The Relationship between Th1/Th2 Balance and 1α, 25-Dihydroxyvitamin D3 in Patients with Allergic Rhinitis

Objective:With regard to the correlation between T helper1/T helper2 (Th1/Th2) cell balance and 1α,25-dihydroxyvitamin D3, active metabolite of vitamin D, we studied Th1/Th2 cell balance by measuring levels of the cytokines interleukin (IL)-4, IL-10 and interferon- gamma (IFN-γ), which are important for immune response of patients with allergic rhinitis.Methods:Thirty adult patients diagnosed with allergic rhinitis (study group) and 40 healthy volunteers (control group) are examined in the research. IFN-γ, IL-4, IL-10, and total immunoglobulin E (IgE) levels from serum samples and vitamin D3 levels from plasma were determined in all patients.Results:In IgE, IL-4, IL-10, IFN-γ, and 1α,25-dihydroxyvitamin D3 levels (p<0.05), a statistically noticeable difference was observed between the study and control group. The 1α,25-dihydroxyvitamin D3 levels in both groups were compared and a statistically significant difference between the 1α,25-dihydroxyvitamin D3 levels in the study group and that in the control group (p<0.05) was observed. There was a positive correlation between IFN-γ and vitamin D levels (p<0.05) in the study group, whereas IgE, IL-4, and IL-10 levels showed a negative correlation with vitamin D3 levels (p<0.05).Conclusion:In our study, 1α,25-dihydroxyvitamin D3 levels were associated with Th1/Th2 balance in allergic rhinitis, and a remarkable correlation was observed among vitamin D deficiency and allergy. These findings show that 1α,25-dihydroxyvitamin D3 may have a remarkable role in the severity and control of allergic disorders. In addition, further investigations are required to confirm how vitamin D should be used in allergic diseases. Furthermore, to reveal the exact mechanism of vitamin D on allergic diseases, further studies are required

Ankara’daki hipertansiyon hastalarının farkındalık, tedavi ve kontrol oranları

Aim: It was aimed to evaluate the awareness levels of patients about hypertension, treatment and control rates. Methods: The descriptive study included 203 patients between ages of 35–80 with a previous diagnosis of hypertension to the primary care outpatient clinic of Ankara Numune Training and Research Hospital in September 2011- January 2012. A 42-item questionnaire was used and 19 questions were used to determine the level of awareness among them. Nine measurements were in the office by the researcher and 12 measurements at home by the patient. Results: 25.6% of the patients were males and 74.4% were females. The median age was 59 years (IQR=13). The section for scoring the awareness levels revealed following: 27.1% of patients were non-aware, 58.6% had a low level of awareness and 14.3% had a high level of awareness. 72.9% of the patients were aware, 93.1% were taking antihypertensive treatment, while 42.4% measured blood pressures both at home and at office are under control. Awareness level is related to diet, exercise, education, salt usage, blood pressure measurement frequency, doctor referral frequency, education and knowledge level about hypertension, blood pressure monitoring branch, antihypertensive treatment status, hypertension duration, number of antihypertensive drugs and regular usage rates; but hypertension control was only associated with salt use, antihypertensive treatment and number of antihypertensive drugs. Conclusion: Hypertension is a common problem in our country and as we have seen in our studies, awareness rates are insufficient. Although the treatment rates are high, the control rates are not sufficient. This suggests that patients' compliance with treatment is not at the desired level. The most important thing to do in this regard is to raise awareness by increasing public awareness about hypertension. In this respect, primary care physicians have a great responsibility. Keywords: awareness, blood pressure, antihypertensive agents, primary careAmaç: Çalışmamızda hastaların hipertansiyon konusunda farkındalık düzeyleri, tedavi ve kontrol oranlarının değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışmaya Kasım 2011-Ocak 2012 tarihleri arasında Ankara Numune Eğitim ve Araştırma Hastanesi Aile Hekimliği polikliniğine başvuran ve yaşları 35-80 arasında değişen, daha önceden hipertansiyon tanısı alan toplam 203 hasta dahil edilmiştir. Kırk iki soruluk bir anket ve farkındalık düzeyini belirlemek için bunların arasından 19 soru kullanıldı. Poliklinikte araştırmacı tarafından 9 ölçüm, evde ise hastalar tarafından 12 kez kan basıncı ölçümü yapıldı. Bulgular: Hastaların% 25,6'sı erkek ve % 74,4’ü kadın olmakla birlikte, ortanca yaş 59 (CAG = 13) idi. Farkındalık düzeylerinin skorlanması sonucunda hastaların %27,1'inin farkındalığının olmadığı, %58,6'sının farkındalık düzeyinin düşük ve % 14,3'ünün farkındalık düzeyinin yüksek olduğu saptandı. Çalışmamızda hastaların %72,9’unun farkındalığı mevcut, %93,1’i antihipertansif tedavi almakta, %42,4’ünün ise hem ofiste, hem evde ölçülen kan basınçları kontrol altındadır. Farkındalık düzeyi diyet, egzersiz, eğitim, tuz kullanımı, tansiyon ölçüm sıklığı, doktora başvuru sıklığı, hipertansiyon hakkında eğitim ve bilgi düzeyi, tansiyon takip branşı, antihipertansif tedavi alma durumu, hipertansiyon süresi, antihipertansif ilaç sayısı ve ilacı düzenli kullanım oranlarıyla ilişkili bulunmuş, ancak hipertansiyon kontrolü sadece tuz kullanımı, antihipertansif tedavi alma ve antihipertansif ilaç sayısı ile ilişkilendirilmiştir. Sonuç: Hipertansiyon ülkemizde sık görülen bir sorun olup çalışmamızda da görüldüğü üzere farkındalık oranları yetersizdir. Tedavi oranlarının yüksek olmasına karşılık kontrol oranları yeterli düzeyde değildir. Bu da hastaların tedaviye uyumlarının istenilen seviyede olmadığını göstermektedir. Bu konuda yapılması gereken en önemli şey, hipertansiyon konusunda toplumsal bilincin arttırılması yolu ile farkındalığın arttırılmasıdır. Bu hususta birinci basamak hekimlerine büyük görev düşmektedi

A Monogenic Disease with a Variety of Phenotypes: Deficiency of Adenosine Deaminase 2

Objective: Deficiency of adenosine deaminase 2 (DADA2) is an autosomal recessive autoinflammatory disorder associated with ADA2 mutations. We aimed to investigate the characteristics and ADA2 enzyme activities of patients with DADA2 compared to non-DADA2 patients. Methods: This is a descriptive study of 24 patients with DADA2 who were admitted to the Adult and Pediatric Rheumatology, Pediatric Haematology, and Pediatric Immunology Departments of Hacettepe University. All ADA2 exons were screened by Sanger sequencing. Serum ADA2 enzyme activity was measured by modified spectrophotometric method. Results: Twenty-four patients with DADA2 were included: 14 with polyarteritis nodosa (PAN)-like phenotype (Group 1); 9 with Diamond-Blackfan anemia (DBA)-like features, and 1 with immunodeficiency (Group 2). Fourteen PAN-like DADA2 patients did not have the typical thrombocytosis seen in classic PAN. Inflammatory attacks were evident only in Group 1 patients. Serum ADA2 activity was low in all patients with DADA2 except one, who was tested after hematopoietic stem cell transplantation. There was no significant difference in ADA2 activities between PAN-like and DBA-like patients. In DADA2 patients with one ADA2 mutation, serum ADA2 activities were as low as those of patients with homozygote DADA2. ADA2 activities were normal in non-DADA2 patients. ADA2 mutations were affecting the dimerization domain in Group 1 patients and the catalytic domain in Group 2 patients. Conclusion: We suggest assessing ADA2 activity along with genetic analysis because there are patients with one ADA2 mutation and absent enzyme activity. Our data suggest a possible genotype-phenotype correlation in which dimerization domain mutations are associated with PAN-like phenotype, and catalytic domain mutations are associated with hematological manifestations.PubMe