Biomedical subjects
Publications and source records attributed to T Hermanowska-Szpakowicz.
According to performed researchers statistically important highest increase activity of LDH was indicated in the group of patients with the most severe course of illness which remains after the treatment. No correlation was shown between increased LDH activity in CSF and pleocytosis, protein and glucose concentrations.
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BACKGROUND: The aim of this study was to evaluate the concentrations of soluble CD4, CD8 and CD25 antigens in the serum of patients with early LocaLized, (group I, n = 22 patients) and early disseminated Lyme borreliosis (group II n = 23 patients), before and after antibiotic therapy compared with controls (group III n = 7 healthy persons). MATERIALS AND METHODS: The diagnosis of Lyme borreliosis based on clinical features was confirmed by ELISA and Western blot. The assays of sCD4, sCD8 and sCD25 concentrations were performed using Endogen (USA) kits. RESULTS: In group I the sCD4 level decreased in examination 2 (p < 0.001) compared to examination 1. The mean concentration of sCD8 in initial examination 1 in group II was higher than in controls (p < 0.0001); it decreased in examination 2 but was still higher (p < 0.01) than in controls (p < 0.006). Prior to treatment mean sCD25 concentration in group II was higher compared to controls (p < 0.0008) like in examination 2 after treatment (p < 0.02) and this persisted. The mean value of sCD8 in initial examination 1 before treatment in group II was higher than in group I (p < 0.00001). CONCLUSION: Increased initial concentrations of sCD8 and sCD25 indicate the activation of CD8 and CD25 lymphocytes and their role in immunopathogenesis of Lyme disease. Elevated levels of sCD8 in group II before and after treatment suggest a significant involvement of CD8 lymphocytes, indicating the role of long-lasting cellular response in this stage of Lyme disease.
Cerebrospinal fluid (CSF) serotonin was determined in 38 patients with pyogenic meningitis and tick-borne encephalitis (TBE) before and after treatment. Increase of CSF serotonin concentration was observed in acute phase of pyogenic meningits and normalized after treatment.
The aim of this study was the assessment of certain PMN functions involving migration, chemotaxis, phagocytic activity and intracellular oxygen-dependent killing in patients with TBE. The examination involved 47 persons treated in the Department of Infectious and Neuroinfectious Diseases Medical Academy in Białystok. Two examinations were done: before and just after treatment. Control group contained 29 healthy persons. Migration and chemotaxis were assessed by agarose method of Nelson and al. and Glaser and al. Phagocytic activity was examined by microscopic method and intracellular oxygen-dependent killing by reduction test of NBT by Parks method. Analysis of results showed a decrease of all examined parameters both before and after treatment. It indicates a depression of non-specific cellular response in patients with Lyme meningoencephalitis.
The evaluation of the changes of lymphocytes: T(CD3), B (CD19), subpopulations CD4, CD8, active lymphocytes CD3 + HLA-DR+, lymphocytes with the receptor for IL2(CD3 + CD25+), NK cells as well as the CD4/CD8 ratio in 30 patients with the early localized (group I n = 7) and early disseminated (group II n = 23) type of Lyme disease, before (examination 1) and after the antibiotic therapy (examination 2) was performed. Group III was composed of 90 healthy people. Measurements were carried out in an COULTER EPIC XL cytoflowmeter, using Becton Dickinson antibodies. Statistical analysis was performed using AnStat software. In the examined groups, a decrease of the subpopulations of CD4, CD8 lymphocytes in comparison with healthy subjects was revealed, as well as a decrease of the CD4/CD8 ratio after treatment. A considerably lower percentage value of active lymphocytes CD3 + HLA-DR+ in both groups and the reduction of the NK subpopulation before and after treatment of early disseminated Lyme disease in comparison with healthy people was observed. The higher percentage values of the lymphocytes with IL-2 receptor were not statistically significant. The indicated essential changes in the subpopulations of T lymphocytes, characterized by a decrease before the antibiotic therapy and by the tendency towards an increase after that therapy of the percentage of CD4, CD8, NK and CD3 + HLA-DR+ lymphocytes in peripheral blood, point out their role in the immunopathogenesis of the Lyme disease. The absence of the complete normalization of the examined parameters after the treatment, on the one hand, may provide evidence for some inertia of the elements of the immune system, on the other hand can also result from too short antibiotic therapy and maintenance of the antigenic stimulation.
BACKGROUND: Lyme borreliosis is a tick-transmitted, chronic, zoogenous disease caused by Borrelia burgdorferi spirochete. The clinical picture of Lyme disease is characterized by the variety of tissue and organ involvement and differing severity of symptoms. One of the pathogenic symptoms of early Lyme disease is a skin lesion called erythema migrans. MATERIAL AND METHODS: The purpose of our research was to estimate the parameters of the antioxidant system and the concentration of lipid peroxidation products in the plasma of patients with erythema migrans (EM). The parameters measured included the activity levels of superoxide dismutase (SOD) according to Sykes, gluthatione reductase (GSSG-R) according to Mize and Langdon, glutathione peroxidase (GSH-Px) according to Paglia and Valentine; the concentrations of malondialdehyde (MDA) were examined by means of a Bioxytech LPO-586 kit. The total sulphydryl groups (-SH) according to Ellman and reduced glutathione (GSH) were measured using a Bioxytech GSH-400 test in plasma samples collected from 20 patients with EM aged from 19 to 50, taken before (examination 1) and after (examination 2) therapy with amoxycycline. The control group consisted of 8 healthy people. RESULTS: The results of our examinations prove that beta-lactamase antibiotic therapy brings non-enzymatic antioxidant parameters to control values, though the treatment causes no change in enzymatic antioxidant parameters, resulting in the further activation of free radicals. CONCLUSIONS: In patients with Erythema migrans, the decreased capability to reduce lipid superoxidants leads to maintaining a high concentration of membrane lipid peroxidation products.
Since 1987 when Januszkiewicz and Kieda first described borreliosis, it is commonly recognized as infection of the nervous system in Poland, especially in north-east region. The diagnosis of the disease is mainly based on typical clinical signs, supported by serological testing. In 14 patients with clinical symptoms of neuroborreliosis CT and MR were performed to evaluate CNS changes. MR examinations were abnormal in 36%. Most patients (60%) presented cerebral atrophy. In 2 cases areas of abnormal signal were identified within cerebral white matter as well as within the brain stem. In the first case it was, recognized as demyelination focus, in second one MR showed evidence of or were suggestive of vascular involvement. In one case symmetrical calcifications were also found in internal capsules. Neuroradiological signs in Lyme disease are not specific. Neuroborreliosis has to be considered when patients present foci of hyperintense signal (T2-weighted images) in white matter and brain stem.
Five cases of tuberculous meningoencephalitis with severe course treated in the period 1991-1994 at the Department of Parasitic Diseases and Neuroinfections, Medical Academy in Białystok are reported. Diagnostic difficulties encountered in these cases, the clinical courses and the results of the treatment are discussed. The always lethal outcome of untreated tuberculous meningoencephalitis requires antituberculosis treatment to be tried in all cases of meningitis with severe and protracted course, with equivocal results of cerebrospinal fluid analysis, and lacking effect of non-specific therapy.
There were 58 patients (aged 17 to 72) analyzed in our study: 34 women and 24 men one year after TBE. Psychic state was estimated with the use of psycho-pathologic scales CPRS, Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale, Mini Mental State and our own questionnaire. It was assumed that 22 patients required psychiatric treatment because of dementia, personality change, depressive disorder and anxiety disorder. It seems that so many syndromes stated in this group of patients were caused by TBE reaction increase of intellectual-mnestic functions as well as social and professional status.
The purpose of this work was to detect the concentration of cytokines--tumor necrosis factor (TNF)-alpha and Interleukin (IL)-1 beta in cerebrospinal fluid (CSF) and serum, their diagnostic and prognostic usefulness among patients with purulent meningitis. 25 patients of Centre of Parasitic Diseases and Neuroinfections hospitalized with diagnosis or suspicion of purulent meningitis were studied. The patients were divided into two groups: I-12 persons with diagnosis of purulent meningitis and group II-13 controls where suspicion of meningitis was excluded during clinical procedure. The cytokines were detected by immunometric assay. This examination was performed twice--before and after treatment. In group I-patients with purulent meningitis, TNF-alpha and IL-1 beta CSF concentrations were significantly higher in comparison with group II. After treatment the concentrations of cytokines did not show significant differences between group I and II. In acute phase of meningitis correlations between CSF concentration of TNF-alpha and IL-1 beta and other indexes of inflammation in CSF: pleocytosis, concentration of protein and glucose were found. The serum concentrations of the cytokines were many times lower than in CSF. The detection of TNF-alpha and IL-1 beta CSF concentration can be used to estimate the efficacy of therapy and regression of inflammation in the central nervous system.
Any headache in the course of Lyme disease could be an early manifestation of invasion of the CNS by spirochaetes. The most characteristic symptoms of early neuroborreliosis are meningitis with cranial or peripheral neuropathies connected with radiculopathies, less common are encephalitis and myelitis, neuropathies, polyneuropathies, encephalopathies. Encephalomyelitis is the most serious form of neuroborreliosis. From the pathophysiologic point of view all cranial and peripheral neuropathies are forms of mononeuritis multiplex. Encephalopathy is due to neuroimmunomodulators, like lymphokins and or by toxico-metabolic effect could be connected with each form of systemic borreliosis. Certain diagnosis of neuroborreliosis is based on culturing of B. burgdorferi from CSF, detection of specific antispirochaetal antibodies produced in the subarachnoid space, detection of activated lymphocytes B producing specific antibodies, detection in CSF of other antigens of B. burgdorferi or DNA sequences.