Evaluation of the Levels of Selected Cytokines and Their Possible Influence on the Development of Cardiovascular and Pulmonary Complications in Patients after COVID-19.

Background and Objectives: The aim of this study was to evaluate the levels of selected cytokines and their possible influence on the development of cardiovascular and pulmonary complications in patients hospitalized at the Silesian Centre for Heart Disease in Zabrze after having undergone COVID-19. Materials and methods: The study included 76 randomly selected patients from the SILCOVID-19 database. The median time from symptom onset to the study visit was 102 (86-118) days. The median age of the study group was 53 (44-60) years. Assays of a panel of 30 cytokines were carried out in the serum of patients on a Luminex100 platform using the Milliplex MAP kit from Merck KGaA Germany. Results: There were no statistically significant differences in most of the cytokines analyzed between patients with confirmed or excluded lung lesions or cardiac abnormalities. Additionally, no statistically significant differences in cytokine concentrations according to gender, age, comorbidity of diabetes, renal disease, hypertension, increased risk of thrombotic disease, or psychological disorders were demonstrated. There were high concentrations of cytokines such as platelet-derived growth actor-AA (PDGF-AA), monocyte chemoattractant protein-1 (MCP-1), monokine-induced gamma interferon (MIG), and vascular endothelial growth factor-A (VEGF-A). Conclusions: No direct impact of the dependencies between a panel of cytokines and the incidence of cardiovascular and pulmonary complications in patients hospitalized at the Silesian Centre for Heart Disease in Zabrze after having undergone COVID-19 was demonstrated. The demonstration of high levels of certain cytokines (PDGF-AA, VEGF, MIG, and IP10) that are of significance in the development of many lung diseases, as well as cytokines (MCP-1) that influence the aetiopathogenesis of cardiovascular diseases seems to be highly concerning in COVID-19 survivors. This group of patients should receive further monitoring of these cytokine levels and diagnostic imaging in order to detect more severe abnormalities as early as possible and administer appropriate therapy.

Dietary trends among Polish women in 2011-2022-cross-sectional study of food consumption frequency among women aged 20-50 in Silesia region, Poland.

Background: Women's nutrition should be different from that of men. Women have lower energy requirements than men. And the need for certain vitamins and minerals is higher in women, this applies to iron, calcium, magnesium, vitamin D and vitamin B9 (folic acid). This is related to hormonal changes including menstruation, pregnancy, breastfeeding and the onset of menopause. Through hormonal changes and the changing physiological state, women are at greater risk of anaemia, bone weakness and osteoporosis.The aim of the study was to assess changes in the dietary pattern among women from the Silesian Agglomeration in Poland between 2011 and 2022. Material and method: The survey was conducted in 2011 (March-May 2011) and in 2022 (October-November 2022) among women living in the Silesian Agglomeration (Silesia region) in Poland aged 20-50. After consideration of the inclusion and exclusion criteria, 745 women were included in the final analysis, including 437 women screened in 2011 and 308 women screened in 2022.The research tool used in this publication was a survey questionnaire consisting of 2 parts. The first part of the questionnaire consisted of demographic data. The second part of the study focused on the dietary habits of the women surveyed and the frequency of consumption of individual foods (FFQ). Results: More women in 2022 ate breakfast than in 2011 (77.6% vs. 63.8% p < 0.001), were more likely to eat breakfast I at home (73.1% vs. 62.5%; p < 0.001), were more likely to eat breakfast II (39.0% vs. 35.2%; p = 0.001), were more likely to eat breakfast II at home (28.6% vs. 19.2%; p = 0.002), and were more likely to eat lunch at work (16.6% vs. 3.4%; p < 0.001). Women in 2022 were more likely to consume fast-food (p = 0.001), salty snacks (chips, crisps) (p < 0.001) and sweets (p < 0.001). Women in 2022 were more likely to consume whole-grain bread (p < 0.001), wholemeal pasta (p < 0.001), brown rice (p < 0.001), oatmeal (p < 0.001), buckwheat groats (p = 0.06), and bran (p < 0.001) than women in 2011. They were less likely to consume white bread (p < 0.0001), light pasta (p = 0.004), white rice (p = 0.008) and cornflakes (p < 0.001) in 2022.Women in 2022 were significantly more likely to consume vegetables (p < 0.001) than women in 2011. Conclusion: Eating habits in Silesia region women changed between 2011 and 2022. In 2022, women were more likely to choose cereal products considered health-promoting and rich in dietary fiber (including whole-grain bread, whole-grain pasta, oatmeal, bran) were more likely to consume vegetables, dry pulses and vegetarian dinners, and consumed less meat, cured meats, fish and dairy products. Consumption of fast-food, salty snacks (such as chips) and sweets increased.

Assessment of Anti-Human Leukocyte Antigen (HLA)-Antibody-Dependent Humoral Response in Patients before and after Lung Transplantation.

Background and Objectives: Testing for anti-human leukocyte antigen (HLA) antibodies both before and after transplantation is of fundamental significance for the success of lung transplantation. The aim of this study was the evaluation of anti-HLA immunization of patients before and after lung transplant who were subjected to qualification and transplantation. Materials and Methods: Prior to the transplantation, patients were examined for the presence of IgG class anti-HLA antibodies (anti-human leukocyte antigen), the so-called panel-reactive antibodies (PRA), using the flow cytometry method. After the transplantation, the class and specificity of anti-HLA antibodies (also IgG) were determined using Luminex. Results: In the group examined, the PRA results ranged from 0.1% to 66.4%. Low (30%) and average (30-80%) immunization was found in only 9.7% of the group examined. Presence of class I anti-HLA antibodies with MFI (mean fluorescence intensity) greater than 1000 was found in 42.7% of the patients examined, while class II anti-HLA antibodies were found in 38.4%. Immunization levels before and after the transplantation were compared. In 10.87% of patients, DSA antibodies (donor-specific antibodies) with MFI of over 1000 were found. Conclusions: It seems that it is possible to confirm the correlation between pre- and post-transplantation immunization with the use of the two presented methods of determining IgG class anti-HLA antibodies by increasing the size of the group studied and conducting a long-term observation thereof.

Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA).

Patients with pulmonary arterial hypertension (PAH) become candidates for lung or lung and heart transplantation when the maximum specific therapy is no longer effective. The most difficult challenge is choosing one of the above options in the event of symptoms of right ventricular failure. Here, we present two female patients with PAH: (1) a 21-year-old patient with Eisenmenger syndrome, caused by a congenital defect-patent ductus arteriosus (PDA); and (2) a 39-year-old patient with idiopathic PAH and coexistent PDA. Their common denominator is PDA and the hybrid surgery performed: double lung transplantation with simultaneous PDA closure. The operation was performed after pharmacological bridging (conditioning) to transplantation that lasted for 33 and 70 days, respectively. In both cases, PDA closure effectiveness was 100%. Both patients survived the operation (100%); however, patient no. 1 died on the 2nd postoperative day due to multi-organ failure; while patient no. 2 was discharged home in full health. The authors did not find a similar description of the operation in the available literature and PubMed database. Hence, we propose this new treatment method for its effectiveness and applicability proven in our practice.

Diagnostics of the Epstein-Barr Virus Before and After Lung Transplantation in a Patient With Developing Posttransplant Lymphoproliferative Disease: A Case Report.

The most important risk factor for the development of posttransplant lymphoproliferative disorders (PTLD) is Epstein-Barr virus (EBV) infection after transplant. It increases in seronegative EBV recipients from 23% to 50%. The aim of the study was to assess the serologic status of EBV infections (before lung transplant) and the expression of the virus itself after lung transplant in a 25-year-old patient with cystic fibrosis. In a 25-year-old patient with cystic fibrosis, immediately before lung transplant, all diagnostically significant antibodies related to EBV infection were determined in blood serum using enzyme-linked immunosorbent assay methods, using tests by Euroimmun and PerkinElmer Company. Additionally, the organ donor's serologic profile was assessed with the same tests. After lung transplant, the risk of EBV infection was monitored in whole blood and virus expression was determined by reverse transcriptase-polymerase chain reaction with Biomerieux Argene tests. Before lung transplant, the patient was shown to have no antibodies against EBV in both IgM and IgG classes. The constellation of organ donor antibodies clearly indicated a past infection. The presence of EBV virus copies in whole blood was demonstrated in the patient 9 months after transplant. Constant monitoring of the patient and modification of the treatment did not, unfortunately, protect him from the development of PTLD. The obtained results clearly confirm the purposefulness of both serologic and molecular determinations in lung recipients related to EBV. The likelihood of developing PTLD increases both in people who have not had EBV infection and patients with reactivation of the infection.

Assessment of the Serologic Status in Epstein-Barr Virus in Patients Qualified for Lung Transplantation in the First Half of 2021.

BACKGROUND: The aim of the study was to assessment serologic status of Epstein-Barr virus (EBV) infections in patients qualificated for lung transplantation in the first half of 2021. METHODS: The study included 72 patients qualified for lung transplantation from January to June 2021. The youngest patient was aged 14 years and the oldest was aged 65 years. The study group consisted of 36 women and 36 men. In the serum of patients, a multi-parameter, comprehensive diagnosis of EBV infections was performed using the IIFT BIOCHIP EBV sequence tests. This test is based on a combination of several substrates, enabling the simultaneous evaluation of antibodies against capsid antigens (anti-CA antibodies), both in the IgG and IgM class, early antigens (anti-EA), nuclear antigens and the assessment of the avidity of anti-CA antibodies. The analysis of all diagnostically significant antibodies specific for EBV infections, including the avidity of anti-CA antibodies, increases the diagnostic accuracy in differentiating active and past infection with EBV. RESULTS: In the studied group it was shown that 58 had past EBV infection (80.6%). Twelve patients (16.6%) have anti-EA antibodies, which indicate that the virus is reactivated. Only 2 patients (2.8%) had no antibodies to EBV. CONCLUSIONS: Comprehensive assessment of antibodies against various EBV antigens in patients qualified for lung transplantation is important in the management and further diagnosis of this infection, especially after transplantation, due to the risk of developing post-transplant lymphoproliferative disease.

Interleukin 6 and Interleukin 10 in Patients Before and After Lung Transplantation.

The aim of the study was to investigate the serum concentration of cytokines (interleukin 6 [IL-6] and IL-10) in patients before and after lung transplantation (LTx). The studied groups consisted of 14 patients (9 men and 5 women aged 47.7 ± 11.4; body mass index [BMI] 21.9 ± 2.3) followed for up to 6 months after LTx and 29 patients (15 men and 14 women, age 49.2 ± 9.4; BMI 23.1 ± 3.7) who were considered for LTx. The study population consisted of patients with idiopathic lung disease (ILD; 8 vs 17) and patients with chronic obstructive pulmonary disease (COPD; 6 vs 12). Cytokine serum levels were assessed using commercially available enzyme-linked immunosorbent assay kits. Significantly lower levels of IL-10 were observed in the group of patients considered for LTx compared to those in recipients (1.8 ± 0.99 vs 5.1 ± 1.44; P = .000726). Significantly lower levels of IL-10 were observed in the group of patients with ILD considered for LTx compared to recipients (1.8 ± 0.95 vs 3.4 ± 1.16; P = .005984). There were no differences in levels of IL-10 in the group of patients with COPD. There were no differences in levels of IL-6 when the studied groups were compared. The present results introduce the cytokines IL-6 and IL-10 in patients before and after LTx. The procedure of LTx influenced increasing of plasma concentration of IL-10. Immunosuppressive drugs may affect IL-10 serum levels. Further studies are needed to evaluate whether analyzed cytokines could be used as biomarkers of clinical status in patients before and after LTx.

Assessment of Cytokines, Biochemical Markers of Malnutrition and Frailty Syndrome Patients Considered for Lung Transplantation.

BACKGROUND: The aim of the study was to investigate the serum concentration of cytokines and biochemical markers of malnutrition in correlation with frailty syndrome in patients qualified for lung transplantation (LTx). METHODS: The study population comprised 31 potential lung recipients, including 18 patients with idiopathic lung disease, 12 patients with chronic obstructive pulmonary disease, and 1 patient with bronchiectasis who qualified for a LTx. Cytokine serum levels were assessed using commercially available enzyme-linked immunosorbent assay kits and the Luminex 200 platform (ProcartaPlex Hu Cytokine/Chemokine Panel 1A 34plex, Invitrogen, Carlsbad, Calif., United States). The patients were also asked to complete a questionnaire, the Clinical Frailty Scale. RESULTS: All patients were found to have higher cytokine concentrations (IL6, IL 2,IL18, IL23, IL 12p70, IL 10, IL 7). No statistically significant differences in the analyzed cytokines were noted when the men's results were compared to those of the women. There were no significant differences between patients who scored 6 vs 7 points on the Canadian Study of Health and Aging Function Scale. In comparing chronic obstructive pulmonary disease to idiopathic lung disease patients, no significant differences were observed in the analyzed cytokine values. Significant correlations were observed between the analyzed cytokines and age of the patients, C-reactive protein, triglycerides, transferrin, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. CONCLUSIONS: Our findings indicate that cytokines may not have a statistically significant effect on the parameters of the frailty syndrome. The results require further investigations on larger study groups. The findings suggest that the analyzed cytokines may play a proinflammatory role in the end stages of lung diseases, but further studies are needed to evaluate whether these cytokines could be used as biomarkers in this group of patients.

Serum Levels of Visfatin, Omentin and Irisin in Patients with End-Stage Lung Disease Before and After Lung Transplantation.

BACKGROUND The aim of this study was to investigate serum concentrations of visfatin, irisin, and omentin in patients with end-stage lung diseases (ESLD) before and after lung transplantation (LTx) and to find relationship between adipokines levels and clinical outcomes. MATERIAL AND METHODS Fourteen consecutive lung transplant recipients (six males and seven females; age 32.0±14.2 years; body mass index (BMI) 21.8±5.3 kg/m²) who underwent lung transplantation with initial diagnosis of respiratory failure due to cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) were included. Visfatin, irisin, and omentin serum levels were assayed using commercially available ELISA kits at four time points: the day of LTx (day 0), 72 hours (day 3), one month (day 30) and three months (day 90) after LTx. RESULTS Omentin serum concentration decreased significantly within three days after LTx (350.5±302.0 to 200.0±0.90 ng/mL; p<0.05), while visfatin serum levels decreased later, 30 days after Ltx (4.81±3.78 to 0.78±0.35 [0.4-1.1] pg/mL; p<0.05). Downregulated serum levels of both adipokines remained stable for the next two months (256.0 [201.7-642.9] ng/mL and 0.77±0.76 pg/mL, respectively; p<0.05). Serum levels of irisin were unchanged before and after Ltx. Immunosuppressive regimen did not affect serum levels of the analyzed adipokines. CONCLUSIONS The study showed for the first time serum omentin and visfatin levels to be decreased after LTx in ESLD patients. Successful LTx contributes to the improvement of impaired lung function parameters and attenuation of ongoing inflammatory process, resulting in altered visfatin and omentin serum levels. Additional influence of immunosuppressive treatment on omentin and visfatin serum concentration cannot be excluded.

Urinary iodine as an iodine deficiency test in lung transplant recipients in order to prevent iodine deficiency disorders.

BACKGROUND: In Poland, lung transplantation (LTx) as a routine method began in 2004, and since then, the Silesian Center for Heart Disease in Zabrze 85 LTx has performed (54 single-lung transplantations, 30 double-lung transplantations, and 1 heart-lung) transplantation. The recommendation to take vitamin supplements (without specific indication of the iodine content) does not apply to another iodine prophylaxis in patients after lung transplantation, excluding patients with known thyroid disease. The aim of this study was to assess thyroid gland function based on hormones and urinary iodine (UI) concentration in patients after LTx. MATERIAL AND METHODS: UI analysis was performed in 19 lung recipients (12 men and 7 women; mean age: 46.2 ± 12.47 years, BMI: 21 ± 2.25) and compared to TSH, free T3, and free T4. RESULTS: Sufficient UI was observed only in 2 (9%) samples. In 12 samples (54.5%), mild iodine deficiency was recorded, in 4 samples (18.2%) moderate iodine deficiency was noted, and in 3 (13.6%) severe iodine deficiency was found. No correlation between BMI and UI, as well as hormones concentration, was observed. No correlation was revealed when analyzed samples were divided by patient sex. CONCLUSIONS: Although thyroid gland hormones were in the normal range, we found moderate, mild, and severe iodine deficiency in the majority of analyzed samples. Measurements of urinary iodine in lung transplant recipients should accompany thyroid hormone measurements as an iodine deficiency test and in order to prevent iodine deficiency disorders.

Association between age at diagnosis of Graves' disease and variants in genes involved in immune response.

BACKGROUND: Graves' disease (GD) is a complex disease in which genetic predisposition is modified by environmental factors. The aim of the study was to examine the association between genetic variants in genes encoding proteins involved in immune response and the age at diagnosis of GD. METHODS: 735 GD patients and 1216 healthy controls from Poland were included into the study. Eight genetic variants in the HLA-DRB1, TNF, CTLA4, CD40, NFKb, PTPN22, IL4 and IL10 genes were genotyped. Patients were stratified by the age at diagnosis of GD and the association with genotype was analysed. RESULTS: Polymorphism in the HLA-DRB1, TNF and CTLA4 genes were associated with GD. The carriers of the HLA DRB1*03 allele were more frequent in patients with age at GD diagnosis ≤30 years than in patients with older age at GD diagnosis. CONCLUSIONS: HLADRB1*03 allele is associated with young age at diagnosis of Graves' disease in Polish population.

Urinary iodine in patients with differentiated thyroid cancer (DTC) during L-thyroxine treatment.

INTRODUCTION: Urinary iodine concentrations were analyzed in the morning urine samples of patients with differentiated thyroid cancer (DTC). MATERIAL AND METHODS: The analyzed group included 572 DTC patients who were treated with radioiodine or hospitalized for evaluation of radioiodine treatment effects in 2009 at the Institute of Oncology in Gliwice. Ioduria was analyzed by PAMM (Program Against Micronutrient Malnutrition) method before rhTSH administration. A total of 545 tests were performed during L-thyroxine treatment and 27 after L-thyroxine withdrawal. RESULTS: Median L-thyroxine dose was 150 µg/day. Median ioduria was 127.5 µg/L during L-thyroxine therapy and 134 µg/L after the L-thyroxine withdrawal. No distinct relation between ioduria and L-thyroxine dose was observed. Ioduria < 200 µg/L was observed in over 90% of patients and this cut-off was chosen for the reference range. Only 1.2% of patients showed a distinct stable iodine contamination (ioduria ≥ 300 µg/L). CONCLUSIONS: Urinary iodine concentrations in differentiated thyroid cancer patients treated with L-thyroxine vary in a wide range and do not show a clear relation with L-thyroxine dose.