Turkish Journal of Medical Sciences最新文献

{"title":"Serum phosphoproteome alterations associated with cardiac troponin I levels in acute myocardial infarction.","authors":"Merve Öztuğ, Meltem Aşicioğlu, Konca Altinkaynak, Evren Kilinç","doi":"10.55730/1300-0144.6194","DOIUrl":"https://doi.org/10.55730/1300-0144.6194","url":null,"abstract":"<p><strong>Background/aim: </strong>Acute myocardial infarction (AMI) triggers systemic biochemical responses, including dynamic changes in the phosphorylation status of circulating proteins. However, the phosphoproteomic profile of serum in the context of AMI remains insufficiently characterized. This study aimed to investigate serum phosphoproteomic alterations associated with AMI and to explore potential correlations with markers of cardiac injury.</p><p><strong>Materials and methods: </strong>A comparative phosphoproteomic analysis was performed on serum samples obtained from eight patients with AMI and pooled healthy control samples. High-abundance serum proteins were depleted, and phosphopeptides were enriched using TiO₂ phosphopeptide enrichment kit. Samples were analyzed by liquid chromatography-tandem mass spectrometry using a Q Exactive HF-X Orbitrap mass spectrometer. Data were searched against the Homo sapiens database using Sequest HT with a 1% false discovery rate and were quantified by label-free quantification using Proteome Discoverer version 2.4.</p><p><strong>Results: </strong>A total of 46 phosphoproteins were confidently identified, revealing distinct phosphorylation profiles between AMI and control samples. Increased phosphorylation levels were observed for solute carrier family 12 member 5, apolipoprotein L1, the low-molecular-weight isoform of kininogen-1, and osteopontin in AMI serum. Conversely, phosphorylated inter-alpha-trypsin inhibitor heavy chain H2, antithrombin III, histidine-rich glycoprotein, peroxiredoxin-4, GTPase ERas, and the 26S proteasome non-ATPase regulatory subunit 1 were reduced or undetectable. A strong negative correlation was found between apolipoprotein L1 phosphorylation and cardiac troponin I concentrations (r = -0.91; p = 0.0016).</p><p><strong>Conclusion: </strong>These findings demonstrate that serum phosphoproteomics can provide valuable insights into the molecular events associated with AMI. The inverse relationship between apolipoprotein L1 phosphorylation and cardiac troponin I levels suggests that phosphoproteomic profiling may aid in understanding myocardial injury mechanisms.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"613-623"},"PeriodicalIF":1.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between frailty status and pain, balance, and quality of life in patients with lumbar spinal stenosis.","authors":"Musa Güneş, Aydın Sinan Apaydin","doi":"10.55730/1300-0144.6158","DOIUrl":"https://doi.org/10.55730/1300-0144.6158","url":null,"abstract":"<p><strong>Background/aim: </strong>Frailty is a clinical syndrome that affects individuals physically and psychosocially. However, the association between lumbar spinal stenosis (LSS) and frailty remains unclear. This study aimed to compare pain, balance, disability, fear of falling, and quality of life between patients with LSS with and without frailty.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 43 frail and 48 nonfrail patients with LSS according to the frailty criteria of Fried et al. Pain intensity (numeric rating scale [NRS]), static balance (single leg stance test [SLST]), dynamic balance (Timed Up and Go test [TUG]), disability (Oswestry Disability Index [ODI]), fear of falling (Falls Efficacy Scale-International [FES-I]), and quality of life (Short form-36 [SF-36]) were assessed.</p><p><strong>Results: </strong>Frailty was observed in 47.3% of patients, and baseline characteristics were similar between the groups (p > 0.05). NRS scores for low back and leg pain, ODI and FES-I scores, and TUG test durations were significantly higher in frail patients with LSS than in nonfrail patients (p < 0.05). SLST durations and SF-36 subscale scores were significantly lower in frail patients with LSS (p < 0.05). TUG duration (p = 0.001, OR = 1.482), physical activity level (p = 0.007, OR = 0.999), and the SF-36 vitality subscale (p = 0.031, OR = 0.968) were significantly associated with frailty in the logistic regression model (p < 0.001).</p><p><strong>Conclusion: </strong>Frail patients with LSS experience greater pain intensity, balance disorders, disability, fear of falling, and poorer quality of life. Moreover, reduced mobility, lower physical activity levels, and decreased vitality are associated with a higher likelihood of frailty in patients with LSS. Therefore, early assessment of frailty in patients with LSS and the implementation of personalized rehabilitation approaches may help mitigate its negative impact.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"246-255"},"PeriodicalIF":1.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of sexual health literacy and cyberchondria levels in women with vaginismus.","authors":"Gonca Türker Ergün, Cemal Ünlü, Ayşe Kuyulu Akman, Elçin Işlek Seçen, Raziye Toksöz","doi":"10.55730/1300-0144.6156","DOIUrl":"https://doi.org/10.55730/1300-0144.6156","url":null,"abstract":"<p><strong>Background/aim: </strong>This study aimed to compare sexual health literacy and cyberchondria levels between women who had been diagnosed with vaginismus and those who had not.</p><p><strong>Materials and methods: </strong>The research was conducted as a prospective cohort study including 60 women over the age of 18 who were married and unable to engage in sexual intercourse due to primary vaginismus and 60 sexually active married women without vaginismus. Data collection tools included a patient information form, the Cyberchondria Severity Scale (CSS-12-TR), and the Sexual Health Literacy Scale (SHLS).</p><p><strong>Results: </strong>The median age of the women diagnosed with vaginismus was 27 (21-54) years, while the median age of the women without a vaginismus diagnosis was 30 (20-57) years. The majority of women diagnosed with vaginismus were not employed and had married for love. No significant difference was found between the groups in terms of the total SHLS score. Women with vaginismus showed lower levels of cyberchondria. Most participants were university graduates and sexual health literacy levels were found to be high.</p><p><strong>Conclusion: </strong>Cyberchondria levels in women diagnosed with vaginismus may be low because confronting their condition is challenging. However, it can be inferred that women with vaginismus who seek help from healthcare institutions have high levels of problem-solving skills.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"229-236"},"PeriodicalIF":1.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-assisted neuropharmacology: reshaping drug discovery and translational strategies for neurological diseases.","authors":"Priyanka Rathee, Sunidhi Lohan, Sarita Khatkar, Neelam Malik, Esra Küpeli Akkol, Renu Sehrawat, Pooja Rathee, Anurag Khatkar","doi":"10.55730/1300-0144.6176","DOIUrl":"https://doi.org/10.55730/1300-0144.6176","url":null,"abstract":"<p><p>The rapid expansion of data-driven technologies, particularly machine learning (ML) and artificial intelligence (AI), has substantially influenced biomedical research and drug discovery. In neuropharmacology, the availability of large-scale genomic, proteomic, chemical, and clinical datasets has stimulated the adoption of AI-based approaches to address persistent challenges in neurological drug development, including high attrition rates and the scarcity of disease-modifying therapies. Unlike prior reviews that broadly discuss AI applications in drug discovery or neurology, this narrative review focuses specifically on neuropharmacology, with an emphasis on translational relevance, disease-oriented examples, and real-world constraints. We critically examine the application of AI and ML across key stages of the neuropharmacological drug discovery pipeline, including target identification, drug-target interaction prediction, lead optimization, toxicity assessment, and early-stage clinical translation. Particular attention is given to concrete case studies in neurodegenerative and neurological disorders, illustrating where AI has meaningfully enhanced discovery efficiency and where its anticipated \"revolutionary\" impact has not yet been realized. In parallel, we analyze the biological, technical, and regulatory barriers that limit the clinical success of AI-driven strategies, including data bias, limited model interpretability, incomplete understanding of brain biology, and translational bottlenecks. By integrating case-based evidence with a critical analytical perspective, this review delineates both the opportunities and limitations of AI in neuropharmacology. We argue that AI is most effective when deployed as a complementary tool alongside mechanistic neuroscience and clinical expertise, rather than as a standalone solution. As AI methodologies continue to mature, their careful, transparent, and ethically governed integration into neuropharmacological research may advance precision medicine and help bridge persistent gaps in the treatment of neurological disorders.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 2","pages":"405-425"},"PeriodicalIF":1.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and outcomes of childhood interstitial lung disease: a tertiary center experience.","authors":"Ayyüce Ünlü, Şule Selin Akyan Soydaş, Satı Özkan Tabakçi, Işıl Bilgiç, Meltem Kürtül Çakar, Gamze Akca Dinç, Hande Yetişgin, Çelebi Yildirim, Gökçen Dilşa Tuğcu, Dilber Ademhan Tural, Sanem Eryilmaz Polat, Güzin Cinel","doi":"10.55730/1300-0144.6153","DOIUrl":"https://doi.org/10.55730/1300-0144.6153","url":null,"abstract":"<p><strong>Background/aim: </strong>Childhood interstitial lung diseases (chILD) constitute a rare and clinically complex group of disorders. This study aimed to characterize the clinical, radiological, and genetic features, as well as the outcomes, of chILD in a Turkish cohort classified according to the chILD-EU framework.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the medical records of 84 pediatric patients diagnosed with chILD between 2017 and 2024 at a tertiary referral center in Türkiye. Patients were categorized according to the chILD-EU classification. Clinical variables, imaging findings, genetic analyses, pulmonary function test results, and Fan severity scores were systematically assessed. Logistic regression analysis was performed to identify independent predictors of clinical instability.</p><p><strong>Results: </strong>The median age at diagnosis was 6.0 years (IQR: 1.1-12.9). Surfactant dysfunction disorders (A4) and immune- or environmental-related diseases (B2) were the most frequently identified subtypes. Hypoxia was observed in 36 of 84 patients (42.8%) and emerged as the strongest independent predictor of clinical instability (OR: 8.5; 95% CI: 2.2-33.0; p = 0.002). Pathogenic or likely pathogenic variants were identified in 18 of 84 patients (21.4%); among variant-positive cases, <i>ABCA3</i> was the most frequently affected gene (3 of 18; 16.7%). Chest computed tomography was available in 82 of 84 patients, with ground-glass opacities being the most common finding, observed in 51 of 82 patients (62.2%). A decrease of at least one point in the Fan severity score was observed in 42 of 84 patients (p < 0.001). Mortality was 12 of 84 patients (14.3%) after a median follow-up of 3.2 years (range: 1.2-4).</p><p><strong>Conclusion: </strong>This study presents one of the largest single-center pediatric chILD cohorts reported from Türkiye. It highlights the prognostic relevance of baseline hypoxia and underscores the importance of comprehensive radiological and genetic assessment in the management of chILD.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"195-207"},"PeriodicalIF":1.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of adenosine A_2A receptor agonist and antagonist on ovarian ischemia/reperfusion injury in rats.","authors":"Azad Mammadov, Abdullah Tuncay Demiryürek, Ahmet Saracaloğlu, Cahit Demirkiran, İsmail Tuncer Değim, Ömer Eronat, Şeniz Demiryürek","doi":"10.55730/1300-0144.6170","DOIUrl":"https://doi.org/10.55730/1300-0144.6170","url":null,"abstract":"<p><strong>Background/aim: </strong>To determine the effects of an A_2A receptor agonist regadenoson, an A_2A receptor antagonist istradefylline, and istradefylline nanosuspension on ovarian ischemia/reperfusion (I/R) injury in rats.</p><p><strong>Materials and methods: </strong>A total of 80 female rats were divided into 10 groups: sham, ovarian I/R, blank nanosuspension + ovarian I/R, regadenoson (3 μg/kg) + ovarian I/R, regadenoson (30 μg/kg) + ovarian I/R, istradefylline (0.3 mg/kg) + ovarian I/R, istradefylline (3 mg/kg) + ovarian I/R, istradefylline-loaded nanosuspension (3 mg/kg) + ovarian I/R, istradefylline (3 mg/kg) + regadenoson (30 μg/kg) + ovarian I/R, and istradefylline-loaded nanosuspension (3 mg/kg) + regadenoson (30 μg/kg) + ovarian I/R. ELISA, chemiluminescence, and spectrophotometric analyses were performed on blood and ovarian tissue samples. Histopathological changes were analyzed using hematoxylin and eosin staining, and a scoring system was applied to assess ovarian tissue damage.</p><p><strong>Results: </strong>Serum malondialdehyde levels were augmented in the I/R and blank nanosuspension + I/R groups. Although tissue superoxide dismutase levels were decreased with I/R, these levels were increased with regadenoson (3 μg/kg), istradefylline (0.3-3 mg/kg), and istradefylline nanosuspension (3 mg/kg). While there was augmentation in the serum and tissue 3-nitrotyrosine levels in the I/R group, a marked decrease was identified with regadenoson (30 μg/kg, p < 0.05). Native thiol levels were decreased in the I/R group, and this decrease was prevented by regadenoson. Serum disulfide levels were increased in the I/R group, and this increase was suppressed by regadenoson.</p><p><strong>Conclusion: </strong>These data showed that adenosine A_2A receptors may contribute to the ovarian I/R injury and regadenoson can produce protective effects.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"364-376"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing spinal muscular atrophy through the national premarital screening program in Türkiye: an economic comparison with treatment costs.","authors":"Gamze Dur, Gülcan Tecirli, Nurullah Okumuş","doi":"10.55730/1300-0144.6169","DOIUrl":"https://doi.org/10.55730/1300-0144.6169","url":null,"abstract":"<p><strong>Background/aim: </strong>Spinal muscular atrophy (SMA) is a severe neuromuscular disorder with high treatment costs and significant psychosocial burden. In 2021, Türkiye launched a national premarital SMA carrier screening program integrated with in vitro fertilization (IVF) with preimplantation genetic testing (PGT) services for couples identified as carriers. This study aimed to compare the costs associated with the carrier screening and prevention program versus a no-screening (treatment-only) scenario.</p><p><strong>Materials and methods: </strong>A cost comparison model was developed using data from the Turkish Statistical Institute, the Ministry of Health, and the Social Security Institution. The annual costs of SMA treatment (with nusinersen and risdiplam) and the costs associated with carrier screening, genetic counseling, and IVF with PGT were compared. Projections estimated 115 new SMA cases annually based on national birth rates and carrier frequencies.</p><p><strong>Results: </strong>The total annual cost of the premarital carrier screening and prevention program was estimated at TRY 112,801,201.6 (EUR 2,418,550.6). In contrast, the treatment of 115 new cases of SMA with nusinersen would cost TRY 1,091,623,700 in the first year alone, reaching a cumulative cost of TRY 2,183,247,377 over three years. The three-year cumulative cost for risdiplam treatment was calculated as TRY 1,196,414,795. The cost of preventing the birth of one SMA-affected child through the screening program was estimated as TRY 854,554.6, whereas treatment costs per child reached as high as TRY 18,984,759.6 with nusinersen.</p><p><strong>Conclusion: </strong>The SMA premarital carrier screening and prevention program in Türkiye significantly reduces healthcare expenditures and disease burden. Primary prevention through carrier screening is associated with lower overall costs than long-term treatment, offering both economic and social advantages for public health policy.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"351-363"},"PeriodicalIF":1.0,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroendocrine effects of exogenous adropin administration on the hypothalamic pituitary testicular axis in male rats.","authors":"Ersen Eraslan, Ayhan Tanyeli, Mustafa Can Güler, Aslı Özbek Bilgin, Fazile Nur Ekinci Akdemir, Elif Polat, Selim Çomakli, Nezahat Kurt, Tuğba Bal Taştan","doi":"10.55730/1300-0144.6164","DOIUrl":"https://doi.org/10.55730/1300-0144.6164","url":null,"abstract":"<p><strong>Background/aim: </strong>Obesity impairs male fertility through metabolic dysfunction, oxidative stress, and disruption of the hypothalamic-pituitary-testicular (HPT) axis. Adropin (ADR), a peptide hormone whose circulating levels are reduced in obesity, plays emerging roles in metabolic homeostasis; however, its involvement in reproductive endocrine regulation remains unclear. The present study was conducted in healthy, nonobese male rats and aimed to investigate the neuroendocrine and testicular effects of exogenous ADR administration, focusing on circulating reproductive hormones, hypothalamic regulatory peptides, and testicular antioxidant pathways.</p><p><strong>Materials and methods: </strong>Thirty-two male Wistar rats were randomized into control, sham, low-dose ADR (4 μg/kg/day), and high-dose ADR (40 μg/kg/day) groups and treated for 10 days. An enzyme-linked immunosorbent assay (ELISA) was used to measure circulating gonadotropins, testosterone, inhibin B, and activin A. Hypothalamic gonadotropin-releasing hormone (GnRH) and kisspeptin expression, and testicular superoxide dismutase 1 (SOD1) localization were assessed by immunohistochemistry. Brain and testis morphology were examined histologically.</p><p><strong>Results: </strong>High-dose ADR administration was associated with increased hypothalamic GnRH and kisspeptin expression, accompanied by reduced circulating LH levels, while FSH concentrations remained unchanged. Testosterone and inhibin B levels were higher, whereas activin A levels were lower, in the high-dose ADR group compared with controls. ADR administration was also associated with enhanced testicular SOD1 immunoreactivity and dose-dependent reductions in body weight. No overt histopathological alterations were observed in the cerebral cortex or testicular tissue.</p><p><strong>Conclusion: </strong>In healthy, nonobese male rats, exogenous ADR administration was associated with changes in central neuroendocrine markers and testicular antioxidant responses without overt histopathological alterations. These findings do not demonstrate improvements in fertility but suggest that ADR may be involved in pathways linking metabolic signals with reproductive endocrine regulation. The potential relevance of these observations to obesity-associated male reproductive dysfunction remains hypothesis-generating and requires confirmation in appropriate disease models and functional reproductive studies.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"302-314"},"PeriodicalIF":1.0,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocrine-disrupting chemicals in metabolic bone diseases, including osteoporosis.","authors":"Betül Gündüz, Elif Kiliç Kan, Ayşegül Atmaca","doi":"10.55730/1300-0144.6128","DOIUrl":"10.55730/1300-0144.6128","url":null,"abstract":"<p><p>Endocrine disruptors are chemical substances widely utilized across various industrial sectors. Due to their structural similarity to natural ligands, they bind to receptors and influence the endocrine system via agonist-antagonist mechanisms. Exposure occurs through the consumption of contaminated food and water, inhalation of polluted air and dust, and dermal contact. Owing to their dynamic remodeling capacity, bones represent potential targets for endocrine-disrupting chemicals. These chemicals can disrupt bone formation, skeletal development, hormonal regulation, and calcium metabolism. Sensitivity to endocrine-disrupting chemicals is greatest during the prenatal and early postnatal periods. This review summarizes the effects of endocrine-disrupting chemicals on bone tissue.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 7","pages":"1664-1670"},"PeriodicalIF":1.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fitness cost and biofilm formation in fosfomycin-resistant clinical <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> isolates.","authors":"Mustafa Ökeer, Sabire Şöhret Aydemir, Bayrı Eraç","doi":"10.55730/1300-0144.6165","DOIUrl":"https://doi.org/10.55730/1300-0144.6165","url":null,"abstract":"<p><strong>Background/aim: </strong>Fosfomycin has regained importance owing to its unique mechanism of action and effectiveness against extended-spectrum β-lactamase-producing Gram-negative bacteria. This study aimed to evaluate the biological fitness cost associated with fosfomycin resistance and its impact on biofilm formation in clinical <i>Enterobacteriaceae</i> isolates.</p><p><strong>Materials and methods: </strong>A total of 78 <i>Escherichia coli</i> and 34 <i>Klebsiella pneumoniae</i> strains isolated from urine samples at Ege University Hospital were analyzed. Fosfomycin minimum inhibitory concentrations (MICs) were determined using the reference agar dilution method. Resistance was induced by exposing two <i>K. pneumoniae</i> strains with a fosfomycin MIC of 4 μg/mL and two <i>E. coli</i> strains susceptible to fosfomycin (MIC ≤ 8 μg/mL) to gradually increasing concentrations of the antibiotic. Biofilm-forming capacities, growth rates, and expression levels of selected virulence genes (<i>fimH</i> and <i>papC</i> in <i>E. coli</i>; <i>entB</i>, <i>mrkD</i>, <i>uge</i>, <i>wabG</i>, and <i>ycfM</i> in <i>K. pneumoniae</i>) were compared between variants with low and high fosfomycin MICs.</p><p><strong>Results: </strong>Of the 78 <i>E. coli</i> isolates, 13 (16.6%) were resistant to fosfomycin. Additionally, eight (23.5%) of 34 <i>K. pneumoniae</i> isolates exhibited high fosfomycin MICs (MIC > 32 μg/mL). No significant differences in biofilm formation were observed between the variants. However, the expression of the <i>fimH</i> gene decreased in one <i>E. coli</i> resistant variant compared with its susceptible counterpart. While the expression of the <i>uge</i> gene decreased in one <i>K. pneumoniae</i> isolate with a high MIC, the expression of the <i>wabG</i> gene increased. Slower growth rates were observed in two fosfomycin-resistant <i>E. coli</i> strains and one <i>K. pneumoniae</i> strain with a high fosfomycin MIC than in their counterparts.</p><p><strong>Conclusion: </strong>These findings suggest that, in the examined isolates, decreased susceptibility to fosfomycin was associated with slower growth, whereas biofilm formation ability remained largely unaffected. Continued surveillance of fosfomycin resistance is essential owing to its potential implications for bacterial fitness and pathogenicity.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"56 1","pages":"315-325"},"PeriodicalIF":1.0,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}