Low levels of vitamin D in population exposed to significant environmental pollution.

In recent years, monitoring of vitamin D levels and possible use of supplementation is gaining attention. Numerous studies showed low levels of vitamin D in winter months followed by improvement during summer. These changes are mostly dependent on the level of sun exposure, but also on geographical location, genetic factors, social-economic status, quality of nutrition and environmental pollution. In this observation we found significant decrease in vitamin D levels in populations exposed to extreme environmental pollution in area of central Europe. This region is known for extreme burden from microparticles originating in chemical industry, surface coal mining and cold-based power stations. Vitamin D levels in all patients was determined by ELISA. Using 540 patients in our department of clinical immunology and allergology we measured the levels of vitamin D in 2016 to 2021 period. In only 4 patients (0.74 %) we found vitamin D levels higher than 30 ng/ml. The curve of observed values does not reflect dependency on sun exposure and does not change during the year. We discuss the effect of environmental contaminants, lifestyle and economic and social factors. From our observations, we propose to directly supplement population with vitamin D, particularly children and seniors. From our observations, we propose to directly supplement population with vitamin D, particularly children and seniors.

Glucans as New Anticancer Agents.

For decades, glucans have been studied for their biological and immunological activities. The scientific community has mainly focused on immune reactions, but other areas, such as cholesterol levels and diabetic retinopathy, have shown the positive effects of glucan supplementation. However, the majority of studies focused on possible cancer suppression, where glucans showed clear and significant effects on numerous types of cancers, leading not only to clinical trials, but to approval as an official drug. The aim of this review is to describe the current knowledge of this field.

Beta Glucan: Supplement or Drug? From Laboratory to Clinical Trials.

Glucans are part of a group of biologically active natural molecules and are steadily gaining strong attention not only as an important food supplement, but also as an immunostimulant and potential drug. This paper represents an up-to-date review of glucans (ß-1,3-glucans) and their role in various immune reactions and the treatment of cancer. With more than 80 clinical trials evaluating their biological effects, the question is not if glucans will move from food supplement to widely accepted drug, but how soon.

Effects of ß-glucan and Vitamin D Supplementation on Inflammatory Parameters in Patients with Diabetic Retinopathy.

The objective of this article is to evaluate the potential effects of beta-glucan and vitamin D supplementation in patients with diabetic retinopathy. We evaluated the levels of several parameters of inflammatory reactions (C-reactive protein [CRP], serum amyloid A [SAA], and interleukin- [IL-] 6), leptin, and vitamin D. Using a 3-month interval, we divided the patients into three groups: (1) supplemented with beta-glucan and vitamin D, (2) supplemented with vitamin D and placebo, and (3) supplemented with vitamin D alone. By this division, we aim not only to observe whether beta-glucan can increase the effects of vitamin D, but also to eliminate the potential effects of placebo. The doses of vitamin D corresponded to phototype, weight, age, and sex of the individual. Fifty-two diabetic retinopathy patients were selected for our study. We found significant vitamin D deficits in all cases, even after three months of supplementation with vitamin D. Significant changes in levels of CRP were observed in the beta-glucan-supplemented group; levels of SAA and IL-6 were not changed. Leptin levels were significantly lowered in the beta-glucan-supplemented group and increased in the other groups. More detailed studies and/or longer supplementation is necessary.

Effects of Glucan and Vitamin D Supplementation on Obesity and Lipid Metabolism in Diabetic Retinopathy.

BACKGROUND: Diabetes mellitus is a chronic disease manifested by an increase of blood glucose. OBJECTIVE: To evaluate the effects of glucan and vitamin D supplementation in patients with diabetic retinopathy. METHOD: We evaluated the effects of 3-month supplementation with glucan and vitamin D in 54 patients with diabetic retinopathy. We measured levels of vitamin D, cholesterol, HDL cholesterol, and triglycerides. RESULTS: The supplementation strongly decreased the cholesterol levels and improved the levels of HDL cholesterol. In addition, vitamin D levels were strongly improved, but still not at optimal values. CONCLUSION: From our data, we concluded that glucan and vitamin D supplementation strongly influence lipid metabolism and have positive effects on human health.

IgG-4 related disease in ophthalmology.

IgG-4 related disease (IgG4-RD) is a recently discovered systemic fibro-inflammatory disease which affects the ocular system. This pathology is not limited only to the orbit, but may also frequently affect the anatomical structures of the eye, as well as other organs. Suspicion of IgG4-RD is based on careful clinical, radiological and immuno-histological examination with a finding of characteristic histopathological changes. Increased values of serum IgG4 need not necessarily be an unequivocal diagnostic criterion for the diagnosis of IgG4-RD. Only a careful histological and immunophenotyping examination together with a clinical finding provide a basis for distinguishing IgG4-RD from other inflammatory pathologies. Corticoids are applied in the treatment of this disease, but they do not exclude the possibility of relapses of clinical manifestations. Second choice pharmaceuticals are azathioprine, mycophenolate mofetil, and the effect of treating relapse of the disease with rituximab is significant.Key words: IgG4 related disease, eye, diagnosis, treatment.

ß-glucan affects mucosal immunity in children with chronic respiratory problems under physical stress: clinical trials.

BACKGROUND: The role of ß-glucan in children with respiratory problems is getting more and more attention. In this report we focused on the effects of 30 days oral supplementation with ß-glucan on physical activity and immune status of children with respiratory problems. METHODS: We measured the level of sIgA, eNO and physical activity [using a 6-minute walking test (6MWT)] in 77 children and evaluated the effect of 100 mg/day oral dose. RESULTS: We found a significant difference between males and females in physical endurance. In the glucan group, the positive effects of glucan were significant in both age groups. In the glucan group, we found significant decrease of eNO levels and stabilization of the sIgA levels. CONCLUSIONS: Short-term oral application of natural immunomodulator ß-glucan stimulated physical endurance in children with respiratory problems and, via stabilization of the sIgA levels, helps their mucosal immunity.

Clinical trials of yeast-derived ß-(1,3) glucan in children: effects on innate immunity.

BACKGROUND: The role of glucan in the stimulation of immune reactions is well established. In our report, we focused on the effects of orally administered glucan on nonspecific immunity of children with chronic respiratory problems. MATERIALS AND METHODS: We measured the levels of albumin, lysozyme. C-reactive protein (CRP) and calprotectin in the saliva of 60 children ages 8-12 years and evaluated the effects of 30-day treatment with 100 mg/d oral dose of glucan. RESULTS: We found a significant increase in the production of lysozyme, CRP and calprotectin in glucan-treated children. CONCLUSIONS: Short-term oral application of natural immunomodulator ß-glucan significantly stimulated mucosal immunity of children with chronic respiratory problems.

[Diagnosis of whooping cough by serology and real-time PCR]. / Diagnostika cerného kasle sérologickými technikami a metodou real-time PCR.

The goal of this study is to summarize the results of the detection of Bordetella pertussis (BP) and Bordetella parapertussis (BPP) by a real-time polymerase chain reaction (RT-PCR) assay and serological methods. In 2008-2010, 73 patients of the Department of Clinical Immunology and Allergology of the Centre for Immunology and Microbiology, Public Health Institute in Ústí nad Labem were screened for pertussis. They were selected according to the WHO and ECDC criteria, i. e. they presented with a persistent cough lasting more than two weeks. Direct detection of BP and BPP DNA from nasopharyngeal wash specimens was performed using a RT PCR assay. The serological responses were evaluated by a direct agglutination test for the detection of total antibodies and by enzyme-linked immunosobent assay (ELISA) for the detection of IgG, IgA, and IgM antibodies against pertussis toxin. Forty-two patients were positive for BP and/or BPP, 19 of them by RT-PCR (group A) and 23 by serology (group B). Ten group A patients (52.6%) were also positive by serology. Our results show that pertussis needs to be a consideration in persistent cough. We believe that increased awareness of the medical community, along with improved laboratory tests will result in increased detection of pertussis that is still considered by many physicians as a childhood infection.

Placebo-driven clinical trials of yeast-derived ß-(1-3) glucan in children with chronic respiratory problems.

BACKGROUND: The role of glucan in stimulation of immune reactions has been studied for several decades. In this report we focused on the effects of orally administered glucan in children with chronic respiratory problems. MATERIALS AND METHODS: We measured the levels of albumin, lysozyme and CRP in saliva of 40 children aged 8-12 years and evaluate the effects of 100 mg/d oral dose of glucan. RESULTS: We found a significant increase in production of changes in production of lysozyme and CRP in glucan-treated children. In addition, a strong improvement in general conditions was found. CONCLUSIONS: Short-term oral application of natural immunomodulator ß-glucan stimulated mucosal immunity of children with chronic respiratory problems.

Stimulation of ileal epithelium growth and regeneration by dietary nucleotide extracts.

The gastrointestinal tract epithelium plays an important role not only in digestion and absorption of nutrients, but also in antigen and pathogen signal translocation toward the gut associated lymphoid tissue. Malnutrition in various degrees is recognized as the most common cause of the immune system dysfunction. Research done in the past several years has revealed that dietary nucleotides (dNT) represent an essential compound of nutrition because of their importance in metabolic pathways, energetic processes and nucleic acid synthesis during tissue renewal. Much evidence accumulated suggests that dNT are essential for the growth and maturation of the gut epithelia. In previous experiments we have documented immunoregulative properties of dNT-containing extracts. In this study Balb/c female mice were fed (1) standard diet, (2) dNT-supplemented diet, and (3) dNT-supplemented water for 4 weeks. The supplement in dose of 100 mg/kg/l comprised original extract (Imuregen, Uniregen Ltd., Náchod, Czech Republic). Samples of terminal ileum in each dietary group were removed for histological examination. The length of villi was evaluated by computer morphometry. The highest growth of intestinal villi was observed in group administered dNT-supplemented water. We have found no pathological changes of intestinal epithelium in any experimental group.

High-dose aprotinin reduces activation of hemostasis, allogeneic blood requirement, and duration of postoperative ventilation in pediatric cardiac surgery.

BACKGROUND: Though multiple studies have affirmed the effectiveness of aprotinin in reducing blood loss in adult cardiac surgery, the possible benefit in pediatric cardiac surgery is controversial. METHODS: In a double-blind, randomized, and placebo-controlled study, the efficacy of aprotinin in attenuating the hemostatic and inflammatory activation during cardiopulmonary bypass in 60 patients weighing less than 10 kg was investigated. Secondary endpoints were the influence of aprotinin on the reduction of blood loss and allogeneic blood requirement, as well as postoperative oxygenation and length of mechanical ventilation. Aprotinin was administered in a high-dose of 3 x 10(4) KIU/kg plus a bolus of 5 x 10(5) KIU (not weight adjusted) added to the pump prime. RESULTS: Aprotinin plasma concentration at the end of cardiopulmonary bypass (CPB) was with 184 +/- 45 KIU/mL, within the targeted range of 200 KIU/mL. Coagulation and fibrinolysis were suppressed (F1.2 1 hour after CPB: 5.35 +/- 2.9 nmol/L vs 14.5 +/- 23.1 nmol/L; D-dimer 1 hour after CPB: 0.63 +/- 0.6 ng/mL vs 2.3 +/- 3.1 ng/mL; p < 0.05), inflammatory markers (interleukin [IL]-6, IL-8, IL-10) increased over time without significant differences between the groups, and only complement C3a activation was significantly attenuated at the end of CPB in the aprotinin group. Chest tube drainage was significantly reduced (24 hours: median 13.5 [IQR 12.2] mL/kg vs 19.4 [8.2] mL/kg; p < 0.05). All patients received one unit of packed cells to prime the heart lung machine. A second unit was needed significantly less often in the aprotinin group (13% vs 47%; p < 0.05). Postoperative oxygenation (pO2/FIO2 172 [IQR 128] mm Hg vs 127 [74]; p < 0.05) improved, and the time on ventilator was shorter in the aprotinin group (median 45 hours [IQR 94] vs 101 [IQR 74]; p < 0.05). No side effects were attributable to the use of aprotinin. CONCLUSIONS: High-dose aprotinin effectively attenuated hemostatic activation and reduced blood loss and transfusion requirement in pediatric cardiac surgery. Postoperative ventilation was also shortened in the aprotinin group.

The predictive value of modified computerized thromboelastography and platelet function analysis for postoperative blood loss in routine cardiac surgery.

UNLABELLED: Hemorrhage after cardiopulmonary bypass (CPB) remains a clinical problem. Point-of-care tests to identify hemostatic disturbances at the bedside are desirable. In the present study, we evaluated the predictive value of two point-of-care tests on postoperative bleeding after routine cardiac surgery. Prospectively, 255 consecutive patients were studied to compare the ability of modified thromboelastography (ROTEG) as well as a platelet function analyzer (PFA-100) to predict postoperative blood loss. Measurements were performed at three time points: preoperatively, during CPB, and after protamine administration with three modified thromboelastography and PFA tests. The best predictors of increased bleeding tendency were the tests performed after CPB. The angle alpha is the best predictor (area under the receiver operating characteristic curve 0.69) and, in combination with the adenosine diphosphate-PFA test, the predictive accuracy is enhanced (area under the receiver operating characteristic curve 0.73). The negative predictive value for the angle alpha is 82%, although the positive predictive value is small (41%). Thromboelastography is a better predictor than PFA. In routine cardiac surgery, impaired hemostasis as identified by point-of-care tests does not inevitably lead to hemorrhage postoperatively. However, patients with normal test results are unlikely to bleed for hemostatic reasons. Bleeding in these patients is probably caused surgically. The high negative predictive value supports early identification and targeted treatment of surgical bleeding by distinguishing it from a significant coagulopathy. IMPLICATIONS: Thrombelastography and platelet function analysis in routine cardiac surgery demonstrate high negative predictive values for postoperative bleeding, which supports early identification and targeted treatment of surgical bleeding by distinguishing it from a significant coagulopathy. The positive predictive values are small. The best predictors are thrombelastography values obtained after cardiopulmonary bypass.