Occurrence of soluble supra-molecular FN-fibrin complexes in the plasma of children with recurrent respiratory infection.

OBJECTIVES: Fibronectin (FN) is able to bind fibrin and FN-fibrin complexes and is found in the plasma of some patients suffering from inflammatory disease. The present study was undertaken to determine whether soluble supra-molecular FN-fibrin complexes were present in the plasma of children with recurrent respiratory infections (RRI). DESIGN AND METHODS: The frequency of occurrence and relative amounts of the supra-molecular FN-fibrin forms, concentrations of immunoglobulins and numbers of natural killer cells (NK) were determined in the plasma of children with recurrent respiratory infections. The frequencies of these parameters were compared with their frequencies in the plasma of children with acute respiratory infections and plasma from healthy children. RESULTS: SDS-agarose immunoblotting of patients' plasma revealed the presence of several additional FN-fibrin bands, with decreasing electrophoretic mobilities and increasing molecular masses of 750 kDa, 1000 kDa, 1300 kDa, 1600 kDa and 1900 kDa. Such FN-fibrin complexes occurred with higher frequency and in larger amounts in the plasma of children with RRI and acute infection than they did in plasma from normal children. Moreover, bands above 1000 kDa were absent in most young healthy individuals. The occurrence of FN-fibrin complexes did not correlate with either immunoglobulin concentrations, or with the number of NK cells. CONCLUSIONS: The occurrence of plasma supra-molecular FN-fibrin complexes is associated with acute and recurrent respiratory infections of children.

Identification of soluble supramolecular FN-fibrin complexes in human plasma.

SDS-agarose FN immunoblotting of 257 normal and pathological human plasma samples revealed the ladder pattern of multiple plasma FN bands which corresponded to FN monomer and dimer, and 5 FN-fibrin bands with increasing molecular masses. The FN-fibrin bands of about 750 kDa, 1000 kDa, 1300 kDa, 1600 kDa, and 1900 kDa appeared more frequently and in significantly higher relative amounts in the pathological samples (P < 0.000) than in relatively healthy individuals. The revealing of high-molecular FN-fibrin complexes by SDS-agarose FN immunobloting might have the potential to become a laboratory biomarker of some diseases in which the coagulation system is triggered.

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.

Alterations in molecular status of plasma fibronectin associated with aging of normal human individuals.

OBJECTIVES: Senescence, progressive deterioration of many bodily functions might be associated with age-dependent alterations of plasma fibronectin (FN) molecular status (i.e., domain, glycotope, and molecular form expressions). DESIGN AND METHODS: FN molecular status was analyzed in 127 plasma samples of healthy individuals in groups of newborns, and subjects aged 3-14, 15-39, 41-59, and 60-82 years by FN-ELISA, lectin-FN-ELISA, and immunoblotting using a set of domain-specific monoclonal antibodies, specific lectins, and monoclonal antibody to FN, respectively. RESULTS: During the first four decades of human life the levels of cell-binding-, carboxyl-terminal-, collagen-, heparin-, and fibrin-domains of plasma FN gradually increased. In subjects aged up to 82 years the cell-binding and carboxyl-terminal FN domain concentrations did not change, while the heparin, fibrin, and collagen domains significantly increased. The relative reactivity of plasma FN with Maackia amurensis lectin, specific to α2,3-linked sialic acid, significantly decreased after birth, reaching a stable level in the subsequent life period, whereas with Sambucus nigra lectin, specific to α2,6-linked sialic acid, it significantly decreased in the 60-82 year old group. Moreover, the appearance of 280-kDa and 320-kDa FN bands, absent in young and mature healthy individuals, was found in the groups of 41-59 and 60-82 year olds. CONCLUSIONS: The alterations of FN molecular status throughout growth, maturation and senescence might be associated not only with disturbances in the balance of FN production rate and degradation, but concomitantly with conformational rearrangements of FN and its engagement in age-related vascular remodeling processes.

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.

[Estimation of immunological markers in children with intermediate uveitis symptoms]. / Ocena wybranych wykladników odpowiedzi immunologicznej u dzieci z objawami zapalenia czesci posredniej blony naczyniowej.

PURPOSE: The purpose of this study was to estimate markers of immunological response in the blood of children with intermediate uveitis. MATERIAL AND METHODS: The records of 13 children (26 eyes), aged 10-17 years, with idiopathic intermediate uveitis were reviewed. In all cases indicators of inflammation and immunological response parameters were analyzed during the active stage of the disease. RESULTS: In almost all patients ((90%) with intermediate uveitis disturbances in the level and activity of lymphocyte system, were detected. There were also nonspecific changes in immunoglobulins level in all patients, in 31% in more then one class of immunoglobulins. Chemiluminescence of phagocytic cells were reduced in more than 50% of children, and increase in their phagocytic activity was observed in 62% of patients. Circulating immune complexes were present in 50% of cases. CONCLUSIONS: The study presents data supporting the theory of autoimmunological background of the intermediate uveitis.

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--pathogenesis, diagnosis, and treatment problems]. / Zespól fibromialgii--patogeneza, problemy diagnostyczne i lecznicze.

Fibromyalgia is a fairly common syndrome characterized by chronic, widespread musculoskeletal pain, multiple "tender points", fatigue, sleep disturbance, stiffness and other symptoms such as headache, dizziness, trouble with concentration, irritable bowel syndrome, urinary urgency, depression. Fibromyalgia may occur at any age, even in childhood, is much more common in women than in men. The cause of fibromyalgia is unknown. It is difficult to diagnose because many of the symptoms are similar to symptoms of other disorders. There are no laboratory tests that can confirm a diagnosis of fibromyalgia. Average time from onset to diagnosis is 5-8 years. Treatment of fibromyalgia requires a comprehensive approach.

[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.

[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.