Researcher:
Ünlü, Serhan

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Undergraduate Student

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Serhan

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Ünlü

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Ünlü, Serhan

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    Publication
    Prolonged complete response of early stage primary adenocarcinoma of the lung to nivolumab monotherapy
    (SciTechnol, 2021) Grant, Michael J; Gettinger, Scott; Adeniran, Adebowale; Kluger, Harriet M; N/A; Ünlü, Serhan; Undergraduate Student; School of Medicine; N/A
    Immune checkpoint inhibitors are currently employed for the treatment of various malignancies, including advanced melanoma and non-small cell lung cancer. As more patients are treated with checkpoint inhibitors, situations will arise in which early-stage disease may be subjected, intentionally or unintentionally, to these agents. This is especially relevant for patients presenting with multiple primary malignant tumors (MPMTs). Here we report the case of a patient presenting synchronously with metastatic melanoma to multiple regional lymph nodes and stage I lung adenocarcinoma with high Programmed-Death Ligand 1 (PD-L1) expression. Given the high-risk nature of his melanoma, he was treated with nivolumab monotherapy, and had a durable response of both malignancies to a PD-1 inhibitor. He remains disease-free, off therapy sixteen months after completing a 19-month course of treatment. This highlights the complexity of treating patients with MPMTs in the era of effective immunotherapy and raises the possibility of treating primary lung cancer with systemic immunotherapy in situations in which surgery is not feasible due to comorbidities or other circumstances.
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    PublicationOpen Access
    The role of microbiota in the development and progression of chronic kidney disease
    (Logos Tıp Yayıncılığı, 2019) N/A; Kanbay, Mehmet; Dağel, Tuncay; Ünlü, Serhan; Şahan, Dilek Özgenaz; Faculty Member; Doctor; School of Medicine; 110580; N/A; N/A; N/A
    Researchers related to micobiota have claimed that intestinal microbiome exerts an effect on development of disease in many organ systems. Fat tissue, kidneys, heart and vasculature, intestines and even brain tissue are affected by dysbiosis of gut flora. With the increasing number, and quality of the studies, the topics investigated have demonstrated variations from being focused solely on microbiome itself to metabolites of this flora penetrating into serum and immune response of the body to these metabolites. Metabolites released by intestinal flora trigger chronic inflammation in the body and lead to the development of metabolic syndrome, chronic renal disease or cardiovascular diseases. With such a vast gamut of diseases and pathologic conditions related to intestinal microbiome, it should come as no surprise that there have been attempts at treatment of dysbiosis with methods including flora transfer from healthy individuals. This review will focus on these disease states and how they are affected by dysbiosis of flora. The roles played by specific metabolites that increase during intestinal dysbiosis such as indoxyl sulfate, p-cresyl sulfate or trimethylamine N-oxide in chronic kidney disease and atherosclerosis will be discussed. Besides, increase in the permeability of intestinal barriers due to the evolvement of uremia as a result of chronic renal disease, ensuing development of dysbiosis, and the effects of these diseases on dysbiosis will be also dealt with. / Mikrobiyota hakkındaki araştırmalar bir çok sistemdeki hastalık gelişiminde bağırsak mikrobiyomunun etkisi olduğunu iddia ediyor. Bunlardan birkaçı; yağ doku, kalp, dolaşım sistemi, sindirim sistemi ve hatta santral sinir sistemidir. Bu konudaki araştırmaların sayısının ve kalitesinin artmasıyla birlikte üzerinde araştırılan konular; bağırsak mikrobiyomunun saf oluşumundan, bu floranın kana geçiş yapan metabolitleri ve vucüdun buna verdiği tepkiye kadar çeşitlilik göstermeye başladı. Bağırsak florasının salgıladığı metabolitler, vücutta kronik enflamasyonu tetikleyerek metabolik sendrom, kronik böbrek hastalığı ya da kardiyovasküler hastalıklar gibi hastalıklara yol açabilmektedir. Bunlar gibi geniş kapsamlı ve multi-sistemik hastalıkların bağırsak mikrobiyomuyla bağlantıları kurulması üzerine, bağırsak mikrobiyomunun bozulmasının flora aktarımı gibi yöntemlerle tedavi edilmeye çalışılması şaşırtıcı olmayan bir gelişme olmuştur. Bu yazı bazı hastalıkların flora disbiyozundan nasıl etkilendikleri üzerine yoğunlaşacaktır. Indoxil sülfat, p-krezil sülfat ya da trimetilamin N-oksit gibi bağırsak disbiyozu sırasında artan metabolitlerin kronik böbrek hastalığı ve ateroskleroz gibi hastalıklarda ne gibi roller oynadığı tartışılacaktır. Bağırsak bariyerlerinin permeabilitesinin kronik böbrek hastalığı sonucunda gelişen üremi sebebiyle artması ve bunun sonucunda gelişen disbiyoz gibi bu hastalıkların da disbiyoz üzerindeki etkilerine de değinilecektir.