Concentrations of SP-A and HSP70 are associated with polarization of macrophages in pleural effusions of non-small cell lung cancer.

Damage-associated molecular pattern (DAMP) molecules can initiate an immune response through Toll-like receptors (TLRs). DAMPs are released from cells as a response to the extracellular danger and can be by-products of tissue damage. In cancer microenvironment necrotic cells release debris which has potency to become DAMPs. Non-small cell lung cancer (NSCLC) is often accompanied by pleural effusion (PE), which contains a variety of DAMPs. Surfactant protein A (SP-A) and heat shock protein 70 (Hsp70) are important DAMPs in the respiratory tract. The aim of this study was to determine a correlation between SP-A or Hsp70 and development of PE in the course of NSCLC. Moreover, we aimed to determine relationships between DAMPs and certain humoral factors associated with formation and persistence of PE as well as pleural-residing macrophages. In 34 PE samples, we estimated concentration of SP-A, Hsp70, IL-6, IL-18, G-CSF, M-CSF, SCF, SDF1α, VEGF as well as the fraction of macrophages and their pattern of polarization. We have found correlations between the concentration of the SP-A and Hsp70 and the percentage of PE-derived macrophages, also between concentrations of SP-A and Hsp70, and cytokines which participate in inflammation and processes involved in remodeling of extracellular matrix (ECM). Our data indicate an important role of SP-A during the development of PE associated with NSCLC. We suggest that measurement of concentration level of SP-A can be helpful in the course of diagnosis of malignant PE associated with NSCLC.

[Analysis of nutritional status disorders in patients with chronic obstructive pulmonary disease]. / Analiza zaburzen stanu odzywienia u pacjentów z przewlekla obturacyjna choroba pluc.

INTRODUCTION: Among the most common extrapulmonary manifestations of COPD are nutritional status disorders. The specific loss of weight, called cachexia, characterized by loss of lean body mass in some COPD patients is observed. The aim of the study was the quantitative and qualitative analysis of COPD patients' nutritional status disturbances. MATERIAL AND METHODS: Fifty-five patients in different stages of COPD--43 males and 12 females (mean age 62.31 +/- 11.08) and 32 subjects from a control group (mean age 57.43 +/- 8.79) participated in the study. In both groups nutritional status was assessed using different indicators such as PIBW--percentage of ideal body weight, BMI--body mass index, FFMI--fat-free mass index and FMI--fat mass index. RESULTS: Malnutrition measured by PIBW, BMI, BMI percentiles, and FFMI was observed in 5.45%, 3.64%, 3.64% and 18.18% of COPD patients, respectively, and in the control group 3.12%, 0%, 3.12% and 3.12%, respectively. The BMI mean value did not differ significantly between groups. It was confirmed that cachexia assessed by FFMI occured more frequently in COPD patients than in the control group--19.05 kg/m2 vs. 20,55 kg/m2 (p = 0.04). CONCLUSIONS: 1. Nutritional status disorders pose a serious problem, which concerns about 1/5 of the COPD population. 2. It is necessary to perform quantitative analysis of nutritional status (assessment of lean and fat mass) because indicators of body mass (PIBW, BMI) are not sufficient for cachexia detection. 3. Having normal body mass does not exclude the possibility of nutritional status disorders in COPD patients.

Coccidioidomycosis in a 38-year-old man: a case report.

The present article describes a case of acute pulmonary coccidioidomycosis in a 38-year-old man, a research worker. The disease started during the patient stay in Arizona, USA, and clinical symptoms persisted after his return to Poland. Acute coccidioidomycosis is one the clinical manifestations of Coccidioides immitis strain endemic infections occurring in the south-western regions of USA including California (mainly San Joaquin Valley), Western Texas, New Mexico and the desert areas of Arizona, and Central and South America. The native environment of Coccidioides immitis is soil penetrated by rodents. People, domestic and wild animals suffer from coccidioidomycosis. The infection rate in endemic areas is about 2-4% a year in the healthy population. Coccidioidomycosis can be observed in non-endemic areas due to population mobility and in immunocompromised patients. The Coccidioides immitis infection is caused by inhaled airborne fungal spores and it may occur as primary pulmonary (acute or chronic) asymptomatic form, meningitis, or disseminated disease. The clinical symptoms of coccidioidomycotis like acute pulmonary manifestations may resemble typical, resistant to empiric antibiotic treatment of bacterial pneumonia. In healthy subjects, pulmonary coccidioidomycosis may occur as asymptomatic infection, which resolves spontaneously without medication. Sometimes, slight shadows like local fibrosis and cavities may be visible on the chest X-ray. The Coccidioides immitis infection in people with immunological deficiency syndromes, e.g. HIV/AIDS, manifests itself as disseminated disease and may lead to severe complications including death.