In recent years, biological agents have emerged as the most popular drugs for the treatment of rheumatoid arthritis (RA). The most frightening side effects of biological agents are infections, with tuberculosis being the leader. On account of the fact that biological agents have been used widespread, a number of algorithms have been developed to search latent tuberculosis. Among these algorithms, the most popular is the purified protein derivatives (PPD) test which is based upon late sensitivity reaction. The objective of this trial is to investigate the relevance of PPD response for the disease in RA patients. A total of 149 subjects (80 patients, 69 healthy), 35 RA patients who have not been treated before, 23 RA and 22 AS patients who are candidates for biological agents and being treated with immunosuppressive drugs, and 69 healthy subjects, have been included in this trial. Swelling joints, number of tender joints, visual analog scale, erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor were recorded. PPD was performed using the Mantoux method and was measured 72 h later. Statistically significant lower PPD values were determined in untreated RA patients compared to PPD values of treated RA and AS patients and healthy subjects. No correlation was determined between disease activity score 28 activity and PPD values in untreated and treated groups. Similarly, there was no correlation between acute phase reactants and PPD. Lower PPD responses in patients not being treated with immunosuppressive are due to the disease itself, rather than to the drugs being used. It is also important to interpret PPD results in early RA patients with suspicion, when it is intended to start anti tumor necrosis factor therapy.

The interleukin (IL)-4 receptor alpha chain gene (IL4RA) is a polymorphic gene which is reportedly involved in the development of atopy. Of the 14 single-nucleotide polymorphisms (SNP) reported to date in the coding region of IL4RA, 11 are positioned to exon 11. This big exon encodes more than two thirds of the mature protein, including most of the cytoplasmic region. Here we report the identification of a new IL4RA SNP at the first nucleotide of codon 554 (GTA --> ATA) in exon 11, leading to an amino acid substitution from Val to Ile (V554I). Furthermore, we present complete nucleotide sequence data for eight common alleles resulting from combinations of 9 out of the 12 SNP at IL4RA exon 11. Homo- or heterozygous combinations of these eight alleles accounted for all the IL4RA exon 11 genotypes found in Caucasian individuals from our geographical area.

Aim: Nowadays PPD is the most inexpensive and easy to apply modality of test in identification of latent tuberculosis infection. Isoniazid (INH) prophylaxis must be given before usage of anti-TNF-α agents for patients. We aimed to investigate the change in Tuberculin skin test (TST) levels and Isoniazid (INH) prophylaxis rates in patients with inflammatory rheumatic diseases treated with anti-tumor necrosis factor alpha (TNF-α) agents. Methods: A cross-sectional study was planned. Patients with inflammatory rheumatic diseases treated with anti-TNF agents were included in the study. Demographic data, initial TST level and INH prophylaxis had obtained from patient's files. Control TST tests had done at tuberculosis dispensaries in different time periods such as 1-2 / 2-3 / 3-4 / ≥4 years of anti TNF treatment. INH prophylaxis rates according to initial and control TST tests were compared. The relationship between INH prophylaxis and duration of anti-TNF therapy were examined. Results: A total of 117 patients were included in the study. The mean age of the patients (81 male, 36 female) was 40.4±12.90. The control TST levels was significantly higher than initial TST (p=0.001). INH prophylaxis was given to total 99 (84.6%) of 117 patients (to 63 (53.8%) according to initial and to 36 (30.8%) according to control TST tests). There was no relationship between duration of anti TNF therapy and INH prophylaxis initiation (p=0.180). Conclusion: Anti-TNF treatments may reduce the rates of false-negative TST in patients with rheumatic diseases and latent tuberculosis (LTBI) at any stage of the treatment. Therefore, LTBI, which is not determined with initial TST tests, may be determined with TST test applied in the later stages of anti-TNF treatment, and the risk of active tuberculosis can be reduced by INH prophylaxis in this patients.

The aim of the study was to examine whether SLC22A12 gene mutations might be influenced in primary gout disease. We included 32 patients with diagnosis of primary gout disease and 100 healthy volunteers. DNA was purified from peripheral blood, and all exons of the SLC22A12 gene were sequenced. We did not find any mutations in the SLC22A12 gene in all of the patients, but found 5 polymorphisms in exons 1 (g.T258C, g.C246T), 2 (g.C1246T) and 8 (g.T8011C) and in intron 9 (g.C8577T). However, we have not found any significant differences in the frequency of the individual genotypes between patients with primary gout disease and control group. In addition, the polymorphisms were not associated with hyperuricemia in our patients with primary gout disease. There was no previously reported mutation/polymorphisms of SLC22A12 gene in Turkish population. Our study is the first one in Turkish population and suggests that there is no association between primary gout disease and SLC22A12 gene polymorphisms. Sequence changes in the promotor and intronic regions of SLC22A12 gene should be investigated further with larger case groups.

Since 1977, various reports have been published concerned with locomotor system involvement in thalassaemia minor. In this blind study, a further 80 cases with thalassaemia minor were evaluated and compared with 63 healthy controls. In 52% of thalassaemia minor cases and 54% of controls, varying musculoskeletal involvement was found by means of history, clinical examination and radiological investigation. Three patients had a history of short-lived arthritis. It was concluded that arthralgia was the most frequent finding, and hands (wrist) and shoulders were mostly involved.