Evaluation of oxidative stress using exhaled breath 8-isoprostane levels on chronic kidney disease

Background: There have been limited numbers of studies on patients with chronic kidney disease (CKD) to determine oxidative stress in exhaled breath condensate (EBC). Those two studies have been carried out on hemodialysis patients, and hydrogen peroxide and nitric oxide have been studied in order to show oxidative stress on EBC.Aims: We investigated oxidative stress in EBC evaluating 8.isoprostane levels on different stages of CKD.Materials and Methods: A total of 81 patients with 2-4 CKD stages have been evaluated prospectively. The patients have been categorized into three groups according to their CKD stages. For biochemical analysis, blood and breathing air samples were taken. 8.-isoprostane has been measured using immunoassay method as the indicator of oxidative stress in EBC.Results: 8-isoprostane values were 8.19 ± 4.56, 13.89 ± 8.70, and 14.20 ± 10.68 pg/min group 1, 2, and 3, respectively; and the EBC 8-isoprostane levels increased significantly as CKD stages advanced (P = 0.018). There was a statistically significant reverse correlation between 8-isoprostane and glomerular filtration rate (GFR; r = .0.275; P = 0.014), but not between 8-isoprostane and Creactive protein (r = .0.183; P = 0.177).Conclusions: We determined the level of 8-isoprostane in EBC of patients with different stages of CKD and showed that the level of 8-isoprostane significantly increased through the progress of CKD. We consider that our study is important because there have been limited number of studies that evaluate oxidative stress in CKD using EBC which is a noninvasive method.Key words: 8-isoprostane, chronic kidney disease, exhaled breath condensate, oxidative stres

Analysis of common MDR1 (ABCB1) gene C1236T and C3435T polymorphisms in Turkish patients with familial Mediterranean fever

ABSTRACT. The multidrug resistance (MDR1) gene encodes a P-glycoprotein that plays a key role in drug bioavailability and response to drugs in different human populations. More than 50 SNPs have been described for the MDR1 gene. Familial Mediterranean fever (FMF) is considered an autosomal recessive hereditary disease, associated with a single gene named the Mediterranean fever gene (MEFV). However, about one-third of FMF patients have only one mutated allele, suggesting that this disease is expressed as an autosomal dominant trait with partial penetration or an additional gene might be responsible for the disease. We made genotype and haplotype analyses of the MDR1 gene in 142 FMF patients and 130 unrelated Turkish subjects; two MDR-1 genetic markers (C1236T and C3435T) were analyzed by PCR-RFLP analysis. FMF patients had a significantly higher frequency of the 3435 CT genotype compared with the control group (59.9 % in FMF patients versus 44.6 % in controls; odds ratio [OR] = 1.85; 95 % confidence interval [CI] = 1.14-3.00). Based o

Real-life safety and efficacy of vildagliptin as add-on to metformin in patients with type 2 diabetes in Turkey - GALATA study

PubMed ID: 25697921Objective: To evaluate tolerability/safety and the efficacy of the combination of vildagliptin plus metformin in a real-life population of patients with type 2 diabetes mellitus (T2DM). Research design and methods: This multicenter, single-arm, 6 month, observational, prospective cohort study was conducted at 39 centers across Turkey. T2DM patients on vildagliptin and metformin for ?4 weeks were enrolled regardless of their previous antidiabetic therapy. Main outcome measures: Efficacy was evaluated by measuring hemoglobin A1c (HbA1c) levels. Tolerability/safety parameters evaluated included hypoglycemic events, gastrointestinal events, peripheral edema and weight gain. Results: This study enrolled 665 patients with a mean±standard deviation (SD) age of 55.1±10.2 years and female predominance (n=394, 59.2%). Safety was assessed in all enrolled patients. Hypoglycemia was reported in 10 (1.5%) patients (95% confidence interval = 0.8-2.7%). Efficacy was assessed in 289 (43.5%) patients treated for 6±1 months; these patients showed a mean decrease in HbA1c of 0.8% from baseline value of 7.8% (p65 years) and body mass index (<30 vs. ?30 kg/m2) (p<0.001 each). In total, 136 adverse events (AEs) were observed in 71 (10.7%) patients; 10 (1.5%) patients experienced hypoglycemia and gastrointestinal AEs were most commonly reported (n=29, 4.4%). Conclusions: In a 'real-life' setting, the vildagliptin and metformin combination was associated with significant improvements in reaching target HbA1c levels, even in elderly and obese patients with T2DM. Moreover, vildagliptin and metformin demonstrated a good overall tolerability/safety profile. © 2015 All rights reserved: reproduction in whole or part not permitted.Novartis Pharmaceuticals CanadaThe study was funded by Novartis Pharmaceuticals Turkey. -- The authors thank Cagla Ayhan MD and Prof. Sule Oktay MD PhD from Kappa Consultancy Training Research Ltd, Istanbul, who provided editorial support, and Mehmet Berktas MD MICR from Kappa Consultancy Training Research Ltd, Istanbul, who performed statistical analysis funded by Novartis Pharmaceuticals Turkey. -

Real-life safety and efficacy of vildagliptin as add-on to metformin in patients with type 2 diabetes in Turkey - GALATA study

Objective: To evaluate tolerability/safety and the efficacy of the combination of vildagliptin plus metformin in a real-life population of patients with type 2 diabetes mellitus (T2DM). Research design and methods: This multicenter, single-arm, 6 month, observational, prospective cohort study was conducted at 39 centers across Turkey. T2DM patients on vildagliptin and metformin for ≤4 weeks were enrolled regardless of their previous antidiabetic therapy. Main outcome measures: Efficacy was evaluated by measuring hemoglobin A1c (HbA1c) levels. Tolerability/safety parameters evaluated included hypoglycemic events, gastrointestinal events, peripheral edema and weight gain. Results: This study enrolled 665 patients with a mean±standard deviation (SD) age of 55.1±10.2 years and female predominance (n=394, 59.2%). Safety was assessed in all enrolled patients. Hypoglycemia was reported in 10 (1.5%) patients (95% confidence interval = 0.8-2.7%). Efficacy was assessed in 289 (43.5%) patients treated for 6±1 months; these patients showed a mean decrease in HbA1c of 0.8% from baseline value of 7.8% (p65 years) and body mass index (<30 vs. ≥30 kg/m2) (p<0.001 each). In total, 136 adverse events (AEs) were observed in 71 (10.7%) patients; 10 (1.5%) patients experienced hypoglycemia and gastrointestinal AEs were most commonly reported (n=29, 4.4%). Conclusions: In a 'real-life' setting, the vildagliptin and metformin combination was associated with significant improvements in reaching target HbA1c levels, even in elderly and obese patients with T2DM. Moreover, vildagliptin and metformin demonstrated a good overall tolerability/safety profile. © 2015 All rights reserved: reproduction in whole or part not permitted