Browsing by Author "Dokuyucu, Recep"

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Association of Gla-Rich Protein (GRP) With Inflammatory Markers in Critically Ill Patients: A Cross-Sectional Observational Study
(MDPI, 2025) Eygi, Elif; Bayrakci, Sinem; Bayrakci, Onur; Ayhan, Nazire Ates; Atlas, Ahmet; Kilinc, Metin; Dokuyucu, Recep
Objectives: Gla-rich protein (GRP), a vitamin K-dependent protein, has been increasingly recognized for its dual role in modulating inflammation and inhibiting pathological calcification. Despite its emerging importance in chronic conditions, limited evidence exists regarding its behavior during acute critical illness. This study aimed to investigate the association between GRP, systemic inflammatory markers, oxidative stress (via total thiol oxidation-reduction ratio, TORR), and calcium metabolism in critically ill patients. Materials and Methods: This cross-sectional observational study included 93 critically ill patients admitted to the intensive care unit (ICU) and 60 age- and sex-matched non-critically ill volunteers. Serum GRP levels were measured using ELISA. Other biomarkers including TORR, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), immature granulocytes (IGs), and serum calcium were also analyzed. Pearson's correlation, multivariate linear regression, and ROC analysis were performed to assess the relationships among GRP and biochemical markers, as well as their capacity to differentiate ICU patients from controls. Results: GRP, TORR, CRP, PCT, WBC, IGs, and ferritin levels were significantly elevated in ICU patients compared to the control group, whereas serum calcium levels were markedly reduced (all p < 0.05). GRP levels demonstrated moderate positive correlations with WBC (r = 0.47), neutrophils (r = 0.51), TORR (r = 0.42), CRP (r = 0.30), and IGs (r = 0.46), and a strong negative correlation with calcium (r = -0.63). In multivariate regression, TORR, CRP, WBC, IGs, PCT, and calcium levels showed significant correlations with GRP levels in univariate analysis. ROC analysis revealed that CRP had the highest discriminatory power (AUC = 0.88; 95% CI: 0.82-0.94), followed by TORR (AUC = 0.79; 95% CI: 0.71-0.86), GRP (AUC = 0.76; 95% CI: 0.68-0.84), and IGs (AUC = 0.77; 95% CI: 0.69-0.85), for distinguishing ICU patients from non-critically ill individuals. Conclusions: Our findings demonstrated that GRP is significantly associated with systemic inflammation, oxidative stress, and calcium metabolism disturbances in critically ill patients. The combined evaluation of GRP and TORR may enhance the understanding of inflammatory and oxidative mechanisms in acute critical illness. Although this study did not assess patient outcomes, these biomarkers could serve as promising candidates for future prognostic research in ICU settings.
Citation - WoS: 3
Citation - Scopus: 3
Elevated Urotensin-Ii and Tgf-Β Levels in Copd: Biomarkers of Fibrosis and Airway Remodeling in Smokers
(Mdpi, 2024) Kilinc, Metin; Demir, Ibrahim; Aydemir, Semih; Gul, Rauf; Dokuyucu, Recep; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background and Objectives: Small airway fibrosis plays a critical role in the progression of chronic obstructive pulmonary disease (COPD). Previous research has suggested that Urotensin-II (U-II) and transforming growth factor-beta (TGF-beta) may contribute to pathological fibrosis in various organs, including the cardiovascular system, lungs, and liver. However, their specific relationship with airway fibrosis in COPD has not yet been thoroughly investigated. This study aims to evaluate the concentrations of U-II and TGF-beta in individuals with COPD, as well as in healthy smokers and non-smokers, to explore their potential roles in COPD-related fibrosis. Materials and Methods: The study included three distinct groups: a healthy non-smoker control group (n = 98), a healthy smoker group (n = 78), and a COPD group (n = 80). All participants in the COPD group had a smoking history of at least 10 pack-years. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, with only patients classified as GOLD stage 2 or higher being included in the study. Urotensin-II (U-II) and transforming growth factor-beta (TGF-beta) levels were measured using a commercially available ELISA kit. Results: COPD patients had a significantly lower FEV1 (58 +/- 15.4%) compared to smokers (79 +/- 4.5%) and non-smokers (92 +/- 3.7%) (p < 0.001). Similarly, COPD patients had a lower FEV1/FVC ratio (55 +/- 9.4%) compared to smokers (72 +/- 4.2%) and non-smokers (85 +/- 3.6%) (p < 0.01 and p < 0.05, respectively). SaO(2) was significantly lower in COPD patients (87%) compared to smokers (96.5%) and non-smokers (98%) (COPD vs. smokers: p < 0.05 and smokers vs. non-smokers: p > 0.05). U-II levels were significantly higher in COPD patients (175.10 +/- 62.40 pg/mL) compared to smokers (118.50 +/- 45.51 pg/mL) and non-smokers (85.29 +/- 35.87 pg/mL) (p < 0.001 and p < 0.05, respectively). COPD patients also had significantly higher levels of TGF-beta (284.60 +/- 60.50 pg/mL) compared to smokers (160.00 +/- 41.80 pg/mL) and non-smokers (92.00 +/- 25.00 pg/mL) (p < 0.001 and p < 0.05, respectively). Conclusions: Our study supports the growing body of evidence that U-II and TGF-beta play central roles in the development and progression of fibrosis in COPD. The negative correlation between these markers and lung function parameters such as FEV1 and FEV1/FVC indicates that they may be key drivers of airway remodeling and obstruction. These biomarkers could serve as early indicators of fibrotic changes in smokers, even before the onset of COPD.