[Not Available]. / Mieszanki ziolowe o dzialaniu przeciwgoraczkowym jako przyklady tradycyjnego leku roslinnego stosowanego w populacji pediatrycznej.

Herbal medicines with antipyretic action have a long tradition of use in Polish phytotherapy. Over the years, they have proven both their efficacy and safety in a feverishness, which very often have accompanied the upper respiratory tract infections in children. Leading active ingredient of these products is the willow bark (Cortex salicis), which has been the active ingredient in both, the herbal mixture Pyrosan placed on the market in the 50's of last century and Pyrosal syrup marketed in the year 1989. Other herbal substances used in such preparations are elder flower, lime flower and meadowsweet flower. The usage of a pharmaceutical form of syrup is prerequisite when the main group of the patients are children. Such products are continuously in use for nearly 30 years in Poland.

Elastase, α1-proteinase inhibitor, and interleukin-8 in children and young adults with end-stage kidney disease undergoing continuous ambulatory peritoneal dialysis.

Peritoneal dialysis is one of the main modality of treatment in end-stage kidney diseases (ESKD) in children. In our previous work in chronic kidney disease patients, in pre-dialyzed period and on hemodialysis, the neutrophils were highly activated. The aim of this study was to assess an inflammatory condition and neutrophil activation in ESKD patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Thirteen CAPD patients without infection, both sexes, aged 2.5-24 years, and group of healthy subjects (C) were studied. For comparative purposes the conservatively treated (CT) group of ESKD patients was included. Neutrophil elastase in complex with α1-proteinase inhibitor (NE-α1PI; ELISA), α1-proteinase inhibitor (α1PI; radial immunodiffusion) and interleukin-8 (IL-8; ELISA) were measured in the blood samples from CAPD, CT, and C group and in the peritoneal dialysate fluid (PDF) samples of patients on CAPD. A significantly increased plasma NE-α1PI levels (median 176.5 µg/L, range 85.2-373.2 µg/L; p < 0.00005), serum IL-8 (median 18.6 pg/mL, range 15.73-35.28 pg/mL; p < 0.05), and slightly decreased serum α1PI (median 1,540 mg/L, range 1,270-1,955; p ≤ 0.05) compared to the control groups were found. There were no significant differences of analyzed parameters between CAPD and CT patients. The concentration ratio of NE-α1PI, α1PI and IL-8 in blood/PDF was 29.97, 8.24, and 4.48, respectively. There were significantly positive correlations between serum and PDF concentration of α1PI and IL-8 (r = 0.613, p < 0.05; r = 0.59; p < 0.005, respectively). The results of our study demonstrate that neutrophils are highly activated in non-infected CAPD patients. The pivotal marker of this activation is NE-α1PI. It may contribute to chronic inflammation and tissues injury.

Iron status and dietary iron intake of vegetarian children from Poland.

BACKGROUND/AIM: In Poland, vegetarian diets are becoming more and more popular. The aim of this study was to examine the effect of iron intake on iron status in vegetarian children. METHODS: Dietary iron intake, iron food sources, blood count, serum iron, ferritin level and total iron-binding capacity were estimated in two groups of children, namely vegetarians (n = 22) and omnivores (n = 18) of both sexes, aged from 2 to 18 years. Seven-day food records were used to assess their diet. RESULTS: Dietary iron intake in vegetarians and omnivores was low (up to 65.0 and 60.1% of the recommended dietary allowance). A significantly higher intake of vitamin C was observed in vegetarians compared with omnivores (p = 0.019). The main sources of iron in vegetarians were cereal products, followed by vegetables and mushroom products, then fruit. The prevalence of iron deficiency (ID) was higher in the vegetarian group (p = 0.023). The serum ferritin level and mean corpuscular volume in the vegetarians were also lower than in the omnivores (p = 0.01 and p = 0.014, respectively). CONCLUSIONS: Children who follow a vegetarian diet may suffer from ID in spite of having a high vitamin C intake. This indicates the need to introduce dietary education and iron status monitoring.

Relation among ghrelin, nutritional status, and immunity in children.

BACKGROUND: Ghrelin is an important mediator of energy balance and metabolism. The aim of this study was to investigate the relationship among ghrelin concentration, growth patterns, and immunological parameters in children with an impairment or inefficiency in functioning of the immune system. METHODS: Twenty patients with primary immunodeficiency diseases (PIDs), 20 patients with recurrent respiratory tract infections (RRTIs), and 20 healthy children (control group) were included. The anthropometric measurements, ghrelin plasma levels, and selected immunological parameters were measured. RESULTS: Ghrelin levels and nutritional status parameters (weight, height, and body mass index) values were negatively correlated only in the control group. Ghrelin negatively correlates with complement hemolytic activity in the PID group and with IgA serum level in the RRTI group. CONCLUSION: Our results show evidence that there is a relationship between ghrelin and nutritional status of healthy children but not in children with PID or RRTI.

Innate immune properties of selected human neuropeptides against Moraxella catarrhalis and nontypeable Haemophilus influenzae.

BACKGROUND: Considerable evidence supports the concept of active communication between the nervous and immune systems. One class of such communicators are the neuropeptides (NPs). Recent reports have highlighted the antimicrobial activity of neuropeptides, placing them among the integral components of innate immune defense. This study examined the action of four human neuropeptides: calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), substance P (SP) and somatostatin (SOM), which are accessible in the upper respiratory tract, against two human-specific respiratory pathogens. We studied: (i) neuropeptide-mediated direct antibacterial activity exerted against Moraxella catarrhalis and nontypeable Haemophilus influenzae, and (ii) indirect immunomodulatory role of these neuropeptides in the neutrophil-mediated phagocytosis of indicated pathogens. RESULTS: We found that 100 micromolar concentrations of CGRP, NPY, SP, and SOM effectively permeabilized bacterial membranes and showed (except SOM) bactericidal activity against both pathogens. SOM acted only bacteriostatically. However the killing efficacy was dependent on the bactericidal assay used. The rank order of killing NP effect was: NPY ≥ CGRP > SP >> SOM and correlated with their potency to permeabilize bacterial membranes. The killing and permeabilization activity of the analyzed NPs showed significant correlation with several physicochemical properties and amino acid composition of the neuropeptides. M. catarrhalis was more sensitive to neuropeptides than nontypeable H. influenzae.The immunomodulatory bimodal effect of physiological concentrations of CGRP, NPY, and SP on the phagocytic function of human neutrophils against M. catarrhalis and H. influenzae was observed both in the ingestion (pathogen uptake) and reactive oxygen species generation stages. This effect was also dependent on the distinct type of pathogen recognition (opsonic versus nonopsonic). CONCLUSIONS: The present results indicate that neuropeptides such as CGRP, NPY, and SP can effectively participate in the direct and indirect elimination of human-specific respiratory pathogens. Because the studied NPs show both direct and indirect modulating antimicrobial potency, they seem to be important molecules involved in the innate host defense against M. catarrhalis and nontypeable H. influenzae.

[The use of intravenous immunoglobulins in the treatment of primary immunodeficiencies]. / Dozylne preparaty immunoglobulin w terapii pierwotnych niedoborów odpornosci.

In this paper we present indications for use of intravenous immunoglobulins (IVIG). The role of IVIG in the therapy of immunodeficiency of IgG subclasses was underlined. The goal of the treatment is to obtain the immunoglobulin serum level sufficient to prevent patients against infections. The active component of IVIG is immunoglobulin G. The IVIG supplementation is required for agammaglobulinemia, common variable immunodeficiency diseases and some other serious immunodeficience. The probable side-effects of IVIG infusions are those associated with proteins transfusions, therefore the special caution during the infusion is required. However, the modern IVIG preparations are highly purified. The IVIG production techniques protect immunoglobulins against any unwanted changes and the procedures ensure patients against transmission of infections and unwanted reactions.

Impact of micelle ionic electrical double layer structure on the excited state protolytic reaction in the fluorescent probe bound to the colloidal nanoparticles.

The fluorescent probe, 2-hydroxynaphthalene(dodecylo)-6-sulfonamide (NSDA) bound selectively to shear plane of various electrostatic charges was synthesized and its photophysical properties have been investigated by means of steady state fluorescence and nanosecond time-resolved spectroscopy. Our experimental data allowed us to determine the excited state proton transfer (ESPT) rate and equilibrium constants of NSDA bound to micelles and to estimate the electric potential value (Ψ) at the particle surface. The spatial dependence of proton movement velocity through electric double layer (EDL) of micelles has been thoroughly analyzed. In this article, a new approach of estimating the values of the micelle potential (Ψ(R)) from the excited state proton transfer rate constant of the fluorescent probe bound at a certain distance (R) to a micellar surface has been proposed. The Ψ(R) values, obtained in this way, are compared with electrophoretic values of the particle potential (ζ). Our results on electrophoretic potentials and the reaction course of the ESPT in colloidal environment may contribute to a deeper understanding of micellar interactions and behavior of the living cells in contact with various diluted substances such as pharmacological drugs, hormones, proteins, and other colloidal particles.

Elastase, α1-proteinase inhibitor, and interleukin-8 in pre-dialyzed and hemodialyzed patients with chronic kidney disease.

BACKGROUND: Neutrophil elastase in complex with α(1) -proteinase inhibitor (NE-α(1) PI) and interleukin (IL)-8 may serve as indicators of neutrophil activation and inflammatory stage. The aim of the study was to evaluate NE-α(1) PI, α(1)-PI, and IL-8 levels in the blood of patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) or conservatively treated (CT). The influence of a single HD session on the investigated parameters was also assessed. METHODS: Blood samples were obtained from two groups of hemodialyzed patients (children/young adults [group HD1, n = 8] and adults [group HD2, n = 13]), as well as 13 CT patients and a group of healthy subjects. The proteins were measured using enzyme-linked immunosorbent assay or radial immunodiffusion. RESULTS: There were no significant differences in NE-α(1) PI, α(1)-PI, and IL-8 concentrations between the HD1 and HD2 patients. The levels of NE-α(1) PI were considerably higher than normal in both groups of HD patients (before and after the HD session) and in the CT patients. Higher titers of NE-α(1) PI (P < 0.05) and α(1)-PI (P < 0.01) were obtained in the adults during the course of HD. Increased NE-α(1) PI was positively correlated with α(1)-PI. The serum concentration of IL-8 was significantly higher in the HD2 patients before and after dialysis than in the controls. CONCLUSIONS: The data indicate that in CKD patients, neutrophils are highly activated both in the pre-dialyzed period and on regular HD. Contact with the dialysis membrane during HD causes a significant increase in blood NE-α(1) PI and α(1)-PI in adults, but not in children/young adults. NE-α(1) PI seems to be a much better indicator of an inflammatory state in CKD patients than free α(1)-PI or IL-8.

Association of HLA-*08:DRB1*03 with immunoglobulin A-deficiency.

OBJECTIVE: Susceptibility to IgA deficiency (IgAD) is strongly associated with alleles of HLA, but it is not equally strong in different human populations. Therefore, the goal of this study was to determine the HLA-A, -B and -DRB1 antigenic and haplotypic frequencies in unrelated Polish Caucasian IgA-deficient patients who had never been examined so far in this respect. METHODS: The HLA alleles were determined by means of low resolution polymerase chain reaction with sequence specific primers (PCR-SSP) method in a group of IgA-deficient patients and control subjects from the same area. RESULTS: The HLA-DRB1*03 allele showed the strongest association with IgA deficiency in the Polish population (OR=6.6, p cor=0.0084). The HLA-B*08 allele was also associated with predisposition to the disease (OR=6.22, p cor=0.033). These significant associations could be explained in the context of a positive association of IgAD with the HLA-B*08:DRB1*03 haplotype, previously reported in other Caucasoid populations from Northern and Central Europe. In our group the HLA-B*08:DRB1*03 haplotype was present in 52.9% of IgA-deficient patients comparing to 9.9% in controls (p< 0.00011). A positive association of HLA-B*08 and DRB1*03 was stronger in IgA-deficient males than in females from the same group. CONCLUSION: Immunoglobulin A deficiency in Polish population is strongly associated with HLA-B*08:DRB1*03 haplotype rather than with single alleles.

[IgA, an essential part of the immune system: selected issues]. / IgA istotny element ukladu odpornosci--wybrane zagadnienia.

Immunoglobulin class A is the main protein of the mucosal immune system. The daily production of this isotype exceeds the synthesis of all other classes of immunoglobulins. Because the mucosal surface area of the human organism is about 400 m2, the role of IgA in the defense of this surfaces from harmful agents from the external environment is extremely essential. Any changes connected with a lack or an overproduction of this immunoglobulin can manifest as different clinical diseases. In this paper some selected issues on the heterogeneity of the IgA are presented, its structure and significance for the human organism, the formation of IgA immunity during ontogenesis on one hand and antigenic stimulation on the other, as well as disorders connected with abnormal synthesis or structure of these molecules.

[The role of IL-6/sIL-6R complex and its natural inhibitor sgp130 in modulation of inflammatory process]. / Rola kompleksu IL-6/sIL-6R oraz jego naturalnego inhibitora sgp130 w modulowaniu procesu zapalnego.

IL-6/sIL-6R complex belongs to one of the most pleiotropic ligand-receptor system. Participating in leukocytes migration and apoptosis it plays a crucial role in modulation of inflammatory process. Firstly it contributes to resolution of acute inflammatory response regulating a maintaining of organism's homeostasis. Secondly it is a main factor responsible for transition between acute and chronic inflammatory reaction, that underlies the pathogenesis of chronic inflammatory diseases. Presented work focus on the IL-6/sIL-6R structure, function, formation, mechanism of action as well as the role of its natural inhibitor sgp130 in mentioned processes.

Enterobacterial 38-kDa outer membrane protein is an age-dependent molecular marker of innate immunity and immunoglobulin deficiency as results from its reactivity with IgG and IgA antibody.

In earlier studies on an animal model we observed protective properties of outer membrane proteins (OMPs) of Shigella, Hafnia, and Escherichia coli strains. In order to investigate human sera for reactivity with OMPs we subjected these proteins to immunoblotting with umbilical cord plasma and sera from children and adults. The IgG and IgA antibodies interacted primarily with a 38-kDa protein, in similar way for several enterobacterial strains, but different for Pseudomonas aeruginosa. This observation prompted us to determine the reactivity with the purified 38-kDa OMP in the sera of several groups of children. The reactivity of the protein from Shigella flexneri serotype 3a with sera in ELISA was age dependent, increasing from low reactivity in infants to the adult antibody level. The IgG and IgA antibody specific response thus revealed the normal pattern of immunity. The level of IgA and IgG antibody was significantly low in child patients with IgA and/or IgG immunoglobulin deficiencies, but was at the healthy control level in children with recurrent respiratory tract inflammation. These data correlated with total IgA and IgG levels in immunoglobulin-deficient children. The results indicate that this protein may serve as an immunodiagnostic marker, but also as an antigen carrier in vaccines.

[IgA, an essential part of the immune system: selected issues]. / IgA istotny element ukladu odpornosci--wybrane zagadnienia.

Immunoglobulin class A is the main protein of the mucosal immune system. The daily production of this isotype exceeds the synthesis of all other classes of immunoglobulins. Because the mucosal surface area of the human organism is about 400 m2, the role of IgA in the defense of this surfaces from harmful agents from the external environment is extremely essential. Any changes connected with a lack or an overproduction of this immunoglobulin can manifest as different clinical diseases. In this paper some selected issues on the heterogeneity of the IgA are presented, its structure and significance for the human organism, the formation of IgA immunity during ontogenesis on one hand and antigenic stimulation on the other, as well as disorders connected with abnormal synthesis or structure of these molecules.

[The arthritic pathologies accompanying primary immunodeficiencies with antibody synthesis disturbances]. / Zmiany stawowe towarzyszace pierwotnym niedoborom odpornosci przebiegajace z zaburzeniem syntezy przeciwcial

The problem of arthritis in patients with primary antibody defects is presented in this study. We describe the most common kinds of arthritis (septic, viral, and aseptic), their etiology and treatment. Other diseases characterized by a lack of immunoglobulin are also shown. The most common diseases in primary hypogammaglobulinemia, especially autoimmune disorders, are dealt with. Many disease-modifying drugs (gold, D-penicillamine, sulfasalazine, azathioprine) cause symptomatic hypogammaglobulinemia in some patients. We emphasize the role of intravenous immunoglobulin replacement therapy in the reduction of the arthritis. The possibility of immunodeficiency should be kept in mind when evaluating patients with arthritis.

Neutrophil elastase and interleukin-8 as inflammatory mediators in mechanically ventilated children.

BACKGROUND: Neutrophil elastase is a proteolytic enzyme which can have a destructive effect on respiratory tract structures. Interleukin-8 (IL-8), a proinflammatory cytokine, is an important chemoattractant for neutrophils. The aim of our study was to assess inflammatory states by determining elastase in complex with alpha1-proteinase inhibitor (E-alpha1PI) and IL-8 in children requiring mechanical ventilation. MATERIAL/METHODS: Plasma and respiratory tract lavage fluid (RTLF) levels of E-a1PI and IL-8 were measured (ELISA) in 31 children with (group I) and 22 without (group II) respiratory tract infection. Plasma results were compared with a group of healthy controls. Results are given as medians and ranges. Additionally, the percentage content of neutrophils in RTLF was determined. RESULTS: Significantly higher (p<0.00004) plasma levels of E-alpha1PI were found in group I than in group II. In group II, there were significantly higher (p<0.002) RTLF levels of E-alpha1PI and IL-8 than in group I. In both groups, the percentage content of neutrophils in RTLF exceeded 60%. A negative correlation was found between the plasma and RTLF levels of E-alpha1PI (r=-0.69; p<0.0004), between E-alpha1PI and percentage neutrophil content (r=-0.6; p<0.006), and between IL-8 and percentage neutrophil content (r=-0.5; p<0.04) in RTLF in group II. CONCLUSIONS: The determination of E-alpha1PI and IL-8 may be useful in the assessment of the inflammatory state in children requiring mechanical ventilation.

[Fibromyalgia syndrome: a case of a 16-year old girl: diagnosis, clinical and therapeutic problems]. / Zespól fibromialgii u 16-letniej dziewczynki--problemy diagnostyczne, kliniczne i lecznicze.

Fibromyalgia (FM) is a chronic disorder characterised by musculoskeletal pain, diffuse pain in "tender points", fatigue, sleep disturbances, and multiorgan functional disorders. The case is presented of a 16-year-old girl suffering from fibromyalgia. The clinical course, problems with diagnosis and treatment have been analysed.

[Role of cytokines in pathomechanism of otitis media]. / Rola cytokin w patomechanizmie zapalenia ucha srodkowego.

Otitis media is one of the most common diseases in children. A variety if cytokines, potent inflammatory mediators, play a crucial role in the initiation and maintenance of the immunological response in otitis media. We discussed a profile of cytokines in various forms of otitis media (otitis media acute, chronic otitis media with effusion) and we underlined the differences between these types. We also described the influence of the most common pathogens of otitis media (S. pneumoniae and H. influenzae) on the cytokine panel in middle ear effusion. We discussed the current data supporting the hypothesis that in some cases the middle ear may act as a target organ for allergic inflammation. Since numerous authors demonstrated that the cytokine profiles are relevant for the evolution of otitis media it has been proposed that measurement of some proinflammatory cytokines in the middle ear effusion may be used in order to monitor the inflammatory process. It has been also proposed using cytokines as a target for pharmacological manipulation in the treatment of otitis media.

[Phagocytosis and chemiluminescence of neutrophils in patients with pulmonary tuberculosis]. / Fagocytoza i chemiluminescencja neutrofilów u chorych na gruzlice pluc.

The study included 22 patients (15 males and 7 females) with tuberculosis (infected with Mycobacterium tuberculosis), aged from 14 to 70 years. Taking into account clinical status and inflammatory state indices (ESR, leucocytosis, neutrophil count) the following groups were identified: group I--all patients with tuberculosis (n = 22), with subgroup 1--patients with tuberculosis in serious condition (n = 13), subgroup 2--patients with tuberculosis in moderately serious condition (n = 9). The control group (group II) consisted of 16 healthy volunteers aged from 22 to 52 years (12 women and 4 men). In all patients the following parameters were measured: chemiluminescence (CLmax and CLarea) and phagocytosis of neutrophils (total phagocytic capacity (TPC), phagocytic index (PI), percent of phagocyting neutrophils %phag.), ESR, leukocyte count, neutrophil differential count in blood smear. No difference in CL was shown between patients with tuberculosis and healthy people. Significantly higher TPC values were observed in patients with tuberculosis (group I, subgroups 1 and 2) than in the control group. TPC was highest in subgroup 1. PI was slightly higher in patients with tuberculosis than in the control group. On the contrary, decreased %phag was observed in group I (both subgroups). ESR, total leukocyte count and differential neutrophil count were statistically significantly higher in group I than in group II. In patients from group I, together with a slight increase of CLmax, an elevation of TPC was observed. This dependence was not observed between CLarea and TPC. There was no dependence between CLmax and PI. Together with ESR increase, an increase of phagocytic properties of neutrophils was observed.

[Analysis of bacteriological tests of children with decreased serum immunoglobulin IgA levels]. / Analiza wyników wybrancych badan bakteriologicznych u dzieci z obnizonym stezeniem surowiczego IgA.

Results of 142 children with decreased serum immunoglobulin IgA compared with the reference values for age, and 73 reached normal age levels for serum immunoglobulin (control group), up 6 months to 14 years of age with various clinical symptoms, admitted to hospital between 1999-2000, were analysed. The patients were divided into three groups: group I--children with decreased serum immunoglobulin IgA levels (86 patients), group II--children with hypogammaglobulinaemia IgA and IgG compared with the reference values for age (56 patients), group III--children reaching normal levels of serum immunoglobulin for age (73 patients)--control group. Staphylococcus aureus was found most frequently among pathogenic strains in groups I and II in comparison to the control group. In urine, Enterococcus faecalis strains were observed more often in the first and in the second group than in the control group. All patients in our three groups showed high per cent of Candida albicans in biological material from the pharynx and faeces. We associated this with treatment of recurrent infections in children, using many antibiotics. In conclusion, our results have demonstrated that low serum IgA and IgG concentrations in children are favourable for colonisation with pathogenic microorganisms.

[Intravenous administration of immunoglobulin--preparations and theoretical basis of their use]. / Dozylne podawanie immunoglobulin--preparaty oraz podstawy teoretyczne ich stosowania.

The purpose of this study was to evaluate the varIous types of intravenous immunoglobulins (IVIG) and their indications of use. The side effects including those produced by IVIG cytokines were discussed and the general method of administration was presented.