[Antiangiogenic therapy of malignant pheochromocytoma and paraganglioma with the view to the recent scientific developments]. / Antyangiogenna terapia zLoSliwej postaci pheochromocytoma i paraganglioma w Swietle najnowszych doniesieN naukowych.

Pheochromocytoma is a very rare tumor that stems from chromaffin cells and usually develops in the adrenal glands. Its equivalent, which exists outside of the adrenal glands, is paraganglioma. Approximately 10-26% of pheochromocytoma is malignant, what poses a significant therapeutical problem, as its presence, together with an abundant production of catecholamines, may lead to a number of perilous complications, such as spinal cord oppression or the damage of organs, what is responsible for producing catecholamines. Due to the risk that the tumor is, it is essential to event new and effective ways of treatment. In case of malignant tumors stemming from chromaffin cells, much is expected from antiangiogenic medicine. Its functioning consists of stopping of the process of neovascularization, which is indispensable for the development of the tumor. Sunitinib - a tyrosine kinase inhibitor - is perhaps the most promising antiangiogenic medicine, whose effectiveness is currently being evaluated in 2nd phase clinical trials. Attempts are also being made to conduct treatment with the use of other medicine of similar functioning, such as: thalidomide, imatinib or evrolimus.

[Ocular symptoms in rheumatic diseases]. / Objawy oczne w wybranych chorobach reumatycznych.

Rheumatic diseases are frequently associated with eye disorders presenting with a wide range of signs and symptoms. Dry eye syndrome, keratitis, uveitis, scleritis and retinal vasculitis are often diagnosed in patients with rheumatic diseases. It is important not to overlook even subtle signs of ocular involvement as it may result in serious complications. Moreover in some cases ocular manifestation may help in proper diagnosis of systemic condition or indicate necessity of intensified treatment of underlying condition. Appropriate treatment of rheumatic diseases require careful follow up and involvement of various specialists including ophthalmologists as well as patient education.

[Actual diagnosis, treatment and prevention of human granulocytic anaplasmosis]. / Aktualne postqpowanie diagnostyczne, terapeutyczne i prewencyjne w ludzkiej anaplazmozie granulocytarnej.

Ixodes ricinus tick is widely known as a reservoir and vector for many dangerous pathogens. One of them is gram-negative bacteria called Anaplasma phagocytophilum, that may cause human granulocytic anaplasmosis (formerly called granulocytic ehrlichiosis). Development of modem diagnostics, which allows the implementation of effective pharmacotherapy, caused that this disease can be effectively detected only for last couple years. Human granulocytic anaplasmosis in most cases is not a severe ailment, but in some patients, especially improperly diagnosed and treated, it can lead to serious complications or even death. Due to non-specific clinical symptoms and a small number of laboratories proceeding specialized tests, human granulocytic anaplasmosis constitutes clinical and diagnostic problem. A significant increase in tick-borne diseases needs to increase public and physicians awareness of these issues.

Eplerenone mimics features of the alternative activation in macrophages obtained from patients with heart failure and healthy volunteers.

Alternative activation of macrophages plays protective role in cardiac remodelling in heart failure and the activity of mineralocorticoid receptor may determine the phenotype of these cells. We examined the influence of eplerenone, aldosterone, and IL-4 on descriptors of alternative activation in blood monocytes collected from 19 patients with heart-failure and 20 healthy volunteers. "Heart failure" macrophages in comparison with "healthy" macrophages had increased mineralocorticoid activity, NO and reactive oxygen species production, expression of iNOS mRNA and protein, but decreased expression of arginase I and mannose receptor proteins, and activity of MnSOD and CuZnSOD. Aldosterone increased mineralocorticoid activity, NO and reactive oxygen species production, iNOS mRNA and protein expression, MnSOD and CuZnSOD activity. Eplerenone attenuated the effects of aldosterone on all but MnSOD and CuZnSOD variables. Eplerenone alone increased the production of NO, MnSOD and CuZnSOD activity, arginase I gene and protein expression, and mannose receptor gene and protein expression, but decreased mineralocorticoid activity only in "heart failure" macrophages. The latter suggests altered function of mineralocorticoid receptor in heart failure. Increased mineralocorticoid activity accounts for increased NO production, iNOS gene and protein expression but does not explain the increased basal reactive oxygen species production and decreased markers of alternative activation in "heart failure" macrophages. In the lack of change in basal mineralocorticoid activity, eplerenone increases markers of alternative activation in a mineralocorticoid receptor-independent manner. Because of changes in iNOS and NO variable, eplerenone induced qualitatively different activation of macrophages from that obtained with IL-4.