Turkiye Klinikleri Journal of Medical Sciences

.: REVIEW
The Association Between Glutathione S-Transferase P1 105IIe>Val Gene Polymorphism and the Risk of Bladder Cancer: A Meta-Analysis
Glutatyon S-Transferaz P1 105IIe>Val Gen Polimorfizmi ve Mesane Kanseri Riski: Meta-analiz
Muhammad ILMAWANa, Avan Guntur SATRIAWANa, Yeni PURNAMASARIb, Bagus Aulia MAHDIc Fredo TAMARAd, Besut DARYANTOe, Atma GUNAWANf, Jonny Karunia FAJARd
aUniversitas Brawijaya Faculty of Medicine, Malang, INDONESIA
bUniversitas Brawijaya Faculty of Medicine, Department of Biomedicine, Malang, INDONESIA
cUniversitas Airlangga, Faculty of Medicine, Department of Internal Medicine, Surabaya, INDONESIA
dUniversitas Brawijaya, Faculty of Medicine, Department of Internal Medicine, Malang, INDONESIA
eUniversitas Brawijaya, Faculty of Medicine, Department of Urology, Malang, INDONESIA
fUniversitas Brawijaya, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology and Hypertension, Malang, INDONESIA
Turkiye Klinikleri J Med Sci. 2020;40(2):250-9
doi: 10.5336/medsci.2019-71871
Article Language: EN
Full Text
ABSTRACT
Objectives: In the last three decades, Glutathione STransferase P1 (GSTP1) 105IIe>Val had been extensively reported in the case of Bladder cancer (BC). However, conflicting results were observed among the studies. We aimed to perform a meta-analysis in effort to assess the association between GSTP1 105IIe>Val gene polymorphism and the risk of BC. Material and Methods: A meta-analysis was conducted between May and July 2019. Papers were searched in Pubmed, Embase, Cochrane, and Web of Science and information of interest was extracted. The correlation and effect estimation were analyzed using random or fixed effect model. Results: We collected 17 studies consisting of 4.236 cases and 5.085 controls. Our pooled calculation revealed that GSTP1 105IIe>Val gene polymorphism was not associated with the risk of BC (OR 95%CI=1.11 [0.97-1.26], p=0.1190). We also performed sub-group analyses in accordance with ethnicity and genotyping method. In ethnicity sub-group, we failed to clarify the correlation between GSTP1 105IIe>Val gene polymorphism and the risk of BC both in Asian and Caucasian sub-groups. While, in genotyping method sub-groups, either using polymerase chain reaction (PCR) or PCR-Restriction fragment length polymorphism (PCR-RFLP) had no significant association with the risk of BC. Conclusion: There is no association between GSTP1 105IIe>Val gene polymorphism and the risk of BC.

Keywords: Bladder cancer; GSTP1; SNP; meta-analysis
ÖZET
Amaç: Son 30 yılda, Glutatyon S-Transferaz P1 (GSTP1) 105IIe>Val mesane kanseri (MK) vakalarında yoğun olarak bildirildi. Fakat çalışmalar arasında çelişkili sonuçlar vardı. GSTP1 105IIe>Val gen polimorfizmi ve MK riski arasındaki ilişkiyi değerlendirmek için bir metaanaliz yapmayı amaçladık. Gereç ve Yöntemler: Mayıs ve Temmuz 2019 arasında meta-analiz yapıldı. Pubmed, Embase, Cochrane ve Web of Science'daki makaleler araştırıldı ve ilgili bilgiler alındı. Korelasyon ve etki tahmini rastgele veya sabit etki modeli kullanılarak incelendi. Bulgular: Toplam 4.236 olgu ve 5.085 kontrolü kapsayan 17 çalışmayı topladık. Toplanmış hesaplama GSTP1 105IIe>Val gen polimorfizminin MK riski ile ilişkili olmadığını ortaya koydu (OR %95 GA=1.11[0,97-1,26], p=0,1190). Ayrıca etnisite ve genotiplendirme yöntemine uygun olarak alt grup analizleri yaptık. Etnisite alt grubunda, hem Asyalı hem de vrupalı ırkta GSTP1 105IIe>Val gen polimorfizmi ile BK arasındaki korelasyonu açıklayamadık. Genotiplendirme yöntemi alt gruplarında, polimeraz zincir reaksiyonu (PCR) veya PCR-kısıtlama fragman uzunluğu polimorfizmi (PCR-RFLP) kullanarak MK ile ilişki bulmadık. Sonuç: GSTP1 105IIe>Val gen polimorfizmi ile MK riski arasında ilişki yoktur.

Anahtar Kelimeler: Mesane kanseri; GSTP1; SNP; meta-analiz
REFERENCES:
  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2014;136(5):E359-86. [Crossref]  [PubMed] 
  2. Burger M, Catto JWF, Dalbagni G, Grossman HB, Herr H, Karakiewicz P, et al. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol. 2013;63(2):234-41. [Crossref]  [PubMed] 
  3. Kauppinen T, Toikkanen J, Pedersen D, Young R, Ahrens W, Boffetta P, et al. Occupational exposure to carcinogens in the European Union. Occup Environ Med. 2000;57(1):10-8. [Crossref]  [PubMed]  [PMC] 
  4. Franekova M, Halasova E, Bukovska E, Luptak J, Dobrota D. Gene polymorphisms in bladder cancer. Urol Oncol. 2008;26(1):1-8. [Crossref]  [PubMed] 
  5. Harries LW, Stubbins MJ, Forman D, Howard GC, Wolf CR. Identification of genetic polymorphisms at the glutathione S-transferase Pi locus and association with susceptibility to bladder, testicular and prostate cancer. Carcinogenesis. 1997;18(4):641-4. [Crossref]  [PubMed] 
  6. Moher D, Liberati A, Tetzlaff J, Altman D. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;6(7):e1000097. [Crossref]  [PubMed]  [PMC] 
  7. Rodriguez S, Gaunt TR, Day IN. Hardy-Weinberg equilibrium testing of biological ascertainment for Mendelian randomization studies. Am J Epidemiol. 2009;169(4):505-14. [Crossref]  [PubMed]  [PMC] 
  8. Bae JM. Comparison of methods of extracting information for meta-analysis of observational studies in nutritional epidemiology. Epidemiol Health. 2016;38:e2016003. [Crossref]  [PubMed]  [PMC] 
  9. Altayli E, Gunes S, Yilmaz AF, Goktas S, Bek Y. CYP1A2, CYP2D6, GSTM1, GSTP1, and GSTT1 gene polymorphisms in patients with bladder cancer in a Turkish population. Int Urol Nephrol. 2009;41(2):259-66. [Crossref]  [PubMed] 
  10. Altunkol A, Savas M, Dilmec F, Utangac M, Abat D, Gumus K, et al. Detection of CYP1A1 and GSTP1 gene polymorphisms in bladder cancer patients in a Turkish population using a polymerase chain reaction-restriction fragment length polymorphism method. Turkish Journal of Urology. 2018;44(2):125-31. [Crossref]  [PubMed]  [PMC] 
  11. Broberg K, Björk J, Paulsson K, Höglund M, Albin M. Constitutional short telomeres are strong genetic susceptibility markers for bladder cancer. Carcinogenesis. 2005;26(7):1263-71. [Crossref]  [PubMed] 
  12. Fontana L, Delort L, Joumard L, Rabiau N, Bosviel R, Satih S, et al. Genetic polymorphisms in CYP1A1, CYP1B1, COMT, GSTP1 and NAT2 genes and association with bladder cancer risk in a French cohort. Anticancer Res. 2009;29(5):1631-5.
  13. García-Closas M, Malats N, Silverman D, Dosemeci M, Kogevinas M, Hein D, et al. NAT2 slow acetylation, GSTM1 null genotype, and risk of bladder cancer: results from the Spanish Bladder Cancer Study and meta-analyses. Lancet. 2005;366(9486):649-59. [Crossref] 
  14. Hung RJ, Boffetta P, Brennan P, Malaveille C, Hautefeuille A, Donato F, et al. GST, NAT, SULT1A1, CYP1B1 genetic polymorphisms, interactions with environmental exposures and bladder cancer risk in a high-risk population. Int J Cancer. 2004;110(4):598-604. [Crossref]  [PubMed] 
  15. Kopps S, Angeli-Greaves M, Blaszkewicz M, Prager HH, Roemer HC, Löhlein D, et al. Glutathione S-transferase P1 ILE105Val polymorphism in occupationally exposed bladder cancer cases. J Toxicol Environ Health A. 2008;71(13-14):898-901. [Crossref]  [PubMed] 
  16. Lesseur C, Gilbert-Diamond D, Andrew AS, Ekstrom RM, Li Z, Kelsey K, et al. A case-control study of polymorphisms in xenobiotic and arsenic metabolism genes and arsenic-related bladder cancer in New Hampshire. Toxicol Lett. 2012;210(1):100-6. [Crossref]  [PubMed]  [PMC] 
  17. Ma QW, Lin GF, Chen JG, Shen JH. Polymorphism of glutathione S-transferase T1, M1 and P1 genes in a Shanghai population: patients with occupational or non-occupational bladder cancer. Biomed Environ Sci. 2002;15(3):253-60.
  18. Yuan JM, Chan KK, Coetzee GA, Castelao JE, Watson MA, Bell DA, et al. Genetic determinants in the metabolism of bladder carcinogens in relation to risk of bladder cancer. Carcinogenesis. 2008;29(7):1386-93. [Crossref]  [PubMed]  [PMC] 
  19. Pandith A, Lateef A, Shahnawaz S, Hussain A, Malla T, Azad N, et al. GSTP1 gene Ile105Val polymorphism causes an elevated risk for bladder carcinogenesis in smokers. Asian Pac J Cancer Prev. 2013;14(11):6375-8. [Crossref]  [PubMed] 
  20. Reszka E, Jablonowski Z, Wieczorek E, Jablonska E, Krol M, Gromadzinska J, et al. Polymorphisms of NRF2 and NRF2 target genes in urinary bladder cancer patients. J Cancer Res Clin Oncol. 2014;140(10):1723-31. [Crossref]  [PubMed]  [PMC] 
  21. Steinhoff C, Franke KH, Golka K, Thier R, Römer HC, Rötzel C, et al. Glutathione transferase isozyme genotypes in patients with prostate and bladder carcinoma. Arch Toxicol. 2000;74(9):521-6. [Crossref]  [PubMed] 
  22. Hsu LI, Chiu AW, Huan SK, Chen CL, Wang YH, Hsieh FI, et al. SNPs of GSTM1, T1, P1, epoxide hydrolase and DNA repair enzyme XRCC1 and risk of urinary transitional cell carcinoma in southwestern Taiwan. Toxicol Appl Pharmacol. 2008;228(2):144-55. [Crossref]  [PubMed] 
  23. Mittal RD, Shankar D, Srivastava L, Mandhani A, Mittal B. Genetic polymorphism of drug metabolizing enzymes (CYP2E1, GSTP1) and susceptibility to bladder cancer in North India. Asian Pac J Cancer Prev. 2005;6(1):6-9.
  24. Törüner GA, Akyerli C, Uçar A, Aki T, Atsu N, Ozen H, et al. Polymorphisms of glutathione S-transferase genes (GSTM1, GSTP1 and GSTT1) and bladder cancer susceptibility in the Turkish population. Arch Toxicol. 2001;75(8):459-64. [Crossref]  [PubMed] 
  25. Kellen E, Hemelt M, Broberg K, Golka K, Kristensen VN, Hung RJ, et al. Pooled analysis and meta-analysis of the glutathione S-transferase P1 Ile 105Val polymorphism and bladder cancer: a HuGE-GSEC review. Am J Epidemiol. 2007;165(11):1221-30. [Crossref]  [PubMed] 
  26. Wu K, Wang X, Xie Z, Liu Z, Lu Y. Glutathione S-transferase P1 gene polymorphism and bladder cancer susceptibility: an updated analysis. Mol Biol Rep. 2012;40(1):687-95. [Crossref]  [PubMed] 
  27. Wang Z, Xue L, Chong T, Li H, Chen H, Wang Z. Quantitative assessment of the association between glutathione S-transferase P1 Ile105Val polymorphism and bladder cancer risk. Tumor Biol. 2013;34(3):1651-7. [Crossref]  [PubMed] 
  28. Yu Y, Li X, Liang C, Tang J, Qin Z, Wang C, et al. The relationship between GSTA1, GSTM1, GSTP1, and GSTT1 genetic polymorphisms and bladder cancer susceptibility. Medicine (Baltimore). 2016;95(37):e4900. [Crossref]  [PubMed]  [PMC] 
  29. Namipashaki A, Razaghi-Moghadam Z, Ansari-Pour N. The essentiality of reporting Hardy-Weinberg equilibrium calculations in population-based genetic association studies. Cell J. 2015;17(2):187-92.
  30. Allocati N, Masulli M, Di Ilio C, Federici L. Glutathione transferases: substrates, inihibitors and pro-drugs in cancer and neurodegenerative diseases. Oncogenesis. 2018;7(1):8. [Crossref]  [PubMed]  [PMC] 
  31. Simić T, Savić-Radojević A, Plje?a-Ercegovac M, Matić M, Sa?ić T, Dragičević D, et al. The role of glutathione s-transferases in urinary tract tumors. J Med Biochem. 2008;27(3):360-6. [Crossref] 
  32. Habig WH, Pabst MJ, Jakoby WB. Glutathione S-transferases. The first enzymatic step in mercapturic acid formation. J Biol Chem. 1974;249(22):7130-9.
  33. Hayes JD, Flanagan JU, Jowsey IR. Glutathione transferases. Annu Rev Pharmacol Toxicol. 2005;45(1):51-88. [Crossref]  [PubMed] 
  34. Pljesa-Ercegovac M, Savic-Radojevic A, Kravic-Stevovic T, Bumbasirevic V, Mimic-Oka J, Simic T. Co-localization of GSTP1 and JNK in transitional cell carcinoma of urinary bladder. Genet Mol Biol. 2010;33(3):460-2. [Crossref]  [PubMed]  [PMC] 
  35. Adler V, Pincus MR. Effector peptides from glutathione-S-transferase-pi affect the activation of Jun by Jun-N-terminal kinase. Ann Clin Lab Sci. 2004;34(1):35-46.
  36. Ketterer B. A bird's eye view of the glutathione transferase field. Chem Biol Interact. 2001;138(1):27-42. [Crossref] 
  37. Moyer AM, Salavaggione OE, Wu TY, Moon I, Eckloff BW, Hildebrandt MAT, et al. Glutathione S-transferase P1: gene sequence variation and functional genomic studies. Cancer Res. 2008;68(12):4791-801. [Crossref]  [PubMed]  [PMC] 
  38. Sharma A, Pandey A, Sharma S, Chatterjee I, Mehrotra R, Sehgal A, et al. Genetic polymorphism of glutathione S-transferase P1 (GSTP1) in Delhi population and comparison with other global populations. Meta Gene. 2014;2:134-42. [Crossref]  [PubMed]  [PMC] 
  39. Garte S, Gaspari L, Alexandrie AK, Ambrosone C, Autrup H, Autrup JL, et al. Metabolic gene polymorphism frequencies in control populations. Cancer Epidemiol Biomarkers Prev. 2001;10(12):1239-48.
  40. Uhlen M, Fagerberg L, Hallström BM, Lindskog C, Oksvold P, Mardinoglu A, et al. Proteomics. Tissue-based map of the human proteome. Science. 2015;347(6220):1260419. [Crossref]  [PubMed] 

.: Up To Date

Login



Contact


Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com