Time-dependent cytokines changes in ultra-rush wasp venom immunotherapy.

Venom immunotherapy (VIT) represents a potential therapeutic approach for the management of venom allergies, aiming to modify the immune response to venom allergens and enhance its precision. Previous studies have demonstrated that VIT induces a shift in T helper cell responses from Th2 to Th1, characterized by the production of IL-2 and interferon-gamma by CD4+ and CD8+ cells. In order to explore long-term pathways following VIT treatment and verify potential new outcomes, the serum concentrations of 30 cytokines were assessed in a cohort of 61 patients (18 control, 43 study group) exhibiting hypersensitivity to wasp venom. Cytokine levels were measured at 0, 2, 6, and 24 weeks after the initiation phase of VIT in the study group. The present study found no significant alterations in the levels of IL-2 and IFN-γ in the peripheral blood following VIT. However, a noteworthy finding was the substantial increase in the concentration of IL-12, a cytokine capable of promoting the differentiation of Th0 cells into Th1 cells. This observation supports the involvement of the Th1 pathway in the desensitization process induced by VIT. Additionally, the study revealed a significant rise in the levels of IL-9 and TGF-ß after VIT. These cytokines may play a role in the generation of inducible regulatory T (Treg) cells, indicating their potential importance in the immune response to venom allergens and the desensitization process associated with VIT. Nevertheless, further investigations are required to comprehend the underlying mechanisms driving the VIT process comprehensively.

Effectiveness of immunoprophylaxis in suppressing carriage of Neisseria meningitidis in the military environment.

Neisseria meningitidis, etiological factor of invasive meningococcal disease, is a human commensal that colonizes the nasopharynx. Colonization is usually asymptomatic, but it is a prerequisite for disease. Asymptomatic carriers are the major source of infection. In the present study, a survey of N. meningitidis carriage was conducted between January and March 2013 in a military unit in Poland. Single-time throat culture samples were collected from professional 559 soldiers (302 unvaccinated vs. 257 vaccinated individuals with the quadrivalent conjugate vaccine ACYW-135). Bacterial identification was performed with classic microbiological methods (culture, incubation, identification). Non-culture method (PCR) was used for confirmation of detected strains of N. meningitidis and determination of serogroups. We found 29 carriers in the group of unvaccinated soldiers (9.6 % of examined individuals) whereas among vaccinated soldiers only 3 persons were carriers of N. meningitidis (1.2 %). The most frequently identified serogroups among the carriers serving in the same military facility were serogroup B (28 %), followed by Y (25 %), and C (22 %). In conclusion, the initiation of mass vaccination with the quadrivalent conjugate vaccine ACYW-135 in the military environment seems an effective method of suppressing N. meningitidis carriage.

Etiological factors causing lower respiratory tract infections isolated from hospitalized patients.

Lower respiratory tract infections (LRTI) account for 20-30 % of all hospital-acquired contagions. They are characterized by high mortality of hospitalized patients. The most serious form of LRTI is pneumonia, and the most common etiological factors in such cases are bacteria. The article gives the analysis of bacterial flora samples obtained from lower respiratory tract of hospitalized patients. In vitro susceptibility of pathogens to selected antibiotics has also been assessed. We carried out a retrospective analysis of 1,171 bacterial strains isolated from 1,171 patients treated in clinics of the Military Institute of Medicine in Warsaw, Poland. In most cases the samples were collected from an endotracheal or tracheostomic tube (71.5 %) and from bronchoalveolar lavage (21.7 %). The most commonly isolated pathogens included Acinetobacter baumannii (35.8 %), Staphylococcus aureus (27.6 %), Klebsiella pneumoniae (19.4 %), and Pseudomonas aeruginosa (16.2 %). Multidrug-resistant gram-negative bacteria exhibited 100 % susceptibility to colistin only. Klebsiella pneumoniae ESBL+ and Acinetobacter baumannii were most susceptible to carbapenems, while Pseudomonas aeruginosa strains to ceftazidime. Methicillin-resistant Staphylococcus aureus were 100 % susceptible to vancomycin, linezolid, and tigecycline. In conclusion, identifying the etiological factors causing infections of the lower respiratory tract and determining their drug-susceptibility is of key importance in empirical treatment.

Competition of IL-1 and IL-1ra determines lymphocyte response to delayed stimulation with PHA.

BACKGROUND: Human peripheral blood mononuclear cells (PBMC) left in microcultures for 24h without mitogen do not respond to subsequent stimulation with PHA. They regain reactivity if the native culture medium is absorbed with other party lymphocytes or partially replaced with the medium from a PHA-stimulated culture. The observations suggest that, during the incubation, some inhibitory agent had accumulated in the culture medium. AIM: The study was performed to determine the nature of the observed phenomenon in respect of the possible role of monocytes and their products IL-1 and IL-1 receptor antagonist (IL-1ra), and to test for immunodiagnostic purposes the significance of quantifying the lymphocyte response to delayed stimulation with PHA in patients suffering from inflammatory prosesses. METHODS: Lymphocyte response to delayed stimulation with PHA, calculated as the lymphocyte-monokine interaction (LM) index, was determined in the microcultures of PBMC isolated from the blood of healthy donors or of patients with acute tonsilitis. The values of LM indices were compared with the ratios of IL-1ra/IL-1beta concentration estimated by enzyme-linked immunosorbent assay method in the culture supernatants. The influences of exogenous IL-1beta, IL-1ra, anti-IL1ra antibodies and antibiotic cefaclor on the monokine concentrations and on the values of LM index were tested. RESULTS AND CONCLUSIONS: The results show that the level of lymphocyte response to delayed stimulation with PHA (LM index) is inversely proportional to the ratio of IL-1ra/IL-1beta concentration in the culture. The low LM values at high IL-1ra/IL-1beta ratios in PBMC cultures from healthy donors, reversed proportions found in patients' PBMC (acute tonsilitis), and the cefaclor-induced reduction of LM value with correlated increase of the IL-1ra/IL-1beta ratio suggest that the LM assay may prove to be useful for immunodiagnostic purposes.

[The effect of inhaled ambroxol treatment on clinical symptoms and chosen parameters of ventilation in patients with exacerbation of chronic obstructive pulmonary disease patients]. / Wplyw leczenia wziewna postacia ambroksolu na objawy kliniczne i wybrane parametry wentylacji u chorych hospitalizowanych z powodu zaostrzenia przewleklej obturacyjnej choroby pluc.

It was a randomised, double-blind, placebo controlled comparative study of the clinical symptoms and chosen parameters of ventilation of inhaled ambroxol in patients hospitalized with exacerbation of chronic obstructive pulmonary disease (COPD). Eligible patients--30 patients (13 men and 17 women) aged of mean value 70.5 +/- 6.9 years who fulfilled the clinical traits of exacerbation of chronic bronchitis entered the study. 15 patients were treated with inhaled ambroxol and 15 were treated with placebo. Moreover all patients were treated with concomitant medications typical for exacerbation of COPD (systemic steroids, intravenous infusions with euphillin, antibiotics, Berodual nebulizations and oxygen therapy). Spirometry and data related to clinical symptoms were taken at the beginning of the study and after 1 and 3 days and after the end of the treatment. At the end of the treatment period in both groups (inhaled ambroxol therapy vs. placebo) there wasn't found statistically significant difference in the number of cough and dyspnoe attacks. There was found the difference in FEV1 and FEF 50 in both groups, but improvement in patients treated with ambroxol was statistically significantly faster, that can influence the cost of treatment. Moreover there were not found important adverse events in ambroxol group.

[Adhesion molecules LFA-1(CD-11a), Mac-1(CD-11b) of t-lymphocytes in bronchoalveolar lavage fluid and blood in patients with chronic respiratory tract disease]. / Czasteczki adhezyjne LFA-1(CD11a), Mac-1(CD11b), ICAM-1(CD54) limfocytów T pochodzacych z plukania oskrzelowo-pecherzykowego i krwi u chorych na przewlekle choroby ukladu oddechowego.

Adhesion molecules play an important role in inflammatory processes and influence on recruitment of effector cells. The aim of our study was to assess the percentage of T-lymphocytes expressing LFA-1, Mac-1 and ICAM-1 in bronchoalveolar fluid (BALF) and blood of patients with sarcoidosis, atopic bronchial asthma and chronic bronchitis. The reference group consisted of patients with haemoptysis or suspected of having bronchial carcinoma. Expression of adhesion molecules was revealed by /APAAP/ alkaline phosphatase anti alkaline phosphatase method. The highest percentage of lymphocytes expressing all adhesions molecules in BALF and blood was observed in patients with chronic bronchitis. Reductions of T-cells in BALF of patients with bronchial asthma and sarcoidosis may reflect of their direct binding in inflammatory sites. This studies confirm the involvement of adhesion molecules in maintenance of chronic inflammatory processes in the respiratory tract.

[Serological screening examinations of atypical pathogens (Mycoplasma pneumoniae, Chlamydia pneumoniae) in respiratory tract infection]. / Serologiczne badanie przesiewowe atypowych czynników (Mycoplasma pneumoniae, Chlamydia pneumoniae) w zakazeniach ukladu oddechowego.

Lower respiratory tract infections are a heterogeneous group of disorders induced by plenty of pathogens. Atypical bacteria play an important role in the respiratory tract pathology. In our study 90 patients with acute infection of the respiratory tract were examined in serological screening test for Mycoplasma pneumonia and Chlamydia pneumoniae. It was confirmed that in 21 patients with community acquired pneumonia Mycoplasma pneumonia antibodies were detected in 38% and Chlamydia pneumoniae in 10%. In our opinion this screening serological tests are useful for early diagnosis of atypical bacterial infections of the respiratory tract.

[Expression of adhesion molecules LFA-1 (CD11a and ICAM-1 (CD54) on lymphocytes and chemokines IL-8 and MCP-1 concentrations in bronchoalveolar lavage of patients with asthma or chronic obstructive pulmonary disease]. / Ekspresja czasteczek adhezyjnych LFA-1 (CD11a) i ICAM-1 (CD54) na limfocytach oraz stezenia chemokin IL-8 i MCP-1 w materiale z plukania oskrzelowo-pecherzykowego u chorych na astme oskrzelowa i przewlekla obturacyjna chorobe pluc.

Chemokines and cellular adhesion molecules are crucial determinants of the migration of immune effector cells to the tissues asthma and chronic obstructive pulmonary disease (COPD) are a complex of conditions, which have airflow limitation in common. The aim of this study was to determine the numbers and percentages of lymphocytes expressing adhesion molecules: LFA-1, ICAM-1 together with assessment of chemokines concentrations: IL-8 and MCP-1 in bronchoalveolar lavage fluid (BAL) of patients with asthma or chronic obstructive pulmonary disease (COPD). 12 patients with asthma, 14 patients with COPD, and 6 subjects of control group took part in this study. The expression of LFA-1 and ICAM-1 was assessed on lymphocytes by using immunohistochemistry (streptavidyn-biotin, DAKO, Denmark). ELISA test was used to measure IL-8 and MCP-1 concentrations in BAL (kits from R&D, USA). The percentage of lymphocytes expressing LFA-1 and ICAM-1 were: 33.9 +/- 23.8% and 25.8 +/- 12.2% in COPD patients, 23.9 +/- 12.1% and 15.3 +/- 4.42% in asthma patients, and 14.2 +/- 10% and 5.2 +/- 1.6% in the control group respectively. There was observed significant difference between the percentage of lymphocytes expressing LFA-1 and ICAM-1 of COPD and the control group. The concentrations of IL-8 were: 2306 +/- 1501 pg/ml in COPD, 233 +/- 27.3 pg/ml in asthma and 64 +/- 28.7 in the control group (p < 0.05). The concentrations of MCP-1 were: 768.9 +/- 668.1 pg/ml in COPD, 126.8 +/- 30.8 pg/ml in asthma, and 83.0 +/- 16.4 pg/ml in the control group (p < 0.05). There was observed correlation between lymphocytes expressing LFA-1 and IL-8 concentration (r = +0.5, p < 0.05) and between lymphocytes expressing LFA-1 and MCP-1 concentration (r = +0.5, p < 0.05), and between lymphocytes expressing ICAM-1 and MCP-1 concentration (r = +0.4, p < 0.05) only in COPD patients. Our data suggest that LFA-1 and ICAM-1 are important molecules in the recruitment of leukocytes and together with IL-8 and MCP-1 may have a role in pathomechanism of inflammation in asthma and especially in COPD.

[The role of inflammation mediators in bronchial asthma and chronic obstructive pulmonary disease]. / Rola niektórych mediatorów reakcji zapalnej w astmie oskrzelowej i przewleklej obturacyjnej chorobie pluc.

Bronchial asthma and chronic obstructive pulmonary disease (COPD) are chronic inflammatory diseases of the bronchial tree. Some products of eosinophils, neutrophils and other cells have been implicated in causing bronchial mucosal damage and may play important role in monitoring degree of airway inflammation and differentiation between bronchial asthma and COPD. The author described some of them.

[Eosinophil cationic protein in children with allergic diseases of the respiratory tract in exacerbation and remission of symptoms]. / Eozynofilowe bialko kationowe u dzieci chorych na alergiczne choroby ukladu oddechowego w okresie zaostrzenia i remisji objawów.

The role of eosinophil cationic protein (ECP) in allergic inflammatory reaction has been documented in experimental and clinical studies, but a clinical usefulness is still discussed. In the study serum level of ECP has been evaluated in children with allergic diseases of the respiratory system in exacerbation and remission of symptoms for purpose of monitoring of disease course. In 111 children aged 12.0 +/- 3.3 yrs with atopic bronchial asthma and/ or allergic rhinits ECP serum concentrations have been determined in following groups: children with grass pollen hypersensitivity (group P, 17 female and 41 male), children with hypersensitivity to D. pteronyssinus and D. farinae (group D, 16 female and 37 male) and controls without allergic hypersensitivity with negative prick skin tests (19 children, 11 female and 5 male). All children have been qualified to immunotherapy with pollen or mite allergens (Allergovit or Novo-Helisen, Nexter, Allergopharma) and ECP evaluation was performed before, during and after therapy. Serum ECP and IgE levels have been determined with CAP-system (Pharmacia) and obtained results related to clinical symptoms. In all analyzed children serum total IgE has been significantly increased in relation to controls. Serum ECP levels have been increased during clinical exacerbation of symptoms in observed children and parallel with clinical score of symptoms, especially during pollen season. Authors conclude that a degree of increase of serum ECP level is parallel with clinical score of symptoms, especially during highest exposition to pollen allergens. Observed changes of serum ECP levels during immunotherapy suggest the close relationship with allergic inflammatory reaction and indicate clinical usefulness for monitoring of this process.

[Local treatment with tumor necrosis factor alpha in a patient with lung cancer]. / Miejscowe leczenie czynnikiem martwicy nowotworów-alpha u chorej z guzem pluca.

Tumor Necrosis Factor alfa (TNFa) is a cytokine with cytolytic and cytotoxic properties. First clinical trials in which TNF was administered parenterally date back to early 70-ties. Soon it was noticed that when administered strictly to the tumor mass TNF exhibits high anti-tumor efficacy, exemplified by total or at least substantial regression of the tumor mass while producing minor and controllable symptoms. In this paper the case of local administration of the recombinant TNFa directly into the tumor mass constricting the bronchus was presented.

[Tumor necrosis factor-alpha--biological and immunologic properties]. / Czynnik martwicy nowotworów-alpha--wlasciwosci biologiczne i immunologiczne.

The studies investigating antitumor efficacy of bacterial infections, started by Coley, resulted in isolation of tumor necrosis factor (TNF-alpha), released by activated macrophages. It was hoped that direct and indirect cytotoxic, cytostatic and immunomodulatory effects of TNF-alpha would prove helpful in obtaining an effective antitumor drug. In this paper, we describe biologic and immunologic activity of cachectin as well as pre-clinical trials of TNF application in antitumor therapy.

[Tumor necrosis factor-alpha--phase I and phase II clinical trials]. / Czynnik martwicy nowotworów-alpha badania kliniczne I i II fazy.

Not fully successful therapy of carcinomas makes us search for new methods of antitumor treatment. Beside radiotherapy and chemotherapy, immunotherapy is the method we put our hopes on. Since its isolation in mid 70s TNF-alpha has been the subject of careful studies investigating its clinical usefulness. In phase I and II clinical trials dose- and manner of administration-dependent side effects were observed, which considerably limited the use of TNF-alpha in clinical practice. Topical (intratumoral) therapy eliminated most systemic side effects. Synergic antitumor efficacy of TNF-alpha, cytokines, such as interferon-gamma (IFN-gamma) and interleukin-2 (IL-2), and cytostatic drugs (etoposide, cyclophosphamide) was proved.

[Pneumococcal pneumonia with a sever course]. / Paciorkowcowe zapalenie pluc o ciezkim przebiegu.

The authors present a case of a 70-years old patients with bilateral pneumonia of pneumococcal etiology. During the treatment, after the initial improvement respiratory failure was observed and mechanical ventilations was applied. Following this procedure appeared such complications as left pneumothorax and pleural empyema. After drainage and evacuation of purulent fluid from pleural cavity the clinical improvement was observed. The case shows how pneumonia is still dangerous, especially for patients with chronic obstructive pulmonary disease.

[Non-Hodgkin's lymphoma: diagnostic problems]. / Chloniak z limfocytów t obwodowych--problemy diagnostyczne.

The aim of this article was to describe rarely occurred non-Hodgkin's lymphomas from peripheral lymphocyte T. Epidemiology, course of the disease and difficulties of diagnostic was described with the special regards of early diagnostic.

[Granulocyte-macrophage colony stimulating factor (GM-CSF) in material from broncho-alveolar lavage and serum of patients with bronchial asthma]. / Czynnik stymulujacy wzrost kolonii granulocytów i makrofagów (GM-CSF) w materiale z plukania oskrzelowo-pecherzykowego i w surowicy chorych na astme oskrzelowa.

Granulocyte-macrophage colony stimulating factor (GM-CSF) is an important hematopoietic growth factor which has been shown to induce proliferation and activation of inflammatory cells and may play a role in allergic diseases. An activity of GM-CSF was determined in serum and BAL-fluid of 12 asthma patients with bronchial hyperreactivity to histamine before and 24 hours after challenge test. It was found statistically significant increase (p < 0.05) of GM-CSF activity in patients with bronchial hyperreactivity to histamine.

[Clinical evaluation of disodium cromoglycate with beta-2-agonist in therapy of patients with atopic bronchial asthma (preliminary study)]. / Ocena przydatnosci klinicznej kromoglikanu dwusodowego w polaczeniu z beta-2-agonista w leczeniu chorych na atopowa astme oskrzelowa (badania wstepne).

In 38 patients with atopic bronchial asthma DNCG (disodium cromoglycate) and DNCG comp. (disodium cromoglycate and reproterol hydrochloride) were applied in inhalation way. After 7 days course spirometric values were monitoring in all patients. Decrease of Raw values and increases of FEF50 and FEV1 were noticed in all patients, especially in asthmatics treated with DNCG comp. Obtained results suggest a good clinical effect and improvement of spirometric values in patients with atopic bronchial asthma during DNCG and DNCG comp. therapy.

[Cellular analysis of bronchoalveolar lavage fluid (BAL) in patients with acute and chronic bronchitis (preliminary study)]. / Próba analizy cytologicznej materialu z plukania oskrzelowo-pecherzykowego (BAL) u chorych na zapalenie oskrzeli (badania Wstepne).

Cell morphology of BAL- fluid and index bronchitis (by Thompson) were evaluated in 52 patients with acute and chronic bronchitis. A significant increase of index bronchitis and percentage of neutrophils in BAL were observed in acute and chronic bronchitis. There was no correlation between index bronchitis and cell in BAL- fluid.