Telomerase activity in transthoracic fine needle biopsy aspirates as a marker of peripheral lung cancer.

BACKGROUND: A study was undertaken to evaluate the usefulness of telomerase activity assay in transthoracic fine needle biopsy (TFNB) aspirates collected from peripheral tumours of the lung in predicting the malignant aetiology of lung infiltrations. METHODS: 100 patients with a peripheral infiltration of the lung underwent TFNB of the focal lesion. The aspirates were subjected to standard cytological evaluation. Telomerase activity in the specimens was determined with the PCR-ELISA PLUS method. The sensitivity, specificity, accuracy and predictive value of TFNB were calculated for cytological examination of aspirates alone and cytological examination with additional telomerase activity assessment. RESULTS: Lung cancer was newly diagnosed in 84 subjects and benign peripheral lesions were found in 16. During the first TFNB, lung cancer was identified in 56 cases of cancer (66.7%) while increased telomerase activity was found in 61 cancer aspirates (72.6%). No subject with a benign infiltration had a false positive result from cytological examination, but in one case (6.25%) increased telomerase activity was observed. The diagnostic sensitivity, accuracy and negative predictive value of the combination of cytological examination and telomerase activity assay in TFNB specimens were significantly higher than for cytological examination alone (89.3% vs 66.7%, p = 0.0004; 90% vs 72%, p = 0.001; 62.5% vs 36.4%, p = 0.039), but a combination of the two examinations was associated with a lower specificity of TFNB (96.9% vs 100%, p = 0.002). CONCLUSION: Detection of telomerase activity in aspirates taken during TFNB of a peripheral lung infiltration should be considered as an indication of the risk of malignancy in cases with false negative cytological results.

Serum thymus and activation-regulated chemokine, macrophage-derived chemokine and eotaxin as markers of severity of atopic dermatitis.

BACKGROUND: Expression of CCR4 ligands, such as thymus and activation-regulated chemokine (TARC) and macrophage-derived chemokine (MDC), leads to preferential influx of T-helper (Th) 2-type lymphocytes to the lesional skin in atopic dermatitis (AD). Eotaxin, like the CCR3 ligand, is an important contributor of eosinophils recruitment in the course of AD. These chemokines are assumed to play an important role in the pathomechanism of AD. METHODS: In this study, the serum concentration of TARC, MDC, eotaxin and total immunoglobulin E (IgE) in AD patients and healthy people were compared. Correlation between the studied indices and activity of AD was established. Severity of AD was assessed according to the SCORAD score. The study comprised 44 healthy people and 43 patients with AD. The serum concentrations of TARC, MDC, eotaxin and IgE were measured with the use of enzyme-linked immunosorbent assay kits. RESULTS: The serum levels of TARC, MDC, eotaxin and IgE appeared to be significantly higher in patients with AD than in healthy people. A strong positive correlation was revealed between the levels of TARC, MDC, total IgE in serum of patients with AD and SCORAD. In contrast, no significant relationship was found for the serum eotaxin concentration and TARC, MDC, IgE or disease severity. CONCLUSION: Our findings indicate that TARC and MDC are actively involved in the pathogenesis of AD and their expression, opposite to that of eotaxin, is strongly associated with clinical picture of atopic dermatitis.

Influence of age and gender on serum eotaxin concentration in healthy and allergic people.

BACKGROUND: Eotaxin is one of the important chemokines that modulate allergic inflammation. In many studies a correlation between an elevated serum concentration of eotaxin, allergen exposure and allergic symptoms has been confirmed. Influence of other factors on eotaxin concentration is feebly recognized. We made an attempt to assess the influence of age and gender on the serum eotaxin level in healthy people and in patients with intermittent IgE-mediated rhinoconjunctivitis (AR). METHODS: The serum eotaxin level was measured in 245 healthy people and 241 patients with AR before the pollen season with the ELISA technique (KITS, R&D USA, pg/ml). The parametric tests and linear regression analysis were used in statistical calculations. RESULTS: There were no differences between the allergic group and the healthy one in the mean age (accordingly: 31.3 +/- 11.6 yrs. vs. 31.6 +/- 12.5 yrs.; p=0.1) and the mean serum eotaxin content (118.1 +/- 44.9 pg/ml vs. 116.3 +/- 34.8 pg/ml; p=0.3). A significant relationship between the serum eotaxin level, gender and age was revealed in both groups and regression models were derived. A linear correlation between age (semi-partial correlation beta = 0.47, p = 0.0000001) and gender (semi-partial correlation beta = 0.3, p = 0.0000001), on the one side, and the serum eotaxin level, on the other, was found for the allergic people. In the control group a similar relationship between the serum eotaxin level and age (semi-partial correlation coefficient beta = 0.63, p = 0.0000001) and gender (semi-partial correlation factor beta = 0.23, p = 0.000006) was observed. CONCLUSIONS: Age and sex significantly influence the serum eotaxin content in healthy people and patients with IgE-mediated rhinoconjunctivitis.

Cc-chemokine eotaxin as a marker of efficacy of specific immunotherapy in patients with intermittent IgE-mediated allergic rhinoconjunctivitis.

BACKGROUND: Allergen-specific immunotherapy (SIT) is believed to be a valuable remedy in several allergic diseases; however, an accurate immunological marker of the efficacy of this treatment method has not been found yet. Cc-chemokine eotaxin, owing to its selective action on eosinophils, seems to play an important role in the pathophysiology of allergic response. The purpose of this study was to assess the usefulness of eotaxin in monitoring of SIT efficacy in patients with IgE-mediated allergic rhinoconjunctivitis. METHODS: One hundred and twenty-two patients with seasonal IgE-mediated allergic rhinoconjunctivitis due to tree- (birch, n = 42; hazel/alder, n = 14) or grass/cereal- (n = 66) pollen received allergen-specific immunotherapy. Serum eotaxin levels were determined four times in every patient, shortly before immunotherapy (Evaluation 0), immediately after the treatment (Evaluation 1), in the height of pollen season (Evaluation 2) and at least 2 weeks after the pollen season (Evaluation 3). Serum eotaxin levels were simultaneously measured in 59 healthy people from the control group. Changes in serum eotaxin levels were assessed in the healthy and allergic groups. Clinical symptoms of IgE-mediated rhinoconjunctivitis were evaluated and compared with serum eotaxin concentration changes. RESULTS: Mean values of eotaxin concentrations in serum during Evaluations 0-3 did not significantly differ in the healthy subjects and the patients with IgE-mediated rhinoconjunctivitis (P > 0.05). Moreover, no statistically significant differences in the serum eotaxin levels between the visits were observed in the patients who received immunotherapy (P > 0.05); however, immediately after immunotherapy (Evaluation 1) the mean serum level of eotaxin was lowest and closest to the serum eotaxin concentration in the control group at the same visit. No significant correlation between the mean value of the serum eotaxin level in the height of pollen season (r = -0.12, P > 0.05) or mean changes of the eotaxin levels between Evaluations 2 and 1 (r = -0.03, P > 0.05), on the one hand, and the cumulative score of symptoms and drug, on the other, were found. CONCLUSIONS: The results allow to conclude that although eotaxin plays a significant role in the mechanism of antigen-specific immunotherapy, its serum expression remains a poor marker of SIT efficacy.

[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.

[The effect of specific immunotherapy on serum eotaxin level in patients with pollinosis: preliminary studies]. / Wplyw swoistej immunoterapii na zachowanie sie stezen eotaksyny w surowicy u chorych na pylkowice--doniesienie wstepne.

Eotaxin belongs to CC chemokines with selective activity for eosinophils and basophils. Specific immunotherapy (SIT) represents the only curative approach for allergic inflammation. The aim of this study was an evaluation of the effect of SIT on serum eotaxin level in patients with seasonal allergy. 40 patients (mean age 26 +/- 8.15 with seasonal allergy to birch, 25 with seasonal allergy to grasses) and 35 persons (mean age 27 +/- 8) of the control group took part in this study. Preseasonal immunotherapy (Allergovit, Germany) was performed in conventional schedule in patients with pollinosis. Clinical assessment of symptoms in season (score) was done by all of the patients studied. ELISA test was used to measure serum eotaxin level (pg/ml, kits from R&D) before, after immunotherapy, in pollen season and after season in patients with disease. There was observed increased eotaxin concentration in patients with allergy to birch (140.6 +/- 53.7) as compared to the eotaxin level in the control group (102.1 +/- 53.7) (p < 0.05). There was observed decreased eotaxin level after immunotherapy (115.9 +/- 49.9) (p < 0.05) in patients with allergy to birch, but no with allergy to grasses. When patients with clinical improvement were taken into account, the significant difference (p < 0.05) in eotaxin concentration was showed before (126.7 +/- 52.4) and after immunotherapy (102.5 +/- 44.8). The eotaxin level in pollen season of patients with clinical improvement was significantly (p < 0.05) decreased (116.5 +/- 54.3) as compared to the eotaxin level in patients without clinical improvement (139.8 +/- 46.3). The results suggest an involvement of eotaxin in pathomechanism of SIT. The effect depends on kind of allergen evaluated. Further longitudinal controlled investigations should establish the role measuring serum eotaxin level in the clinical evaluation of SIT.

[Frequency of complications after transthoracic fine-needle biopsy of lung tumors]. / Analiza czestosci powiklan transtorakalnej biopsji cienkoiglowej guzów pluc.

Transthoracic fine-needle biopsy (TFNB) is a valuable method of recognizing changes in lungs, especially suspected of cancer. Such operations are cheap, don't demand expensive instruments and are possible to perform in each pneumonology ward, especially if they are an ideal supplement for bronchofibroscoping examination. The possibility of quick and effective performance of transthoracic biopsy shortens the diagnostics considerably. From January 1997 to April 1999 there were performed 406 operations of TFNB. There were 334 people operated on (294 men--74.5%; 85 women--25.5%), average age for the whole group of patients--62.8 (+/- 10.4 years). The patients were divided into two groups considering hospitalization places: I--patients from (not transported for operation)--135 (40.4%), II--patients transported for operation from another hospitals--199 (59.6%) The examination was performed under control of rtg apparatus (7600 OEC Medical System with mobile x-ray tube on a C-arm and laser localizer). The usual complication was an pneumothorax--52 cases (12.8%); drained--16 cases (3.9%). An average depth of inserting in an early pneumothorax is 6.56 (+/- 0.73), in a late pneumothorax--8.6 cm (+/- 1.75), (p = 0.0015). An average depth of inserting in a drained pneumothorax was 8.9 cm (+/- 2.17), in a non-drained pneumothorax 7.7 cm (+/- 1.3) (p = 0.024). Patients that had to be transported for the operation had pneumothoraxes that needed to be drained considerably more often: 14 cases in 199 comparing to 2 in 135 among patients not demanding to be transported (p = 0.02). Pneumothoraxes appeared more often after indicating tumors of smaller size, from 3 cm--21.6%; 3.1-6 cm--13.3% (p = 0.036). From another complications one could notice: hemoptysis--4 cases; subcutaneous emphysema--1 case; fever and shivers--1 case; hypotonia--2 cases; cough--1 case. Those complications were treated symptomatically or vanished themselves.

[Retroperitoneal fibrosis with coincidence of fibrosis in mediastinum]. / Zwlóknienie zaotrzewnowe wspólistniejace ze zwlóknieniem w sródpiersiu.

Retroperitoneal fibrosis is a disease with replacement of normal retroperitoneal tissue with isolated fibrotic plaque placed around aorta and entrapping ureters. In 15% of patients an fibrotic process can be found outside the retroperitoneum. The most common localisation outside retroperitoneum is mediastinum, however, it can occur in every organ. The patient usually is diagnosed due to symptoms connected to compression of the ureters. We report the case of 41-year-old woman with chronic obstructive pulmonary disease complaining of nonspecific, dull, noncolicky pain localized to the back and abdomen. Finally we recognised retroperitoneal fibrosis. The diagnosis was proven by lumbar mass biopsy.

[Blood serum eotaxin and eosinophil cationic protein in asthmatic patients]. / Stezenia eotaksyny i eozynofilowego bialka kationowego w surowicy chorych na astme oskrzelowa.

Eotaxin belongs to CC class of chemokines and is a potent eosinophil chamoattractant. Activated eosinophils are able to release many cytotoxic proteins, including eosinophil cationic protein (ECP), which has central role in allergic inflammation. The aim of this study was to assess eotaxin and ECP levels in plasma of atopic asthma patients in stable period of the disease. 19 patients with asthma and 10 healthy controls took part in this study. ELISA test was used to measure eotaxin (kits from R&D, pg/ml) and ECP (kits from Pharmacia, mg/l) levels. Plasma eotaxin level (mean +/- SD) was 176.52 +/- 50.3 (range 89-288) in asthma patients and 101.42 +/- 49.4 (range 35-206) in control group (p < 0.001). Plasma ECP concentration was 16.7 +/- 6.4 (6.3-28) and 16.8 +/- 17.1 (3.1-61.6), respectively (n.s). There was correlation between plasma eotaxin and ECP levels (Pearsons correlation co. r = +0.5, p < 0.05) and between eotaxin and FEV1 (Pearsons correlation co r = -0.4, p < 0.05) in asthma patients. We suggest that measurement of eotaxin and ECP levels as well may be useful indicator of disease.

[Comparison evaluation of cost-effectiveness in bronchial asthma patients]. / Porównawcza ocena skutecznosci i kosztów leczenia chorych na astme oskrzelowa.

A choice of a proper drug and method for clinically successful therapy in patients with bronchial asthma has to be based on results of experimental and clinical studies and cost analysis. Some problems connected with cost-effectiveness analysis are presented in relation to glucocorticosteroids, agonist of beta2-adrenoreceptors and allergen-specific immunotherapy.

[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.

[Fine needle biopsy in diagnosis of lung tumors]. / Biopsja cienkoiglowa w diagnostyce guzów pluc.

Fine-needle biopsy is one of the method used in diagnosis of lung tumors. In this study the results of 192 biopsies performed by x-ray apparatus inspection were analysed. There was shown that lung cancer was recognized in over 50% of patients studied. In another cases non-specific inflammation (31%), lung fibrosis (1%), tuberculosis (1%), purulent inflammation (1%), blood (7%) were recognized. These results indicate for usefulness of this method in diagnosis of not only peripheral, but also central localized lung tumors.

Monocyte chemotactic and activating factor/monocyte chemoattractant protein (MCAF/MCP-1) in bronchoalveolar lavage fluid from patients with atopic asthma and chronic bronchitis.

Monocyte chemotactic and activating factor/monocyte chemoattractant protein (MCAF/MCP-1) is a member of the beta (C-C) subfamily of chemokines. The biological roles played by MCAF/MCP-1 in a number of inflammatory and noninflammatory diseases states is not well known. Several studies have confirmed that inflammation is present in the airways of subjects with atopic asthma and with chronic bronchitis. Analysis of bronchoalveolar lavage fluid (BALF) is an effective method of sampling lower respiratory tract inflammation. The aim of this study was to examine associations among MCAF/MCP-1, BALF cells and spirometry parameters and bronchial hyperresponsiveness in patients with atopic asthma and chronic bronchitis. Twenty patients with atopic asthma, 10 patients with chronic bronchitis and 10 patients of the control group, took part in this study. An ELISA test was used to assess MCAF/MCP-1 in BALF. The levels of MCAF/ MCP-1 (mean +/- SEM) were 150 +/- 18.6 pg/ml in patients with atopic asthma, 320 +/- 39.7 pg/ml in chronic bronchitis and 74.9 +/- 3.3 pg/ml in the control group (p < 0.05). When all patients with disease were considered, there was negative correlation with FEF50 (Kendall's correlation coefficient = - 0.4; p < 0.01). Regression analysis has shown that a level of MCAF/MCP-1 over 100 pg/ml was correlated with duration of illness (Pearson's correlation coefficient = 0.7; p < 0.02). In conclusion, MCAF/MCP-1 probably possesses proinflammatory properties in atopic asthma and chronic bronchitis. The elevated level of this chemokine may support the clinical suspicion of specific diagnosis.

[Chemotactic monocyte and activation factor (MCAF/MCP1)in material from bronchoalveolar lavage fluid of patients with chronic bronchitis]. / Czynnik chemotaktyczny i aktywujacy monocyty (MCAF/MCP1) w materiale z plukania oskrzelowo-pecherzykowego u chorych na przewlekle zapalenie oskrzeli.

UNLABELLED: The aim of this study was to evaluate concentrations of monocyte chemotactic and activating factor (MCAF/MCP1) in bronchoalveolar lavage fluid (BAL) from patients with chronic bronchitis. 32 patients (aged 46 +/- 2 years) with chronic bronchitis and 14 patients (aged 30.5 +/- 3.4 years) of control group took part in this study. ELISA test (kits from R&D, USA) was used to measure concentrations of this chemokine in BALF. The results indicate for significant increase of MCAF/MCP1 in BALF from patients with chronic bronchitis (mean +/- SEM = 393 +/- 105.9 pg/ml) as compared from those of control group (middle +/- SEM = 36.4 +/- 10.9 pg/ml). CONCLUSION: MCAF/MCP1 may participate in creation of inflammatory changes of airways in patients with chronic bronchitis.

[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.