Browsing by Author "Siva, Aksel"

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CSF Proteomics Identifies Specific and Shared Pathways for Multiple Sclerosis Clinical Subtypes
(PUBLIC LIBRARY SCIENCE, 2015-01-01) Avsar, Timucin; Durasi, Ilknur Melis; Uygunoglu, Ugur; Tutuncu, Melih; Demirci, Nuri Onat; Saip, Sabahattin; Sezerman, O. Ugur; Siva, Aksel; Turanli, Eda Tahir
Multiple sclerosis (MS) is an immune-mediated, neuro-inflammatory, demyelinating and neurodegenerative disease of the central nervous system (CNS) with a heterogeneous clinical presentation and course. There is a remarkable phenotypic heterogeneity in MS, and the molecular mechanisms underlying it remain unknown. We aimed to investigate further the etiopathogenesis related molecular pathways in subclinical types of MS using proteomic and bioinformatics approaches in cerebrospinal fluids of patients with clinically isolated syndrome, relapsing remitting MS and progressive MS (n=179). Comparison of disease groups with controls revealed a total of 151 proteins that are differentially expressed in clinically different MS subtypes. KEGG analysis using PANOGA tool revealed the disease related pathways including aldosterone-regulated sodium reabsorption (p=8.02x10(-5)) which is important in the immune cell migration, renin-angiotensin (p=6.88x10(-5)) system that induces Th17 dependent immunity, notch signaling (p=1.83x10(-10)) pathway indicating the activated remyelination and vitamin digestion and absorption pathways (p=1.73x10(-5)). An emerging theme from our studies is that whilst all MS clinical forms share common biological pathways, there are also clinical subtypes specific and pathophysiology related pathways which may have further therapeutic implications.
Differences Between General Neurologists and Multiple Sclerosis Specialists in the Management of Multiple Sclerosis Patients: A National Survey
(AVES, 2019-01-01) Kurtuncu, Murat; Tuncer, Asli; Uygunoglu, Ugur; Caliskan, Zeynep; Kokenli Paksoy, Aysenur; Efendi, Husnu; Sagduyu Kocaman, Ayse; Ozcan, Cemal; Terzi, Murat; Turan, Omer Faruk; Saip, Sabahattin; Karabudak, Rana; Siva, Aksel
Introduction: The management of multiple sclerosis (MS) has become more complicated after the introduction of new diagnostic and treatment options. Despite the abundance of guidelines, the experience of physicians still plays a major role in the management of patients. This study aimed to define differences in behavior patterns between general neurologists (GNs) and MS specialists (MSSs). Methods: We conducted a survey of 36 questions to 318 neurologists, including 33 MSSs. The survey covered topics including laboratory investigations, pregnancy, and treatment. Results: Our study found many differences between GNs and MSSs in terms of management, the most important being treatment initiation and switching. GNs had a tendency to initiate treatment later than MSSs however, they tended to switch treatment faster. Our study also showed that GNs ordered magnetic resonance imaging (MRI) more frequently than MSSs, even if patients were clinically stable. Moreover, although GNs more frequently relied on MRI, they did not consider brain atrophy as an important measure in the follow-up of their patients. Furthermore, GNs considered replacement therapy less often than MSSs, even in patients with vitamin D deficiency. Discussion: Our study revealed important discrepancies between the management patterns of GNs and MSSs in MS patients. These findings suggest the need for a national education program for GNs on MSSs.
Investigating the role of common and rare variants in multiplex multiple sclerosis families reveals an increased burden of common risk variation
(NATURE PORTFOLIO, 2022-01-01) Everest, Elif; Ahangari, Mohammad; Uygunoglu, Ugur; Tutuncu, Melih; Bulbul, Alper; Saip, Sabahattin; Duman, Taskin; Sezerman, Ugur; Reich, Daniel S.; Riley, Brien P.; Siva, Aksel; Turanli, Eda Tahir
Many multiple sclerosis (MS)-associated common risk variants as well as candidate low-frequency and rare variants have been identified
Investigation of multiple sclerosis-related pathways through the integration of genomic and proteomic data
(PEERJ INC, 2021-01-01) Everest, Elif; Ulgen, Ege; Uygunoglu, Ugur; Tutuncu, Melih; Saip, Sabahattin; Sezerman, Osman Ugur; Siva, Aksel; Turanli, Eda Tahir
Background. Multiple sclerosis (MS) has a complex pathophysiology, variable clinical presentation, and unpredictable prognosis
The Socioeconomic and Psychological Impact of the COVID-19 Pandemic on People with Multiple Sclerosis in Turkey
(TURKISH NEUROPSYCHIATRY ASSOC-TURK NOROPSIKIYATRI DERNEGI, 2022-01-01) Gunduz, Tuncay; Uzunkopru, Cihat; Demir, Serkan; Tutuncu, Melih; Seferoglu, Meral; Gumus, Haluk; Sen, Sedat; Gungor Dogan, Ipek; Tutuncu, Mesude; Solak Calikoglu, Yasemin; Beckmann, Yesim; Sagduyu Kocaman, Ayse; Siva, Aksel
Introduction: Various restrictions due to the coronavirus infection have affected working life globally. People with multiple sclerosis (pwMS) have several difficulties in social life, patient follow-up, and receiving treatments. In this study, we aimed to evaluate the experiences of pwMS during the COVID-19 pandemic. Method: We developed a 50-question survey aiming to determine fears, anxieties, and the problems experienced by patients regarding their diseases and social lives during the COVID-19 pandemic. The questionnaire was released online via the Turkish MS Society website, local MS societies websites, and social media accounts. Only the answers of the patients who filled out the questionnaire completely were evaluated. Results: In total, 6008 patients took the survey, and 3255 of them completed the questionnaire. Among all, 378 patients (11.6\%) were positive for COVID-19. The most common COVID-19-related symptom was fatigue (48.4\%). The routine medical follow-up was interrupted in 61.4\% and the medication was discontinued in 14\% of the patients. Approximately 25\% of the patients reported different symptoms related to relapse activity. The main concern of the patients related to the COVID-19 pandemic was the disruption of the health of the ones they loved. Among all the patients, 4.4\% lost their jobs. Conclusion: Our data showed that the COVID-19 pandemic strongly affected the working lives of pwMS. Also, the pandemic changed the attitudes of patients and neurologists. Therefore, the long-term effects of the COVID-19 pandemic on disease approach, patient follow-up, social conditions, and working life should be monitored.