[Interleukin-13 in the nasal lavage of pollinosis patients after specific intranasal challenge]. / Interleukina-13 w popluczynach nosa chorych na pylkowice po swoistej prowokacji donosowej.

The unique properties of interleukin-13 have drawn the attention of investigators to its role in atopic diseases and in the mechanism of specific immunotherapy. The aim of this paper was to determine whether the presence of interleukin-13 will, apart from interleukina-4, be found in the nasal lavage after specific challenge and if the levels of these cytokines will differ. The studies included 13 patients in whom grass and rye pollen allergy was confirmed by the case history, skin tests and the presence of specific IgE in the blood serum. In all these persons active anterior rhinomanometry and than specific challenge with gradually increasing concentrations of the grass pollen allergen were performed before the season. At the end of these challenge, nasal lavage was done and the lavage fluid was preparated for determination of IL-4 and IL-13. Both cytokines were found to be present in the nasal lavage and in 6 patients the IL-13 concentration was higher than that of IL-4. Three of these patients had been previously hyposensitized. Although the results presented here are preliminary, they may provide inspiration four further investigations of the role of IL-13 in the specific immunotherapy in pollinosis patients.

[Evaluation of the enhaled glucocorticosteroid effect on non-specific and specific bronchial reactivity with particular reference to the late inflammatory phase in atopic asthma patients. I. The effect of a single dose of budesonide R on specific and non-specific bronchial reactivity]. / Wplyw wziewnych glikokortykosteroidów na nieswoista i poalergenowa reaktywnosc oskrzeli ze szczególnym uwzglednieniem póznej fazy zapalnej u chorych na atopowa astme oskrzelowa. I. Wplyw pojedynczej dawki budezonidu R na swoista i nieswoista reaktywnosc oskrzeli.

The effect of a single dose of 320 micrograms of budesonide R on specific and non-specific bronchial response was evaluated. The study was carried out on a group of 12 patients suffering from mild allergic asthma, sensitive to Dermatophagoides pteronyssinus (D. pteronyssinus). On the first day the bronchial provocation test (BPT) with metacholine was performed, and the next day the effect of a single dose of the drug studied on bronchial response to metacholine was evaluated. On the third day sBPT with D. pteronyssinus allergen was performed. The allergen challenge could induce an early (EAR) and a late asthmatic reaction (LAR). After the BPT with the allergen, a 42 days' run-out period was required to eliminate the effects of the allergen provocation on the results of the next tests. Before the evaluation of the effect of budesonide on the allergen challenge, the non-specific response to metacholine was checked again. The results indicate that a single dose of budesonide R does not affect non-specific and specific bronchial response.

[Evaluation of the inhaled glucocorticosteroid effects on non specific bronchial reactivity with particular reference to the late inflammatory phase in atopic asthma patients. II. The effect of regular administration of budesonide R on specific and non-specific bronchial reactivity]. / Wplyw wziewnych glikokortykosteroidów na nieswoista i poalergenowa reaktywnosc oskrzeli ze szczególnym uwzglednieniem póznej fazy zapalnej u chorych na atopowa astme oskrzelowa. II. Wplyw regularnego stosowania budezonidu R na odczyn zapalny oraz swoista i nieswoista reaktywnosc oskrzeli.

The purpose of the study was to determine whether regular administration of budesonide R decreases inflammation, specific and non-specific bronchial hyperreactivity in allergic asthma patients. The studies were carried out on 16 patients suffering from mild to moderate allergic asthma, sensitive to D. pteronyssinus allergen. After performance of the specific and non-specific bronchial provocation tests, collection of blood samples for an ECP evaluation, the patients were regularly treated with budesonide R, 2 x 320 micrograms for a period of 8 weeks. At the end of the study the BPTs and blood collection were repeated. BPTs with methacholine and D. pteronyssinus were performed according to Ryan's method. After the allergen challenge, early (EAR) and late asthmatic reaction (LAR) were to be observed. After the therapy non-specific BHR to methacholine expressed as PC20FEV1 and specific BHR to allergen (PD20FEV1D. pteronyssinus) and serum ECP concentrations decreased significantly. Although after the treatment with budesonide R, the patients had to inhale much larger amounts of allergen, in order to induce EAR, the number of LAR did not change significantly. After treatment the LAR appeared about 1 hour later and the decrease in FEV1 was less than previously. We conclude that budesonide R decreases the intensity of the inflammation and BHR.

[The efficacy of a new medication -- intranasal glucocorticoid mometasone furoate (Nasonex) -- in seasonal allergic rhinitis]. / Skutecznosc nowego preparatu steroidowego Nasonex-aerozol w leczeniu sezonowego, alergicznego niezytu nosa.

The aim of this open study was to evaluate the efficacy and safety of new topical corticosteroid Nasonex (mometasone furoate) in allergic, seasonal rhinitis. The investigations were carried out on 30 patients with proven grass pollen allergy. Nasonex was administered intranasally during the pollen season, in a single dose 200 micrograms. During the 3 subsequent visits nasal and nonnasal symptom (total and individual) scores and patient reaction to the treatment were evaluated. Rhinomanometry and number of eosinophils in nasal smear were calculated before and after the treatment. Complete or marked relief of symptoms was observed in 24 patients, moderate improvement in 4 patients and no positive reaction in 2 cases. Nasonex markedly inhibited eosinophil influx to the nasal mucosa. No adverse reaction was observed during 2-week Nasonex treatment. We conclude that Nasonex aerosol is a very effective and well tolerated drug in the treatment of seasonal allergic rhinitis.

[Clinical evaluation of 12 week salmeterol therapy in allergic asthma patients]. / Kliniczna ocena 12 tygodniowej terapii salmeterolem chorych na alergiczna astme oskrzelowa.

The purpose of the study was to evaluate the efficacy of salmeterol in asthma therapy. The study was performed on a group of 16 allergic asthma patients sensitive to house dust mite allergens. After a run-in period the patients were treated with salmeterol, 2 x 50 micrograms, for a period of 12 weeks. They noted an intensity of asthma symptoms, morning and evening PEF, beta 2-agonist consumption and adverse in their diary cards. On the visit to the clinic spirometry was performed. During the treatment a significant reduction in the symptom score, PEF variation, beta-agonist consumption and an increase in the value of morning and evening PEF were noted. The above results indicate the great efficacy of salmeterol in asthma therapy.

[Evaluation of efficacy and tolerance of an antiasthmatic preparation--Ditec, consisting of low doses of disodium cromoglycate and fenoterol]. / Ocena skutecznosci i tolerancji preparatu przeciwastmatycznego--Ditec, zawierajacego niskie dawki kromoglikanu disodowego i fenoterolu.

The efficacy, tolerance and, in addition, the effect of the antiasthmatic drug-Ditec, consisting of low doses disodium cromoglycate (DSCG) and fenoterol on bronchial hyperreactivity (BHR) were evaluated. The studies were carried out on a group of 22 mild asthma patients aged from 10 to 20 years. The patients took DSCG during the first four weeks and then were treated with Ditec, 4 x 2 puffs, for next four weeks. The following parameters were evaluated: symptom score, beta 2-agonist "taken on demand" consumption, spirometry, morning and evening PEF, and possible adverse effects. Decreases in the symptom score, beta 2-agonist consumption (mainly in Ditec period) and increase in PEF during the study were noted. The low doses of DSCG contained in Ditec were as effective as the 80 mg of this drug given previously. No statistically significant decrease in BHR after DSCG treatment was observed. At the end of the Ditec therapy, BHR to histamine markedly diminished. Because the last doses of Ditec were taken 2 hours before the bronchial provocation test with histamine, the increase in tolerance of histamine, mentioned above, was probably only due to the so-called acute effect of beta 2-agonist on BHR. Ditec seems to be a valuable antiasthmatic drug, especially for children and young persons. Unfortunately, our studies did not answer the additional question whether regular treatment with Ditec changes BHR.

[Usefulness of allergen extract Aquagen SQ-Dpt for administering bronchial provocation tests]. / Przydatnosc wyciagu alergenowego Aquagen SQ-Dpt do przeprowadzania testów swoistej prowokacji oskrzelowej.

The value of the allergen extract, Aquagen SQ-Dpt, for performance of the bronchial provocation test in allergic asthma patients was evaluated. The studies were carried out on 117 patients suffering from allergic mite asthma. Bronchial challenge was performed according to Ryan's method. After an allergen inhalation, an early asthmatic reaction (EAR) and a late asthmatic reaction (LAR) may appear. In our studies a dual reaction (EAR and LAR) was observed in 53.8% of the patients, the EAR only in 27.4% and the LAR only in 2 patients. The subjects with the dual response demonstrated a higher sensitivity to the allergen than those with only the EAR. A positive, statistically significant correlation between specific and non-specific bronchial hyperreactivity was found. The frequency of the appearance particular patterns of the bronchial responses was similar to those published by other authors, using different allergen extracts. Aquagen SQ-Dpt can be used to perform of the sBPT.

The effects of a new generation of H1 antihistamines (cetirizine and loratadine) on histamine release and the bronchial response to histamine in atopic patients.

The effects of two selective H1 receptor blockers, cetirizine and loratadine, in comparison with placebo, on basophil histamine release and the bronchial response to histamine were assessed. The studies were performed in a group of 18 patients with pollinosis and 22 with atopic asthma. Both tests were performed before and after medication. Histamine release from isolated basophils was evaluated by Shore's method using anti-IgE and pollen antigen as stimulants. The bronchial provocation tests were performed by Ryan's method. The results were expressed as PC20FEV1. It was shown that both drugs significantly inhibited basophil histamine release induced by anti-igE or specific allergen. It was also found that these drugs effectively reduced the bronchial response to histamine challenge. These findings confirm the beneficial clinical effect of a new generation of selective H1 blockers in the treatment of IgE-mediated allergic diseases, and also the possible role of these drugs in the therapy of atopic asthma.

[An immunologic evaluation of Polish pollen extract Catalet "C" and Catalet "D" in patients with pollinosis]. / Immunologiczna ocena polskich preparatów alergenowych Catalet "C" i Catalet "D" u chorych na pylkowice.

In a group of 41 hay fever and/or seasonal asthma patients, sensitive to weed or tree pollens the influence of specific immunotherapy (sIT) on the level of IgE, specific IgE and IgG4, and HR induced by anti-IgE and specific allergens was evaluated. It was shown that both allergenic extracts, Catalet C and Catalet D, are really immunogenic, which is manifested in a decrease in specific IgE and in a marked increase in specific IgG4, after 2 years of sIT. In comparison with the placebo, the sensitivity of blood basophils to both specific allergens and non-specific factors significantly decreased.

[Clinical evaluation of Polish allergen extracts Catalet C and Catalet D in patients with pollinosis]. / Kliniczna ocena Polskich preparat-ow alergenowych Catalet C i Catalet D w leczeniu chorych na pylkowicle.

The aim of this paper was to evaluate the clinical efficacy, individual tolerance and side effects of allergen extracts, a weed pollen vaccine Catalet C and a tree pollen vaccine Catalet D. The study was carried out on a group of 41 patients aged from 15 to 46 years in comparison with a placebo group (36 patients). A good tolerance, no serious side effects and a high clinical efficacy, manifested in diminution of pollinosis symptoms in more than 80% of patients was noted. In the treated patients a significant reduction of antiallergic drug consumption in the pollen season was noted as compared with the placebo. The extracts Catalet C and Catalet D are usefull in the specific immunotherapy in weed and tree pollen allergic patients.

[Efficacy and tolerance of allergenic extracts Allergovit and Novo-Helisen depot in immunotherapy of allergic diseases]. / Skutecznosc i tolerancja preparatów alergenowych Allergovit i Novo-Helisen depot w immunoterapii chorób alergicznych.

The aim of this study was to evaluate the efficacy, tolerance and immunogenity of allergenic extracts: Allergovit and Novo-Hellisen depot (produced by Allergopharma--Germany), used for sIT in pollinosis and house dust mite allergy. The treatment was carried out on 40 patients for three years. The evaluation included the results of a physical examination, the score of symptoms from self-observations and the consumption of antiallergic medicines. In addition to the serum IgE and IgG4 the percentage of histamine, liberated by a-IgE and specific allergens, from peripheral blood basophils was determined. In some of patients treated with Novo-Helisen depot the specific and nonspecific bronchial challenge tests were made. It was shown that the allergenic extracts Allergovit and Novo-Helisen depot are effective in treatment of pollinosis and house dust mite allergy, and are well tolerated by the patients. The changes in humoral response during sIT manifest their immunogenity. The sIT with Allergovit decreases the sensitivity of the peripheral blood basophils, whereas the treatment with Novo-Helisen depot causes a diminution of bronchial specific and nonspecific reactivity and a negativisation of late allergic reaction.

[Specific immunotherapy in patients with bronchial asthma hypersensitive to housedust mites]. / Swoista immunoterapia u chorych na astme oskrzelowa uczulonych na alergeny roztoczy kurzu domowego.

An efficacy and effects of immunotherapy (IT) on skin and bronchial reactivity, and serum levels of some immunoglobulins in mite asthma patients were evaluated. A usefulness of some tests was assessed additionally. The studies were carried out on 37 asthmatics. Thirty of them were treated with Alutard SQ and 7 were observed as a control group for a period of 24 months. During the successive visits to the clinic the following examinations were carried out: physical examination, checking patient diary cards, skin prick tests, PS test and blood samples were taken for determination of IgE, sIgE Dpt, sIgG4 Dpt. Specific and nonspecific bronchial hyperactivity (BHR) were evaluated before, after 1 year and 2 years of IT. The obtained results evidenced a clinical improvement, a reduction of other antiasthmatic drugs consumption, decreases in serum IgE and sIgE Dpt levels and increases in serum sIgG4 Dpt levels. The changes in humoral response did not correlate with the clinical improvement. At the successive visits were needed higher concentrations of allergen to cause the positive allergic reaction in PS test. The reductions in specific and nonspecific DHR during IT were observed. The bronchial allergen challenge test seems to be a very valuable method in monitoring of IT in asthma patients.

[CAP system methods versus FAST methods in immunologic monitoring of specific immunotherapy in pollen allergy]. / Metoda CAP-System versus metoda FAST w immunologicznym monitorowaniu swoistej immunoterapii w alergii py kowej.

The aim was to study the value of the CAP system (Pharmacia) in comparison with the FAST method (Bio Whittaker) in determination of total IgE, specific IgE and IgG4 during specific immunotherapy (sIT). The studies were carried out on a group of 67 patients with pollinosis treated with various pollen allergen extracts. The immunological studies were performed before and after several courses of sIT. A higher reproducibility and sensitivity of the CAP System was shown. The values of specific IgE were somewhat higher on using the CAP system than using the FAST method. The CAP system seems to be of great value in diagnostics and monitoring sIT, especially in birch pollen allergy.

[Behavior of various spirometry parameters during bronchial provocation tests with D. pteronyssinus in patients with asthma, sensitized to housedust mites]. / Zachowanie sie rónych wskaników spirometrycznych w czasie swoistej prowokacji oskrzeli alergenem D. pteronyssinus u chorych na astme, uczulonych na roztocza kurzu domowego.

Changes in particular spirometry parameters during specific bronchial provocation test (BPT) with an allergen in asthmatics sensitized to house dust mites were evaluated. Studies were carried out on 130 patients. Specific BPT with D. pteronyssinus was performed according to the Ryan's method using a jet De Villbiss 646 nebuliser powered by compressed air and connected to the French Rosenthal dosimeter. The spirometry was measured using Pneumoscreen II (Jaeger - Germany). The provocation was terminated when a value of FEV1 fell at least 20% from baseline and then the spirometry parameters were measured hourly for a period 8 hours. Early and late asthmatic responses were founded. Results were expressed as a percentage of the maximum decrease from the baseline in particular parameters. To the statistical calculations only positive sBPT results founded in 96 patients were selected. The mean values of the decreases during of the EAR were as follow: FEV1 = 30.6 +/- 9.9%, FVC = 18.9 +/- 9.9%, FEV/FVC = 14.6 +/- 9.2%, FEV25-27 = 41.5 +/- 15.7%, PEF = 30.8 +/- 15.7%. The correlation coefficients were between FEV1 and FVC -0.57, FEV1 and FEV1/FVC -0.56, FEV1 and FEF25.75 -0.65, FEV1 and PEF -0.6. The results were statistically significant. Decreases in FEV1 and PEF were very similar each other. The greatest changes were observed in FEF25.75. The curves of the FEV1 and PEF averages observed during LAR were quite close to each other and almost parallel. The usefulness of the both parameters seems to be equal.

[Production of selected cytokines by monocytes (IL-1 beta, IL-6) and lymphocytes (IL-2, IL-4) in peripheral blood of patients with nonallergic bronchial asthma treated with Broncho-Vaxom]. / Wytwarzanie wybranych cytokin przez monocyty (IL-1 beta, IL-6) i limfocyty (IL-2, IL-4) krwi obwodowej u chorych na niealergiczna astme oskrzelowa leczonych preparatem Broncho-Vaxom.

In 16 patients with nonallergic bronchial asthma treated with Broncho-vaxom and 10 healthy persons the mononuclear peripheral blood cells ability for IL-1 beta, IL-2, IL-4 and IL-6 production were studied. Nonallergic asthmatics were characterised by increased levels of IL-1 beta and IL-6 produced by monocytes. After Broncho-vaxom therapy a decreased for IL-1 beta and IL-6, and an increased production of IL-2 were observed. These findings indicate that orally administered Broncho-vaxom affects on biological activity of mononuclear peripheral blood cells.

[Effect of Ribomunyl therapy on production of selected cytokines by mononuclear peripheral blood cells in nonatopic bronchial asthma]. / Wplyw leczenia preparatem Ribomunyl na wytwarzanie wybranych cytokin przez komórki jednojadrowe krwi obwodowej u chorych na nieatopowa astme oskrzelowa.

In a group of 14 patients with nonatopic bronchial asthma, with recurrent infections of airways (approximately 5 - 10 episodes/year) and in 9 healthy persons the effect of Ribomunyl on IL-1 beta, IL-2, IL-4 and IL-6 production by mononuclear peripheral blood cells were assessed. After Ribomunyl treatment in asthmatics the significant decrease in IL-1 beta and IL-6 production by monocytes stimulated with lipopolysaccharides (LPS) and significant increase in IL-2 production by lymphocytes were observed.

[Effect of flunisolide on exacerbation of clinical symptoms, spirometric parameters, consumption of B2-adrenergic drugs and levels of cortisol and ECP in serum of patients with bronchial asthma]. / Wplyw flunizolidu na nasilenie objawów klinicznych, parametry spirometryczne, konsumpcje lek-ow beta 2-adrenergicznych oraz steenie kortyzolu i ECP w surowicy chorych na astme oskrzelowa.

The effects of flunisolide on a symptoms, spirometry, beta 2-agonist consumption, serum cortisol and ECP levels in 30 asthmatics were assessed. The patients qualified for the study after a two week run--in period, inhaled flunisolide from MDI--1000 micrograms daily (2 x 2 puffs) for a period of 4 weeks. Patients noted daily asthma symptoms, morning and evening PEF, the beta 2-agonists consumption and side effects in their diary cards. Each patient had 3 visits to the clinic, before and after the run-in period and at the end of the study. During the visits spirometry were performed. After the flunisolide therapy, statistically significant decreases in the daily and nightly asthma symptoms, diurnal variations of PEF, beta 2-agonist consumption, serum ECP levels and increases in morning and evening PEF and in serum cortisol levels. The patients tolerated the drug well. No serious side effects were observed during the study.