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Biomedical subjects

Maciej Kupczyk

Publications and source records attributed to Maciej Kupczyk.

11 recordsLinked to original sources
PubMed2006

The effect of 4 weeks treatment with desloratadine (5mg daily) on levels of interleukin (IL)-4, IL-10, IL-18 and TGF beta in patients suffering from seasonal allergic rhinitis.

Anti-inflammatory effect of desloratadine (DL), including, but not limited to depression of production of IL-4, IL-6 and IL-8, has been shown in several in vitro experiments but only a few in vivo studies refer to this findings. The purpose of our study was to evaluate the influence of DL on levels of IL-4, IL-10, IL-18 and TGF-beta in sera of patients with seasonal allergic rhinitis (SAR). Sixty-nine subjects suffering from SAR with hypersensitivity to grass pollen were included into the evaluation of clinical efficacy of DL (5mg once daily). None of them was taking any H(1) receptor antagonist during the pollen season before inclusion into the study. Samples of peripheral blood were taken before and after 4 weeks of treatment. Levels of cytokines were determined using the ELISA method. The mean level of IL-4 was 0.212+/-0.07pg/ml before and 0.221+/-0.1pg/ml after the treatment (p=0.52); IL-10 5.13+/-3.14 and 4.71+/-0.88 (p=0.69); IL-18 54.45+/-26.09 and 44.80+/-22.42 (p=0.48); TGF beta 949.17+/-401.5 and 955.7+/-391.2 (p=0.97)pg/ml before and after the treatment, respectively. Unless in vitro DL demonstrates not only anti-allergic but also anti-inflammatory activities data from this in vivo study in a group of patients suffering from SAR do not support previous pre-clinical findings.

Adult↗
PubMed2006

The effect of montelukast (10mg daily) and loratadine (10mg daily) on wheal, flare and itching reactions in skin prick tests.

UNLABELLED: Antileukotriene agents are widely used for the treatment of allergic conditions including bronchial asthma and allergic rhinitis. The influence of montelukast on skin reactivity has not been clearly evaluated. The aim of this study was to determine the effect of montelukast on wheal, flare and itching in skin prick tests (SPTs). METHODS: Fifteen atopic patients (5 women and 10 men) with average age 28.04 (SD+/-8.24) were tested with histamine, codeine, negative control solution and allergen extract (grasses). Montelukast (10mg), loratadine (10mg) or placebo were given to the volunteers for 5 days in a double-blind manner, followed by SPT, with 14 days of wash-out period. RESULTS: There was no differences in wheal, flare and itching (p=0.205; 0.086 and 0.069, respectively, Wilcoxon rank-sum test) between SPT performed after placebo and wash-out period. The analysis revealed a statistically significant suppression of wheal and flare by loratadine (p<0.05 for all tested solutions). Pre-treatment with montelukast did not influence wheal size (p=0.099, 0.21, 0.066 for histamine, codeine and allergens, respectively), but significantly reduced flare (p=0.005; 0.003; 0.02 for histamine, codeine and allergens, respectively). We found a significant suppression of itching produced by montelukast (p=0.02) and loratadine (p=0.03) as compared to placebo (p=0.068 vs. wash out). CONCLUSIONS: Our data show a tendency to suppressive effect of montelukast on flare and itching but not on wheal which is basic for SPT interpretation. We conclude that found suppression have little impact on clinical effectiveness of SPT as a diagnostic tool.

Acetates↗
PubMed2006

Adhesion molecules and their ligands in nasal polyps of aspirin-hypersensitive patients.

BACKGROUND: Chronic inflammation with tissue eosinophilia plays a key role in the pathogenesis of asthma and nasal polyps in patients with aspirin hypersensitivity. OBJECTIVE: To evaluate the expression of vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule I (ICAM-1) and their ligands (the integrins lymphocyte function-associated antigen 1 and very late-activation antigen 4 [VLA-4]) in nasal polyps of patients with aspirin hypersensitivity compared with aspirin-tolerant individuals. METHODS: Immunohistochemical studies were performed using a peroxidase method and monoclonal antibodies on 6-microm-thick cryostat sections cut from frozen polyps collected during elective surgery from 21 aspirin-sensitive and 23 aspirin-tolerant patients. RESULTS: The mean +/- SD values of the semiquantitatively evaluated immunoexpression of ICAM-1, VCAM-1, and VLA-4 were significantly increased in patients with aspirin hypersensitivity compared with aspirin-tolerant patients (1.7 +/- 0.8 vs 0.9 +/- 0.8, P < .003; 1.8 +/- 0.8 vs 0.8 +/- 0.8, P < .001; and 2.2 +/- 0.7 vs 1.3 +/- 0.7, P < .001, respectively), whereas the mean +/- SD values of the expression of lymphocyte function-associated antigen 1 did not differ significantly (2.4 +/- 0.5 vs 2.2 +/- 0.9; P = .57). We found a correlation between the immunoexpression of VCAM-1 and its ligand VLA-4 in all studied tissue samples (r = 0.4; P < .02). CONCLUSIONS: In nasal polyps of aspirin-hypersensitive patients, up-regulation of the adhesion molecules ICAM-1 and VCAM-1 and the integrin VLA-4 may play an important role in the development of chronic eosinophilic inflammation.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2005

[Cockroach hypersensitivity in children suffering from perennial allergic rhinitis].

UNLABELLED: The role of cockroach allergens in the etiology of allergic disorders is still not clear. Published studies show a high variability in frequency of hypersensitivity to cockroaches. The aim of our work was to study the possible role of cockroach allergy in children suffering from perennial allergic rhinitis. MATERIAL AND METHODS: The study group consisted of 97 children with symptoms of perennial rhinitis admitted to our Outpatient Clinic. The data about medical history, symptoms, incomes and accomodation were gathered using a questionnaire. Skin prick tests (SPT) with a set of allergens including cockroaches were performed. RESULTS: Sixty boys and 37 girls with mean age 9.15 +/- 3.48 years, with mean duration of symptoms of perennial rhinitis 2.92 +/- 1.86 years were included it the study. In 28 children (28.9% of the study group) had all SPT negative. At least one positive SPT was found in 69% of patients. The most frequent allergens were house dust mites (Der f--65.2%, Der p--60.9%), followed by grasses (58%) and moulds (46.%). Positive SPT with cockroaches was found in 16 children (23.2%). The most frequent symptom in our study group was nasal congestion (68.4%). 46.4% of children complained about deterioration of nasal symptoms during a day. Perennial rhinitis coexisted with diagnosed bronchial asthma in 28 patients (28.9%) and with atopic dermatitis in 14 patients (14.4%). Presence of cockroaches at home was noticed in 3 cases and at school in 1 case. We did not find correlation between type of housing, living in a big city, small city or countryside and allergy to cockroaches (chi2 test p = 0.75). Hypersensitivity to cockroaches did not correlate with severity of rhinitis (U-Mann-Whitney test p = 1.0). There was no correlation between low incomes and allergy to cockroaches (chi2 test p = 0.294). CONCLUSIONS: The results of our study show that in our region hypersensitivity to cockroaches is one of possible, but not leading factor responsible for the development of perennial rhinitis.

Allergens↗
PubMed2004

Aspirin intolerance and allergy to house dust mites: important factors associated with development of severe asthma.

BACKGROUND: Although the occurrence of bronchial asthma is still increasing, the possible factors associated with the development of severe asthma have not been completely determined. OBJECTIVE: To measure the incidence of severe asthma and its determinants in outpatients. Aspirin intolerance, house dust mite (HDM) allergy, male sex, age older than 65 years, and duration of asthma exceeding 10 years were investigated as factors potentially related to the severity of asthma. METHODS: The study population included 598 women and 408 men, mean age of 44.59 years (SD +/- 16.45 years), randomly chosen from patients with asthma under follow-up surveillance in an outpatient clinic. Their medical histories were reviewed; spirometry and skin prick tests were performed. RESULTS: The asthma was diagnosed as intermittent in 35.39%, persistently mild in 33.40%, moderate in 23.76%, and severe in 7.45% of the study cohort. In the patients with atopy, HDM allergy was a significant factor associated with the development of severe asthma [odds ratio (OR) = 5.65]. Of the 1,006 patients, 341 (33.90%) had had asthma for at least 10 years, which was a significant factor in the overall study group (OR = 3.64). We found 95 cases (9.44% of the study group) of aspirin intolerance, including 23 of the 75 patients with severe asthma (30.67%; OR = 5.44). Logistic regression analysis showed that aspirin intolerance was most closely associated with severe asthma (beta = 5.79; P < .001). CONCLUSIONS: The data from this study show that aspirin intolerance, HDM allergy, and asthma duration exceeding 10 years are major factors associated with severe asthma in outpatients.

Adolescent↗
PubMed2002

[Precision and economy of skin prick tests].

Due to a rise in the number of cases of allergic disease and a need to increase financial resources for the diagnosis of these conditions, the possibility of reducing costs of skin pricks tests (SPT) was very welcome. In an attempt to reduce costs some practitioners use one lancet for several pricks in one patient. The purpose of this study was to determine whether this way of performing SPT influences the results. 52 subjects with (39) and without (13) atopy were tested with histamine, codeine and standard allergen extracts. SPT were applied to the volar surface of a randomly assigned forearm using two methods: one lancet-one prick on one forearm (single test method) and one lancet-multiple pricks ("multiple test" method) on the other. The false positive tests at the placebo site following allergen were recorded only in multiple test method, in 41 out of 72 pricks (p < 0.00001) when all reactions above baseline were considered and in 26 out of 72 (p = 0.00001) when a 3 mm cut-off was considered. The size of the false positive reaction depends on the intensity of the reaction to the preceding allergen (rang Spearman factor R = 0.706, p < 0.000001) and decreases in the second consecutive placebo test. Our data show that one lancet for multiple test method cannot be used to diagnose factors responsible for allergy, particularly in patients qualified for immunotherapy and in scientific studies. For financial reasons multiple test method can be used in screening and epidemiological studies where atopy is studied and there is no need to identify the specific allergen.

Adult↗
PubMed2002

[Mucolytics in acute and chronic respiratory tract disorders. I. Pathophysiology and mechanisms of action].

Mucus hypersecretion is a cardinal sign of both acute and chronic pulmonary diseases. Normally, mucus protects respiratory tract, but its overproduction leads to airway obstruction and promotes bacterial colonization. In the first part of our review we outlined the possible factors responsible for mucus hypersecretion and clinical consequences of this process. Mucolytic agents such as Ambroxol and N-acetylcysteine are able to alter the secretion of mucus and its physical properties which results in improvement of mucociliary clearance. Mechanisms of action and indications for use of mucolytics are presented. Mucolytics have been shown to have a role in improving lung functions and patients' quality of life. Undoubtedly they are useful as an adjunctive therapy of respiratory tract disorders.

Acetylcysteine↗
PubMed2002

[Mucolytics in acute and chronic respiratory tract disorders. II. Uses for treatment and antioxidant properties].

In the first part of our editorial we reviewed the possible factors responsible for mucus hypersecretion in acute and chronic pulmonary diseases. The present paper presents the results of studies proving, that mucolytics are useful in adjunctive therapy of respiratory tract disorders. Mucolytic agents such as Ambroxol and N-acetylcysteine are able to alter the secretion of mucus and its physical properties which results in improvement of mucociliary clearance. Current evidence indicate, that these drugs are effective, especially in chronic obstructive pulmonary disease, asthma and acute bronchitis. They produce a modest improvement in symptom control and lung function. It has been demonstrated that there is a synergism between mucolytics and antibiotics in the treatment of exacerbation of chronic bronchitis. Moreover, they act as scavengers of reactive oxygen species. Ambroxol is able to inhibit mediator release involved in the pathogenesis of allergic inflammation. As mucolytics are cheap and well-tolerated they are beneficial in the therapy of patients suffering from respiratory tract disorders.

Acetylcysteine↗
PubMed2002

[Myeloperoxidase (MPO) as a marker of neutrophil influx into nasal mucosa after recombinant IL-8 challenge].

Myeloperoxidase (MPO) has been proposed to mirror the degree of neutrophil activation, however its role as a marker of the participation of neutrophils in allergic inflammation is still unclear as the literature is controversial. The aim of this study was to evaluate the MPO levels and neutrophil influx in nasal lavage after recombinant Il-8 challenge. Eight patients suffering from seasonal allergic rhinitis, hypersensitive to grass pollens, with average age 30.1 +/- 2.67 were challenged both with Il-8 and diluent for Il-8 on a subsequent day, in two phases: before the pollen season (unprimed mucosa) and during the season (primed mucosa). Nasal lavage with saline were collected before, during Il-8 or placebo challenge and 30 minutes, 2 hours and 3 hours after the challenge. The number of neutrophils and MPO levels in the nasal fluid were determined. After the challenge with Il-8 of primed mucosa the number of neutrophils increased from 28250 cells/ml at the baseline to 28778, 251020 and 333660 at 0, 5, 2 and 3 hours respectively. There was a statistically significant difference between cells number after diluent and Il-8 challenge (p < 0.05, Wilcoxon rank-sum test). The number of neutrophils in the nasal lavage of primed mucosa after Il-8 challenge was significantly higher (p < 0.005) at all time points in comparison with the diluent and Il-8 challenges in the unprimed mucosa. There was no difference (p < 0.05) in MPO levels in the nasal lavage between Il-8 (mean 17.43 ng/ml +/- 10.98) and diluent challenge (20.98 ng/ml +/- 11.89) of unprimed mucosa. In the primed mucosa fluid we observed a peak of MPO level at 2 hours time point, however that was not significant as compared to diluent challenge (p = 0.465). We did not find the relationship between MPO levels and the neutrophils number in the lavage (rank Spearman factor, rs = 0.258, p = 0.42). Due to the lack of statistically confirmed relationship between MPO level and the number of neutrophils, MPO seems to be of little value as a marker of neutrophil influx into nasal mucosa.

Adult↗
PubMedDate not supplied

Long-term deterioration of lung function in asthmatic outpatients.

BACKGROUND: Although the long-term deterioration of lung function in asthmatic patients has been described, the exact mechanism remains to be determined. OBJECTIVES: The aim of this study was to find correlations between age, sex, atopic status, duration of asthma, asthma severity and the decline in pulmonary function. METHOD: The medical histories of 1,006 randomly chosen asthmatic outpatients were studied and retrospective data on asthma duration, spirometry results, treatment and symptomatology were gathered. A screening spirometry was performed. RESULTS: 598 women and 408 men (age: 44.59, range 12-95 years) participated in the study. Intermittent asthma was diagnosed in 35.4%, chronic mild asthma in 33.4%, moderate asthma in 23.8% and severe asthma in 7.45% of the patients. Statistically significant correlations between patient age, asthma duration and lung function measurements were found. Linear regression revealed the following differences in lung functions per year of asthma duration: FEV1: -0.882% of predicted; FVC: -0.509% of predicted; FEV1/FVC: -0.324% of predicted. The unadjusted annual decline was 80.1 ml/year (p = 0.00003) in FEV1 and 20.5 ml/year (p = 0.036) in FVC. A multiple regression model revealed that asthma severity appears to be the strongest factor influencing pulmonary function (beta = -0.55, p < 0.001 for FEV1). Also, significant associations between pulmonary function measurements, patient age, atopic status and male sex were noted. CONCLUSIONS: The results of this large cohort study show that asthmatic patients develop a progressive decline in pulmonary function correlated with age, sex, duration of asthma and asthma severity. Early diagnosis and intervention is necessary to ameliorate any potential negative impact of asthma on lung function.

Adolescent↗