[Insufficient formation of interferon in children with recurrent respiratory infections]. / Nedostatecná tvorba interferonu u detí s opakovanými respiracními infekcemi.

The authors investigated the ability of IFN-alpha formation in 50 children followed up on account of frequent and relapsing respiratory diseases. The ability to produce IFN-alpha was consistent with the clinical condition. Children who were frequently ill and whose condition did not improve during the last two years had an inadequate IFN-alpha production. Conversely, children whose health status improved substantially during the follow up period or those who were considered cured had a normal IFN-alpha production. Influencing of the IFN-alpha production might have a favourable effect on the clinical course of the disease.

Deficiency of interferon production in children with recurrent respiratory diseases.

In 50 children followed-up for frequent and repeated respiratory diseases, IFN-alpha production was examined. The ability to produce IFN-alpha correlated with the clinical situation of the children. It was low in children constantly ill and better or even normal in children whose health substantially improved or who were without symptoms during the last two years. The influencing of IFN-alpha production probably could have a favourable effect also on the clinical development of the disease.

[The role of cellular immunity in the etiopathogenesis of obstructive bronchitis in childhood]. / Uloha bunecné imunity v etiopatogenezi obstrukcní bronchitidy v detském veku.

The development and aetiopathogenetic role of the immune response were studied in group of infants and children aged 4-6 years by comparison of clinical status, concentrations of serum immunoglobulins, virological tests (levels of specific antibodies and cultivation of viruses) and the macrophage migration inhibition test. A respiratory syncytial virus was found in 44% of virologically positive children. The macrophage migration inhibition test was positive in 45% of infants suffering from obstructive bronchitis. The macrophage migration inhibition test was positive in 60% of older children followed up on account of obstructive bronchitis during the two first years of life suffering from repeated diseases of the lower respiratory tract and only in 32% children after clinical recovery. A decrease of concentrations of immunoglobulins IgA, IgG and IgM in blood serum was not observed. The results indicated the fundamental role of cell immunity in the aetiopathogenesis of obstructive bronchitis.

Ultrastructure of bronchial epithelium in children with chronic or recurrent respiratory diseases.

The ultrastructure of the bronchial epithelium in three children with recurrent bronchopneumonia, four patients with cystic fibrosis and two with Kartagener's syndrome was studied. The children with recurrent bronchopneumonia and those with Kartagener's syndrome had mostly changes in the pseudostratified ciliated epithelium, and two of them had ultrastructural signs of developing squamous metaplasia. Developed stratified squamous epithelium was found in three of four patients with cystic fibrosis and in one patient with recurrent bronchopneumonia. The squamous epithelium showed striking pathological changes, but, only the oldest patient with cystic fibrosis showed signs of onset of keratinization. Both patients with Kartagener's syndrome had the defect of dynein arms typical of the immotile-cilia syndrome. In the youngest patient the partial absence of dynein arms was combined with a defect in the radial structures of the axonemes.

A comparison between the efficacy of ketotifen and clemastine in children.

In a controlled single-blind study of 12 weeks' duration the prophylactic anti-asthmatic effects of ketotifen and clemastine in children with bronchial asthma were compared. The drugs were administered in syrup form in doses from 1 to 2 mg per day according to the body-weight. Fifty-seven children, twenty-nine in the ketotifen group and twenty-eight in the clemastine group took part. The clinical parameters, namely asthmatic complaints, dyspnoea and total duration of asthmatic attacks initially improved with both drugs but only with ketotifen was there a further marked benefit leading to a significant superiority of this drug over clemastine in the 8th and 12th week of treatment. In the overall assessment ketotifen was considered to be very effective and effective in 29%. Both drugs were well tolerated.

[Pathological ultrastructural findings in the epithelium of the respiratory passages in children and adults with repeated and chronic respiratory diseases (author's transl)]. / Pathologische ultrastrukturelle Befunde im Epithel der Luftwege bei Kindern und Erwachsenen mit wiederholten und chronischen respiratorischen Erkrankungen.

The ultrastructure of the respiratory passages epithelium of children, adolescents and older adults suffering from repeated or chronic respiratory disease was studied in the material obtained as a small excision during bronchoscopy. The findings were classified into 4 groups according to the character of the ultrastructural changes found in the epithelium. In large bronchi was found: I--a completely unaltered pseudostratified columnar ciliated epithelium, II--a pseudostratified columnar epithelium with various signs of pathological alteration, III--an altered pseudostratified columnar epithelium with first ultrastructural signs of the development of squamous metaplasia, IV--a developed stratified squamous epithelium. In our opinion, in the respiratory passages of children and adolescents, even if they suffer from repeated respiratory diseases, the pseudostratiified ciliated epithelium persists however damaged to various degree. These patients were classified into the second or at most into the third group. The observation of fully developed squamous metaplasia is reserved to older patients with longer history of chronic respiratory disease.