Biomedical subjects

Jerzy Liebhart

Publications and source records attributed to Jerzy Liebhart.

11 recordsLinked to original sources

PubMed2006

Corticosteroid-induced laryngeal disorders in asthma.

BACKGROUND: Inhaled corticosteroids have proven to be the most effective agent available in treating bronchial asthma, and such treatment is believed to be very safe. Concerns regarding side effects of inhaled corticosteroids usually focus on potential systemic effects, where local side effects are often overlooked. The purpose of this study was to analyze and assess the influence of inhaled corticosteroids on the vocal cords of patients treated for bronchial asthma. MATERIAL/METHODS: Fifty patients (mean age: 50 years, range: 22 to 83 years) suffering from asthma and receiving corticosteroidal inhaled agents entered in this study. All of the patients underwent detailed videoscopic examination of the larynx. None complained of any laryngeal disorders or dysfunction before the diagnosis of asthma. All of the patients were non-smokers. RESULTS: Significant changes in the laryngeal status were observed. Changes included atrophy of laryngeal mucosa, vocal fold atrophy, and vocal fold bowing. CONCLUSIONS: Damage to the larynx is an important factor in patients with asthma treated with inhaled corticosteroids, which elicit apoptosis of the epithelium.

Adrenal Cortex Hormones↗

PubMed2006

Nitric oxide production by pulmonary leukocytes from induced sputum in patients with asthma and its effect on epithelial cell viability.

INTRODUCTION: Nitric oxide (NO) is one of many factors potentially involved in lung remodeling in asthma. The aim of the study was to assess the effect of pulmonary leukocytes from patients with bronchial asthma on alveolar epithelial cell damage in relation to NO production. MATERIALS AND METHODS: Induced sputum samples were obtained from 25 patients with bronchial asthma and 10 healthy volunteers. Twelve asthmatics were on inhaled corticosteroid treatment and 13 were corticosteroid free. Type II-like alveolar epithelial (A549) cells were cultured for 48 h in the presence of cell-free media from a 24-h culture of leukocytes obtained from the induced sputa (IS-Su). The level of NO was measured in supernatants from the cell cultures and the viability of the A549 cells was established. RESULTS: The levels of NO in IS-Su from corticosteroid-free asthmatics were significantly higher (p = 0.001) than those in IS-Su from healthy controls. Furthermore, NO production by A549 cells exposed to IS-Su from steroid-free asthmatics (group A) was significantly higher than that from asthmatics on corticosteroid therapy (group cA) as well as from healthy controls (p = 0.01 and p = 0.001, respectively). Lower viability of the epithelial cells exposed to IS-Su was observed in group A compared with controls (median: 72% vs. 97.5%; p < 0.001). In addition, a negative correlation (R(S) = - 0.706, p < 0.001) was found between the levels of NO produced by pulmonary leukocytes and the viability of epithelial cells. CONCLUSIONS: The results suggest that in the course of asthma, pulmonary leukocytes may interact with alveolar epithelial cells by inducing an excessive production of NO which, in turn, may contribute to epithelium impairment.

Adult↗

PubMed2005

The overproduction of nitric oxide associated with neutrophilic predominance is relevant to airway mycotic infections in asthmatics undergoing prolonged glucocorticoid treatment.

The complex relationship between the local inflammatory response and the spread of airway mycosis during prolonged glucocorticoid therapy in bronchial asthma patients remains unclear. We assessed the ability of airway leukocytes to produce nitric oxide (NO) in relation to differential inflammatory cell counts, levels of asthma severity, and coexisting airway mycotic infections. The study was carried out on leukocytes from the induced sputa (IS) of 14 patients with asthma complicated by mycotic airway infections undergoing prolonged glucocorticoid therapy (group FcA). Three groups of subjects without airway fungal infections were also studied: 18 glucocorticoid-treated asthmatics (group cA), 11 steroid-free asthmatics (group A), and 13 healthy control subjects (group H). In group FcA, both the level of spontaneous production of NO and the percentages of neutrophils in the IS were significantly higher than in all the remaining groups. Additionally, a significant positive correlation was noticed between the NO levels and both the percentages of neutrophils in the IS and the symptom intensity scores. The results suggest a possible predominant role of neutrophils in the overproduction of NO related to asthma severity and coexisting fungal infections in glucocorticoid-treated patients.

Adult↗

PubMed2005

[Markers of oxidative balance and concentration of selected metals in pollinotics].

It was reported that catalytically active metals are presented in both the soluble and insoluble fractions of ambient air pollution particles. Both catalyses generate and stimulate oxidative stress. There are very few reports on the role of oxidative stress in pollen allergy Theoretical presumptions may suggest that oxidative metabolism can be influenced by the activity of some metals and, on the other hand, pollens could be a carrier of at least catalytic amount of metals. The aim of our study was to evaluate concentrations of some metals (Cd, Cr, Pb, Ni, Mg, Zn) and compare the markers of oxidative balance expressed as malondialde-hyde (MDA) concentration, superoxide dismutase (SOD) and glutathion peroxidase (GPx) activities in the blood of patients with pollinosis. The investigation was performed on the group of 50 individuals, 34 diagnosed as pollen allergic and 16 healthy volunteers. We have found Pb blood concentration higher in pollen allergics group, but only on the verge of statistical significance (p = 0.058). No statistically significant differences in the concentrations of other examined metals between pollen allergics and controls were observed; whereas SOD activity was higher in allergics (p = 0.015), GPx activity lower in allergics (p = 0.045) and MDA concentration higher in allergics (p = 0.044). The positive linear correlations between SOD and Pb (r = 0.492; p < 0.001) as well as between Mg and MDA (r = 0.329; p = 0.02) were observed. On the basis of these results we formulated the following hypotheses, in our opinion worth further investigations: The statistically significant increase in SOD activity in the group of pollen allergics when compared to the group of controls points out the role of oxidative stress in pollen allergic persons. The statistically significant decrease in GPx activity suggests the long-lasting duration of oxidative stress in pollen allergic. The positive correlation between SOD activity and Pb level may suggest the putative role of Pb in oxidative stress. The positive correlation between Mg and MDA may suggest the presence of an additional mechanism in pollen allergy probably connected with the activation of phagocytosis by magnesium.

Adult↗

PubMed2005

[TGF-beta1 gene polymorphism in chronic obstructive pulmonary disease].

Gene polymorphism is often responsible for occurrence of some chronic diseases. It has not been clarified, why only 15-20% of smokers suffer from chronic obstructive pulmonary disease (COPD). TGF-beta1 gene polymorphism has been postulated as one of possible genetic risk factors. The aim of our study was to evaluate TGF-beta1 gene polymorphism in codons 10 and 25 in COPD patients in comparison to healthy controls. Thirty six COPD patients and 60 healthy persons entered the study. The distribution of TGF-beta1 genotypes in codon 10 was as follows in COPD group: T/C--50%, T/T--25% and C/C--25% in control group: 45%, 42% and 13% respectively. The distribution of genotypes in codon 25 in COPD patients was: G/G 86% and G/C 14%, in control group 83% and 17% respectively. There were not statistically significant differences between evaluated groups with regard to both polymorphisms. Moreover, in group of 27 smokers without COPD the distribution of the analysed TGF-beta1 gene polymorphism was similar to that in COPD group. After adjustment to sex, age and smoking index, in the logistic regression model, we can not confirm the hypothesis that TGF-beta1 gene polymorphisms in codons 10 and 25 might be significant risk factors of COPD.

Adult↗

PubMed2004

Prevalence of Hymenoptera venom allergy and its immunological markers current in adults in Poland.

BACKGROUND: The prevalence of insect venom allergy is still being assessed. The aim of our study was to estimate, on the basis of an interviewer-administered questionnaire survey, the frequency of post-sting allergic reactions and venom sensitization. MATERIAL/METHODS: The study was performed within the framework of the ECRHS. A random sampling of 3000 persons was selected from among 68,000 persons living in the area of Wrocław, Poland. Of the 2050 persons responding to a mailed screening questionnaire, 169 were randomly selected to complete a questionnaire designed only for insect allergy detection. Venom skin test and sIgE assessment were performed on 146 and 132 patients, respectively. RESULTS: Allergic post-sting symptoms were found in 20.7% of surveyed patients. Large local reactions (LLs) occurred in 11.8% and systemic reactions (SYSs) in 8.9% of the study population. SYS was most often manifested by urticaria (4.7%). The frequencies of SYS II, III and IV were 1.8%, 1.8%, and 0.6%, respectively. Only LLs were more frequent in subjects with other allergic diseases (p=0.03). The presence of positive skin tests and/or sIgE in serum were 42.8% of subjects with LL, 53.3% with SYS, and 17.1% of "asymptomatic" patients. No significant differences were found between these groups regarding venom skin test results and sIgE serum concentrations. Occurrence of sIgE to bee venom was frequently associated with the presence of sIgE to timothy grass. CONCLUSIONS: Insect venom allergy and asymptomatic venom sensitization in adults are common in Poland. Only some venom allergy cases are IgE dependent.

Adult↗

PubMed2003

[Studies of the specificity of immediate allergic reactions to ampicillin].

Ampicillin belongs to the drugs causing most frequently IgE-dependent allergic reactions, but the current specificity of these reactions is poorly known. Some experimental data suggest that the side chain of ampicillin may induce synthesis of drug-specific IgE antibodies. In our study we have decided to explain the specificity of ampicillin-induced allergic reactions type I appearing in patients after drug administration. Thirty-eight subjects developing an immediate response after administration of ampicillin entered the study. In all the patients skin tests with penicillin, ampicillin and amoxicillin determinants were performed. We have observed positive skin tests results with penicillin determinants in 23 subjects, in 32 subjects with ampicillin and in 17 cases with amoxicillin. Only in three persons the results were positive exclusively to ampicillin. The results of our study indicate that in the Polish population ampicillin induces an immediate IgE response with variable degree of cross-reactivity to other tested drugs, and selective response to ampicillin is uncommon.

Adult↗

PubMed2003

[Lung remodeling in asthma].

Repair is an integral part of every inflammation. Injured cells are replaced by new cells of the same type or by connective tissue. This may result in restitution "ad integrum" or lead to structural changes referred to as remodelling. For many years the importance of this phenomenon for the course of asthma, an undoubtedly chronic inflammatory disease, was underestimated. The presence of only partial reversibility of airflow obstruction in some patients with asthma has significantly changed our view on that problem. The irreversible component of airway obstruction is more prominent in patients with severe disease and persists despite aggressive anti-inflammatory treatment. Recent studies have proved that remodelling in asthma encompasses not only the bronchial tree, but also alveolar tissue. There are many factors supposedly responsible for lung reconstruction characteristic of asthma: mediators, cytokines, and growth factors. Better understanding of these processes should provide a basis for novel, long-term therapeutic strategies in asthma.

Asthma↗

PubMed2002

Comparison of leukocyte populations from bronchoalveolar lavage and induced sputum in the evaluation of cellular composition and nitric oxide production in patients with bronchial asthma.

Bronchoalveolar lavage (BAL) or induced sputum (IS) techniques may provide leukocytes for the evaluation of airway inflammatory response in bronchial asthma. The aim of the present study was to compare features of leukocyte populations obtained by the two different methods regarding the cell types and their activity in patients with bronchial asthma. The nitric oxide (NO) level released from the cells was measured as a marker of their activity. Pulmonary leukocytes were obtained from the BAL and IS of 11 asthmatic patients in stable condition at the time of the study. The BAL and IS leukocyte populations varied in cell count and NO production. Macrophages were the predominant leukocyte population in BAL (median (Me) = 83.0%, range 67.9-88.4%), whereas sputum sediments were found to consist mainly of neutrophils (Me = 55.7%, range 29.0-64.9%). The IS leukocytes released much more NO (p = 0.0022) than the BAL leukocytes. In spite of these quantitative differences, a similar pattern of NO production was observed in BAL and in IS cells. Both BAL and IS leukocyte populations produced almost the same amounts of NO before and after lipopolysaccharide stimulation (p = 0.9063, p = 0.4801, respectively). Furthermore, a slight positive correlation Spearman's rank (RS) = 0.5578, p = 0.0594) was noticed between the neutrophil percentages and NO levels produced by BAL cells, whereas in IS a statistically significant correlation between the percentage of neutrophils and the levels of NO (RS = 0.6643, p = 0.0184) was observed. In conclusion, the BAL and IS leukocyte populations are different in cell type, their size and activity. Depending on the asthma severity and the type of cells needed in a study, either BAL or IS specimens may be chosen as a source of pulmonary leukocytes. The use of IS as a noninvasive technique is supposed to be potential value particularly in the study of the airway inflammatory response mediated mainly by neutrophils, i.e. during and/or after exacerbation of the disease. Based on our results, a possible contribution of neutrophils in the production of NO in the airways of asthmatic patients can be proposed apart from other cells such as macrophages.

Adult↗

PubMed2002

[Value of the leukotriene generation test in diagnosis of immediate hypersensitivity to penicillin].

In this study we have decided to explore the diagnostic usefulness of CAST-ELISA test in patients with immediate allergic reactions caused by penicillin. Peripheral blood leukocytes were stimulated by commercially available penicillin allergens--Penicillin G, Benzyl-penicillin--Polylysine and specially performed Penicillin G conjugated to human serum albumin. Test was performed in 33 allergic persons and in 13 control healthy persons well tolerated penicillin antibiotics with negative skin tests results. CAST-ELISA test gave the positive results in 30.3% when unconjugated penicillin was used and in 18.18% with penicillin--polylysine. The best results were obtained when cells were stimulated with penicillin conjugated to human serum albumin--positive results were observed in 47.82%. Accumulate percentage of positive results was 73.91%. In our opinion CAST-ELISA test is reliable method in diagnosis of immediate allergic reactions caused by penicillin and inclusion of penicillin conjugated to human serum albumin seems to be justifiable.

Adult↗

PubMed2002

[Studies on cross reactivity to penicillins in patients with immediate allergic reactions caused by amoxicillin].

In this study we have explored the presence of cross reactivity to penicillin and ampicillin in patients with immediate allergic reactions caused by amoxicillin. Skin test results with amoxicillin were positive in 66.66% and in the remaining 33.34% were negative. In 81.48% patients we observed positive results of skin tests with penicillin and/or ampicillin. Only in 14.48% of the patients we observed selective response to amoxicillin. On the basis of obtained results we conclude that sensitivity of skin tests with amoxicillin is rather moderate and confirmation of amoxicillin hypersensitivity can be obtained using skin tests with other penicillins. In our material selective amoxicillin hypersensitivity can be defined as a relatively rare phenomenon. These data should have the important implications in antibiotics' selection in patients with amoxicillin allergy.

Adult↗