patients currently receiving these treatments, and retrospective data as much as allowed by the participating centers' records. Finally, a high-quality prospective dataset will be built over the ensuing years from patients with a new diagnosis of RA or SpA.Publication Open Access Epidemiological characteristics of hepatitis B and C in patients with inflammatory arthritis: Implications from treasure database(2023-09-01) ATAGÜNDÜZ, MEHMET PAMİR; Ersözlü E. D., EKİCİ M., COŞKUN B. N., Badak S. Ö., BİLGİN E., KALYONCU U., Yağız B., PEHLİVAN Y., KÜÇÜKŞAHİN O., Erden A., et al.Objectives: This study aimed to evaluate the hepatitis B (HBV) and C (HCV) frequency and clinical characteristics among patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) who receive biological treatments. Patients and methods: The observational study was conducted with patients from the TReasure database, a web-based prospective observational registry collecting data from 17 centers across Türkiye, between December 2017 and June 2021. From this database, 3,147 RA patients (2,502 males, 645 females; median age 56 years; range, 44 to 64 years) and 6,071 SpA patients (2,709 males, 3,362 females; median age 43 years; range, 36 to 52 years) were analyzed in terms of viral hepatitis, patient characteristics, and treatments used. Results: The screening rate for HBV was 97% in RA and 94.2% in SpA patients. Hepatitis B surface antigen (HBsAg) positivity rates were 2.6% and 2%, hepatitis B surface antibody positivity rates were 32.3% and 34%, hepatitis B core antibody positivity rates were 20.3% and 12.5%, HBV DNA (deoxyribonucleic acid) positivity rates were 3.5% and 12.5%, and antibody against HCV positivity rates were 0.8% and 0.3% in RA and SpA patients, respectively. The HBsAg-positive patients were older and had more comorbidities, including hypertension, diabetes, and coronary artery disease. In addition, rheumatoid factor (RF) positivity was more common in HBsAg-positive cases. The most frequently prescribed biologic disease-modifying antirheumatic drugs were adalimumab (28.5%), etanercept (27%), tofacitinib (23.4%), and tocilizumab (21.5%) in the RA group and adalimumab (48.1%), etanercept (31.4%), infliximab (22.6%), and certolizumab (21.1%) in the SpA group. Hepatitis B reactivation was observed in one RA patient during treatment, who received rituximab and prophylaxis with tenofovir. Conclusion: The epidemiological characteristics of patients with rheumatic diseases and viral hepatitis are essential for effective patient management. This study provided the most recent epidemiological characteristics from the prospective TReasure database, one of the comprehensive registries in rheumatology practice.Publication Metadata only The investigation of sacroiliitis with different imaging techniques in spondyloarthropathies(SPRINGER HEIDELBERG, 2005) ATAGÜNDÜZ, MEHMET PAMİR; Inanc, N; Atagunduz, P; Sen, F; Biren, T; Turoglu, H; Direskeneli, HPurpose: The aim of this study was to compare the value of different imaging techniques in spondyloarthropathy (SpA) patients with inflammatory low back pain. Patients and Methods: We evaluated 54 patients who fulfilled the European spondyloarthropathy classification criteria and had inflammatory low back pain. They were subdivided into two groups according to changes on plain radiography rated on a 0-4 scale according to modified New York criteria. Group A patients had at least grade-2 unilateral or bilateral changes in the sacroiliac (SI) joints, whereas group B included patients with radiologic changes not exceeding grade 0-1. Quantitative SI scintigraphy and magnetic resonance imaging (MRI) were performed to investigate the value of these techniques to the diagnosis of sacroiliitis, and the sacroiliac joint:sacrum uptake ratios were calculated. Scintiscanning was done in 80 healthy subjects to define the normal range. Results: The sensitivities of plain radiography, quantitative SI scintigraphy, and MRI were 61%, 55%, and 89%, respectively, among the patients with SpA. MRI and quantitative SI scintigraphy detected sacroiliitis in 97% and 49% of group A, respectively. In group B, these results were 76% and 66%, respectively. Conclusion: Magnetic resonance imaging is the most sensitive method for detecting acute or chronic changes in SpA patients with histories of inflammatory low back pain and normal or indeterminate findings on plain radiographs.Publication Open Access Tuberculin skin test before biologic and targeted therapies: does the same rule apply for all(2022-10-01) ATAGÜNDÜZ, MEHMET PAMİR; Ilgen U., KARADAĞ Ö., Emmungil H., KÜÇÜKŞAHİN O., KOCA S. S., ERDEN A., Bes C., Kanitez N. A., DALKILIÇ H. E., AKAR S., et al.This study aimed to compare Tuberculin Skin Test (TST) and QuantiFERON (R)-TB Gold In-Tube (QFT-GIT) test in rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients scheduled for biological and targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) in a Bacillus Calmette-Guerin-vaccinated population. Adult RA (n = 206) and SpA (n = 392) patients from the TReasure database who had both TST and QFT-GIT prior to initiation of biological and targeted synthetic DMARDs were included in the study. Demographic and disease characteristics along with pre-biologic DMARD and steroid use were recorded. The distribution of TST and performance with respect to QFT-GIT were compared between RA and SpA groups. Pre-biologic conventional DMARD and steroid use was higher in the RA group. TST positivity rates were 44.2% in RA and 69.1% in SpA for a 5 mm cutoff (p < 0.001). Only 8.9% and 15% of the patients with RA and SpA, respectively, tested positive by QFT-GIT. The two tests poorly agreed in both groups at a TST cutoff of 5 mm and increasing the TST cutoff only slightly increased the agreement. Among age, sex, education and smoking status, pre-biologic steroid and conventional DMARD use, disease group, and QFT-GIT positivity, which were associated with a 5 mm or higher TST, only disease group (SpA) and QFT-GIT positivity remained significant in multiple logistic regression. TST positivity was more pronounced in SpA compared to that in RA and this was not explainable by pre-biologic DMARD and steroid use. The agreement of TST with QFT-GIT was poor in both groups. Using a 5 mm TST cutoff for both diseases could result in overestimating LTBI in SpA.