Importance of maternal diet in the training of the infant's immune system during gestation and lactation.

Latest forecasts predict that half of the European population will be allergic within the coming 15 years, with food allergies contributing substantially to the total burden; preventive measures are urgently needed. Unfortunately, all attempted alimentary strategies for primary prevention of allergic diseases through allergen avoidance so far have failed. This also holds true for the prevention of food allergies in breastfed infants by the common practice of excluding certain foods with allergenic potential from the maternal diet. As a preventive measure, therefore, exclusion diets should be discouraged. They can exhaust nursing mothers and negatively impact both their nutritional status as well as their motivation to breastfeed. A prolonged exclusion diet may be indicated solely in cases of doctor-diagnosed food allergy following rigid medical tests (e.g. double-blind placebo-controlled food challenges). Indicated cases usually involve exclusion of only a few food items. Continued breastfeeding is generally important for many aspects of the infant's health, including the training of the infant's immune responses to foreign compounds and avoidance of overshooting inflammatory responses. Recent studies suggest that the presence of maternal dietary proteins in amniotic fluid, cord blood, and human milk might support the induction of tolerance towards solid foods in infants. These are exactly the same species of proteins or remnants thereof that, in comparatively few cases, trigger allergic responses. However, the insight that the proteins of maternal dietary origin in human milk are more likely to be cure (or, more precise, directing prevention) than curse has still largely evaded the attention of health care professionals consulted by worried breastfeeding mothers. In this paper, we summarize recent literature on the importance of exposure to dietary proteins in the establishment of immunological tolerance and hence prevention of allergic disease. Multiple organizations have used the scientific knowledge to build (local) guidelines (e.g. AAAAI, EAACI, BSACI) that can support health care professionals to provide the best strategy to prevent the onset of allergic diseases. We thus hope to clarify existing confusion about the allergenic propensities of dietary proteins during early life, which has contributed to exaggerated fears around the diet of pregnant and breastfeeding mothers.

[Clinical applications of photodynamic therapy in the treatment of laryngeal lesions]. / Kliniczne zastosowanie fotodynamicznej terapii w leczeniu schorzen krtani.

Photodynamic therapy (PDT) has been used in the treatment of laryngeal lesions. The disorders comprised primary dysplasia and leukoplakia of the vocal cords. The patients after diagnosis were subjected to the therapy. Six hours prior to the light irradiation the patients received 4% solution of delta-aminolevulinic acid (ALA) during 30 minutes inhalation. After 6 hours all the changes were irradiated using 400 nm wavelength light from 300 W halogen lamp (range: 380-420 nm) in order to visualize them. Next, the wavelength was tuned to 650 nm (range 620-680 nm) and the total dose 120 J/cm2 for all cases. Control examinations in patients revealed complete response of the lesions within 2-3 months after PDT.