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Biomedical subjects

Piotr Kuna

Publications and source records attributed to Piotr Kuna.

At least 19 recordsLinked to original sources
PubMed2006

A randomized, double-blind trial of the effect of anti-asthma treatment on lung function in children with asthma.

BACKGROUND: Pulmonary function tests (PFTs) and especially spirometry measures are useful tools in evaluating early response to treatment of asthma in children mainly due to their worldwide availability. The aim of our study was to determine the effects of anti-asthma treatment in children, equally on FEV(1), FEF25-75%, R(int) and SR(aw) values. METHODS: Children 6-18 years of age with moderate atopic asthma were randomized to 4-week, placebo-controlled, double-blind trial. Patients were randomly allocated to receive 200 microg budesonide (B) (n=29), 5 or 10 mg (according to age) montelukast (M) (n=29), 200 microg B + 5 or 10 mg M (n=29), 200 microg B + 9 microg formoterol (F) (n=29) or placebo (n=27). FEV(1,) FEF25-75%, R(int), SR(aw) were measured before and after treatment. RESULTS: R(int), SR(aw), FEV(1) improved significantly in all active treatment groups while FEF25-75% improved significantly only in BM group and M group. Combination therapy, showed significantly greater effects on R(int) than monotherapy: BM group compared to B group (P=0.01) and M group (P=0.03) and BF group compared to B group (P=0.01) and M group (P=0.04). CONCLUSION: This study shows that using single parameter for monitoring asthma can be misleading. Using combination of lung function techniques provides better assessment of treatment. Results of our study confirm this hypothesis. The best effect on large and small airways was achieved with combined anti-inflammatory therapy.

Acetates↗
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↗
PubMed2006

Budesonide/formoterol improves lung function compared with budesonide alone in children with asthma.

UNLABELLED: We aimed to compare the efficacy and safety of budesonide/formoterol (Symbicort) with budesonide alone (Pulmicort) or budesonide (Pulmicort) and formoterol (Oxis) administered via separate inhalers in children with asthma. In a 12 wk, double-blind study, a total of 630 children with asthma (mean age 8 yr [4-11 yr]; mean forced expiratory volume in 1 s (FEV(1)) 92% predicted; mean inhaled corticosteroid dose 454 microg/day) were randomized to: budesonide/formoterol (80/4.5 microg, two inhalations twice daily); a corresponding dose of budesonide alone (100 microg, two inhalations twice daily); or a corresponding dose of budesonide (100 microg, two inhalations twice daily) and formoterol (4.5 microg, two inhalations twice daily) (budesonide + formoterol in separate inhalers). The primary efficacy variable was the change from baseline to treatment (average of the 12-wk treatment period) in morning peak expiratory flow (PEF). Other changes in lung function and asthma symptoms were assessed, as was safety. Budesonide/formoterol significantly improved morning PEF, evening PEF and FEV(1) compared with budesonide (all p < 0.001); there was no significant difference between budesonide/formoterol and budesonide + formoterol in separate inhalers for these variables. All other diary card variables improved from baseline in all treatment groups; there were no significant between-group differences. Adverse-event profiles were similar in all groups; there were no serious asthma-related adverse events in any treatment group. CONCLUSION: budesonide/formoterol significantly improved lung function in children (aged 4-11 yr) with asthma compared with budesonide alone. Budesonide/formoterol is a safe and effective treatment option for children with asthma.

Adrenergic beta-Agonists↗
PubMed2006

Efficacy and safety of high-dose budesonide/formoterol (Symbicort) compared with budesonide administered either concomitantly with formoterol or alone in patients with persistent symptomatic asthma.

OBJECTIVE AND BACKGROUND: Budesonide/formoterol 160/4.5 microg, two inhalations bd, is an effective and well-tolerated maintenance therapy for patients not controlled on inhaled corticosteroids alone. The authors assessed the efficacy and safety of a higher dose of budesonide/formoterol in patients with persistent symptomatic asthma. METHODS: This was a 24-week, double-blind, double-dummy randomized study. Budesonide/formoterol 320/9 microg, two inhalations bd (1280/36 microg/day), was compared with corresponding doses of budesonide during weeks 1-12 and budesonide plus formoterol via separate inhalers during weeks 1-24. Efficacy was assessed during weeks 1-12; the primary variable was morning PEF. Safety was assessed over weeks 1-24. RESULTS: Patients (n=456; aged 12-79 years) had a mean reversibility in FEV1 of 28% and mean pre-study inhaled corticosteroid dose of 1038 microg/day. Mean morning PEF increased by 37 L/min and 36 L/min with budesonide/formoterol and budesonide plus formoterol, respectively, versus an increase of 5 L/min with budesonide (P<0.001 for both vs. budesonide). Budesonide/formoterol increased time to first mild exacerbation (P<0.005) versus budesonide. Budesonide/formoterol and budesonide plus formoterol had similar efficacy. All treatments were well tolerated and the incidence of class-related adverse events was similarly low in all groups. Changes in serum potassium and plasma cortisol were comparable across treatments. CONCLUSIONS: High-dose budesonide/formoterol (320/9 microg, two inhalations bd) is effective and well tolerated in patients with persistent symptomatic asthma. The findings also support the safety of regular high-dose formoterol (36 microg/day).

Administration, Inhalation↗
PubMed2006

[Prevalence of atopy and atopic diseases in children living in an orphanage in Lodz area--pilot study].

UNLABELLED: Over the past three decades there has been an increase in the prevelance of allergic diseases, specially among children. THE AIM OF THE STUDY: was to estimate the prevalence of atopy and atopic diseases in children who are living in orphanages in Lodz. MATERIAL AND METHODS: 120 children 5-18 years old living in 2 orphanages were studied. Main outcome measures were history, physical examination, FEV1, skin prick-test results with 18 allergens; peripheral blood eosinophil count, level of total and specific IgE in children with positive skin-test results were secondary and point. RESULTS: Bronchial asthma was diagnosed in 5.83% (6 of 120) patients, seasonal allergic rhinitis was diagnosed in 2.5% (3 of 120) patients and atopic dermatitis was diagnosed in 1.67% (2 of 120) patients. The skin prick-tests were positive in 12.5% children. Mean number of respiratory tracts infection in early childhood was significantly lower in atopic children than in non-atopic children--3.3 +/- 2,3 vs 8.7 +/- 2.5 (p<0.001). Mean total serum IgE concentration value reached upper limit in 26.6% of non-atopic patients and in 32.4% non-atopic children peripheral blood eosinophil count was significantly increased suggesting possible presence of active helminth infection, what might protect against atopy. CONCLUSION: In children living in orphanages we observed the lower prevalence of atopy (12.5%) and atopic diseases than in general population (25.4-40.2%).

Adolescent↗
PubMed2006

[Asthma as a mask of other respiratory diseases].

Everyday clinical practice reveals both cases of asthma with non-typical symptoms as well as pseudo-asthmatic syndromes with symptoms typical for asthma. Bronchofiberoscopy is a diagnostic method which may help to overcome many diagnostic problems. Although it is a safe procedure, an increased risk of severe bronchoconstriction exists in patients with asthma. The fear of this complication may cause late diagnosis of some asthma-mimicking diseases and may delay the proper treatment. In the present paper we describe two cases showing the possibility of making diagnostic mistakes, and especially illustrating the role ofbronchoscopy in differential diagnosis of bronchial asthma. The authors remind specific indications for this examination in patients with asthma or those presenting asthma-like symptoms. Safety precautions have been also recollected. If safety rules are met, severe bronchoconstriction in patients with bronchial hyperreactivity can be avoided.

Adult↗
PubMed2005

The effect of montelukast and different doses of budesonide on IgE serum levels and clinical parameters in children with newly diagnosed asthma.

BACKGROUND: Since IgE is considered to play a crucial role in allergic immune responses, the reduction of free IgE level has been an attractive target in the treatment of allergic diseases. The present study was conducted to determine the effects of a 6-month treatment with different doses of inhaled budesonide and montelukast sodium in children with newly diagnosed atopic asthma. METHODS: In this randomized, double-blind, double-dummy trial, 51 children with newly diagnosed asthma and sensitivity to house-dust mites were randomly allocated to receive budesonide (in two different doses 400 or 800 mcg) or montelukast for 6 months. The primary end point was the level of serum total and specific IgE before and after treatment. The secondary end points were clinical parameters and forced expiratory volume in 1s (FEV1). RESULTS: After 6 months of treatment, a high dose of inhaled corticosteroid and montelukast, significantly decreased levels of total and specific IgE. Medium dose of inhaled corticosteroid had no effect on total and specific IgE serum level. Clinical score and FEV1 significantly improved after 6 months of treatment with medium (P = 0.002) and high dose (P = 0.001) of inhaled budesonide and montelukast (P = 0.002). There were no differences between groups in changes of all clinical parameters after treatment. CONCLUSION: Only high doses of inhaled corticosteroids and montelukast decreased the serum IgE levels. Perhaps long-term treatment with montelukast will be beneficial to asthma patients by decreasing IgE levels.

Acetates↗
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↗
PubMed2005

[Lipoxins--new view on old mediators carrying potent anti-inflammatory action].

Lipoxins are the class of bioactive lipid mediators that carry potent anti-inflammatory signals. They are generated in humans during cell-cell interactions by one of at least three routes. Recently, aspirin was found to influence one of them and to trigger formation of 15-epir-lipoxins that may contribute to some of the beneficial action ascribed to aspirin. Lipoxins carry unique counter-regulatory actions that promote resolution of inflammation via multiple mechanisms, including inhibition of leukocyte recruitment and activation, cytokine and chemokine release and biosynthesis of pro-inflammatory lipid mediators. As lipoxins are likely to play physiologic role during homeostatic response, they may be also associated with number of inflammatory diseases. Thus, lipoxins and their stable analogues could provide novel therapeutic approach to the treatment of inflammatory disorders. Here, we present an overview of the recent knowledge about the biosynthesis and bioactions of these anti-inflammatory lipid mediators.

Anti-Inflammatory Agents↗
PubMed2005

[Basophil degranulation test in the diagnosis of nonsteroidal anti-inflammatory drug hypersensitivity].

UNLABELLED: Nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity affects from 5 to 30% of adult asthmatics. The diagnosis is established on the basis of anamnesis and confirmed by provocation tests, but the last one carry the risk of serious side effects. There is lack of in vitro test to diagnose NSAID hypersensitivity. The aim of our study was to establish the usefulness of basophil degranulation test in the diagnosis of NSAID hypersensitivity. MATERIAL AND METHOD: The study population consisted of 10 patients with aspirin asthma, 6 asthmatics with tolerance of NSAID and 6 healthy subjects. NSAID hypersensitivity was confirmed by aspirin challenge. The level of specific IgE for aspirin was determined in all subjects by ELISA method. Basophil degranulation test (BDT) was performed The BDT was assessed as positive when the basophils degranulation exceeded 30% as compared to control. RESULTS: In all NSAID hypersensitive subjects, sensitivity was confirmed by aspirin challenge. The specific IgE test was negative for all studied subjects. BDT was positive in 9 from 10 NSAID hypersensitive patients and negative in all NSAID tolerant subjects. The positive degranulation was observed in range 10 to 750 microg of aspirin/ml. One false negative result was observed in patient receiving high dose of oral glucocorticosteroids which stabilized basophils and prevent from degranulation. CONCLUSION: BDT, when performed in increasing aspirin concentration from 50 to 500 microg/ml, seems to be a valuable and safe diagnostic method of NSAID hypersensitivity. The study revealed that sIgE for aspirin are not useful diagnostic method. The study confirmed the involvement of basophils in the NSAID hypersensitivity reaction beyond IgE system.

Adult↗
PubMed2005

[Exploring new therapeutic approaches to the treatment of inflammatory disorders--lipoxins].

The prevalence of inflammatory disorders continues to increase and its optimal treatment still remains a challenge. Lipoxins, endogenous eicosanoids biosynthesised in vivo at inflammatory sites, are potent anti-inflammatory mediators. Therefore, it is of interest to investigate the potential effects of lipoxins that could attenuate chronic inflammation. Currently, only limited data on the effects of lipoxins in clinical investigations are available. Nevertheless, lipoxins caused inhibition of hyper-responsiveness and allergic airway inflammation in asthma. They could also impact the progression of inflammatory arthritides through the reduction of the inflammatory infiltrates and limiting tissue destruction. Lipoxins may play important anti-inflammatory roles in intestinal inflammation as well as in a number of cutaneous inflammatory disorders like psoriasis or atopic dermatitis. Taken together, the available data suggests that lipoxins may have broad therapeutic potential in inflammatory disorders and could provide an alternative to corticosteroids in certain clinical settings.

Anti-Inflammatory Agents↗
PubMed2005

[The Churg-Strauss syndrome and antileukotriene agents].

The Churg-Strauss syndrome (CSS), characterized by asthma, eosinophilia and systemic vasculitis, was initially described in 1951. Criteria of recognition were defined by: Churg and Strauss (pathologic criteria), Lanham and coworkers (clinical criteria) and American College of Rheumatology (differentiation from others forms of vasculitis). CSS is often a triphasic illness and main symptoms derive from an affection of respiratory, cardiovascular, nervous and digestive systems. The pathogenesis of CSS is not clear, but it is suspected that antileukotriene agents, used in the treatment of asthma, are probably involved in. However, this association has not been unequivocally proved until now.

Anti-Asthmatic Agents↗
PubMed2005

[Level of interleukin-12 and interferon gamma in blood serum of children with neoplasms and allergy].

UNLABELLED: Interleukin-12 (IL-12) shows strong antineoplasm properties. THE AIM: of the study was to evaluate concentration of IL-2 in children's serum with malignant disease, association cytokines with the presence allergic reaction. MATERIAL AND METHODS: We analysed 100 patients with malignant disease, and/or with allergy (NA+/NA-, respectively), 100 children with allergic disease (A). The control group was 48 healthy cases (K). In all cases were performed skin prick-tests. Concentration of total IgE (t-IgE), IL-12 and INFgamma determined by using ELISA method. RESULTS: T-IgE concentration was to higher in children with allergy disease compared with healthy cases. To low concentration of IL-12 observed in children's group with malignant and allergy disease compared with the other cases ((NA+) = 123,7 pg/ml, (NA-) = 181,7 pg/ ml, (A) = 167,7 pg/ml, (K) = 154,2 pg/ml, Me respectively). Higher point of INFgamma observed in children with malignant and allergic disease compared with groups with malignant disease but without allergic disease, allergic disease and healthy cases (Me = 0,95 pg/ml, Me = 0.0 pg/ml, Me = 0,28 pg/ml, Me = 0,55 pg/ml, respectively). CONCLUSION: Coexistence malignant process and allergy describes the interference of synthesis IL-12 and increase t-IgE thus prevelance of humoral reaction.

Adolescent↗
PubMed2005

[The influence of mononucleosis infection on atopic disease development in children].

The aim of the study was to determine whether infectious mononucleosis may trigger atopic symptoms or modulate their clinical course. Data from literature point out to such a relationship and attribute it to the influence of EBV on lymphocytes B and IL-4,IL-5,IL-10 and vIL-10 secretion stimulation. The authors examined 30 children who had suffered from symptomatic infectious mononucleosis 2-4 years previously, evaluating symptoms of allergic diseases and performing skin prick tests with selected inhalant and food allergens. The symptoms of atopic disease were found in 57 % in the mononucleosis group, a significantly higher percentage (p<0.0001) than in general population of children in Lódź (16%). The frequency of positive skin prick tests with common allergens was also significantly higher (60% vs 27%, respectively).

Adolescent↗
PubMed2004

Aspirin sensitivity and IgE antibodies to Staphylococcus aureus enterotoxins in nasal polyposis: studies on the relationship.

BACKGROUND: Nasal polyposis is a multifactorial disease characterized by a chronic eosinophilic inflammation of the sinus mucosa, often associated with asthma and aspirin sensitivity. We have recently shown that the presence of IgE antibodies to Staphylococcus aureus enterotoxins (SAEs) was related to the severity of eosinophilic inflammation in nasal polyp tissue. In this study, we therefore aimed to determine, whether aspirin sensitivity was related to an immune response to SAEs, and how both criteria would be related to eosinophilic inflammation. METHODS: 40 subjects with nasal polyposis (NP) were classified as aspirin-sensitive (n=13, ASNP) or aspirin-tolerant (n=27, ATNP) based on a bronchial aspirin challenge test. Homogenates prepared from nasal polyp tissue and inferior nasal turbinates from healthy subjects (n=12) were analyzed for concentrations of IL-5 by enzyme immunoassay and for ECP, total and IgE to a mix of SAEs (A, C, TSST-1) using the ImmunoCAP system. RESULTS: Concentrations of IL-5, ECP, total IgE, and IgE to an SAE mix were significantly increased in ASNP compared with ATNP patients and controls. In addition, a subgroup analysis showed an increase in eosinophilic markers in ATNP-SAE(+) compared to ATNP-SAE(-). This relationship, however, was not found in ATNP-SAE(+) and ATNP-SAE(-) subjects, indicating that SAE immune response is overlapped or not relevant in this condition. CONCLUSIONS: Aspirin sensitivity was associated with increased concentrations of eosinophil-related mediators, as well as IgE antibodies to SAEs in nasal polyp tissue. However, a direct impact of S. aureus could not be established. It seems that aspirin sensitivity and immune reactions to SAEs are independently related to eosinophilic inflammation.

Adult↗