Effect of Septoplasty Surgery on Serum Prolidase Enzyme Activity Levels

Effect of Septoplasty Surgery on Serum Prolidase Enzyme Activity Levels | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect of Septoplasty Surgery on Serum Prolidase Enzyme Activity Levels Adnan EKİNCİ This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7299635/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective In this study, we aimed to compare the serum prolidase enzyme activity (SPEA) levels between patients with nasal septum deviation (NSD) and the control group, and also to determine the effects of septoplasty surgery on SPEA levels in the patient group. Materials and Methods Serum SPEA levels were compared between the study group consisting of 35 patients and the control group consisting of 35 patients. Preoperative and postoperative SPEA levels were also compared in the patient group. Results The mean SPEA value was 214.77 ± 31.13 U/L preoperative group and 184.87 ± 27.68 U/L postoperative group. The decrease in SPEA levels after the septoplasty was statistically significant (p < 0.05). When the patient and control groups were compared, SPEA levels in the patient group were statistically significantly higher than in the control group (p < 0.05). The mean SPEA value was 179.48 ± 15.48 U/L in the control group, whereas it was 214.77 ± 31.13 U/L in the patient group. Conclusions We found that SPEA levels were statistically significantly higher in patients with NSD compared to healthy individuals. Furthermore, a significant decrease in SPEA levels was detected after septoplasty in the patient group.These findings suggest that prolidase may be a powerful enzyme in the etiopathogenesis of NSD and may be a marker of clinical recovery. Septoplasty Prolidase Nasal Septum Deviation Figures Figure 1 Figure 2 Introduction Nasal congestion is one of the most common complaints seen in otolaryngology clinics [ 1 ]. Nasal septum deviation (NSD) is defined as the nasal septum bending to the right or left and is a condition that frequently causes nasal congestion [ 2 ]. Septoplasty is the surgical correction of a deviated septum and is one of the simple yet effective procedures performed in otolaryngology clinics [ 3 ]. Prolidase is a metalloenzyme belonging to the hydrolase group. Prolidase is found in many tissues throughout the body and its primary function is the degradation of proline and hydroxyproline peptides. Due to this property, it plays a role in collagen degradation and recycling and remodels the extracellular matrix [ 4 ]. Decreases and increases in prolidase levels have been reported to be associated with various diseases. It is thought to play a role in the development of many diseases, including type 2 diabetes mellitus, bipolar disorder, schizophrenia, liver fibrosis, osteoporosis, nasal polyps, anxiety, chronic hepatitis C, major depression, bronchial asthma, and chronic obstructive pulmonary disease [ 5 – 11 ]. In our study, we aimed to determine prolidase enzyme levels in patients with a deviated septum and healthy individuals. We investigated whether there were differences in SPEA levels between the groups. We also measured SPEA activity again after performing septal deviation in patients with septal deviation. We aimed to determine how septoplasty affects SPEA levels. According to our literature review, the relationship between septoplasty and SPEA has not been previously investigated. Therefore, our study is the first to conduct this study in the literature. Patients and methods Patients This clinical study was conducted at the Department of Ear, Nose, and Throat at XXX University. No funding was received for the study. Our study involving human participants, human material, or human data must have been conducted in accordance with the Declaration of Helsinki and approved by an appropriate ethics committee. The study began on June 1, 2017, and concluded on April 1, 2019. Prior to the study, ethical approval was obtained from the Clinical Research Ethics Committee of XXX University (Project number: XXX). The study group consisted of 35 patients with a deviated septum. The control group consisted of 35 healthy individuals. Individuals in both groups were between the ages of 18 and 50. Individuals presenting to our clinic with complaints of nasal congestion first underwent a detailed history, then underwent anterior rhinoscopy and nasal endoscopic examination. These individuals diagnosed with SND were included in the patient group. Patients with malignancy, hypertension, diabetes mellitus, atherosclerosis, heart disease, systemic inflammatory disease, allergies, nasal polyps, or turbinate pathology were excluded from the patient and control groups. All patients were provided with detailed information about the study and signed an informed consent form.. The protocol requirements of the Declaration of Helsinki were adhered to throughout the study. Explanatory informed consent forms were obtained from all participants. Preoperative biochemical, hematological, and ELISA tests were performed on participating patients and controls. Those with normal laboratory results were allowed to continue the study. Data collection The same clinician used a standard cold knife surgical technique under general anesthesia for all patients. Blood samples were collected half an hour before the operation and two months after the operation. Blood tests were performed on all patients included in the study between 8:00 and 10:00 a.m. 30–45 minutes after placing a 10 ml venous blood sample in a vacuum biochemistry tube, Blood samples were centrifuged at 4000 rpm. The separated serum was then stored in a -80°C refrigerator. An automated ELISA device called Radim ALIS-I was used to measure SPEA levels. The coefficient of variation criterion within the group was determined to be less than 8% and between the groups was determined to be less than 10%. The assay range was between 93.75 and 6000 mU/ml. The assay sensitivity was 93.75 mU/ml. Statistical Analysis The SPSS package program was used for statistical analysis. The Shapiro-Wilk test was used to examine the normal distribution of the data. When presenting continuous variables, mean ± standard deviation and median (min-max) values were given, while numbers and percentages were used in presenting categorical variables. The Mann-Whitney U test was used to compare prolidase levels in the case-control groups because the data obtained did not show a normal distribution between the groups. Wilcoxon Signed Rank test was used to examine preoperative and postoperative prolidase levels. The criterion for statistical significance was p < 0.05. Results The control group consisted of 16 female and 19 male patients. The patient group consisted of 18 female and 17 male patients. Comparison of the groups according to gender showed similar characteristics (p = 0.873). The mean age of the control group was 35.24 years, while the mean age of the patient group was 33.57 years. While the mean SPEA value in the SND group was 214.77 ± 31.13 U/L, it was measured as 184.87 ± 27.68 U/L after septoplasty. The decrease in mean SPEA levels after septoplasty was found to be statistically significant (p < 0.05) (Table 1 ) (Fig. 1 ). The SND group was also compared with the control group consisting of healthy individuals. The mean SPEA value was 179.48 ± 15.48 U/L in the control group, while it was 214.77 ± 31.13 U/L in the SND group. SPEA levels were found to be statistically significantly higher in the septum deviation group than in the control group (p < 0.05) (Table 2 ) (Fig. 2 ). Table 1 Comparison of SPEA levels between pre and postoperative groups N Mean ± SD Median (min-max) P value Preoperative 35 214.77 ± 31.13 208± (159–278) p < 0.05* postoperative 35 184.87 ± 27.68 181 ± (116–266) *statistically significant p < 0.05 Table 2 Comparison of SPEA levels between patient and control groups N Mean ± SD Median (min-max) P value Patient group 35 214.77 ± 31.13 208± (159–278) p < 0.05* Control 35 179.48 ± 15.48 179 ± (151–207) *statistically significant p < 0.05 Discussion According to our literature search, although the relationship between prolidase and many diseases has been investigated, we found that the relationship between prolidase and septal deviation or septoplasty has not been investigated before. There are not many studies on prolidase in ear, nose, and throat diseases. The few studies that have been conducted have examined the relationship between nasal polyps, sleep apnea, and prolidase. Prolidase is known to be effective in collagen biosynthesis and degradation. Therefore, it is known to play an important role in the regulation of collagen metabolism. Collagen catabolism produces proline and hydroxyproline as degradation products. Prolidase is the only enzyme that catalyzes proline and hydroxyproline within the cell [ 12 ]. Studies have shown that prolidase levels increase significantly when chronic inflammation increases and collagen production and degradation increase [ 13 ]. Normally, the body maintains a balance between the production and degradation of the extracellular matrix. If this balance is disrupted, fibrosis occurs [ 14 ]. Prolidase enzyme has been detected in many tissues throughout the body, including the brain, liver, pancreas, stomach, kidney, heart, and amniotic fluid. Because collagen is a component of the extracellular matrix of many organs and tissues, it can be affected by many pathological processes [ 15 ]. An increase or decrease in SPEA can be an indicator of many diseases. Some studies have reported a decrease in SPEA in diseases such as asthma and chronic obstructive pulmonary disease [ 9 , 16 ]. San et al. conducted a study on prolidase enzyme in 30 patients with nasal polyps. They determined SPEA levels in the serum and nasal polyp tissues. They also included 30 patients with turbinate hypertrophy or deviated septum as a control group. SPEA levels were also measured in the control group. They compared both groups and reported that SPEA was higher in both the serum and polyp tissues in the nasal polyp group compared to the control group. They suggested that increased SPEA levels may be a consequence of chronic inflammation and concluded that this may be an indicator of fibrotic processes in polyp development [ 17 ]. Ekinci et al. found that serum SPEA levels were higher in patients with nasal polyps compared to the control group. They reported a significant decrease in SPEA levels after oral steroid treatment. Therefore, it is thought that an increase in prolidase enzyme may play an important role in nasal polyp development [ 1 ]. Salihoğlu and colleagues determined biochemical SPEA levels in serum and tissue samples of patients with nasal polyps. They compared their findings with those of healthy individuals. The control group consisted of patients who had undergone inferior turbinate reduction surgery but did not have nasal polyps. Based on their findings, they reported that SPEA levels in both tissue and serum were significantly higher in patients with nasal polyps compared to the control group [ 5 ]. San and colleagues determined SPEA levels in patients with nasal polyps. They compared the results with those in individuals with turbinate hypertrophy and deviated septum but no nasal polyps. They reported that prolidase levels in the serum and polyp tissue of patients with nasal polyps were higher than in the control group. Based on this result, they concluded that higher levels may be an indicator of fibrotic processes in nasal polyp development [ 17 ]. Another study found significantly higher oxidative stress levels in asthmatic patients compared to the control group. In the same study, lower prolidase levels were found in asthmatic patients compared to controls, and it was suggested that this might be due to a defect in collagen metabolism or collagen accumulation in the basement membrane [ 9 ]. Studies have shown that SPEA is associated with oxidative stress and is increased in Parkinson's disease patients [ 19 ]. In their study on patients with SND, Ekinci and colleagues found a significant difference between total antioxidant status (TAS) and total oxidant status (TOS) levels before and after septoplasty. They reported that the mean TAS value increased after septoplasty, while the mean TOS value decreased. Consequently, they reported that patients with nasal septum deviation (NSD) experienced less oxidative stress after septoplasty. Ekinci also reported that patients with nasal septum deviation had greater oxidative stress than the control group [ 20 ]. Another study found that SPEA levels were significantly lower in patients with chronic obstructive pulmonary disease (COPD) compared to the control group. They noted a decrease in SPEA according to the average age of COPD patients, but no significant difference [ 21 ]. Prolidase enzyme may repair damage caused by oxidative stress in the cell resulting from hypoxia due to septal deviation through collagen synthesis. Conversely, elevated prolidase enzyme levels may play a role in protein degradation and exacerbate the damage. The high levels of this enzyme in our patient group suggest that it is used in damage mechanisms and may not assist in repair mechanisms. The increase in inflammatory events in some studies and the decrease in others may be related to this dual function of the prolidase enzyme. Consequently, we believe that prolidase enzyme levels may serve as a warning for other systemic diseases that this NSD disease may cause in the future. Limitations The relatively small number of patients in the study group and the fact that the study was conducted at a single center are limitations. I believe that conducting similar studies with a larger number of patients would be beneficial. The lack of grading of septal deviation and the lack of scoring of the patient's clinical complaints are also limitations of the study. Comparing enzyme levels in patients with mild septal deviation with those in patients with more severe septal deviation may yield meaningful results. Patients with septal deviation may be exposed to greater oxidative stress as the degree of deviation increases. Therefore, it may be beneficial to re-evaluate patients, especially those with severe respiratory complaints and advanced septal deviation. Conclusıon In conclusion, we found that SPEA levels were statistically significantly higher in patients with NSD compared to healthy individuals. Furthermore, a significant decrease in SPEA levels was detected after septoplasty in the patient group.These findings suggest that prolidase may be a powerful enzyme in the etiopathogenesis of NSD and may be a marker of clinical recovery. More comprehensive and detailed studies are needed on this topic. Declarations Acknowledgment/disclaimers/conflict of interest: The authors have no conflict of interest. Informed consent: This study was conducted in accordance with the ethical principles of the Declaration of Helsinki. The study permission was approved by the Hitit University Faculty of Medicine Clinical Research Ethics Committee (approval code: 2017/43-06.06.2017 Author Contribution CONTRIBUTION TYPE DESCRIPTION CONTRIBUTORSIDEA/CONCEPT Ideas or hypotheses for the research and/or article; Adnan EkinciCONCEPTION Planning the methods to achieve results; Adnan EkinciSUPERVISION/CONSULTANCY Supporting the project and article, and overseeing and taking responsibility for the process; Adnan EkinciRESOURCES Implementing personnel, space, financial resources, tools, and equipment vital to the project; Adnan EkinciMATERIALS Biological characteristics, reagents, and shipped products; Adnan EkinciDATA COLLECTION AND/OR PROCESSING Taking responsibility for conducting experiments, personal monitoring, organizing, and reporting data; Adnan EkinciANALYSIS AND/OR COMMENTARY Taking responsibility for the explanation and presentation of findings; Adnan EkinciLITERATURE REVIEW Taking responsibility for this necessary function; Adnan EkinciWRITERS Taking responsibility for the abstract or the main drafting of the article; Adnan EkinciCRITICAL REVIEW Reworking the article not only for spelling and grammar but also for intellectual content before submission.; Adnan Ekinci References Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hann ley MT (2004) Development and validation of the nasal obstruc tion symptom evaluation (NOSE) scale. 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J Pak Med Assoc 65:131–135 Selek S, Altindag A, Saracoglu G, Celik H, Aksoy N (2011) Prolidase activity and its diagnostic performance in bipolar disorder. J Affect Disord 129:84–86 Cakmak A, Zeyrek D, Atas A, Celik H, Aksoy N, Erel O (2009) Serum prolidase activity and oxidative status in patients with bronchial asthma. J Clin Lab Anal 23:132–138 Duygu F, Koruk ST, Karsen H, Aksoy N, Taskin A, Hamidanoglu M (2012) Prolidase and oxidative stress in chronic hepatitis C. J Clin Lab Anal 26:232–237 Abraham P, Wilfred G, Ramakrishna B (2000) Plasma prolidase may be an index of liver fibrosis in the rat. Clin Chim Acta 295:199–202 Myara I (1987) Effect of long preincubation on the two forms of human erythrocyte prolidase. Clin chim acta 170:263–270 Şen V, Uluca Ü, Ece A et al (2014) Serum prolidase activity and oxidant–antioxidant status in children with chronic hepatitis B virus infection. Ital J Pediatr 40:95 Friedman SL (2004) Mechanisms of disease: mechanisms of hepatic fibrosis and therapeutic implications. Nat clin prac Gastroenterol hepatol 1:98–105 Gürdöl F, Genç S, Yalçin Ö et al (1995) The presence of prolidase activity in amniotic fluid and its evaluation as a maturity test. Neonate 67:34–38 Gencer M, Aksoy N, Dagli EC et al (2011) Prolidase activity dysregulation and its correlation with oxidative–antioxidative status in chronic obstructive pulmonary disease. J Clin Lab Anal 25:8–13 San I, Ulas T, Bozkus F, Lynen I, Yesilova Y, Sezen H et al (2013) Prolidase activity and oxidative stress parameters in patients with nasal polyps. Clin Ter 164:209–213 Ekinci A, Kayadibi H, Demir E, Ozcan M (2021) The effects of oral steroid therapy on prolidase enzyme activity in patients with nasal polyps. Turkish J Biochem 46(4):473–477 Verma AK, Raj J, Sharma V, Singh TB, Srivastava S, Srivastava R (2015) Plasma Prolidase Activity and Oxidative Stress in Patients with Parkinson’s Disease. Parkinson’s Disease, 2015: 1–6 Ekinci A, Karataş D, Yetiş A, Demir E, Ozcan M (2017) The effects of septoplasty surgery on serum oxidative stress levels, vol 274. European Archives of Oto-Rhino-Laryngology, pp 2799–2802 Ekin S, Arısoy A, Gunbatar H, Sertogullarindan B, Sunnetcioglu A, Sezen H, Asker S, Yıldız H (2016) The relationships among the levels of oxidative and antioxidative parameters, fev1 andprolidase activity in copd. Redox Rep 15:1–4 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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2","display":"","copyAsset":false,"role":"figure","size":33977,"visible":true,"origin":"","legend":"\u003cp\u003eBox blots of mean changes of SPEA levels between patient and control groups.\u003c/p\u003e","description":"","filename":"figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7299635/v1/a045efeae5ca1913f0b8342f.jpg"},{"id":93769687,"identity":"d1108cd6-c375-4e7e-8479-93eb122fd649","added_by":"auto","created_at":"2025-10-17 11:38:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":470621,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7299635/v1/ea5cbbe5-2c2d-43fb-9748-0ed91ea5d6e1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eEffect of Septoplasty Surgery on Serum Prolidase Enzyme Activity Levels\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNasal congestion is one of the most common complaints seen in otolaryngology clinics [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Nasal septum deviation (NSD) is defined as the nasal septum bending to the right or left and is a condition that frequently causes nasal congestion [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Septoplasty is the surgical correction of a deviated septum and is one of the simple yet effective procedures performed in otolaryngology clinics [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Prolidase is a metalloenzyme belonging to the hydrolase group. Prolidase is found in many tissues throughout the body and its primary function is the degradation of proline and hydroxyproline peptides. Due to this property, it plays a role in collagen degradation and recycling and remodels the extracellular matrix [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDecreases and increases in prolidase levels have been reported to be associated with various diseases. It is thought to play a role in the development of many diseases, including type 2 diabetes mellitus, bipolar disorder, schizophrenia, liver fibrosis, osteoporosis, nasal polyps, anxiety, chronic hepatitis C, major depression, bronchial asthma, and chronic obstructive pulmonary disease [\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9 CR10\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn our study, we aimed to determine prolidase enzyme levels in patients with a deviated septum and healthy individuals. We investigated whether there were differences in SPEA levels between the groups. We also measured SPEA activity again after performing septal deviation in patients with septal deviation. We aimed to determine how septoplasty affects SPEA levels. According to our literature review, the relationship between septoplasty and SPEA has not been previously investigated. Therefore, our study is the first to conduct this study in the literature.\u003c/p\u003e"},{"header":"Patients and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003ePatients\u003c/h2\u003e\u003cp\u003eThis clinical study was conducted at the Department of Ear, Nose, and Throat at XXX University. No funding was received for the study. Our study involving human participants, human material, or human data must have been conducted in accordance with the Declaration of Helsinki and approved by an appropriate ethics committee. The study began on June 1, 2017, and concluded on April 1, 2019. Prior to the study, ethical approval was obtained from the Clinical Research Ethics Committee of XXX University (Project number: XXX). The study group consisted of 35 patients with a deviated septum. The control group consisted of 35 healthy individuals. Individuals in both groups were between the ages of 18 and 50. Individuals presenting to our clinic with complaints of nasal congestion first underwent a detailed history, then underwent anterior rhinoscopy and nasal endoscopic examination. These individuals diagnosed with SND were included in the patient group. Patients with malignancy, hypertension, diabetes mellitus, atherosclerosis, heart disease, systemic inflammatory disease, allergies, nasal polyps, or turbinate pathology were excluded from the patient and control groups. All patients were provided with detailed information about the study and signed an informed consent form..\u003c/p\u003e\u003cp\u003e The protocol requirements of the Declaration of Helsinki were adhered to throughout the study. Explanatory informed consent forms were obtained from all participants. Preoperative biochemical, hematological, and ELISA tests were performed on participating patients and controls. Those with normal laboratory results were allowed to continue the study.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eThe same clinician used a standard cold knife surgical technique under general anesthesia for all patients. Blood samples were collected half an hour before the operation and two months after the operation. Blood tests were performed on all patients included in the study between 8:00 and 10:00 a.m. 30\u0026ndash;45 minutes after placing a 10 ml venous blood sample in a vacuum biochemistry tube,\u003c/p\u003e\u003cp\u003eBlood samples were centrifuged at 4000 rpm. The separated serum was then stored in a -80\u0026deg;C refrigerator. An automated ELISA device called Radim ALIS-I was used to measure SPEA levels. The coefficient of variation criterion within the group was determined to be less than 8% and between the groups was determined to be less than 10%. The assay range was between 93.75 and 6000 mU/ml. The assay sensitivity was 93.75 mU/ml.\u003c/p\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eThe SPSS package program was used for statistical analysis. The Shapiro-Wilk test was used to examine the normal distribution of the data. When presenting continuous variables, mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation and median (min-max) values were given, while numbers and percentages were used in presenting categorical variables. The Mann-Whitney U test was used to compare prolidase levels in the case-control groups because the data obtained did not show a normal distribution between the groups. Wilcoxon Signed Rank test was used to examine preoperative and postoperative prolidase levels. The criterion for statistical significance was p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe control group consisted of 16 female and 19 male patients. The patient group consisted of 18 female and 17 male patients. Comparison of the groups according to gender showed similar characteristics (p\u0026thinsp;=\u0026thinsp;0.873). The mean age of the control group was 35.24 years, while the mean age of the patient group was 33.57 years. While the mean SPEA value in the SND group was 214.77\u0026thinsp;\u0026plusmn;\u0026thinsp;31.13 U/L, it was measured as 184.87\u0026thinsp;\u0026plusmn;\u0026thinsp;27.68 U/L after septoplasty. The decrease in mean SPEA levels after septoplasty was found to be statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The SND group was also compared with the control group consisting of healthy individuals. The mean SPEA value was 179.48\u0026thinsp;\u0026plusmn;\u0026thinsp;15.48 U/L in the control group, while it was 214.77\u0026thinsp;\u0026plusmn;\u0026thinsp;31.13 U/L in the SND group. SPEA levels were found to be statistically significantly higher in the septum deviation group than in the control group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of SPEA levels between pre and postoperative groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMedian (min-max)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePreoperative\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e214.77\u0026thinsp;\u0026plusmn;\u0026thinsp;31.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e208\u0026plusmn; (159\u0026ndash;278)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.05*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003epostoperative\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e184.87\u0026thinsp;\u0026plusmn;\u0026thinsp;27.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e181 \u0026plusmn; (116\u0026ndash;266)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e*statistically significant p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of SPEA levels between patient and control groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMedian (min-max)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePatient group\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e214.77\u0026thinsp;\u0026plusmn;\u0026thinsp;31.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e208\u0026plusmn; (159\u0026ndash;278)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.05*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eControl\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e179.48\u0026thinsp;\u0026plusmn;\u0026thinsp;15.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e179 \u0026plusmn; (151\u0026ndash;207)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e*statistically significant p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAccording to our literature search, although the relationship between prolidase and many diseases has been investigated, we found that the relationship between prolidase and septal deviation or septoplasty has not been investigated before. There are not many studies on prolidase in ear, nose, and throat diseases. The few studies that have been conducted have examined the relationship between nasal polyps, sleep apnea, and prolidase. Prolidase is known to be effective in collagen biosynthesis and degradation. Therefore, it is known to play an important role in the regulation of collagen metabolism. Collagen catabolism produces proline and hydroxyproline as degradation products. Prolidase is the only enzyme that catalyzes proline and hydroxyproline within the cell [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Studies have shown that prolidase levels increase significantly when chronic inflammation increases and collagen production and degradation increase [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Normally, the body maintains a balance between the production and degradation of the extracellular matrix. If this balance is disrupted, fibrosis occurs [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Prolidase enzyme has been detected in many tissues throughout the body, including the brain, liver, pancreas, stomach, kidney, heart, and amniotic fluid. Because collagen is a component of the extracellular matrix of many organs and tissues, it can be affected by many pathological processes [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. An increase or decrease in SPEA can be an indicator of many diseases. Some studies have reported a decrease in SPEA in diseases such as asthma and chronic obstructive pulmonary disease [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSan et al. conducted a study on prolidase enzyme in 30 patients with nasal polyps. They determined SPEA levels in the serum and nasal polyp tissues. They also included 30 patients with turbinate hypertrophy or deviated septum as a control group. SPEA levels were also measured in the control group. They compared both groups and reported that SPEA was higher in both the serum and polyp tissues in the nasal polyp group compared to the control group. They suggested that increased SPEA levels may be a consequence of chronic inflammation and concluded that this may be an indicator of fibrotic processes in polyp development [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eEkinci et al. found that serum SPEA levels were higher in patients with nasal polyps compared to the control group. They reported a significant decrease in SPEA levels after oral steroid treatment. Therefore, it is thought that an increase in prolidase enzyme may play an important role in nasal polyp development [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSalihoğlu and colleagues determined biochemical SPEA levels in serum and tissue samples of patients with nasal polyps. They compared their findings with those of healthy individuals. The control group consisted of patients who had undergone inferior turbinate reduction surgery but did not have nasal polyps. Based on their findings, they reported that SPEA levels in both tissue and serum were significantly higher in patients with nasal polyps compared to the control group [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSan and colleagues determined SPEA levels in patients with nasal polyps. They compared the results with those in individuals with turbinate hypertrophy and deviated septum but no nasal polyps. They reported that prolidase levels in the serum and polyp tissue of patients with nasal polyps were higher than in the control group. Based on this result, they concluded that higher levels may be an indicator of fibrotic processes in nasal polyp development [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Another study found significantly higher oxidative stress levels in asthmatic patients compared to the control group. In the same study, lower prolidase levels were found in asthmatic patients compared to controls, and it was suggested that this might be due to a defect in collagen metabolism or collagen accumulation in the basement membrane [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Studies have shown that SPEA is associated with oxidative stress and is increased in Parkinson's disease patients [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn their study on patients with SND, Ekinci and colleagues found a significant difference between total antioxidant status (TAS) and total oxidant status (TOS) levels before and after septoplasty. They reported that the mean TAS value increased after septoplasty, while the mean TOS value decreased. Consequently, they reported that patients with nasal septum deviation (NSD) experienced less oxidative stress after septoplasty. Ekinci also reported that patients with nasal septum deviation had greater oxidative stress than the control group [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAnother study found that SPEA levels were significantly lower in patients with chronic obstructive pulmonary disease (COPD) compared to the control group. They noted a decrease in SPEA according to the average age of COPD patients, but no significant difference [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eProlidase enzyme may repair damage caused by oxidative stress in the cell resulting from hypoxia due to septal deviation through collagen synthesis. Conversely, elevated prolidase enzyme levels may play a role in protein degradation and exacerbate the damage. The high levels of this enzyme in our patient group suggest that it is used in damage mechanisms and may not assist in repair mechanisms.\u003c/p\u003e\u003cp\u003eThe increase in inflammatory events in some studies and the decrease in others may be related to this dual function of the prolidase enzyme. Consequently, we believe that prolidase enzyme levels may serve as a warning for other systemic diseases that this NSD disease may cause in the future.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThe relatively small number of patients in the study group and the fact that the study was conducted at a single center are limitations. I believe that conducting similar studies with a larger number of patients would be beneficial.\u003c/p\u003e\u003cp\u003eThe lack of grading of septal deviation and the lack of scoring of the patient's clinical complaints are also limitations of the study. Comparing enzyme levels in patients with mild septal deviation with those in patients with more severe septal deviation may yield meaningful results. Patients with septal deviation may be exposed to greater oxidative stress as the degree of deviation increases. Therefore, it may be beneficial to re-evaluate patients, especially those with severe respiratory complaints and advanced septal deviation.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusıon","content":"\u003cp\u003eIn conclusion, we found that SPEA levels were statistically significantly higher in patients with NSD compared to healthy individuals. Furthermore, a significant decrease in SPEA levels was detected after septoplasty in the patient group.These findings suggest that prolidase may be a powerful enzyme in the etiopathogenesis of NSD and may be a marker of clinical recovery. More comprehensive and detailed studies are needed on this topic.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment/disclaimers/conflict of interest:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe authors have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent:\u0026nbsp;\u003c/strong\u003eThis study was conducted in accordance with the ethical principles of the Declaration of Helsinki. The study permission was approved by the Hitit University Faculty of Medicine Clinical Research Ethics Committee (approval code: 2017/43-06.06.2017\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eCONTRIBUTION TYPE DESCRIPTION CONTRIBUTORSIDEA/CONCEPT Ideas or hypotheses for the research and/or article; Adnan EkinciCONCEPTION Planning the methods to achieve results; Adnan EkinciSUPERVISION/CONSULTANCY Supporting the project and article, and overseeing and taking responsibility for the process; Adnan EkinciRESOURCES Implementing personnel, space, financial resources, tools, and equipment vital to the project; Adnan EkinciMATERIALS Biological characteristics, reagents, and shipped products; Adnan EkinciDATA COLLECTION AND/OR PROCESSING Taking responsibility for conducting experiments, personal monitoring, organizing, and reporting data; Adnan EkinciANALYSIS AND/OR COMMENTARY Taking responsibility for the explanation and presentation of findings; Adnan EkinciLITERATURE REVIEW Taking responsibility for this necessary function; Adnan EkinciWRITERS Taking responsibility for the abstract or the main drafting of the article; Adnan EkinciCRITICAL REVIEW Reworking the article not only for spelling and grammar but also for intellectual content before submission.; Adnan Ekinci\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eStewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hann ley MT (2004) Development and validation of the nasal obstruc tion symptom evaluation (NOSE) scale. Otolaryngol Head Neck Surg 130(2):157\u0026ndash;163\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDinis PB, Haider H (2002) Septoplasty: long-term evaluation of results. Am J Otolaryngol 23(2):85\u0026ndash;90\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGandomi B, Bayat A, Kazemei T (2010) Outcomes of septo plasty in young adults: the nasal obstruction septoplasty effec tiveness study. Am J Otolaryngol 31(3):189\u0026ndash;192\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Dolenga M, Hechtman P (1992) Prolidase deficiency in cultured human fibroblasts: biochemical pathology and iminodipeptide enhanced growth. Pediatr Res 32:479\u0026ndash;482\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSalihoglu M, Gungor A, Ozcan O, C\u0026cedil;es \u0026cedil;meci E (2014) M\u0026uuml;ft\u0026uuml;o˘ glu T, ˙ Ipc \u0026cedil;io˘ glu OM. Tissue and serum prolidase activity in patients with nasal polyposis. Gulhane Med J 56:209\u0026ndash;212\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eErbagcı AB, Araz M, Erbagcı A, Tarakc \u0026cedil;ıoglu M, Namıduru ES (2002) Serum prolidase activity as a marker of osteoporosis in type 2 diabetes mellitus. Clin Biochem 35:263\u0026ndash;268\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBahceci B, Bagcioglu E, Kokacya MH, Dilek AR, Bahceci I, Selek S (2015) Prolidase activity and oxidative stress in patients with schizo phrenia: a preliminary study. J Pak Med Assoc 65:131\u0026ndash;135\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSelek S, Altindag A, Saracoglu G, Celik H, Aksoy N (2011) Prolidase activity and its diagnostic performance in bipolar disorder. J Affect Disord 129:84\u0026ndash;86\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCakmak A, Zeyrek D, Atas A, Celik H, Aksoy N, Erel O (2009) Serum prolidase activity and oxidative status in patients with bronchial asthma. J Clin Lab Anal 23:132\u0026ndash;138\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDuygu F, Koruk ST, Karsen H, Aksoy N, Taskin A, Hamidanoglu M (2012) Prolidase and oxidative stress in chronic hepatitis C. J Clin Lab Anal 26:232\u0026ndash;237\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAbraham P, Wilfred G, Ramakrishna B (2000) Plasma prolidase may be an index of liver fibrosis in the rat. Clin Chim Acta 295:199\u0026ndash;202\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMyara I (1987) Effect of long preincubation on the two forms of human erythrocyte prolidase. Clin chim acta 170:263\u0026ndash;270\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eŞen V, Uluca \u0026Uuml;, Ece A et al (2014) Serum prolidase activity and oxidant\u0026ndash;antioxidant status in children with chronic hepatitis B virus infection. Ital J Pediatr 40:95\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFriedman SL (2004) Mechanisms of disease: mechanisms of hepatic fibrosis and therapeutic implications. Nat clin prac Gastroenterol hepatol 1:98\u0026ndash;105\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eG\u0026uuml;rd\u0026ouml;l F, Gen\u0026ccedil; S, Yal\u0026ccedil;in \u0026Ouml; et al (1995) The presence of prolidase activity in amniotic fluid and its evaluation as a maturity test. Neonate 67:34\u0026ndash;38\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGencer M, Aksoy N, Dagli EC et al (2011) Prolidase activity dysregulation and its correlation with oxidative\u0026ndash;antioxidative status in chronic obstructive pulmonary disease. J Clin Lab Anal 25:8\u0026ndash;13\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e San I, Ulas T, Bozkus F, Lynen I, Yesilova Y, Sezen H et al (2013) Prolidase activity and oxidative stress parameters in patients with nasal polyps. Clin Ter 164:209\u0026ndash;213\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEkinci A, Kayadibi H, Demir E, Ozcan M (2021) The effects of oral steroid therapy on prolidase enzyme activity in patients with nasal polyps. Turkish J Biochem 46(4):473\u0026ndash;477\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Verma AK, Raj J, Sharma V, Singh TB, Srivastava S, Srivastava R (2015) Plasma Prolidase Activity and Oxidative Stress in Patients with Parkinson\u0026rsquo;s Disease. Parkinson\u0026rsquo;s Disease, 2015: 1\u0026ndash;6\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEkinci A, Karataş D, Yetiş A, Demir E, Ozcan M (2017) The effects of septoplasty surgery on serum oxidative stress levels, vol 274. European Archives of Oto-Rhino-Laryngology, pp 2799\u0026ndash;2802\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEkin S, Arısoy A, Gunbatar H, Sertogullarindan B, Sunnetcioglu A, Sezen H, Asker S, Yıldız H (2016) The relationships among the levels of oxidative and antioxidative parameters, fev1 andprolidase activity in copd. Redox Rep 15:1\u0026ndash;4\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Septoplasty, Prolidase, Nasal Septum Deviation","lastPublishedDoi":"10.21203/rs.3.rs-7299635/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7299635/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eIn this study, we aimed to compare the serum prolidase enzyme activity (SPEA) levels between patients with nasal septum deviation (NSD) and the control group, and also to determine the effects of septoplasty surgery on SPEA levels in the patient group.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e\u003cp\u003eSerum SPEA levels were compared between the study group consisting of 35 patients and the control group consisting of 35 patients. Preoperative and postoperative SPEA levels were also compared in the patient group.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe mean SPEA value was 214.77\u0026thinsp;\u0026plusmn;\u0026thinsp;31.13 U/L preoperative group and 184.87\u0026thinsp;\u0026plusmn;\u0026thinsp;27.68 U/L postoperative group. The decrease in SPEA levels after the septoplasty was statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). When the patient and control groups were compared, SPEA levels in the patient group were statistically significantly higher than in the control group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The mean SPEA value was 179.48\u0026thinsp;\u0026plusmn;\u0026thinsp;15.48 U/L in the control group, whereas it was 214.77\u0026thinsp;\u0026plusmn;\u0026thinsp;31.13 U/L in the patient group.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eWe found that SPEA levels were statistically significantly higher in patients with NSD compared to healthy individuals. Furthermore, a significant decrease in SPEA levels was detected after septoplasty in the patient group.These findings suggest that prolidase may be a powerful enzyme in the etiopathogenesis of NSD and may be a marker of clinical recovery.\u003c/p\u003e","manuscriptTitle":"Effect of Septoplasty Surgery on Serum Prolidase Enzyme Activity Levels","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-23 07:09:55","doi":"10.21203/rs.3.rs-7299635/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e4a04edf-24e0-4ffc-b556-d78d29fa0911","owner":[],"postedDate":"September 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-17T11:38:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-23 07:09:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7299635","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7299635","identity":"rs-7299635","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}