Pentraxin-3 as a local inflammatory marker in chronic spontaneous urticaria.

BACKGROUND: The pentraxin family plays an important role in the acute phase response to immune-inflammatory processes. The short pentraxin, C-reactive protein (CRP) is a marker of chronic spontaneous urticaria (CSU) activity, reflecting the systemic effects of inflammatory mediators associated with the disease. It is known, that the long pentraxin, pentraxin 3 (PTX3) is produced at the sites of inflammation, therefore may better reflect activity of the local inflammatory processes. To assess the relevance of PTX3 in CSU patients and its association with CRP. METHODS: Plasma PTX3 and serum CRP concentrations were measured in patients with CSU of varying severity as well as in the healthy subjects. RESULTS: The concentrations of PTX3 and CRP were significantly increased in more severe CSU patients, when compared to mild CSU and the healthy controls. There was a significant correlation between concentrations of PTX3 and CRP. CONCLUSIONS: In contrast to CRP, PTX3 is produced at the sites of inflammation, therefore it seems that elevated PTX3 may result from activation of cells involved in local urticarial processes. Finally, the correlation between these two pentraxins suggests that they may be upregulated by the same mechanisms associated with acute phase response in CSU.

Serum omentin levels in adolescent girls with anorexia nervosa and obesity.

It is believed that omentin is secreted by stromal cells of adipose tissue and modulates insulin sensitivity. Data from a few studies have shown lower serum omentin in obese children and higher in anorexia nervosa. However, to date, there is lack of research on serum omentin concentrations in adolescent patients in a wide range of body mass index (BMI) and insulin resistance. In this cross-sectional study omentin-1 serum concentrations were evaluated using commercially available ELISA kit in 47 Polish girls with restrictive anorexia nervosa (AN), 50 with simple obesity (OB) and 39 healthy controls (C). The mean serum omentin-1 concentration in girls with AN was statistically significantly higher than that of C and OB girls. Statistically significant (P<0.0001) negative correlations between the serum concentrations of omentin-1 and body weight (r=-0.73), BMI (r=-0.75), standard deviation score for body mass index (BMI-SDS) (r=-0.75), insulin (r=-0.81) and HOMA-IR index (r=-0.82) were seen in the entire examined population. We conclude, that omentin-1 is the nutritional marker reflecting body weight and insulin resistance. Our findings support the hypothesized role of omentin in maintenance of body weight and regulation of appetite and suggest the adaptation of its secretion to body weight and glucose metabolism.

Is delayed pressure urticaria associated with increased systemic release of sCD40L?

BACKGROUND: Elevated levels of soluble CD40 Ligand (sCD40L) were found in serum but not in plasma of patients with chronic spontaneous urticaria (CU). What is important is that sCD40L has proinflammatory properties, and its elevated plasma level may indicate increased risk of cardiovascular events. These observations should stimulate further evaluation of sCD40L in different forms of urticaria. AIM: In the present study, sCD40L plasma level was investigated in delayed pressure urticaria (DPU). METHODS: As platelets are predominant and variable sources of sCD40L, we investigated sCD40L concentration in platelet-poor plasma (PPP), which seems the best way to minimize the potential contribution of these cells to the ligand level. RESULTS: Plasma sCD40L concentration was significantly increased in the DPU group compared to the healthy controls. CONCLUSIONS: It seems that DPU is associated with increased systemic release of sCD40L, which is believed to derive predominantly from activated platelets. The present study as well as the earlier contributions suggest that distinct cells activity, including platelets, may be identified in different types of urticaria.

Acute phase inflammatory markers in patients with non-steroidal anti-inflammatory drugs (NSAIDs)-induced acute urticaria/angioedema and after aspirin challenge.

BACKGROUND: Active chronic urticaria, identified as a mast cell- and basophil-dependent inflammatory disorder of the skin is able to elicit acute phase response (APR). However, systemic inflammatory response in different types of urticaria is poorly characterized. AIM: To determine APR pattern in a clearly defined group of patients with acute urticaria and/or angioedema - induced by NSAIDs. METHODS: Plasma IL-6 and serum C-reactive protein (CRP) concentrations were studied in 17 patients with NSAIDs-induced acute urticaria/angioedema (NSAIDsAU) and in 20 healthy controls. Eleven patients who used NSAIDs were presented at the emergency room with acute urticaria/angioedema while the remaining six manifested the symptoms during the aspirin challenge test. Patients were examined in a dynamic manner: during the acute phase, and next, after subsidence of the symptoms. RESULTS: CRP and IL-6 concentrations increased significantly in patients with NSAIDsAU as compared with their asymptomatic period and the healthy subjects. In addition, NSAIDsAU patients showed elevated concentration of the biomarkers following aspirin provocation with the baseline values recovered in the asymptomatic period. CONCLUSION: These results indicate that an acute systemic inflammatory response is activated in patients with NSAIDs-induced urticaria and/or angioedema. The study supports the evidence proving that up-regulation of CRP and IL-6 in urticaria/angioedema does not necessarily reflect any concomitant infection or other inflammatory processes, but may be due to the disease itself.

Analysis of procalcitonin and CRP concentrations in serum of patients with chronic spontaneous urticaria.

BACKGROUND: Our previous findings showed the importance of analysing the peripheral markers of acute phase response (APR) activation, C-reactive protein (CRP) and IL-6 in the context of urticaria activity and severity. However, these biomarkers do not reliably differentiate between APR to infectious and the disease severity. AIM: In order to investigate a possible association between the immune-inflammatory activation markers CRP and procalcitonin (PCT). METHODS: Serum PCT and CRP concentrations were measured in patients with CU of varying severity as well as in healthy subjects. RESULTS: Serum PCT and CRP concentrations were significantly increased in more severe CU patients when compared to healthy controls and mild CU, and within the CU population there was a significant correlation between concentrations of PCT and CRP. Serum PCT concentrations remained within normal ranges in most CU patients and were only slightly elevated in some severe CU cases. CONCLUSIONS: PCT serum concentration may be only slightly elevated in some cases of severe CU. Upregulation of PCT synthesis accompanied by parallel changes in CRP concentration reflects a low-grade systemic inflammatory response in CU. PCT should be considered as a better marker than CRP to distinguish between APR to infection and an active non-specific urticarial inflammation.

Interleukin 1-ß, interleukin-1 receptor antagonist, and interleukin 18 in children with acute spontaneous urticaria.

UNLABELLED: Very little is known about the role of interleukin-1ß (IL-1ß) and interleukin-18 (IL-18) in urticaria. MATERIAL AND METHODS: Serum levels of IL-1ß, IL-1 receptor antagonist (IL-1RA), and IL-18 were measured in 56 children with urticaria and in 41 healthy subjects. RESULTS: Serum IL-1ß did not differ between children with acute urticaria and controls. Children with single episode of urticaria had higher levels of IL-1RA and IL-18 than healthy subjects. In children with single episode of urticaria, level of IL-1RA correlated with C-reactive protein (CRP), D-dimer, and IL-1ß levels. In subjects with recurrence of urticaria IL-1RA was positively correlated with WBC and D-dimer levels. No correlation of cytokine levels and urticaria severity scores (UAS) in all children with urticaria was observed. In children with single episode of urticaria UAS correlated with CRP level. In the group with single episode of urticaria and in children with symptoms of upper respiratory infection, IL-1RA and IL-18 levels were higher than in controls. The former was higher than in noninfected children with urticaria. In conclusion, this preliminary study documents that serum IL-1RA and IL-18 levels are increased in some children with acute urticaria. However further studies are necessary to define a pathogenic role of IL-1ß, IL-1RA, and IL-18 in urticaria.

Plasma IL-6 concentration correlates with clinical disease activity and serum C-reactive protein concentration in chronic urticaria patients.

BACKGROUND: Our previous study was the first to demonstrate enhanced plasma IL-6 concentrations in chronic urticaria (CU). It is known that C-reactive protein (CRP) is a sensitive marker of an underlying systemic inflammation, triggered mainly as a response to IL-6. OBJECTIVE: To evaluate plasma IL-6 concentration in CU patients relating to the clinical disease activity and serum CRP concentration. METHODS: Serum CRP and plasma IL-6 concentrations were measured in 58 CU patients and 30 healthy subjects. Ten CU patients were evaluated twice, during the active period as well as upon the spontaneous clinical remission of the disease. CU activity was assessed with the use of the symptom scores recommended by EAACI/GALEN/EDF guidelines. RESULTS: IL-6 and CRP concentrations were significantly increased in CU patients as compared with the healthy subjects, whereas they decreased remarkably upon the spontaneous remission. IL-6 concentration was associated with weekly urticaria activity scores and also significant differences were found between patients showing different degrees of urticarial activity. Significant correlation was observed between IL-6 and CRP concentrations. CONCLUSIONS AND CLINICAL RELEVANCE: This study reinforces evidence that, apart from a local cutaneous inflammation, CU is associated with a systemic inflammatory response. Such acute-phase response is manifested by increased circulating IL-6, which varies along with CRP changes and may be related to the urticarial activity.

Spirometric parameters in malnourished girls with anorexia nervosa.

Repercussions of obesity on the lung function have been widely studied. The effect of serious malnutrition is less well known. The aim of study was to determine spirometric parameters in 102 malnourished girls with anorexia nervosa. Among these patients, only 71 aged 12-18 years (mean 15.6), mean BMI 15.8 kg/m(2), met the ATS/ERS forced expiratory maneuver criteria for spirometry. The most frequently observed abnormalities were: decreased IC seen in 33 (46%) girls and decreased PEF in 45 (63%) patients. Maximum voluntary ventilation was within the normal range in all but 2 subjects. Diminished values of FEV(1), FVC, FEV(1)/FVC, MEF(50) were observed in 10 (14%), 13 (18%), 3 (4%), and 3 (4%) patients, respectively. We found strong positive correlations between weight and absolute values of the examined parameters. We assume that spirometric abnormalities in anorexia are probably a result of respiratory muscle weakness and body mass loss.

Tacrolimus ointment does not affect the immediate response to vaccination, the generation of immune memory, or humoral and cell-mediated immunity in children.

BACKGROUND: Concern exists that the prolonged application of immunomodulators to treat atopic dermatitis may cause systemic immunosuppression. AIMS: In a 7-month, multicentre, randomised, controlled trial, we investigated the equivalence of response to vaccination against meningococcal serogroup C disease with a protein-conjugate vaccine in children (2-11 years) with moderate to severe atopic dermatitis, by applying either 0.03% tacrolimus ointment (TAC-O; n = 121[corrected]) or a hydrocortisone ointment regimen (HC-O; n = 111). METHODS: TAC-O was applied twice daily (bid) for 3 weeks, and thereafter daily until clearance. 1% hydrocortisone acetate (HA) for head/neck and 0.1% hydrocortisone butyrate ointment for trunk/limbs was applied bid for 2 weeks; thereafter HA was applied bid to all affected areas. At week 1, patients were vaccinated with protein-conjugate vaccine against meningococcal serogroup C, and challenged at month 6 with low dose meningococcal polysaccharide vaccine. The control group (44 non-atopic dermatitis children) received the primary vaccination and challenge dose. Assessments were made at baseline, weeks 1 and 5, and months 6 and 7. The primary end point was the percentage of patients with a serum bactericidal antibody (SBA) titre > or = 8 at the week 5 visit. RESULTS: The response rate (patients with SBA titre > or = 8) was 97.5% (confidence interval (CI) approximately 97.3 to 100), 99.1% (94.8 to 100) and 97.7% (93.3 to 100) in the TAC-O, HC-O and control groups, respectively. CONCLUSIONS: The immune response to vaccination against meningococcal serogroup C in children with atopic dermatitis applying either 0.03% TAC-O or HC is equivalent. Ointment application does not affect the immediate response to vaccination, generation of immune memory or humoral and cell-mediated immunity.

[The effect of dietary fish oil supplementation on the clinical course of asthma in children]. / Wplyw diety wzbogaconej olejem rybnym na przebieg astmy u dzieci.

The effect of fish oil on the clinical progress of asthma in children was examined in this study. Twenty-one children with mild asthma and 16 children with severe asthma were given 15 ml of fish oil daily for 12 weeks. A control group of 23 children took sunflower oil. The basic therapy of asthma was continued. Clinical symptoms, ratings of PEF, FEV1, FEF25-75 and blood levels of total cholesterol, triglicerydes and 25-OHD were monitored. After the 8-th week, only slight improvement in the case of mild asthma was observed. The changes in lipids were within the normal range, but there was a significant increase in the 25-OHD level.

[Is a fish oil enriched diet therapeutically beneficial?]. / Czy dieta wzbogacona olejem rybnym ma wplyw leczniczy?

The metabolism of arachidonic acid (AA) and significance of leukotrienes in the pathogenesis of asthma are presented in this article. The effect of a diet containing eicosapentaenoic acid in the treatment of a variety of diseases is discussed as well.