Evaluation of adipokines in children with cystic fibrosis.

INTRODUCTION: Patients with CF present numerous pathological conditions such as malnutrition, depletion of fat-free mass, metabolic disturbances (abnormal glucose metabolism, increased insulin resistance, chronic energy deficit, local and chronic inflammation), which could affect or be associated with altered adipokines concentration Material and Methods: We aimed in this study to investigate the levels of selected adipokines such as resistin, apelin, adiponectin to demonstrate their application as possible markers of inflammation. RESULTS: Serum level of resistin was higher (p < 0.001) and adiponectin - lower (p=0.02) in CF children than in healthy children. There was no difference in serum apelin level between two examined groups. However, values of adiponectin/BMI and apelin/BMI ratios in CF did not differ significantly from controls. Higher values of resistin/BMI ratio in CF in comparison to controls were observed Serum resistin/adiponectin ratio was significantly higher in CF patients than in controls (p < 0.0001). Resistin/BMI ratio correlated negatively with FEV1 (R:-48,p < 0.043). Serum resistin/adiponectin ratio correlated negatively with FEV1/FVC (R:-49, p=0.04), Adipokines showed no correlation with BMI and BMI-SDS, glucose, total cholesterol, and LDL-, HDL-cholesterol, triglyceride serum levels. Spirometric parameters FEV1, FVC, VC correlated negatively with serum glucose levels (R: -0.55, p < 0.018; R: -0.65 p < 0.0025; R:-0.76, p < 0.0008 respectively). FEV1 and FVC correlated positively with BMI-SDS (R:0.58, p < 0.01; R:0.5, p < 0.036, respectively). CONCLUSIONS: A significant increase in resistin concentration expressed also as resistin/BMI, and resistin/adiponectin ratios, observed in children with CF may suggests that this adipokine is involved in the inflammatory process underlying the disease and is related to worse spirometric parameters describing airways obstruction.

Serum apelin-12 level is elevated in schoolchildren with atopic asthma.

BACKGROUND: There are limited data on the role of adipokines in atopic asthma. AIM: To determine serum level of apelin-12 (APE-12) in asthmatic children in relation to BMI and gender. METHODS: Serum APE-12 levels were measured using ELISA in 89 asthmatic children (61 boys and 28 girls, aged 7.0-17.0 years) and in 33 healthy children. Among examined asthmatics 59 (19 girls and 40 boys) had normal weight and 30 (9 girls and 21 boys) were obese. RESULTS: The mean serum levels of APE-12 were significantly (p < 0.001) higher both in obese (174.1 ± 5.9 pg/mL) and non-obese asthmatic children (171.0 ± 4.0 pg/mL) than in healthy children (130.6 ± 2.1 pg/mL), regardless of gender. No relationships between examined the adipokine level and asthma severity, spirometric parameters, degree of allergic sensitization, BMI, BMI-SDS were observed. CONCLUSION: Increased serum level of APE-12 suggests that this adipokine may be implicated in the pathogenesis of childhood atopic asthma.

Serum visfatin levels are decreased in schoolchildren with atopic asthma.

OBJECTIVES: Very little is known about the role of adipokines in atopic asthma in children. Studies about the potential role of novel proinflammatory adiopcytokine - visfatin are lacking. DESIGN AND SETTING: In this cross-sectional study serum visfatin (VISF) levels were measured in 89 asthmatic out-patients (61 boys and 28 girls aged 7.0-17.0 years) and in 33 healthy children. MATERIAL AND METHODS: Among examined asthmatics 59 (19 girls and 40 boys) had normal weight and 30 (9 girls and 21 boys) were obese. Serum VISF was evaluated using standard ELISA tests and the results were analysed in relation to body weight, asthma severity, and gender were analysed. RESULTS: The mean serum levels of visfatin were significantly (p<0.001) lower both in obese (2.13±0.07npg/ml) and non-obese asthmatic children (2.05±0.06 npg/ml) than in healthy children (2.57±0.07 pg/ml) regardless of gender. After stratifying by gender, there was a significant decrease (p<0.001) in visfatin levels in obese asthmatic girls (2.30±0.08 ng/ml) and asthmatic girls with normal weight girls (2.21±0,09 ng/ml) compared with girls from control group (2.69 ±0.06 ng/ml). In obese asthmatic boys and non-obese asthmatic boys also significantly lower (p<0.01) mean values of visfatin (2.03±0.06 ng/ml and 1.9±0.06 pg/ml respectively) were observed than in control boys (2.391±0.09 ng/ml). No relationships between examined adipokine levels and asthma severity, spirometric parameters, degree of allergic sensitization, BMI, were observed. CONCLUSION: Visfatin is not potential biomarker in atopic asthma in children and further studies evaluating the possible role of this proinflammatory adipokine in childhood atopic asthma pathogenesis are needed.

[Congenital sternal cleft: a case report]. / Wrodzony rozszczep mostka ­ opis przypadku.

Sternal cleft is a very rare congenital defect of sternum, reported only in limited number of publications. Surgical treatment in neonatal period is preferred. The case of child with congenital sternal cleft operated in 17 month of life with successful outcome of repair was reported.

Clinical features of asthma in children differ with regard to the intensity of distal gastroesophageal acid reflux.

BACKGROUND: The prevalence of gastroesophageal reflux (GER) in children with asthma is higher than in healthy controls, but the nature and direction of this association is unclear. OBJECTIVE: The aim of our study was to assess the relationship between esophageal acid exposure and the clinical features of asthma in children. METHODS: In total, 66 children (mean age 122.8 months [SD 44.89 months]) with chronic pulmonary symptoms, fulfilling diagnostic criteria of persistent asthma, underwent 24-hour esophageal pH monitoring and answered a detailed questionnaire-based survey. The questionnaire topics included environmental factors, familial history, current and previous clinical symptoms, atopy, asthma severity, and medication. RESULTS: Abnormal results of 24-hour esophageal pH monitoring were found in 28 out of 66 children (42.4%). Age, sex, severity of asthma, environmental factors, spirometry results, and the type of medication did not correlate with esophageal acid exposure. However, children with abnormal pH results developed asthma significantly earlier (asthma onset 3.63 years [SD 2.52 years] vs 5.77 years [SD 3.82 years]; p < .01). Nonatopic individuals had more intensive esophageal acid exposure than atopic ones (Boix-Ochoa score 28.19 [SD 18.26] vs 18.26 [SD 12.84]; p < .048). The intensity of GER was also significantly correlated with frequent or difficult-to-control nighttime asthma attacks. CONCLUSIONS: There are differences in clinical features of asthma in children with regard to the intensity of esophageal acid exposure. Symptoms of asthma in nonatopic individuals with early onset and difficult-to-control nighttime asthma attacks suggest the possibility of concomitant, clinically relevant GER.

Staphylococcus aureus skin colonization in atopic dermatitis children is associated with decreased IFN-gamma production by peripheral blood CD4+ and CD8+ T cells.

Atopic dermatitis (AD) is a chronic inflammatory skin disorder, which is associated with an increased expression of Th2 cytokines with concomitant decrease in IFN-gamma production by circulating CD4+ and CD8+ T cells. The skin of patients with AD is often colonized by Staphylococcus aureus, which may reflect in changes in immunological parameters. The aim of the study was flow cytometric measurement of some peripheral blood lymphocyte subsets expressing naive/memory marker (RA/RO) and activation marker (CD25) as well as intracellular production of IFN-gamma by peripheral blood CD4+ and CD8+ T cells from varied severity AD children and determine the impact of S. aureus skin colonization on cytokines profiles. There was a significant increase in the percentage of CD4+ and CD8+ T cells producing IL-4 and IL-13 and decrease in the percentage of CD4+ and CD8+ T cells producing IFN-gamma upon in vitro stimulation with phorbol 12-myristate 13-acetate and ionomycin in children with AD compared to healthy ones. The absolute number of CD4+ and CD8+ T cells expressing memory marker CD45RO was elevated as compared with controls. The severity of AD was positively correlated with the percentage of lymphocyte subsets: CD45RO+, CD4+CD45RO+, and the percentage of CD3+ and CD4+ expressing CD25 as well as the number of S. aureus on the skin. In conclusion, both CD4+ and CD8+ memory T cells are involved in the immunopathogenesis of AD. S. aureus skin colonization is related with disease severity and changes in expression of CD45RO and CD25 on T cells. A decrease in the percentage of CD4+ and CD8+ T cells producing IFN-gamma in AD children may explain propensity for skin infection.

[Serum levels of IL-4, IL-10 and IL-12 in infants and young children with recurrent wheezy bronchitis]. / Surowicze stezenia IL-4, IL-10 i IL-12 u niemowlat i malych dzieci z nawracajacymi obturacyjnymi zapaleniami oskrzeli.

Clinical symptoms, IgE, and eosinophil counts are insufficient for establishing diagnosis of asthma in young children. It has been suggested that other serum markers might be useful for supporting diagnosis. The aim of the study was to determine serum levels of IL-4, IL-10, and IL-12 in young children with recurrent wheezy bronchitis. We investigated if there was a relationship between those markers and the maintenance clinical symptoms during a 2-year follow-up period. The study involved 30 young children (average age--22.5 months) with recurrent wheezy bronchitis. Control group consisted of 15 healthy children at the same average age. The serum levels of IL-10 (p<0.0006) and IL-12 (p<0.000005) were significantly increased and the serum level of IL-4 was significantly decreased (p<0.00009) in children with wheezing compared with healthy control. However the serum level of IL-10 (p<0.004, R=0.5) and IL-12 (p<0.001, R=0.54) was positively correlated with a number of episodes wheezing in the past. Children with wheezing and skin rash showed a significantly higher level of IL-4 (p<0.02) and lower levels of IL-10 (p<0.0008) and IL-12 (p<0.005) compared with children without skin rash. No statistically significant differences in serum levels of IL-4, IL-10, and IL-12 were observed between children with persistent wheezing during a 2-year follow-up period and children without respiratory symptoms. This study suggested a potential role cytokines in recurrent wheezing, but follow-up of the children is needed to evaluate the prognostic value of serum cytokines for development asthma in later childhood.

[Effect of gastroesophageal reflux in children on x-ray imaging of the lungs]. / Wplyw choroby refluksowej u dzieci na obraz radiologiczny pluc.

The usefulness of radiologic examination in the diagnosis of aspiration pneumonia in infants. The aim of the study was to estimate whether the connection between the localisation and radiological findings on the plain X-ray chest examination exists in the group of 121 infants and young children, age 1 to 24 month (77 boys and 44 girls), treated for pneumonia and gastroesophageal reflux disease (GERD), established by 24-hour esophageal pH-monitoring. In all children the diagnosis of pneumonia were made on admission to hospital by physical and X-ray chest examinations. GERD, in accordance with consensus ESPAGAN, was diagnosed in the group of 65 children. Children with abnormal results of pH-monitoring had significantly more changes in the lower parts of the right lung and in the intermediate and the lower parts of the left lung. There were no difference in radiological appearance between the changes suspected to the aspiration etiology and other pneumonic changes in the group of 56 children with normal pH-investigation. Additionally, there was no significant difference in the frequency of atelectasis, emphysema and/or enlargement of the thymus between both groups.