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    Cystic Echinococcosis in Northern Cyprus: A Literature Review
    (Aves, 2018) Ruh, Emrah; Ozkan, Aysegul Taylan
    Cystic echinococcosis is a zoonotic disease caused by the larval stages of Echinococcus granulosus sensu lato (s.l.). The life cycle of the parasite consists of dogs and other canids as the definitive hosts and ungulates, such as sheep and goats, as the intermediate hosts. Humans are accidental intermediate hosts in the life cycle of the parasite. The island of Cyprus is located in the eastern part of the Mediterranean region where echinococcosis is endemic. The disease was common in the island until the 1970s. In Southern Cyprus, two control programs for echinococcosis were implemented; the first one was initiated in 1971 and continued until 1985, and the second one was introduced in 1993 and implemented for 5 years. The control programs resulted in a decrease of the prevalence in both dogs and livestock. In Northern Cyprus, a control program was implemented between 1997 and 2005 that also resulted in a decrease of the disease rates in definitive and intermediate hosts. However, termination of the program led to an increase in the prevalence. Recent data suggest that sporadic cases of echinococcosis still exist; therefore, control programs should be continued in order to prevent the disease in Northern Cyprus.
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    Evaluation of the Radiological, Biochemical and Serological Parameters of Patients Prediagnosed as Cystic Echinococcosis in Corum, Turkey
    (Ankara Microbiology Soc, 2015) Gureser, A. Semra; Ozcan, Oguzhan; Ozunel, Leyla; Boyacloglu, Zehra Ilkay; Ozkan, Aysegul Taylan
    Cystic echinococcosis (CE) is a zoonosis caused by Echinococcus granulosus. It is difficult to diagnose CE by clinical symptoms alone, therefore, radiological and serological examinations should be conducted as well. The aims of this retrospective study were to evaluate the biochemical, hemogram, serological and radiological findings of patients prediagnosed as CE, and to survey epidemiological data to detect the status of the disease in our region. A total of 253 patients (148 female, 105 male) who were admitted to Hitit University Training and Research Hospital in Corum province (located in the central Black Sea Region of Turkey), between October 2009 to July 2013, were included in the study. Serum samples collected from the patients were analyzed by indirect hemagglutination (IHA) test, in the Microbiology Reference Laboratories of the Turkish Public Health Institute, and 1/160 and higher titers were considered positive. Twenty-three (15.5%) of female patients and nine (8.6%) of male patients, with a total of 32 (12.7%) were found to be seropositive. The difference between the gender was not statistically significant (X-2= 2.72). The age range of the 32 seropositive patients was between 16-90 years (mean: 51), and of them 24 (75%) being over 40 years old was found as statistically significant (X-2= 22.45). All of the seropositive patients presented radiological findings diagnosed with ultrasonography and computed tomography. Additionally, it was noticed that two patients (one male, one female) who were seronegative by IHA test, have passed a CE operation and the diagnosis was confirmed with pathological findings. Of the patients 43.8% were admitted to general surgery, followed by infectious diseases (21.9%), gastroenterology (21.9%) and other (12.5%) clinics. Radiological diagnosis showed that 31(96.9%) of seropositive patients had CE in the liver, of them two (6.3%) also had lung involvement, while one patient (3.1%) had intraperitoneal involvement alone, without liver infection. Although 50% (16/32) of patients resided in Corum urban area, most of them were dealing with agriculture and animal breeding. Among the biochemical parameters, GGT were detected with highest level (28%), followed by ALT (16%), AST (16%) and ALP (13%), while the other parameters were normal. Elevated RDW level was the most frequently observed result (29%) among hemogram parameters, while decreased levels of hematocrit, hemoglobin and MCV were detected in 23%, 19% and 19% of the patients, respectively. Eosinophilia was detected in 19% of the patients. In conclusion, for the diagnosis of CE, which is still an important public health problem in our region, a comprehensive evaluation of clinical, radiological, serological and biochemical findings is needed, to avoid a confusion of other diseases with similar clinical symptoms.
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    Immune Response and its Effects on the Host during Helminthic Infections
    (Aves, 2020) Gazi, Umut; Ozkan, Aysegul Taylan
    Helminths are multicellular organisms causing chronic infections affecting nearly one-third of the global population. They are experts at immunomodulation, and pathologic outcomes are generally observed in patients with immunodeficiencies or with exaggerated levels of anti-helminth immune responses. Elimination of helminths is usually mediated by T-helper type-2 (Th2) immune responses, characterized by the induction of Immunoglobulin E (IgE) release, increase in eosinophil and mast cell levels, and elevation in the production levels of Th2 cytokines. However, the triggered mechanisms may also depend on the location of the parasite. This is because tissue invasion, an immune evasion strategy for parasites, was considered to activate more Thelper type 1 (Th1) cells in tissues. During chronic infections, immune response regulatory pathways become more influential, thereby reducing the levels of the peripheral T-cell-mediated responses against parasitic antigens. The resultant immune response is termed as modified Th2 response and is characterized by enhanced levels of anti-inflammatory cytokine production and regulatory immune cells as well as high IgG4/IgE ratios. Immunomodulation during chronic helminth infection is not limited to only parasite-specific responses. It can influence the efficiency of vaccination, host susceptibility to infections, and allergen or autoantigen responses. This review discusses anti-helminth immune responses. Moreover, it highlights current literature on the effects of chronic helminth infections on host health as well as their possible use as a treatment strategy against autoimmune, autoinflarnmatory, and allergic diseases.