The -2549 -2567 del18 Polymorphism in VEGF and Irreversible Bronchoconstriction in Asthmatics.

BACKGROUND: While the importance of vascular endothelial growth factor (VEGF) in the pathogenesis of several diseases (eg, neoplasms) has been proven, its role in asthma, especially in terms of the potential associations between genetic variants of VEGF and airway remodeling, has received relatively little attention. Objectives: This study aimed to evaluate the possible connection between a genetic factor, ie, the polymorphism del/ins in the VEGF promoter region, and airway remodeling potential in asthmatics with and without irreversible bronchoconstriction. MATERIAL AND METHODS: The study population comprised 82 patients with asthma (of whom 42 had irreversible bronchoconstriction) and a group of 40 controls. DNA was isolated from peripheral blood leukocytes. Polymerase chain reaction was used to type the VEGF (18-bp deletion/insertion) gene polymorphism at loci -2549 -2567. Other factors (ie, smoking, disease duration) were also taken into consideration. RESULTS: The del/del genotype was found in 74.39% of patients with asthma (P=.031; OR=2.38), 80.95% of patients with irreversible bronchoconstriction (P=.012; OR=3.48), and 67.5% patients with reversible bronchoconstriction (P=.251; OR=1.70). The proportion of smokers to nonsmokers was higher (P=.032) and disease duration was longer (P=.041) in patients with irreversible bronchoconstriction than in those with reversible bronchoconstriction. CONCLUSIONS: Our results showed that the risk of irreversible bronchoconstriction in asthmatics was associated with the presence of the del18 genotype at the -2549 -2567 position in the promoter region of the VEGF gene, as were disease duration and other factors such as smoking.

The -2549 -2567 del18 polymorphism in VEGF and irreversible bronchoconstriction in asthmatics

BACKGROUND: While the importance of vascular endothelial growth factor (VEGF) in the pathogenesis of several diseases (eg, neoplasms) has been proven, its role in asthma, especially in terms of the potential associations between genetic variants of VEGF and airway remodeling, has received relatively little attention. OBJECTIVES: This study aimed to evaluate the possible connection between a genetic factor, ie, the polymorphism del/ins in the VEGF promoter region, and airway remodeling potential in asthmatics with and without irreversible bronchoconstriction. MATERIALS AND METHODS: The study population comprised 82 patients with asthma (of whom 42 had irreversible bronchoconstriction) and a group of 40 controls. DNA was isolated from peripheral blood leukocytes. Polymerase chain reaction was used to type the VEGF (18-bp deletion/insertion) gene polymorphism at loci -2549 -2567. Other factors (ie, smoking, disease duration) were also taken into consideration. RESULTS: The del/del genotype was found in 74.39% of patients with asthma (P=.031; OR=2.38), 80.95% of patients with irreversible bronchoconstriction (P=.012; OR=3.48), and 67.5% patients with reversible bronchoconstriction (P=.251; OR=1.70). The proportion of smokers to nonsmokers was higher (P=.032) and disease duration was longer (P=.041) in patients with irreversible bronchoconstriction than in those with reversible bronchoconstriction. CONCLUSIONS: Our results showed that the risk of irreversible bronchoconstriction in asthmatics was associated with the presence of the del18 genotype at the -2549 -2567 position in the promoter region of the VEGF gene, as were disease duration and other factors such as smoking

ANTECEDENTES: Aunque se ha demostrado la importancia del factor de crecimiento endotelial vascular (VEGF) en la patogénesis de varias enfermedades (p. ej. neoplasias), los datos relativos al asma son escasos, especialmente los relacionados con las posibles asociaciones entre las variantes genéticas de VEGF y la remodelación de las vías respiratorias. OBJETIVOS: En este estudio se propuso evaluar la posible relación entre un factor genético como el polimorfismo del/ins en la región promotora de VEGF y el potencial de remodelación de las vías aéreas en los asmáticos con y sin broncoconstricción irreversible. MATERIALES Y MÉTODOS: en el estudio participaron 82 pacientes con asma (42 pacientes con broncoconstricción irreversible) y un grupo de 40 controles. El ADN fue extraído de leucocitos de sangre periférica. Para la tipificación del polimorfismo del gen VEGF (delección / inserción de 18 pb) en loci -2549 -2567 se utilizó el método de reacción en cadena de la polimerasa (PCR). Se consideraron también otros factores (fumar, duración de la enfermedad). RESULTADOS: El genotipo del/del se encontró en el 74,39% de pacientes con asma (p = 0,031; OR = 2,38), el 80,95% de los pacientes con broncoconstricción irreversible (p = 0,012; OR = 3,48) y el 67,5% de los pacientes con broncoconstricción reversible (p = 0,251; OR = 1,70). La proporción de fumadores con respecto a los no fumadores fue mayor (p = 0,032) y la duración de la enfermedad fue mayor en pacientes con broncoconstricción irreversible en comparación con aquellos con broncoconstricción reversible (p = 0,041). CONCLUSIONES: Nuestros resultados mostraron que la presencia del genotipo del18 en la posición -2549 -2567, en el promotor del gen VEGF, junto con la duración de la enfermedad y otros factores como fumar cigarrillos, se asocian con el riesgo de broncoconstricción irreversible en los individuos asmáticos

A new variant of the basophil activation test for allergen-induced basophil CD63 upregulation. The effect of cetirizine.

OBJECTIVE: The aim of our study was to determine the diagnostic usefulness of a newly developed basophil activation test (BAT) in patients allergic to Dermatophagoides pteronyssinus and pollens. We also analyzed the influence of cetirizine on CD63 upregulation. This popular antihistamine strongly inhibits skin tests, but its impact on BAT sensitivity remains unknown and deserves at least preliminary determination. METHODS: The study sample comprised 22 patients allergic to house dust mite and pollens and 19 healthy controls. All participants underwent skin prick testing and the newly developed flow-cytometric basophil activation test. The protocol for allergen-induced basophil CD63 upregulation consisted of whole blood samples that were processed and stained with anti-CCR3/CD63 antibodies added to the buffer at the beginning of stimulation. Skin prick tests and BAT were performed twice--before and 2 hours after ingestion of 10 mg of cetirizine. RESULTS: The new BAT is characterized by its short processing time, easy basophil gating, and strong CD63 upregulation with very high sensitivity and excellent specificity. Our results suggest that allergen-induced CD63 upregulation by higher doses of allergens is not inhibited 2 hours after administration of cetirizine (unlike skin prick tests). CONCLUSION: The BAT is a very useful and precise method for the diagnosis of allergy to aeroallergens. It is not influenced by cetirizine.

Prevalence and risk factors for asthma in Poland: results from the PMSEAD study.

BACKGROUND: The prevalence of asthma depends on both hereditary and environmental factors. Knowledge of the effects of environmental and congenital factors on the frequency of occurrence of asthma may provide important clues to its pathogenesis and prevention. OBJECTIVES: The Polish Multicentre Study of Epidemiology of Allergic Diseases was designed to obtain estimates representative of the entire Polish population to assess asthma prevalence and risk factors. METHODS: Thirty-three areas were selected in 11 regions of Poland. Epidemiologic diagnoses of asthma were verified by a single recognized expert in each region on the basis of collected data as well as available medical documentation, in accordance with the 1997 guidelines of the Global Initiative for Asthma. Ambient air concentrations of sulfur dioxide and suspended particulates (black smoke) were measured directly or estimated by statistical modelling. RESULTS: Results were obtained for asthma in 16 238 subjects, including 3268 children (aged 3 to 16 years) and 12 970 adults (17 to 80 years). The overall prevalence of asthma was 8.6% (95% confidence interval [CI], 7.7%-9.6%) among children and 5.4% (95% CI, 5.0%-5.8%) among adults. Several risk factors for asthma were identified: family history of asthma, black smoke, residential exposure to traffic-related air pollution in both children and adults, and damp or overcrowded housing in adults. No statistically significant association was observed for passive smoking in the home, use of gas stoves, pet ownership, or exposure to ambient air pollution with sulfur dioxide. CONCLUSION: Our results show that the prevalence of asthma is associated with several host and environmental factors in the Polish population.

Production of leukotriene C4 by peripheral blood leukocytes stimulated with anti-fcepsilonRI antibody, PMA, and fMLP does not correlate with irreversible airway obstruction in asthmatics.

BACKGROUND: Airway remodeling has recently emerged as a major problem in an increasing percentage of patients with asthma. Reasons for great diversity in the progression of irreversible bronchoconstriction among asthmatics remain unclear. OBJECTIVE: The aim of this study was to assess whether the potential ability of leukocytes to produce cysteinyl leukotrienes in response to various stimuli is correlated with magnitude of irreversible airway obstruction in asthmatics. MATERIALS AND METHODS: The study sample comprised 76 asthmatics (34 males, mean +/- SD age 52 +/- 13 years), and 35 healthy controls (18 males, 38.2 +/- 15 years). Each subject underwent 2 pulmonary function tests: before and after bronchodilator administration. In addition, approximate annual decline in forced expiratory volume in 1 second (FEV1) (% of predicted) was calculated. Leukotriene C4 (LTC4) production was assessed combining a cellular antigen stimulation test and enzyme-linked immunosorbent assay using Bulhmann Laboratories AG kits. Leukocytes isolated from peripheral blood were stimulated with anti-FcepsilonRI antibody, N-formyl-methionyl-leucyl-phenylalanine (fMLP) and phorbol 12-myristate 13-acetate (PMA). In separate tubes each subject's leukocytes were tested for spontaneous LTC4 production. Finally, stimulated LTC4 production was expressed in pg/mL after subtraction of values of spontaneous production. RESULTS: In asthmatics, baseline FVC% and FEV% values ranged from 24.4% to 122.4% (mean, 75.5%) and from 23.4% to 126.6% (mean, 74.4%), respectively. There were no significant differences between asthmatics and controls in LTC4 production stimulated by anti-FcepsilonRI antibody (P = .79), fMLP (P = .33) or PMA (P = .86). We found no correlation between stimulated LTC4 production and spirometric parameters at baseline or after bronchodilator administration or annual decline in FEV1%. CONCLUSION: Our results do not confirm the hypothesis that airway remodeling in asthma might be related to enhanced ability of leukocytes to produce cysteinyl leukotrienes in response to various stimuli.

Prevalence of asthma with aspirin hypersensitivity in the adult population of Poland.

BACKGROUND: Acetylsalicylic acid (ASA) and other nonsteroid anti-inflammatory drugs (NSAIDs) are reported to account for 21-25% of all adverse drug reactions. Some asthmatics may react to ASA and other NSAIDs with acute bronchoconstriction, profuse rhinorrhea and skin flushing. This is a distinct clinical syndrome called aspirin-induced asthma (AIA). The prevalence of AIA among asthmatic patients in Poland has not been previously assessed. METHODS: A questionnaire survey of 12,970 adults of both sexes, randomly selected from the population of Poland. RESULTS: The prevalence of AIA in the general population of Poland was estimated as 0.6%. Thirty patients (4.3%; 95% CI: 2.8-5.8) of 703 asthmatics (5.4% of general population) reported symptoms attesting to hypersensitivity to aspirin. In 27% of them the reactions were precipitated by aspirin, whereas in the remaining subjects by other NSAIDs. CONCLUSIONS: The prevalence of AIA in Poland is 4.3%, being somewhat lower than in Finland and Australia, where it was recently reported to account for 8.8 and 10.9% of the adult asthmatics, respectively. These figures indicate that aspirin hypersensitivity might be a significant community problem.

Relevance of the selected cytokine release (TNF-alpha, IL-6, IFN-gamma, and IFN-alpha) to the exacerbation of bronchial asthma from airway mycotic infections. Predominant role of TFN-alpha?

Airway fungal infections are often associated in asthmatics with the exacerbation of asthma symptoms. However, the pathomechanism of this phenomenon has not been fully understood. The aim of our study was to assess whether antimycotic treatment can influence the capacity of bronchoalveolar (BAL) leukocytes to release proinflammatory cytokines, which could contribute to increase in asthma severity. Ten patients with bronchial asthma complicated by airway fungal infections (Candida albicans and/or Aspergillus fumigatus) were included in the study. Seven asthmatics were treated with systemic and inhaled corticosteroids, whereas the remaining three with inhaled ones only. All subjects underwent several courses of therapy with antibiotics due to respiratory infections. BAL leukocytes obtained from the patients were cultured in the absence or presence of lipopolysaccharide E.coli (LPS) or Newcastle disease virus (NDV). The BAL procedure and measurement of the levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (II-6), interferon-gamma (IFN-gamma), and interferon-alpha (IFN-alpha) by specific bioassays were performed twice: before antimycotic treatment and after 3 weeks of therapy with 8 mg of nebulized fluoconazole and 400 mg of oral ketoconazole per day. The elimination of fungi from respiratory tract resulted in an apparent clinical improvement. This coincided with diminished production of TNF-alpha in response to LPS and the production of IFN-alpha in response to NDV, which were initially high and subsided significantly after antimycotic therapy (p = 0.035, and 0.011, respectively). Such changes were not observed in the case of IFN-gamma and IL-6. This may suggest that TNF-alpha as well as IFN-alpha are secreted by fungi-prestimulated leukocytes from the lower respiratory tract and may be involved in the processes of exacerbation of asthma complicated by fungal infections. Further analyses of relationships between changes in cytokine levels and clinical parameters indicated that IFN-alpha seems to be of particular interest in fungal stimulation of asthma.

[Allergy to nickel, chromium and cobalt after osteosynthesis]. / Alergia na nikiel, chrom i kobalt po zespoleniu kosci za pomoca laczników metalowych.

Metals are known as a common cause of contact allergies. The prevalence of sensitisation to the composite metals makes for a potential risk of osteosynthesis complications in patients suffering from long bones fractures. In the study the prevalence of delayed allergy to nickel sulphate, potassium dichromate and cobalt was estimated as well as the relation to the osteosynthesis complications. The atopy prevalence was estimated too. Persons under examination were divided into 3 groups. I--treated with osteosynthesis without complications (n = 20), II--treated with osteosynthesis with synostosis complications (n = 16) and III--negative controls (n = 34). We estimated 5% prevalence of delayed allergy to nickel in group I, 6.25% in group II and 5.8% in group III. In patients exposed to chromium we observed delayed allergy prevalence of 5.8% in group I and 3% in group III. No allergy to chromium in group II was revealed. No allergy to cobalt in all groups was revealed. The prevalence of atopy in group II was rare (6.35%) when in group I it was 45% and in controls 32%. The more frequent occurrence of type IV allergy to metals in atopic patients was not confirmed. There was no difference between the prevalence of delayed allergy to metals in groups I and II. Only one case of secondary allergy to chromium was observed.

[Comparison of exercise and histamine provocation tests in patients with bronchial asthma]. / Porównanie prób prowokacyjnych wysilkowej i histaminowej u chorych na astme oskrzelowa.

Fifty-eight asthmatic patients (22 men and 36 women), aged 17 to 61 years, participated in this study. Thirty-two of them had atopic asthma. Exercise test and histamine inhalation challenge test were performed in all subjects. Patients exercised on a bicycle ergometer for 6-8 min. to increase the heart rate to 80% of predicted maximal heart rate. Twenty-three patients had a bronchospasm following exercise. The PC20 values in patients with exercise induced asthma (Me = 0.35 mg/ml) were significantly lower (p = 0.006) than in subjects without exercise induced asthma (Me = 1.89 mg/ml). There was low but statistically significant correlation between PC20 and delta FEV1 after exercise (R(s) = 0.32; p = 0.01). These results suggest that there are not only similarities but also differences in pathomechanisms of bronchial hyperreactivity to histamine and exercise-induced bronchoconstriction. The lack of statistically significant correlation between diurnal PEF variation and PC20 values suggest that the former parameter cannot be considered as an useful marker of nonspecific bronchial hyperreactivity.

[Validation of the Polish version of St. George's respiratory questionnaire in patients with bronchial asthma]. / Ocena polskiej wersji St. George's respiratory questionnaire u chorych na astme oskrzelowa.

St George's Respiratory Questionnaire (SGRQ) has been widely used in the assessment of health related quality of life (HRQOL) in patients with asthma and chronic obstructive pulmonary disease. Introduction of the new language version of the HRQOL questionnaire needs to be preceded by a highly structured process of validation. We aimed to validate the Polish version of SGRQ in the group of 83 patients with asthma. Following the comprehension study, we thus evaluated reliability, validity, reproducibility, responsiveness, and measurement equivalence of the Polish version of SGRQ. Disease severity and health status were also concurrently assessed. The reliability was good, with Cronbach's alpha coefficient exceeding 0.75 for global and all subscale scores. There have been highly significant correlations between spirometric parameters, intensity of symptoms, health status self-assessment, and the degree of depression, and quality of life scores. Reproducibility, stability and responsiveness were confirmed in the follow-up study. Minimal clinically important difference was found to be 5.3 points. Polish version of SGRQ was found to be psychometrically equivalent to four other versions of SGRQ, which underscores its validity in the population of Polish asthmatics.

TNF-alpha, IL-6 and IFN-gamma secreted by bronchoalveolar leukocytes isolated from patients with bronchial asthma, complicated by fungal airways infections.

It is widely known that fungal airways infections may deteriorate the course of bronchial asthma. The mechanism of the phenomenon is still unclear. The aim of our study was to assess the effect of fungal infections on the secretion of selected cytokines by bronchoalveolar leukocytes. Five patients (group FA) with bronchial asthma and Candida albicans or Aspergillus fumigatus airways infections (confirmed by bronchoscopy and culture) were included in the study. All of them were on the chronic treatment with corticosteroids (10-20 mg of prednisone per day) and underwent several courses of therapy with antibiotics. The control groups comprised 5 previously untreated asthmatics without bronchial colonization with fungi (group A) as well as 5 healthy volunteers (group H). Leukocytes were isolated from bronchoalveolar lavage fluid (BALF) and cultured in the presence or absence of cytokine inducers such as phytohemagglutin L (PHA), lipo-polysaccharide (LPS) from E. coli. The activity of TNF-alpha, IL-6 and IFN-gamma were measured in the BAL cell culture supernatants by using specific bioassays. In comparison with healthy controls the spontaneous or induced secretion of cytokines were significantly augmented in patients from group A. In contrast the asthmatics who represented group FA demonstrated normal levels of spontaneous cytokine secretion. However, the tendency to increase LPS and PHA-induced production was observed in BAL leukocytes from the patients. The above results support the view that beneficial effect of corticosteroid treatment in bronchial asthma may act, at least in part, by inhibition of the high spontaneous secretion of proinflammatory cytokines. Nevertheless, fungal airways infections may lead to increase of LPS- or PHA-induced production of TNF-alpha, IL-6 or IFN-gamma (despite prednisone therapy) by prestimulation of the BAL cells with fungi.

[Diagnostic standard for differentiation between bronchial asthma and chronic obstructive pulmonary disease]. / Wzorzec do róznicowania astmy oskrzelowej i przewleklej obturacyjnej choroby pluc.

The aim of this study was to work out the simplified standard for distinguishing COPD from bronchial asthma. An overall sample of 150 individuals was used for statistical analysis. Sixty one were diagnosed as having COPD and 89 as suffering from asthma. For each patient the modified ATS-DLD-75-C questionnaire was filled out, and laboratory tests results were collected. Laboratory findings included: basic spirometry and flow-volume curve parameters, diurnal PEF variation, tests with bronchodilators (salbutamol, ipratropium bromide and corticosteroids), challenges with histamine and exercise, blood gas analysis, skin tests, chest X-ray, ECG, blood cell count, blood and sputum eosinophilia. Continuous variables were transformed into discrete (dichotomous) ones using commonly accepted threshold values. Then, sensitivity, specificity and accuracy indexes were calculated for each variable and for all possible sets of 2, 3 and 4 variables. Finally, 2 sets of 4 signs and symptoms were selected as the most characteristic of the diseases of interest. Asthma was diagnosed if 3 out of 4 following conditions were present: 1) episodes of shortness of breath and wheezing, 2) smoking index (cigarettes number per day x years of smoking) < or = 200, 3) PC20 < or = 8 mg/ml or delta FEV1 after bronchodilator > or = 15% predicted, 4) diurnal PEF variation > or = 20% predicted. COPD was recognised in the same way on the basis of: 1) productive cough, 2) smoking index > 200, 3) signs of emphysema on the chest X-ray, 4) maximal FEV1 < 80% predicted (after treatment). Diagnosis established using this model was correct in 76% and false (what was very important) in only 2.6% of cases. In the remaining 21% of patients it was uncertain (e.g. both of the diseases confirmed).

[Specificity and sensitivity of some signs, symptoms and basic laboratory findings for differentiation between bronchial asthma and chronic obstructive pulmonary disease]. / Czulosc i swoistosc niektórych podstawowych objawów i wyników badan laboratoryjnych w róznicowaniu astmy oskrzelowej oraz przewleklej obturacyjnej choroby pluc.

The aim of this study was to asses the importance of the most frequently observed signs and symptoms, as well as commonly used laboratory tests for differentiation between bronchial asthma and chronic obturative pulmonary disease (COPD). Sensitivity(Se) and specificity (Sp) indices were calculated for 140 analysed variables. Sixty one patients diagnosed as having COPD and 89 as suffering from asthma were analysed. For each patient the modified ATS-DLD-75-C questionnaire was filled out, and laboratory tests results were collected. Laboratory findings included: basic spirometry, diurnal PEF variation, bronchodilator tests with salbutamol, ipratropium bromide and corticosteroids, challenges with histamine and exercise, blood gas analysis, skin tests, chest X ray, ECG, blood cell count, blood and sputum eosinophilia. The results obtained have shown that there is no single parameter characterised by specificity and sensitivity that enable to differentiate between the diseases of interest with sufficient accuracy. Sputum expectoration for et least 3 months of the year (Se = 84%, Sp = 69%), smoking index (cigarettes number per day x years of smoking) > or = 200 (Se = 89%, Sp = 74%), have appeared to have the highest sensitivity and specificity for COPD. Most typical of asthma are: intermittent episodes of wheezing (Se = 89%, Sp = 69%), positive bronchodilator tests: with salbutamol (Se--73%, Sp--93%), with ipratropium bromide and with corticosteroids (Se--66%, Sp--94%) and diurnal variation of PEF > or = 20% predicted (Se--64%, Sp--92%). Challenge test with histamine is of limited value for differentiation bronchial asthma from COPD (Se--96%, Sp--40%), while blood eosinophilia, resting spirometry or blood gases are useless for this purpose.

[The results of research on the prevalence of allergy to Hymenoptera venom in Southwestern Poland]. / Wyniki badan nad wystepowaniem alergii na jad owadów blonkoskrzydlych na terenie Dolnego Slaska.

A questionnaire designed to estimate the prevalence of allergic reactions to Hymenoptera venom was posted to 1000 inhabitants of south west Poland. 881 persons responded to the questionnaire. 255 (28.9%) reported allergic reactions to stinging insects venom 141 persons (16%) report large local reactions (LL) and 114 (12.9%) systemic reactions (SYS) after stinging. At the second stage of the study 95 persons, out of the 255, were examined by a physician and tested with the intracutaneous skin test. Anamnesis carried out by the physician initially confirmed venom allergy in 87% of the LL group and 77.5% of the SYS group. Skin test results verified the above assessments confirming venom allergy in 38% persons initially reporting LL reactions and in 55% of those initially reporting SYS reaction.

[Secondary hypertension during a course of phaeochromocytoma in a 71-year old woman]. / Nadcisnienie wtórne w przebiegu guza chromochlonnego u 71-letniej chorej.

The case of secondary hypertension to pheochromocytoma in 71 year old woman is described. This woman has been made a false diagnosis of primary hypertension 10 years earlier. The primary objective of this paper was to call practitioners' attention to the necessity of penetrating diagnosis of arterial hypertension, also in elderly patients. Over-hasty diagnosis of primary arterial hypertension hampers the possibility of proper and causal treatment. Labile and paroxysmal hypertension with headache, tachycardia and sweating should alert the clinician to tumor of the adrenal medulla as well as the extra-adrenal paraganglion system (pheochromocytoma is the cause of arterial hypertension in 0.1-1.0% of all cases). Twenty four hours excretion level of vanillylmandelic acid in urine is of diagnostic relevance for patients with pheochromocytoma. The measurement which is done after elevation of blood pressure is more sensitive.

CAST-ELISA test--a new diagnostic tool in pollen allergy.

We have applied a recently developed method called CAST-ELISA to evaluate the degree of leukocyte stimulation by specific allergen. This method is based on the measurement of sulfidoleukotriene levels in supernatants taken from previously stimulated peripheral blood leukocytes by specific allergen in the presence of interleukin 3.23 patients with pollinosis entered the study. All of them received no medication during 2 weeks before the test. Leukocytes were isolated by dextran sedimentation followed by single centrifugation. After removal of platelet rich plasma the cells were suspended in stimulation buffer and divided into portions incubated with or without specific allergen for 40 minutes at 37 degrees C. After the incubation, the cells were centrifuged and the evaluation of sulfidoleukotrienes in supernatant was performed. The results were expressed in pg/ml after subtraction of the value of spontaneous sulfidoleukotriene production in portions incubated without allergen. The concentration higher than 200 pg/ml of sulfidoleukotrienes above spontaneous production was regarded as a positive result. We have observed a large spectrum of the leukocyte response upon allergen stimulation. In the initial part of our study we established the optimal allergen concentration. The concentration of sulfidoleukotrienes in supernatants ranged from 10 to 5130 pg/ml. The mean sulfidoleukotriene concentration in the whole group was 1671.69. Positive results were observed in 20 persons. In 3 persons the results of allergen stimulation were negative. We conclude that CAST-ELISA is a reliable method to determine the allergic status in persons with pollinosis.

[Role of the autonomic nervous system (adrenergic, cholinergic and nonadrenergic, noncholinergic) in regulation of respiratory system function]. / Rola autonomicznego systemu nerwowego (adrenergicznego, cholinergicznego i nieadrenergicznego, niecholinergicznego) w regulacji stanu czynnosciowego dróg oddechowych.

There is now recognized that the autonomic innervation of airways consists of classic adrenergic and cholinergic nerves as well as of a "third" - nonadrenergic noncholinergic (NANC) - nervous system. Taking into account its complex regulatory role can be crucial for better understanding of various phenomena attributable to bronchial asthma.