[Results of immunotherapy with HDM (Bencard) in children with bronchial asthma]. / Wyniki immunoterapii preparatem hdm (bencard) u dzieci chorych na dycahawice oskrzelowa.

Desensitization with HDM manufactured by Bencard was carried out in a group of 20 children with bronchial asthma showing hypersensitivity to Dermatophagoides pteronyssimus allergen in prick skin tests. Ten randomly selected children treated symptomatically and with climate served as a control group. Children were examined clinically before and after desensitization. Clinical improvement was observed 15 months after desensitization together with weakened delayed bronchial response to allergen inhalation. No significant difference in patency of airway was seen in both groups. Differences in serum IgE and IgG levels and mean eosinophilia in the peripheral blood were statistically insignificant.

Studies of bronchial secretion. The influence of inflammatory response and bacterial infection.

Bronchial secretions obtained during bronchoscopic examination of 60 children suffering from respiratory tract infections were studied for the concentration of immunoglobulins, anti-proteolytic factors, lactoferrin, and lysozyme. Eleven children having bronchial asthma without a history of chronic or recurrent infections of the respiratory tract were designated as a control. The results were analysed in relation to clinical diagnosis (chronic bronchitis, bronchitis, bronchiectasis) or to the local status of bronchial mucosa at the time of bronchoscopy (no inflammation, inflammation, inflammation with documented bacterial infection). The statistical analysis of the results revealed a decrease of lactoferrin and locally produced IgA in the group of children suffering from bronchitis and chronic bronchitis. Samples infected with Haemophilus species had significantly higher concentration of lactoferrin than any other group. Similarly, albumin in this group was higher than in the other group except that other bacteria were present. Samples infected with Haemophilus also had increased concentrations of S-IgA, IgG, and anti-proteolytic factors when compared with the group without local inflammation.

[Clinical evaluation of Zaditen syrup in the treatment of children with bronchial asthma]. / Kliniczna ocena skutecznosci preparatu Zaditen (syrop) u dzieci z dychawica oskrzelowa.

60 children with atopic asthma were included to the doubleblind study, in order to compare Zaditen and Clemastine. The trial was completed after 12 weeks of treatment. The efficacy was evaluated on the basis of clinical observation, lung function measurements and laboratory data. The Zaditen was shown to have more beneficial clinical effect on studied group than Clemastine. The lung function measurements before and after treatment did not showed much difference, although a significant decrease of the nonspecific bronchial reactivity to histamine was observed in the group receiving Zaditen . This was observed shortly after beginning of the treatment up to 6 weeks. Zaditen sirup was well tolerated and the only side effect observed was a significant weight increase, which could be explained by the elevation of serum sodium ions concentration.

Decrease of complement hemolytic activity after an allergen-house dust-bronchial provocation test.

Twenty-two children with bronchial asthma and positive skin tests to house-dust allergen were subjected to a bronchial provocation test with the allergen, and both bronchial reactions and serum complement hemolytic activity were measured at different intervals after the challenge. Changes in complement hemolytic activity did not correspond either with early or late bronchial reaction to the allergen. A reproducible drop in complement hemolytic activity after allergen challenge was observed in eight patients and could be prevented in four out of seven patients by sodium cromoglycate. The duration of early bronchial obstructive reaction was longer in tests where parallel complement changes were observed.

The evaluation of immune status in children with the past history of obstructive bronchitis.

Selected parametres reflecting cellular and humoral immunity were analyzed in 98, 10 year-old children, who had been hospitalized during first 2 years of life because of bronchitis. In this group, 46 children suffered from obstructive bronchitis and 52 from other types of bronchitis. Serum immunoglobulins, complement components, and antiproteolytic factor levels, T and B lymphocytes counts, leukocyte migration inhibition, and skin tests to PHA and Polyvaccine were compared and analyzed in relation to bronchial obstruction and allergic symptoms in early childhood. The results obtained did not show any significant difference when the group with obstructive type of bronchitis was compared to the rest of children studied. Some differences (increase of the percentage of EAC-FRC and decrease of the levels of the antiproteolytic factors) were noted in relation to allergic symptoms.

Lung function of children with history of obstructive bronchitis in their infancy.

A group of 98 children admitted to the hospital in the first 2 years of life with diagnosis of obstructive bronchitis was reexamined at 10 years of age. The examination included complexed lung function measurements. No important functional abnormalities were found in relation to passed obstructive bronchitis, features of allergy, frequency of attacks of the disease in the past, and bronchial reactivity to histamine. In the small group of children with diagnosis of bronchial asthma in the meantime made, the results of examination were most frequently abnormal but did not coincide with the previous diagnosis. They indicated rather nonhomogeneity of ventilation, characteristic for peripheral lung abnormalities.

T and B lymphocytes, immunoglobulins and complement components in bronchial asthma.

Sixty children, 7--15 years old, suffering from bronchial asthma and 44 healthy children, 12--14 years old, were studied for the percentage and the total count per mm.3 of T and B lymphocytes. Patients were classified into extrinsic atopic, mixed and intrinsic asthma. According to the clinical course mild and severe cases were analysed separately. The total and "active" T lymphocytes were detected by the ability to form nonimmune rosettes with sheep red blood cells. The B lymphocytes were estimated by the rosetting procedure with antibody mouse complement coated sheep erythrocytes. No decrease of the percentage or total count of T lymphocytes was observed, and an elevation of total count and percentage of active T cell rosettes was even seen in severe cases of extrinsic atopic asthma. The B cell percentage was decreased in severe atopic, mild intrinsic and mild mixed asthma but the total number was lowered only in the last group. The immunoglobulin A, G, M, D and E level, measured by the single radial immunodifussion test, was correlated neither to T cell nor B cell percentage. The complement components C1q, C4, C3, C3 proactivator and C5 were measured by the radial immunodufusion test in the plasma of some patients and controls. The C1q level was normal. An elevation of C4 in mild extrinsic, C5 in severe extrinsic and C3 in severe mixed asthma was seen. A decrease of C3 proactivator was observed in mild extrinsic and mixed asthma, and in three cases of intinsic asthma this was accompanied by lowering of C3, suggesting an activation of the alternative pathway.

[Does airways obstruction in children with asthma bronchial persist in the symptomfree interval? (author's transl)]. / Bleibt die Obstruktion der Atemwege bei Kindern mit Asthma bronchiale im symptomfreien Intervall bestehen?

There is no doubt that asthmatic attack is creating symptoms of long-lasting obstruction. In symptom-free period many functional tests are quite normal. The most distinct changes found in that period of the diseases are the loss of elastic recoil and a raise of static compliance. This suggests that obstruction of any part of the airways cannot persist over the period of attacks.

Importance of respiratory allergy in provoking reversible bronchial obstruction.

In five groups of children: representative sample of normal population, children suffering from bronchitis in the past and children with diagnosed asthmatics, results of unspecific bronchial reactivity to histamine were evaluated and in some of the groups results of skin and inhalatory reactions to allergen solutions were compared. Important discrepancy between skin and inhalatory reactions was shown. Potentialization of unspecific bronchial hyperreactivity after history of bronchitis was noticed. No relationship between attacks of bronchitis in the first 12 months of life and respiratory allergization could be found.