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Biomedical subjects

Piotr Kuna

Publications and source records attributed to Piotr Kuna.

46 records · Page 3Linked to original sources
PubMed2002

[The effect of nedocromil sodium on levels of IL-4 and IgE in serum of children with bronchial asthma].

Levels of pro-allergic cytokine IL-4 are increased in asthmatic airways, contributing to allergic inflammation. IL-4 and IL-13 are the most important factors in production of class E immunoglobulin, playing major role in childhood atopic asthma. The mechanism of effect of nedocromil, often prescribed in children, has been discussed. Our previous study on the effect of nedocromil on different inflammatory markers, showed decreased levels of IL-4 and IgE after monotherapy in 15 asthmatic children. The purpose of this study was to define the effect of treatment with nedocromil on serum level of IL-4 and IgE, clinical symptoms and bronchial hyperreactivity (BHR) in children with moderate atopic asthma. It was 8 week, placebo-controlled and randomized, double blind trial of 81 children with moderate atopic asthma allergic to dust mite. Patients were randomly allocated to receive nedocromil sodium two puffs four times daily (0.002 g/puff) (n = 34) or placebo (n = 47). 69 children completed the study. After treatment with nedocromil the levels of IL-4 and IgE in blood serum in study group significantly decreased, and all clinical parameters improved. Mean levels of IL-4 in serum before and after treatment with nedocromil were 0.13 pg/ml +/- 0.01 and 0.12 pg/ml +/- 0.02 respectively (p < 0.01). Mean serum levels of IgE before and after treatment with nedocromil were 556.83 IU/ml +/- 201.3 and 485 IU/ml +/- 200.5 respectively (p < 0.02). This study demonstrate that one possible way by which nedocromil contribute to inhibition of allergic inflammation is by decreasing IL-4 and IgE levels.

Adolescent↗
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

[IL-10 serum levels in children with moderate asthma].

Levels of an interleukin 10 (IL-10) are reduced in asthmatic patients in comparison to healthy subjects. Fact, that IL-10 is produced by Th1 and that inhibits cytokine production by Th2 lymphocytes has led to the concept that IL-10 might be beneficial in mitigating allergic inflammation. The purpose of this study was to define the effect of 4 week monotherapy with triamcinolone acetonide or nedocromil sodium on the serum level of IL-10, bronchial hyperresponsiveness and clinical parameters in atopic asthma children. It was an 8 week, randomised, double-blind trial of 37 children with moderate asthma allergic to house dust mite. Patients were randomly allocated to receive 200 mcg triamcinolone twice daily (n = 18), or 0.004 g nedocromil four times daily (n = 19). Thirty children completed the study. After treatment with triamcinolone the level of IL-10 in blood serum significantly increased, bronchial hyperreactivity significantly decreased, and all clinical parameters improved. Mean IL-10 levels in serum before and after treatment with triamcinolone were 7.5 pg/ml with 95%CI 6.79%-8.22% and 14.21 pg/ml with 95%CI 11.33%-17.09% respectively (p < 0.001). After treatment with nedocromil, clinical symptoms improved significantly, IL-10 serum levels and bronchial hyperreactivity did not change significantly (p = 0.094 and p = 0.09 respectively). This study demonstrates that one possible way by which triamcinolone contribute to inhibition of inflammation is by effect on IL-10.

Adolescent↗
PubMed2002

[Cockroach allergen Bla g 2 levels in houses in Lodz].

Asthma morbidity increase every year, especially among children. The cause of this is multifactorial, but exposure to high levels of indoor allergens is thought to be one important factor, since we spend the large fraction of time indoors. Next to other popular indoor allergens, many studies underline the importance of cockroach allergen. In this study dust samples from 39 homes were collected. Patients were recruited from Allergy Clinic in Zgierz. In each home the sample from kitchen and bedroom were taken. After extraction Bla g 2 concentration was measured by ELISA assay (Indoor Biotechnologies, Great Britain). Bla g 2 antigen was detected in 43 (55.13%) out of 78 samples, in 62.8% kitchen samples and 37.2% bedroom samples. In all homes with detected cockroach antigen, the levels were higher then sensitization value 8 U/g (at least in one room). The highest levels of Bla g 2 were found in old houses, without central heating and in houses with lower income. Our results showed that concentrations of Bla g 2 antigen in homes in Łódź region, are higher than previously reported in other countries and is strongly related to the house characteristics.

Air Pollution, Indoor↗
PubMed2002

[Bronchial asthma--epidemiology, public and economic problems].

In this review, authors described epidemiology of asthma in regards to mortality and disability caused by the disease. In particular, long-time statistical analyses of asthma mortality in United States and Great Britain has been shown. Specific mortality factors between United States and Regional Health Authority of Lodz were compared. Economical costs of asthma management were studied, taking United States as an example. The review also focused on variety of preventive and counteraction programs, for example the national health program--'Prevention and treatment of asthma and allergic diseases'.

Asthma↗
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↗
PubMedDate not supplied

The effect of inhaled heparin on airway responsiveness to histamine and leukotriene D4.

Inhaled heparin has been shown to reduce the early and late phase of asthmatic reactions and suppress an allergen-induced increase in bronchial hyperreactivity. The mechanism involved in the control of bronchial hyperreactivity in asthma by heparin is still not understood. The purpose of this study was to investigate the effect of inhaled heparin on the airway response to histamine and leukotriene D4. Children with a typical history of mild allergic asthma participated in this randomized, double-blind, placebo-controlled cross-over study. Subjects underwent provocation challenge tests with histamine or leukotriene D4 before and after inhalation of heparin and placebo. Twenty-three patients completed the study. We showed that placebo did not affect the bronchial hyperreactivity to histamine or leukotriene. A single dose of inhaled heparin significantly decreased bronchial hyperreactivity to histamine and leukotriene in children with mild asthma. Results of our study suggest that inhaled heparin, because of its antiallergic and/or anti-inflammatory properties, modifies airway hyperresponsiveness in children with allergic asthma.

Administration, Inhalation↗