Analysis of serum cytokine levels in children with chronic cough associated with Toxocara canis infection.

Toxocara infection is associated with an increased prevalence of airway symptoms and may be a possible aetiologic agent of chronic cough. The occurrence of toxocariasis in Hungary is mild and/or sporadic. The purpose of this study was to investigate the levels of serum cytokines (IL-1, IL-2, IL-4, IL-5, IL-6, IL-10, IL-13, IFN-gamma and TNF-alpha) and total IgE, the blood eosinophil count, the results of skin prick and non-specific bronchus provocation tests in Toxocara-seropositive children with chronic cough relative to those in healthy controls. The patients exhibited moderate eosinophilia, significantly elevated levels of serum total IgE, IL-6, IL-10, IL-13 and IFN-gamma, and higher skin reactivity to common allergens, whereas the bronchial hyperreactivity was similar in the two groups. The protective proinflammatory cytokines (IL-6, IFN-gamma and IL-13) in association with the anti-inflammatory cytokine (IL-10) were simultaneously increased in Toxocara-infected children with chronic cough. During infections, the activation and suppression of immune processes occur simultaneously and cytokines of Th1/Th2 and regulatory T cells contribute to the regulation of the immune response evoked by helminth infections (depending on the parasite load, the timing and duration of the infection and the status of the host immune system).

Prevalence of adult-type hypolactasia as diagnosed with genetic and lactose hydrogen breath tests in Hungarians.

The prevalence of adult-type hypolactasia varies ethnically and geographically among populations. A C/T(-13910) single nucleotide polymorphism (SNP), upstream of the lactase gene, is known to be associated with lactase non-persistence. The aim of this study was to determine the prevalence of lactase-persistent and non-persistent genotypes in the Hungarian population, the age at onset and the applicability of the lactose H2 breath test in comparison with genetic screening. The prevalence of the C/C(-13910) genotype among adults was 37%. Hypolactasia starts to appear at around 5 years of age. Over the age of 12 years, almost all of those with a C/C(-13910) genotype have lactase non-persistence. The C/C(-13910) genotype was closely associated with a positive lactose H2 breath test in symptomatic children, whereas the lactase-persistent genotypes correlated better with a negative H2 test in a control group. In conclusion, supplementary non-invasive breath and genotyping tests furnish a perfect clinical diagnosis.

Toxocariasis associated with chronic cough in childhood: a longitudinal study in Hungary.

Chronic cough lasting 8 weeks or more often seems to be an intractable problem in childhood. Toxocara infection is associated with an increased prevalence of airway symptoms and may be the possible aetiological agent of chronic cough. Of 425 children aged 2-17 years with chronic cough who were investigated for toxocariasis and the distribution of bronchial asthma (BA), cough variant asthma (CVA) and non-asthmatic eosinophilic bronchitis (NAEB), 136 (32%) were seropositive for Toxocara canis antigens. Ninety-three of the 136 were adequately assessed, diagnosed and followed up during 1 year. BA was diagnosed in 40%, CVA in 27% and NAEB in 33% of the children. The eosinophil cell count, serum T. canis IgG levels and symptoms are predictors of the improvement or the decline of the condition. Presuming the aetiopathogenetic role of T. canis in the inflammatory process of chronic cough, we treated the children not only with inhaled corticosteroid (ICS), but also with a 1-week course of anthelminthics. We could significantly decrease the dose of ICS in 23 (62%) of the 37 with BA. The administration of anthelminthics and the avoidance of sensitizers were sufficient for those with NAEB; none needed ICS. ICS therapy could be stopped 2-3 months later in 17 (68%) of the 25 with CVA. We found that 8 of the 25 with CVA (32%) presented asthmatic symptoms at the end of the 1-year period. In Hungary, T. canis may be a potential sensitizer for chronic cough in seropositive children. Deworming therapy will then alleviate the airway symptoms without exacerbation in patients with BA, and have a positive effect on those with NAEB and the majority of those with CVA.

Effects of magnesium supplementation on the glutathione redox system in atopic asthmatic children.

OBJECTIVE: Our aim was to investigate the effects of 12-week oral magnesium (Mg) supplementation on the RBC redox system in stable, persistent, moderately asthmatic children (N = 40, 24 boys, 16 girls) aged 4-16 years in a randomized, double-blind, placebo-controlled study. DESIGN: Oxidized (GSSG) and reduced (GSH) glutathione, oxyhaemoglobin, methaemoglobin (metHb), hemichrome and bilirubin levels before and after treatment were determined, and GSH stability tests were performed. RESULT: The GSH concentration was significantly higher in the Mg-treated than in the placebo-treated patients after the treatment period. There was a positive correlation between the decreased plasma metHb and hemichrome levels and the decreased plasma haemoglobin concentrations in the Mg-treated patients at the end of the study. CONCLUSION: Mg in the given doses exerts antioxidant activity and influences the glutathione redox system.

[Management of hydatid disease of the lung]. / A tüdó hydatid megbetegedése és kezelése.

Cystic echinococcosis is a worldwide zoonose which is not infectious from man to man occurring seldom in our country. The diagnosis and the treatment of a case of a 4-year-old girl with large left-sided lung cyst were presented. Diagnosis was based on history, clinical findings, imaging techniques (conventional X-ray examination, ultrasonography, computer tomography), eosinophilia (7-50%) in blood smear, leucocytosis (28,000), increased sedimentation of blood (85 mm/hour), significantly elevated antibody against of Echinococcus in immunodiagnostic test (passive haemagglutination) with high sensitivity and specificity, light microscopic radiological and scanning electronmicroscopic analysis of cyst content. Continuous thoracic drainage, twice percutan drainage under CT guidance and a new technique for treatment as Puncture-Aspiration-Injection-Respiration and lavage with hypertonic sodium chlorate, long-term chemotherapy with benzimidazole-carbamates (Vermox: 20 mg/kg/day, Zentel: 30-50 mg/kg/day) were reported. The cyst was grown down into a solid mass as large as 4 cm. The body-weight of this child has grown 6 kilograms and laboratory parameters were normalized.

Molecular genetic analysis of HLA-DRB, -DQA, and -DQB polymorphisms in Hungarians and distribution of the DRB1*03 allele in adults and newborns.

We describe here the genetic variability of HLA-DRB1, -DQA, and -DQB in 140 healthy individuals from Hungary, including 95 randomly selected adults and 45 newborns. Allele and haplotype frequencies as well as linkage disequilibria were calculated. It was found that HLA-DRB1*11, -DQA1*0501, and -DQB1*0301 predominate in Hungarians. This information may be helpful in the future for HLA and disease association studies. Simultaneously, we observed that the frequency of the DRB1*03 allele differs between adults and newborns. Since it is well known that bearers of HLA-DR3 (and/or B8) antigens may display significant changes in immune parameters, the lower frequency in adults indicates that children with the DR3 antigen are predisposed to immune diseases in adulthood.