Mustafa Sevim

Type 2 (T2) immunity is classically associated with defense against helminths and environmental threats, from a physiological perspective, and with allergies and eosinophilic inflammatory diseases, in a pathological sense. However, growing evidence reveals that T2 pathways also support other essential homeostatic functions, including tissue protection and repair. There are major clues from the early evolution of T2 responses for protection against massive tissue damage and positive selection for survival against parasites starting over 500 million years ago. These responses likely co‐evolved stepwise with immune‐regulatory circuits, culminating in the emergence of the fully functional human‐type IgG4 in the great apes (Hominidae) within the last ~10 million years. The involvement of body barriers along with the strong influence of local epithelial cells and their interaction with the microbiome and the immune system is a common characteristic of T2 inflammation. An expanding list of new T2 diseases is being reported, characterized by epithelial cell and immune system activation, epithelial barrier damage, and microbial dysbiosis, including opportunistic pathogen colonization and loss of commensals. This evolving understanding coincides with the clinical success of biologics targeting key T2 mediators such as IL‐4, IL‐5, IL‐13, IL‐31, TSLP, and IgE, which have transformed the management of severe allergic diseases and other T2‐driven pathologies. However, the contribution of T2 immunity to homeostatic programs raises questions about the long‐term consequences of sustained T2 suppression. In this review, we examine the dual role of T2 immunity in health and disease, revisit its evolutionary origins, highlight its protective functions beyond allergy, and discuss the potential implications of prolonged T2 pathway blockade.

Background: Preprints—scientific manuscripts shared publicly prior to formal peer review—are gaining momentum across academic disciplines. However, their adoption in clinical and biomedical sciences remains limited, particularly in countries where traditional publishing norms prevail. Editorial ambiguity and a lack of national policy further complicate their use. Objective: This study aimed to assess the awareness, experiences, and attitudes of medical academics at Marmara University School of Medicine toward preprints and to explore the editorial landscape through both journal editor feedback and a review of journal-level preprint policies. Methods: A cross-sectional survey was conducted with 103 medical faculty members. The questionnaire included demographic questions, Likert scale items, and multiple-choice items assessing knowledge, familiarity, and attitudes toward preprints, as well as open-ended items to explore concerns. A “preprint test score” (0‐4) was developed to quantify objective knowledge. Subgroup analyses were conducted by age (<40 vs ≥40 y) and academic discipline (basic vs clinical sciences). Additionally, all responses to open-ended questions from journal editors and 118 biomedical journals were manually reviewed for their stated stance on preprints and article processing charges (APCs). A convergent mixed methods design was used, combining a structured survey, thematic analysis of open-ended responses and editorial feedback, and a document-based review of biomedical journal policies. Results: Only 42.9% (n=34) of participants reported familiarity with the concept of preprints, and 13% (n=10) had previously published on a preprint server. Misconceptions about ethics, peer review, and compatibility with journal policies were common. Subgroup analysis revealed that older participants scored higher on the “preprint test” (mean 2.20, SD 1.31 vs mean 1.97, SD 1.60) and had more experience with preprint publishing (1/40, 2.5% of younger participants; 7/29, 24.1% of older participants). Further, younger academics expressed less openness toward future use (n=7, 17.5% in the younger group; n=8, 27.6% in the older group). Clinical faculty were generally more hesitant than basic science faculty, although both groups raised concerns about the academic recognition of preprints. Editorial responses reflected a mix of cautious endorsement and skepticism. Among the 118 biomedical journals reviewed, most lacked clear preprint policies, while a small number either explicitly prohibited or permitted them. Conclusions: There is limited awareness and cautious engagement with preprints among medical academics and editors in Türkiye. Generational and discipline-based differences further influence knowledge and attitudes. The lack of clear editorial guidance from biomedical journals may reinforce academic uncertainty. Tailored educational initiatives, transparent journal policies, and institutional support will be essential to foster a more open and inclusive scientific publishing environment.

Background Preprints—scientific manuscripts shared publicly prior to formal peer review—are gaining momentum across academic disciplines. However, their adoption in clinical and biomedical sciences remains limited, particularly in countries where traditional publishing norms prevail. Editorial ambiguity and a lack of national policy further complicate their use. Objective This study aimed to assess the awareness, experiences, and attitudes of medical academics at a major university in Istanbul, Türkiye toward preprints, and to explore the editorial landscape through both journal editor feedback and a review of journal-level preprint policies. Methods A cross-sectional survey was conducted with 103 medical faculty members. The questionnaire included demographic questions, Likert-scale and multiple-choice items assessing knowledge, familiarity, and attitudes toward preprints, as well as open-ended items to explore concerns. A “Preprint Test Score” (0–4) was developed to quantify objective knowledge. Subgroup analyses were conducted by age (Results Only 42.9% of participants reported familiarity with the concept of preprints, and 13% had previously published on a preprint server. Misconceptions about ethics, peer review, and compatibility with journal policies were common. Subgroup analysis revealed that older participants scored higher on the Preprint Test and had more experience with preprint publishing. Further younger academics expressed less openness toward future use. Clinical faculty were generally more hesitant than basic science faculty, although both groups raised concerns about the academic recognition of preprints. Editorial responses reflected a mix of cautious endorsement and scepticism. Among the 118 biomedical journals reviewed, most lacked clear preprint policies, while a small number either explicitly prohibited or permitted them. Conclusion There is limited awareness and cautious engagement with preprints among medical academics and editors in Türkiye. Generational and disciplinary differences further influence knowledge and attitudes. The lack of clear editorial guidance from biomedical journals may reinforce academic uncertainty. Tailored educational initiatives, transparent journal policies, and institutional support will be essential to foster a more open and inclusive scientific publishing environment.

PEPITEM is an immune-modulatory peptide that effectively regulates inflammation and mitigates immune-mediated inflammatory diseases (IMIDs). Here we identify two independently active tripeptide pharmacophores within PEPITEM and engineered peptidomimetics with enhanced pharmacodynamic properties. These peptidomimetics regulate T-cell trafficking in vitro and reduce T-cell, neutrophil and macrophage numbers in the inflamed peritoneal cavity i n vivo . In a plaque psoriasis model, topical administration reduced disease severity, inflammation and immune cell infiltration, while regulating cytokine release in macrophages and fibroblasts, as well as keratinocyte proliferation. Th1 and Th17 cell abundance, along with their cytokines, was reduced in secondary lymphoid organs. This expanded functional repertoire of PEPITEM and its derivatives provides innovative tools for countering immune and stromal cell-induced pathology in IMIDs, paving the way for a novel class of anti-inflammatory agents.

Amaç: COVID-19 pandemisinin ve pandemi sırasında sağlıkta şiddetin birinci ve altıncı sınıftaki tıp öğrencilerinin ve hekimlerin motivasyon ve kariyer planlarına yönelik etkilerinin araştırılması amaçlanmıştır. Yöntem: Çalışma, 24 Mayıs-16 Haziran 2021 tarihleri arasında, Marmara Üniversitesi Tıp Fakültesi ve Gazi Üniversitesi Tıp Fakültesi’nde okuyan birinci sınıf öğrencileri ile bu üniversitelerin eğitim ve araştırma hastanelerinde çalışan altıncı sınıf öğrencileri (intörnler) ve hekimlerine yönelik açık uçlu, çoktan seçmeli ve Likert ölçekli 31 sorudan oluşan çevrimiçi anketle gerçekleştirilmiştir. Bulgular: Çalışmaya 228 birinci sınıf, 136 altıncı sınıf öğrencisi ve 112 hekim (toplam 476 kişi) katılmıştır. Son sınıf öğrencilerinin %44,6’sı, hekimlerin ise %51,4’ü COVID-19 pandemisinin kariyer planlarını olumsuz yönde etkilediğini belirtmiştir. İntörnlerin %54,3’ü pandemi döneminde yeteri kadar deneyim kazanamadıklarını ve bundan dolayı mesleki olarak yetersiz hissettiklerini, %68,7’si ise hastanede aktif rol almış olsalardı kendilerine güvenlerinin daha yüksek olacağını belirtmiştir. Tüm katılımcıların %55,3’ü hekim ve hekim dışı sağlık personeline yönelik şiddetin pandemi döneminde arttığını düşünürken, %86,8’i şiddet olaylarından dolayı motivasyonlarının azaldığını, %63,2’si şiddete rağmen mesleklerini bırakmak istemediklerini belirtmiştir. Ancak, kariyer planlamaları ile ilgili cevaplarında katılımcılar ağırlıklı olarak yurt dışı planlarından bahsetmişlerdir. Katılımcıların mesleğe yönelik motivasyonlarının COVID-19 sürecinde olumsuz etkilenmesinde sağlık çalışanlarının mesleğe yönelik tutumları (%40,5) ve hasta ve hasta yakınlarının tutumları (%70,7) etkili olmuştur. Sonuç: COVID-19 pandemisi ve pandemi sırasında artış gösteren şiddet olayları hekimlerin ve öğrencilerin kariyer planlarını ve mesleklerine yönelik motivasyonlarını olumsuz yönde etkilemiştir.

Favipiravir displays a rapid viral clearance, a high recovery rate and broad therapeutic safety; however, its oral administration was associated with systemic side effects in susceptible patients. Considering that the pulmonary route could provide a high drug concentration, and a safer application with less absorption into systemic circulation, it was aimed to elucidate whether favipiravir delivered via soft-mist inhaler has any deleterious effects on lung, liver and kidney tissues of healthy rats. Wistar albino rats of both sexes (n = 72) were placed in restrainers, and were given either saline or favipiravir (1, 2.5, 5 or 10 mg/kg in 1 mL saline) by inhalation within 2 min for 5 consecutive days. On the 6th day, electrocardiographic recording was obtained, and cardiac blood and lung tissues were collected. Favipiravir did not alter cardiac rhythm, blood cell counts, serum levels of alanine transaminase, aspartate transaminase, blood urea nitrogen, creatinine, urea or uric acid, and did not cause any significant changes in the pulmonary malondialdehyde, myeloperoxidase activity or antioxidant glutathione levels. Our data revealed that pulmonary use of favipiravir via soft-mist inhaler enables a high local concentration compared to plasma without oxidative lung injury or cardiac or hepatorenal dysfunction.

Aim: The team-based learning (TBL) method is a student-centered learning method and aims to improve students' ability to study as a team and solve problems. Compared with other learning methods, it allows educational interactions to occur at higher levels in groups working as a team throughout the course period. The disruption of education due to the COVID-19 pandemic and continuation of the courses online have shown that reaching the learning goals is related to the infrastructure resources of the universities as well as to differences in student’s learning profiles. In our study, it is aimed to evaluate how the possible changes that occur in the learning process by transforming the Physiology undergraduate courses, which were carried out with the classical lecture hall and EBÖ method in the Physiotherapy and Rehabilitation Department at Marmara University Faculty of Health Sciences (MUSBF) before the pandemic, into online courses during the pandemic period, affect the students' participation and motivation in the lesson.Methods: The data of the 1st year's Physiology courses, 6 hours of classical lecture courses, 6 hours of TBL courses -which were held before the COVID-19 pandemic- and 6 hours of online courses of during the pandemic in March 2020 were included in the study. Reading materials related to the course were prepared before the TBL courses. In the first stage, the questions, which were expected to be answered individually at the beginning of the course, were then discussed in teams of 10-12 students determined by the instructor and asked to be answered. Afterwards, a short presentation about the course content was made by the instructor. In the second stage, discussion questions were given to the groups and they were asked to solve them as a team. The course was concluded with a test summarizing the content of the lecture. Learning lesson content, participation in the lesson, and attention levels were obtained by a questionnaire. By including open-ended questions in the questionnaire, the processes for learning before and after the course were evaluated, and additional opinions, if there were any, were also requested. The questions in the online form were summarized as descriptive data in the form of frequency distributions. Written notes about the participants' reflections, in which they have assessed the TBL, were evaluated by descriptive interpretive analysis and focus group interview records were evaluated using thematic content analysis.Results: Students emphasized that the teaching methods used in the course not only affected their participation in the lecture but also were compatible with their learning styles. When the questions about the students' learning experiences were assessed, it was seen that the majority of them learned the lesson better when they listened to the instructor (99%). Also, they expressed that either working with friends (78.8%) or studying the sourcebook (79.9%) helped them to learn better. Additionally, it was observed that 74.8% of the students had study habits that included the use of internet as a source. Students reported that TBL affected their learning processes at a higher rate than classical and online learning methods in terms of motivation for the course (91,9%), contribution to the learning processes (90,9%), attention during the course (73,7%), asking questions during the course (67,4%) and making preparation before the course (65,3%). The students stated the aims of making preparation before the course as to facilitate the understanding of the course, and to participate actively in the lesson. They stated that EBÖ makes positive contribution to their learning processes, as well as it was a method that increased productivity and focus.Conclusions: It is thought that TBL is an effective method in learning by discussing problems as a group and increasing the active participation of the students. It was observed that this situation played a positive role in the communication of the participants with their peers, allowing shy students to communicate better.

Increased incidence of inflammatory bowel disease (IBD) is associated with the consumption of westernized diet (WD). In male Wistar albino rats induced with colitis by oral intake of dextran-sulfate sodium (DSS) for 10 days, we investigated how colitis-induced oxidative damage is affected by WD consumption started 3 weeks before DSS intake. Secondly, the putative protective effects of short-chain fatty acids (SCFAs) were evaluated in both WD-fed and normal diet (ND)-fed rats. WD consumption prior to colitis induction alleviated oxidative damage and suppressed inflammatory response of the colon via the modulation of peroxisome proliferator-activated receptor (PPAR)-γ activity, suggesting a preconditioning impact of the WD. Moreover, addition of SCFA to WD abolished the elevations in lipid profile, while SCFA added to either ND or WD during the 10-day development of colonic inflammation depressed the pro-inflammatory TNF-α and IL-6 expressions and upregulated IL-10, but the reduction in oxidative damage due to WD was not further changed. The results demonstrated that acute colonic inflammation is alleviated when it is preceded by the consumption of WD, and SCFAs improved WD-induced disruption in lipid profile, implicating that SCFAs would be advantageous in IBD patients comorbid with metabolic syndrome.