Lazarus-type tumour response to therapy with nivolumab for sarcomatoid carcinomas of the lung.

Pulmonary sarcomatoid carcinoma (psc) is a rare subtype of non-small-cell lung carcinoma with a poor prognosis and poor response to chemotherapy and radiotherapy. A previous study reported that psc expresses high levels of PD-L1, suggesting the potential efficacy of immune checkpoint inhibitors in these tumours. We report 2 cases of patients with a lung sarcomatoid carcinoma. Both patients initially underwent curative lung resection, but developed early recurrent disease. Because PD-L1 was highly expressed in the tumour cells, we initiated therapy with nivolumab, which showed good efficacy, almost complete radiologic tumour remission, and a remarkable improvement in the condition of those patients. Immune checkpoint inhibitors targeting PD-1 might be a valuable therapy option for pscs.

[Changes of salivary alpha amylase activity as an indicator of adrenergic activity in response to laryngoscopy and endotracheal intubation].

The goal of the study was to determine the diagnostic value of the salivary alpha amylase (sAA) as an indicator of adrenergic activity in response to laryngoscopy and endotracheal intubation. The research group consisted of 52 patients (ASA 1-2) with the median age of 52 +/- 16, scheduled for elective orotracheal intubation by the means of standard intravenous induction of anesthesia. sAA and cortisol in saliva as well as norepinephrine (NA) and cortisol levels in plasma were determined in two points: immediately before laryngoscopy (point A) and one minute after intubation (point B). The heart rate (HR) and mean arterial pressure (MAP) were recorded in corresponding time points to reveal if any correlation existed between hemodynamic parameters and neuroendocrine response. The results showed that MAP significantly increased in point B compared to point A, p < 0.05. HR did not show any significant increase. sAA considerable increase in point B correlated with the MAP-shown increase in the same time point (r(s) = 0.328, p < 0.05). NA increased in point B compared to point A and correlated with sAA increase (r(s) = 0.456, p < 0.01) and MAP changes (r(s) = 0.469, p < 0.01). Cortisol levels both in saliva and plasma did not change. The research proved the increased level of sAA as an adrenergic activity response to laryngoscopy and endotracheal intubation and shown it resemblance to changes of NA and MAP.

Decreased FOXP3 expression in small airways of smokers with COPD.

CD4+CD25+ FOXP3-positive T-regulatory cells have an important role in controlling immune and inflammatory reactions. The present authors hypothesise that these cells may be involved in the pathogenesis of chronic obstructive pulmonary disease (COPD). The aim of the present study was to characterise the expression of FOXP3 in large and small airways of nonsmokers, smokers with normal lung function and COPD patients. A total of 19 nonsmokers, 20 smokers with normal lung function and 20 smokers with moderate COPD, undergoing lung resection for a solitary peripheral nonsmall cell carcinoma, were enrolled in the study. Immunohistochemical methods were used to evaluate FOXP3 expression in large and small airways. Smokers with normal lung function and COPD patients had increased numbers of FOXP3-positive cells in large airways compared with nonsmokers. A positive correlation was observed between FOXP3 expression in large airways and smoked pack-yrs. In small airways, COPD patients had decreased numbers of FOXP3-positive cells, compared with asymptomatic smokers and nonsmokers, that negatively correlated with airflow obstruction. To conclude, chronic obstructive pulmonary disease is characterised by upregulation of FOXP3-positive cells in large airways but a downregulation in small airways that correlated with airflow limitation. The results of the present study contribute to a better understanding of the pathogenesis of chronic obstructive pulmonary disease.