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    Altered immune response in organic acidemia
    (Wiley, 2022) Altun, İlayda; Kıykım, Ayça; Zubarioğlu, Tanyel; Bürtecene, Nihan; Hopurcuoglu, Duhan; Topcu, Birol; Zeybek, Ayşe Çiğdem Aktuğlu
    Background Most patients with organic acidemia suffer from recurrent infections. Although neutropenia has been reported in multiple studies, other components of the immune system have not been evaluated thoroughly. This study was conducted to assess the immune status of patients with organic acidemia (OA). Methods Thirty-three patients with OA who were followed up in Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Nutrition and Metabolism Department and a total of 32 age- and sex-matched healthy controls were enrolled to the study. The demographic and clinical data were recorded retrospectively from patient files. Complete blood counts, immunoglobulins, and lymphocyte immunophenotyping were recorded prospectively in a symptom- (infection-) free period. Results Of the 33 patients enrolled to the study, 21 (88%) were diagnosed with methylmalonic acidemia, 10 (33%) with propionic acidemia, and two (6.6%) with isovaleric acidemia. The mean age of the patients with OA and healthy subjects were 5.89 +/- 4.11 years and 5.34 +/- 4.36, respectively (P = 0.602). Twenty-nine (88%) of the patients had experienced frequent hospital admission, 13 (39%) were admitted to pediatric intensive care unit, and 18 (55%) suffered from sepsis. Naive helper T cells and recent thymic emigrants were significantly lower in OAs (P < 0.001). Various defects in humoral immunity have also been documented including memory B cells and immunoglobulins. Conclusions Patients with OAs may show adaptive immune defects rendering them susceptible to infections. Metabolic reprogramming based on nutritional modifications may be a promising therapeutic option in the future.
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    Rapid Determination of L-2-Hydoxyglutaric Acid in Urine Samples By Capillary Electrophoresis with Indirect Uv Detection
    (2020) Cansever, Mehmet Şerif; Kalaycıoğlu, Zeynep; Erim, Fatma Bedia; Zübarioğlu, Tanyel; Kıykım, Ertuğrul; Zeybek, Ayşe Çiğdem Aktuğlu
    Aim: L-2-hydroxyglutaric aciduria (L2HGA) which is autosomal recessive and characterized by psychomotor retardation, cerebellarataxia, variable macrocephaly, and epilepsy is a rarely seen neurometabolic disease. The disease is biochemically identified by slightlyincreased L-2HGA levels in urine, cerebrospinal fluid, and plasma.Materials and Methods: A sensitive and rapid capillary electrophoretic technique was used for the determination of L2HGA in urine.Since the L2HGA lacks of chromophore, an indirect UV detection method was applied.Results: The running electrolyte consisted of 10 mmol/L 2,6-pyridinedicarboxylic acid (PDC) at pH 5.6 containing 0.1 mmol/L ofcetyltrimethylammonium bromide (CTAB). PDC was chosen because of its good chromophoric property for indirect UV detection. CTABwas used as electro-osmotic flow (EOF) reversal. The method was well-validated in the selected conditions. The detection limit of themethod L2HGA was 1.16 ?mol/L. The migration time of L2HGA was less than 2.0 min.Conclusion: The developed method was applied to the urine samples collected from 16 patients who suffer from L-2-hydroxyglutaricaciduria and 4 healthy volunteers.