The Value of Urinary NGAL, KIM-1, and IL-18 Measurements in the Early Detection of Kidney Injury in Oncologic Patients Treated with Cisplatin-Based Chemotherapy.

Cisplatin is still a widely used anticancer drug characterized by significant nephrotoxicity. Acute kidney injury (AKI), diagnosed based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, has limitations, including a delayed increase in creatinine. We determined the usefulness of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) in diagnosing AKI according to the KDIGO criteria in patients treated with cisplatin. We recruited 21 subjects starting cisplatin-based chemotherapy (Cisplatin-based group) and 11 treated with carboplatin-based chemotherapy or 5-fluorouracil regimens (non-cisplatin-based group). Blood and urine samples were collected during four subsequent cycles of chemotherapy (68 and 38 cycles, respectively). AKI occurred in four patients in the cisplatin-based group (5.9% of 68 cisplatin-based chemotherapy cycles). Among them, three urinary markers were increased by over 100% in two cases, two in one case and one in another. A doubling of at least one investigated parameter was observed more frequently during cisplatin-based chemotherapy (80.3% vs. 52.8%; OR = 3.65, 95% CI: 1.49-8.90; p < 0.01). The doubling of at least one new urinary AKI marker was more common in patients receiving cisplatin and frequently was not associated with overt AKI. Thus, a subclinical kidney injury detected by these markers occurs more frequently than deterioration in kidney function stated with creatinine changes.

Increasing prevalence of asthma, respiratory symptoms, and allergic diseases: Four repeated surveys from 1993-2014.

BACKGROUND: Published data shows different prevalence trends depending on the region of Europe. AIM: The aim of the study was to analyze time trends of the frequency of the respiratory symptoms and allergic diseases in school children (Silesia, Poland) over the last 21 years. METHODS: We compared the results of four population-based surveys performed in a town of Chorzow in 1993, 2002, 2007 and 2014 in children aged 7-10 years. All four studies had the same study protocol, recruitment (cluster, school-based sampling), questionnaire (WHO respiratory health questionnaire) and the same principal investigator The surveys included 1130 children in 1993, 1421 children in 2002, 1661 children in 2007 and 1698 in 2014. RESULTS: The results covered a 21 year span and showed a statistically significant (p < 0.05) increase in the prevalence of the following physician-diagnosed disorders (1993-2002-2007-2014): asthma (3.4%-4.8%-8.6%-12,6%); allergic rhinitis (4.3%-11.9%-15.9%-13.9%); atopic dermatitis (3.6%-7.9%-12.0%-13.9%); allergic conjunctivitis (4.3%-7.9%-8.3%-7.9%); A simultaneous increasing trend (p < 0.05) in the attacks of dyspnea (3.9%-5.9%-7.0%-7.3%) and symptoms (wheeze, dyspnea, cough) induced by exercise (7.5%-10.6%-22.0%-22.4%) and - at the same time - decrease (p < 0.05) in the prevalence of cough (31.6%-19.6%15.4%-14.4%). Among children with diagnosed asthma during the 21 year span there was significantly (p < 0.05) increased proportion of treated children (51.3%-51.3%-69.5%-60.7%) and a lower frequency of presenting current symptoms. CONCLUSIONS: Our findings are in line with the concept of a real increase in the occurrence of asthma and allergic disease in children. The pattern involves not only physician-diagnosed allergic diseases but also occurrence of symptoms related to respiratory disorders. Diagnosed asthma is better treated and better controlled.

[The role of TLR4 receptor in development of inflammation and carcinogenesis in ulcerative colitis and pharmacotherapy of this disorder]. / Rola receptora TLR4 w rozwoju zapalenia i karcinogenezy we wrzodziejacym zapaleniu jelita grubego oraz w farmakoterapii tego schorzenia.

Ulcerative colitis (UC), a form of inflammatory bowel disease, is characterized by recurrent exacerbation and remission periods. Disturbances in the TLR4 receptor pathway are suggested to be one of the potential mechanisms responsible for its development. TLR4 belongs to the toll-like receptor family, which is a part of the innate immune system. It is expressed in many cells, including enterocytes, and recognizes lipopolysaccharide of Gram-negative bacteria. The activated receptor leads to the development of the inflammatory reaction involving macrophages stimulated by chemokine CCL2, cyclooxygenase 2 (COX-2), prostaglandin E2 (PGE2) and tumor necrosis factor alpha (TNFalpha). On the other hand, this reaction is inhibited by anti-inflammatory agents, such as prostaglandin 15d-PGJ2, and peroxisome proliferator activated receptor type gamma (PPARgamma). Inflammation is aimed at increasing cell proliferation and rapid mucosal healing. The increased expression of TLR4 and the development of the uncontrolled inflammatory response in UC (increased production of COX-2, PGE2, TNFalpha and CCL2) impairs regeneration of the mucosa, resulting in its damage, and may later lead to the development of colon cancer. The aim of this study is to discuss the role of TLR4 in UC, and to indicate the role of the TLR4 pathway in the mechanism of action of the currently used drugs.