Hasan Yuksel

Celal Bayar Üniversitesi, Saruhan, Manisa, Turkey

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Publications (87)177.71 Total impact

  • European Respiratory Journal 09/2015; 46(suppl 59):PA3889. DOI:10.1183/13993003.congress-2015.PA3889 · 7.64 Impact Factor

  • European Respiratory Journal 09/2015; 46(suppl 59):PA1341. DOI:10.1183/13993003.congress-2015.PA1341 · 7.64 Impact Factor
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    ABSTRACT: Epithelial barrier dysfunction is important in the pathogenesis of asthma and allergic responses, and is therefore a therapeutic target. The aim of the present study was to investigate the effects of dexamethasone, a classic therapeutic agent, an anti-tumor necrosis factor agent (etanercept), which is used to treat difficult cases of asthma, and an anti-vascular endothelial growth factor (VEGF) agent (bevacizumab), which is an angiogenesis inhibitor, on zonula occludens (ZO) proteins in an experimental asthma model. The experimental model of asthma was developed using intraperitoneal (IP) and inhaled administration of ovalbumin in 38 BALB/c mice, which were divided into four groups. The control group (n=6) did not receive any treatment, while the four remaining groups (n=8 per group) received an IP injection of saline, etanercept, bevacizumab or dexamethasone, respectively. Occludin, claudin and junctional adhesion molecule (JAM) were immunohistochemically stained in the left middle lobe samples using an indirect avidin-peroxidase method, after which the staining was semiquantified with H-scores. Statistically significant differences were observed in the occludin, claudin and JAM H-scores among the four groups (P<0.001). In the untreated asthma, etanercept, bevacizumab and dexamethasone groups, the median H-scores for occludin were 93, 177, 280 and 198, respectively, while the H-scores for claudin were 82, 193.5, 274 and 202.5, respectively, and the median H-scores for JAM were 130, 210, 288 and 210, respectively. Pairwise comparisons revealed that all three ZO protein H-scores were significantly lower in the saline group when compared with each treatment group. However, the H-scores of the ZO proteins were not significantly different between the etanercept and dexamethasone groups. Furthermore, the bevacizumab group exhibited higher H-scores for all the proteins compared with the dexamethasone group. Therefore, antagonism of VEGF with bevacizumab restores the epithelial barrier to a greater extent when compared with dexamethasone treatment. This result may be promising for the development of novel therapeutic agents.
    Experimental and therapeutic medicine 05/2015; 10(1). DOI:10.3892/etm.2015.2502 · 1.27 Impact Factor
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    ABSTRACT: Asthma is a heterogeneous disease, and a great majority of pediatric patients with asthma demonstrate atopic characteristics and develop a Th2 type cytokine response. Nonatopic asthma, on the other hand, is seen more rarely. In this study, levels of IL-5, IL-8 and MMP-9 were measured in exhaled breath condensate (EBC) of the subjects to demonstrate the extent of tissue damage as well as eosinophilic and neutrophilic inflammation in children with atopic and nonatopic asthma. A total of 37 children with atopic asthma and 37 children with nonatopic asthma were enrolled in the study. Patients who exhibited protease positive aeroallergen (House dust mite, mould mix, olea, grass mix) sensitivity in allergen skin prick test were included in the atopic asthma group. To evaluate the EBC, the fluid content of the breath was collected by having the patients exhale into an EBC device, after which the IL-5, IL-8 and MMP-9 levels were assayed using the ELISA method. The atopic asthmatics exhibited significantly higher IL-5 levels in their EBC samples than the nonatopic asthmatics (0.271 [0.198-0.489] pg/ml and 0.198 [0.125-0.344] pg/ml, respectively, p = 0.04), while no significant differences were observed in the levels of IL-8 and MMP-9 in the EBC samples of the atopic and nonatopic asthmatics. IL-5 levels, as a marker of eosinophilic inflammation, were demonstrated to be higher in the children with atopic asthma when compared to those with nonatopic asthma in EBC. The fact that no significant difference was apparent in the IL-8 levels between the groups suggests that it is the severity of the disease rather than the atopic state that plays an important role in IL-8 levels. Since no difference was recorded between the groups in terms of MMP-9 levels, lung damage in asthma sufferers seems to develop independent of atopia. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Respiratory medicine 04/2015; 109(6). DOI:10.1016/j.rmed.2015.04.004 · 3.09 Impact Factor
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    ABSTRACT: Variability in children's allergic sensitization has been detected not only among different countries but also among cities within the same nation but yet different climatic areas. The aim of this study was to investigate the sensitization pattern of asthmatic children who lived in different altitude areas: the two largest Turkish cities, Istanbul (sea level) and Erzurum (high altitude). Five hundred and twelve asthmatic children (6-15 years old) from Istanbul (western Turkey, at sea level) and 609 from Erzurum (eastern Turkey, at an altitude of 1800 m) were included in the study. All participants underwent skin testing with common inhalant allergens, spirometry, total IgE level, and clinical examination. The positive sensitization ratio to aeroallergens in children with asthma living at sea level was statistically higher than that in children living in the high altitude group [p = 0.001, OR (odds ratio) 4.9 (confidence interval (CI) 3.67-6.459)]. However, pollen sensitization in asthmatic children living in high altitudes was significantly higher than that in children living at sea level [p = 0.00, OR 2.6 (CI 1.79-3.87)]. Children with asthma who live at high altitudes are characterized by higher pollen but lower mite sensitization rates than those living at sea level in Turkey. Different climatic conditions and altitudes may affect aeroallergen sensitization in children with asthma.
    International Journal of Biometeorology 03/2015; 59(11). DOI:10.1007/s00484-015-0975-0 · 3.25 Impact Factor
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    ABSTRACT: Follicular bronchiolitis (FB) is a benign progressive lung disease. It is characterized with lymphoplasmocellular infiltration and hyperplastic follicles in the peribronchial areas in the small airways. Follicular bronchiolitis should be considered in cases where chronic cough, recurrent upper respiratory tract infections and progressive dyspnea are observed in children. The diagnosis should be supported by lung biopsy. A 8-year old female patient presented to our hospital with complaints including continuing cough and wheezing. Bilateral extensive rales and rhonchi in the lungs were heard on auscultation and lung graphy revealed reticuloglandular appearance. Bilateral extensive septal thickennings, reticulonodular appearance, patchy bronchiectasis, bronchiolectasis and peribronchial thickennings were found on high-resolution thoracal computarized tomography. A diagnosis of follicular bronchiolitis was made as a result of lung biopsy. Improvement was observed in the complaints and findings of our patient after methylprednisolone treatment. This patient was presented to emphasize rare interstitial lung diseases should also be considered in children who present with a clinical picture of chronic bronchial obstruction and do not respond to standard treatment.
    Turk Pediatri Arsivi 01/2015; 49(4):344-347. DOI:10.5152/tpa.2014.306 · 0.06 Impact Factor

  • 01/2015; 16(1):43-52. DOI:10.5152/ttd.2014.4505
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    ABSTRACT: Airway epithelium plays an important role as a physical barrier and a modulator of allergic response. Junctions between cells provide epithelial integrity and barrier function. The aim of this study was to investigate the influence of atopy on airway epithelial integrity in asthma and to measure E-cadherin levels in exhaled breath condensate as an indicator epithelial damage.A total of 74 patients with asthma (35 atopic and 39 non-atopic) and 39 healthy children were enrolled in this case-control study. Sociodemographic characteristics and asthma severity parameters in the last three-month period were recorded and pulmonary function tests were performed. Blood samples were obtained to measure serum immunoglobulin E (IgE) levels and peripheral blood eosinophil count, and exhaled breath condensate (EBC) was obtained to measure E-cadherin.EBC E-cadherin levels were significantly lower in the asthmatics when compared to non-atopic controls (0.109 (0.076) versus 0.191 (0.184) ng mL(-1) respectively, p = 0.01). Atopic and non-atopic asthmatic groups had lower EBC E-cadherin levels compared to the control group. (0.112 (0.060) ng ml(-1), 0.106 (0.089) ng ml(-1) and 0.191 (0.184) ng ml(-1), p = 0.02 and p < 0.01 respectively). However, EBC E-cadherin levels were not different between atopic and non-atopic asthmatics.The results of our study support the role of E-cadherin in the pathogenesis of asthma. However, the absence of difference in E-cadherin levels between atopic and non-atopic asthmatics suggests that allergic sensitization is not the primary factor for development of epithelial barrier dysfunction in asthma.
    Journal of Breath Research 12/2014; 8(4):046006. DOI:10.1088/1752-7155/8/4/046006 · 4.63 Impact Factor
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    Ozge Yilmaz · Ahmet Turkeli · Sebnem Sahin · Hasan Yuksel ·
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    ABSTRACT: Assessment of asthma control in preschool children is important for therapeutic decisions. Aim of this study was to evaluate the predictive value of TRACK questionnaire scores for subsequent clinical parameters and to investigate the validity and reliability of the Turkish version of the TRACK questionnaire. We enrolled 100 children with asthma aged 4 years or younger in this cohort study. We recorded sociodemographic characteristics and clinical severity parameters. A pediatric allergist filled in the asthma severity scale and the caregiver of the child filled in the TRACK questionnaire. We called in the children again at the end of one month and recorded the same parameters and administered TRACK again. Uncontrolled asthma was defined as a TRACK score below 80. According to the TRACK score, 65% of the children had controlled asthma initially while at the end of the study 64.1% had controlled asthma. At the beginning of the study, all clinical parameters were worse in children with uncontrolled asthma according to TRACK score. Similarly, other objective clinical parameters during the following one month period were worse in children with initial uncontrolled asthma. Cronbach's alpha score for the TRACK questionnaire was 0.84. Turkish TRACK questionnaire is a valid and reliable tool that is predictive of short term asthma prognosis.
    Allergy, asthma & immunology research 07/2014; 6(4):357-61. DOI:10.4168/aair.2014.6.4.357 · 2.43 Impact Factor
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    ABSTRACT: Vitronectin (VN) functions as a regulator of platelet adhesion and aggregation, coagulation, and fibrinolysis. The aim of this study was to assess the prognostic significance of serum VN levels in patients with acute myocardial infarction (MI). In this study 62 patients admitted with ST-elevation myocardial infarction (STEMI), or non-ST-elevation myocardial infarction (NSTEMI) were enrolled. Serum VN levels were measured within 6 h after onset of chest pains. The VN serum levels were higher in MI patients with a mean of 2.257 µg/ml (range 1.541-4.493 µg/ml) in the STEMI group, 1.785 µg/ml (range 1.372-4.113 µg/ml) in the NSTEMI group, and 1.222 µg/ml (range 1.033-1.466 µg/ml) in the controls (p = 0.012). Major adverse cardiovascular events could be predicted at 6 months using VN levels independently of other variables [odds ratio (OR) 9.87, 95 % confidence interval (CI) 2.54-47.37, p = 0.001]. There was a significant positive correlation between VN levels and the Gensini score in NSTEMI patients (r = 0.436, p = 0.013). The VN level may be relevant as a clinical biomarker for adverse cardiovascular outcomes not only in patients with ischemic heart disease undergoing coronary interventions, as previously reported, but also in coronary artery disease patients presenting with acute MI.
    Herz 05/2014; 40(4). DOI:10.1007/s00059-014-4105-2 · 0.69 Impact Factor
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    ABSTRACT: Objectives: The aim of the study was to evaluate the levels of interleukin (IL)-4, IL-10, transforming growth factor-beta (TGF-βb), IL-17, and IL-23 cytokines, which reflect different T lymphocyte responses, in bronchoalveolar lavage (BAL) samples of tuberculin skin test (TST)-positive children. Material And Methods: Twelve children with TST positivity, who underwent flexible videobronchoscopy (FB) to evaluate airway involvement and to obtain BAL to improve diagnostic yield, and 11 control children with negative TST, who underwent FB for other reasons, were enrolled in this case-control study. BAL samples were obtained from all children during the FB procedure. Levels of IL-4, interferon gamma (IFN-γ), IL-10, TGF-βb, IL-17, and IL-23 were measured by the ELISA method. Results: Mean age of the children enrolled in the TST-positive and -negative groups were 8.6 (4.3) vs. 6.8 (4.5), respectively (p=0.35). There was a trend of higher TGF-βb levels in TST-positive children compared with TST-negative children [557.9 (515.3) vs. 386.3 (208.1), respectively, p=0.07]. Mean levels of IL-23 were 39.2 (29.5) in TST-positive children vs. 46.2 (72.3) in TST-negative children (p=0.49). IFN-γ, IL-4, IL-10, and IL-17 levels were not significantly different among the groups (p>0.05 for all). Conclusion: Results of this study suggest that TGF-in BAL fluid of children with TST positivity tends to be higher than that in TST-negative children, which indicates an increased activity of regulatory T lymphocytes that may decrease the Th1 immune response. TGF-might be studied in future research for its potential as a diagnostic modality and immunomodulatory treatment target.
    04/2014; 15(2):61-64. DOI:10.5152/ttd.2014.3749

  • Journal of Allergy and Clinical Immunology 02/2014; 133(2-2):AB179-AB179. DOI:10.1016/j.jaci.2013.12.641 · 11.48 Impact Factor
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    ABSTRACT: Background Systemic sclerosis (SSc) is a multisystem disorder characterized by extensive vascular damage, with early generalized microangiopathy and fibrosis of the skin and internal organs. SSc is characterized by parasympathetic impairment and marked sympathetic over activity. Objectives The aim of this study was to investigate the potential relationship between serum asymmetric dimethylarginine (ADMA) and systemic hypertension in patients with SSc. Methods Thirty patients with systemic sclerosis and thirty controls who had no cardiovascular risk factors were included in this study. All patients and the controls underwent a 24-hour holter recording and plasma ADMA levels were measured. Results A total of 10 patients had dipper status (33.3%), 16 patients had non-dipper status (53.3%), 2 patients had reverse dipper status (6.6%) and 2 patients had extreme dipper status (6.6%). ADMA levels were higher in SSc patients when compared with control group and especially significantly higher in SSc patients with reverse dipper status. Conclusions The elevated serum levels ADMA and sympathetic over activity may be the result of reverse dipper blood pressure patterns in patients with SSc. Disclosure of Interest None Declared
    Annals of the Rheumatic Diseases 01/2014; 71(Suppl 3):686-686. DOI:10.1136/annrheumdis-2012-eular.833 · 10.38 Impact Factor
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    ABSTRACT: Objectives In this study, we aimed to show the relationship between CoQ10 and fatigue symptoms of Fibromyalgia (FM). Methods A total of 40 patients diagnosed as primary FM according to the ACR criteria and 30 controls were included in the present study. All patients routine blood tests, erythrocyte sedimentation rate, total antioxidantstatus (TAS), total oxidativestatus (TOS) and Coenzyme Q10 (CoQ10) were evaluated. The patients were given the Fibromyalgia Impact Questionnaire (FIQ). Modified Fatigue Impact Scale (MFIS) weregiven in twogroupsandcompared. Results The mean ages of the patients and the control groups were 36.09±8.87 and 34.44±6.25, respectively. The age difference was not statistically significant (P = 0.266). The mean time of diagnosis of FM patients was 2.88 years and their average number of tender points was 14. The serum CoQ10 levels were significantly lower in FM patients when compared to the healthy control group (p=0.004). The serum TOS levels were higher in the FM group than in the control group (P<0.05). The serum CoQ10 levels were negatively correlated with mean total score of MFIS (p=0.02, r=0.30), the mean scores for the ‘physical’ subscale of the MFIS (p=0.03, r=0.28), ‘cognitive’ (P = 0.02, r=0.30), VAS pain scores (p=0.00, r=0.38) and VAS fatigue scores (p=0.03, r=0.28). Conclusions CoQ10 deficiency may be responsible for the etiopathogenesis of fatigue of FM. Serum Coenzyme Q10 may be a marker for diagnosis and follow-up of patients with FM. Disclosure of Interest None Declared
    Annals of the Rheumatic Diseases 01/2014; 72(Suppl 3):A990-A990. DOI:10.1136/annrheumdis-2013-eular.2982 · 10.38 Impact Factor
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    ABSTRACT: An investigation of immunopathogenetic mechanisms of obesity-associated asthma may demonstrate novel therapeutic targets. The aim of this study was to compare levels of T-helper lymphocyte (Th)1, Th2, regulatory T lymphocyte (Treg), and Th17 cytokines secreted by peripheral blood mononuclear cell culture (PBMC) in response to nonspecific stimulation in obese and nonobese children with asthma. Obese and nonobese children with asthma aged 5-16 were enrolled into this case-control study consecutively. Age at asthma diagnosis and clinical severity were recorded. A skin prick test was performed. Serum adipokine levels and PBMC supernatant interleukin (IL)-4, IL-10, IL-17, IL-23, interferon (IFN)γ, and transforming growth factor (TGF)-β levels were measured. Mean (±standard deviation) ages of obese (n=28) and nonobese (n=39) children with asthma were 8.7±2.9 and 10.5±3.2, respectively. Asthma symptom score was higher, and age at asthma diagnosis was lower in obese compared with nonobese children with asthma (P=0.03 and P=0.004, respectively). Leptin levels were significantly higher in obese than in nonobese asthma group (P<0.001). IL-10 and IL-17 levels in obese group were significantly lower than in nonobese group (P=0.005 and P=0.017, respectively). On the other hand, TGF-β levels were significantly higher in obese compared with nonobese children with asthma (P=0.015). IL-4, IL-23, and IFNγ levels were not significantly different between the groups (P<0.05 for all). Low IL-10 and high TGF-β levels in obese compared with nonobese children with asthma might indicate lower anti-inflammatory cytokine secretion and Treg function as well as a higher remodeling process in obesity-associated asthma in children.
    Pediatric Allergy, Immunology, and Pulmonology 12/2013; 26(4):193-198. DOI:10.1089/ped.2012.0216 · 0.66 Impact Factor
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    ABSTRACT: Antagonism of TNF-α may interfere with remodeling in asthmatic airway. The aim of the study was to compare the influence of TNF antagonism and corticosteroid treatment on epithelial, smooth muscle and basement membrane component of airway remodeling in an experimental murine model of chronic asthma. We used 30 BALB/c mice. Group 1 not exposed to ovalbumin or any medication was designated as control group. Chronic asthma model was achieved in the other three groups with intraperitoneal (IP) and inhaled ovalbumin. Then, Group 2 received IP saline, Group 3 received IP dexamethasone and Group 4 received IP etanercept. Histomorphological examination for epithelial, subepithelial smooth muscle and basement membrane thickness as well as goblet cells and mast cells was performed on samples isolated from middle zone of left lung. Etanercept treatment led to thinner epithelial and basement membrane layer and lower goblet and mast cell number than untreated asthmatic mice (p<0.001, p=0.001, p=0.005 and p=0.03 respectively). Neither epithelial and basement membrane thickness nor mast cell number was different among mice treated with etanercept and dexamethasone (p=0.38, p=0.79 and p=0.51 respectively). However, etanercept group was associated with thicker subepithelial muscle layer but lower goblet cell number (p<0.001 and p=0.04 respectively) than dexamethasone group. TNF antagonists and dexamethasone share many histopathological effects on asthmatic airway. Corticosteroids are more effective in decreasing smooth muscle mass while TNF antagonists in reducing goblet cell number. Therefore, further research is needed to assess the synergistic use of TNF antagonism and dexamethasone for more rational remodeling control.
    International immunopharmacology 09/2013; 17(3). DOI:10.1016/j.intimp.2013.08.021 · 2.47 Impact Factor
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    Dataset: Glucan

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    Dataset: Glucan

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    ABSTRACT: Vascular endothelial growth factor (VEGF) is an important mediator of the neoangiogenesis component of remodeling in asthma. To evaluate the influence of VEGF blockage on airway remodeling, specifically epithelium thickness, subepithelial smooth muscle thickness, number of mast and goblet cells, and basement membrane thickness, in a mouse model of chronic asthma. We used 30 BALB/c mice. The control group was not exposed to ovalbumin or any medication (group 1). Other groups were exposed to intraperitoneal and inhaled ovalbumin to achieve chronic asthma. Each of these groups received intraperitoneal saline (group 2), intraperitoneal dexamethasone (group 3), or intraperitoneal bevacizumab (group 4). Histomorphologic examination for epithelium thickness, subepithelial smooth muscle thickness, number of mast and goblet cells, and basement membrane thickness was performed from the middle zone of the left lung. Treatment with anti-VEGF caused significant reduction in epithelial, subepithelial muscle, and basement membrane thickness compared with untreated asthmatic mice (P = .001, P = .03, and P = .009, respectively). Goblet and mast cell numbers were significantly lower in mice treated with anti-VEGF than in untreated mice (P = .02 and P = .007, respectively). Dexamethasone treatment resulted in improvement of all histomorphologic markers, except goblet cell number. Influences of dexamethasone and anti-VEGF on epithelial and basement membrane thickness and mast and goblet cell numbers did not differ (P > .05), but subepithelial muscle layer was thinner in the former (P = .003). VEGF blockage may provide adjunctive therapeutic options as steroid-sparing agents for more effective treatment of remodeling in asthma.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 03/2013; 110(3):150-5. DOI:10.1016/j.anai.2012.12.015 · 2.60 Impact Factor
  • Talat Ecemis · Ozge Yilmaz · Tamer Sanlidag · Sinem Akcali · Hasan Yuksel ·

    03/2013; 2(1):1-5. DOI:10.5222/buchd.2012.001

Publication Stats

668 Citations
177.71 Total Impact Points


  • 2001-2015
    • Celal Bayar Üniversitesi
      • • Department of Pediatric Allergy and Pulmonology
      • • Department of Pediatrics
      Saruhan, Manisa, Turkey
  • 2014
    • Dicle University
      • Faculty of Medicine
      Amida, Diyarbakır, Turkey
    • Istanbul University
      • Department of Pediatric Cardiology
      İstanbul, Istanbul, Turkey