Cytokine profile in children with asthma undergoing food challenges.

BACKGROUND: The influence of food allergens on the profile of inflammatory markers in children with asthma has not been investigated. To ascertain the influence of food allergens on the intensity of the inflammatory process, a cytokine profile was determined before and after a food challenge test in the peripheral blood of children with asthma and coexistent food allergy. MATERIAL AND METHODS: We studied 22 children with asthma and immunoglobulin (Ig) E-dependent food allergy. Oral challenge tests were carried out using double-blind placebo-controlled food challenge (DBPCFC). Blood was sampled before, and 4 and 24 hours after the oral challenge test. The inflammatory markers interleukin (IL) 4, IL-5, IL-10, tumor necrosis factor (TNF) a, intereron (IFN)-gamma, sIL-2R, and sCD23 were evaluated. The level of cytokines in serum was determined using a commercial enzyme-linked immunoassay Bender Med Systems (Vienna, Austria). RESULTS: The median IL-4 level before the challenge test was 23.5 pg/mL, after 4 hours it was 38.8 pg/mL, and after 24 hours it was 35.4 pg/mL. The median IL-5 levels measured at the same time points were 4.6 pg/mL, 5.7 pg/mL, and 7.5 pg/mL. A significant increase in IL-4 and IL-5 levels 4 hours (P = .0006; P = .006) and 24 hours (P = .014; P = .015) after food challenge was observed. No statistically significant differences in the levels of the other cytokines during allergen or placebo challenge tests were recorded. CONCLUSIONS: Determination of plasma IL-4 and IL-5 levels can be a useful tool for evaluation of the effects of food challenge tests on children with asthma and coexisting IgE-dependent food allergy. The results of determining serum IL-10, TNF-alpha, interleukin (IL) IFN-gamma, sIL-2R, and sCD23 levels during the challenge test are not significant.

[Biochemical characteristics of fungi isolated from ontocenoses of digestive tract in children]. / Wlasciwosci biochemiczne grzybów izolowanych z ontocenoz przewodu pokarmowego dzieci.

Fermentation of carbohydrates and assimilation of carbon compounds were evaluated. The utilization of 18 specific carbon compounds was estimated in the investigation of each strains for differentiation of the species. From among 125 strains of fungi the following were found: Candida albicans (112 strain), C. famata (2), C. glabrata (1), C. guilliermondii (1), C. kefir (4), C. tropicalis (2). The activity of 19 hydrolases was investigated using API ZYM. Biotyping of Candida strains was done according to the Williamson classification (1986), modified by Kurnatowska (1998). All strains were isolated from the oral cavity, rectum, as well as from the materials collected during endoscopy in children.

[Fungal invasions in the digestive tract in children]. / Inwazje grzybami przewodu pokarmowego dzieci.

The aim of presented study were fungal invasions of the oral cavity and gastrointestinal (GI) tract in children suspected of the inflammation of gastric and duodenal mucosa and of absorption disturbance. The fungal strains (125) were identified using API 20C and API 20C AUX (bio Me'rieux); they were as follows: Candida albicans, C. famata, C. glabrata, C. guillermondii, C. kefyr and C. tropicalis.

[The sensitivity to ketoconazole of Candida strains isolated from the digestive tract ontocenoses in children]. / Wrazliwosc na ketokonazol szczepów Candida zasiedlajacych ontocenozy przewodu pokarmowego dzieci.

The study included 52 children. During endoscopy the contents of oesophagus, stomach and duodenum were collected with catheters, and additionally washings from the oral cavity and anal swabs or samples of faeces. Materials were inoculated on Sabouraud's media. The axenic strains of fungi were identified using own methods and others tests (API 20C, API 20C AUX). The activity of ketoconazole (K) was measured against 100 strains of Candida: C. albicans (91 strains), C. kefyr (4), C. famata (2), C. tropicalis (1), C. guilliermondii (1), C. glabrata (1). The strains susceptibility to K (RO4 1400 Janssen) was estimated with the own system based on the dose-response curves; the minimal inhibitory concentration (MIC) values were canculated. The low values of MIC indicate high susceptibility to K of examined Candida strains.

[The significance of iron in development and nutrition of infants. II. Prevention of iron deficiency]. / Znaczenie zelaza w rozwoju i zywieniu niemowlat II. Zapobieganie niedoborom zelaza.

The symptoms and consequences of iron deficiency in the child are described as found in the literature. The role of iron in immune processes is presented and it is noted that there is no proof for the theory of the development of bacterial infections as a result of giving oral iron supplements. The influence of breast milk and cow milk on the intestinal uptake and loss of iron is discussed. Feeding infants formulae or milk-substitute formulae after cessation of breastfeeding prevents the increased blood loss in the digestive tract, which results from the introduction of cow's milk. The iron content of selected Polish infant formulae, follow-on formulae and milk-substitute formulae available on the market are given and compared with FAO, WHO, ESPGAN and EC recommendations. Results of the authors' own researches on the iron content of selected Polish powdered whole cow's milks are presented. The measurements, made by atomic absorption spectroscopy (AAS), showed that iron content of whole powdered milks ranged from 0.23 to 1.19 mg/dm3. The values do not vary significantly from those in the literature on the iron content of unboiled cow's milk. It is shown that up to the point of the doubling of birth weight, formula-fed infants should be fed modified milk containing at least 2 mg/dm3 of iron. Thereafter infants should receive milk containing at least 7 mg/dm3 of iron.

[The significance of iron in infant development and nutrition. I. Metabolism of iron]. / Znaczenie zelaza w rozwoju i zywieniu niemowlat. I. Metabolizm zelaza.

The role of iron in the child organism, as well as the blood's role in regulating the iron homeostasis is described on the basis of relevant literature. From developmental data on Warsaw children and from relevant literature, the child average body iron content and the child average daily iron requirement, which is at age 0-0.5, 0.5-1 and 1-2 years 0.51, 0.92 and 0.76 mg for boys and for girls 0.42, 0.86 and 0.74 mg respectively, are calculated. It is noted that the daily physiological iron loss during the first two years of life can be as much as 50% of the daily iron requirement. Among the causes of infant iron deficiency are the greater blood losses during the peri- and postnatal periods, decreased dietary iron, as well as increased need for iron related to significant body growth. The loss of one ml of blood in children results in the loss of from 0.33 to 0.66 mg of iron. On the basis of the changes in body iron content of infants having various birth weights, it is shown that the quantity of iron needed for proper development is independent of the birth weight. The quantity of iron required by premature infants and children with low birth weight is 25-50% greater, after the infant doubles its birth weight, than that needed by full-term and normal birth weight infants.

[Carbon monoxide poisoning in children hospitalized in the pediatric institute in Lódz in the years 1994-1997]. / Zatrucie tlenkiem wegla u dzieci hospitalizowanych w Instytucie Pediatrii w Lodzi w latach 1994-1997.

Carbon monoxide poisoning is the major cause of inhalation intoxications among children. Tissue hypoxia plays the important role in the pathophysiology of CO poisoning. Especially the CNS and heart are the most susceptible organs to the oxygen deficiency. Presented signs and symptoms are nonspecific and often lead to misdiagnosis. In this article authors present 100 children, aged from 4 weeks to 15 years, hospitalized in the Pediatrics Institute in the period 1994-1997 after carbon monoxide exposition. The most frequent symptoms of this poisoning were headache (46%) and dizziness (25%). We also observed abdominal pain, vomitus, fatigue, weakness and syncope. We estimated the frequency of CO poisoning in relation to the total number of intoxications in children treated in our hospital, clinical course and relationship with carboxyhemoglobin concentration. The analysis shows that CO poisoning is an important and growing toxicological problem among children.

Estimation of antithyroid antibodies occurrence in children with coeliac disease.

INTRODUCTION: The coexistence of coeliac disease (CD) and the diseases of autoimmune origin is often discussed in literature. In this study the evaluation of antithyroid antibodies (antimicrosomal-TMA, anti-thyreoglobulin-ATG, thyroid peroxidase antibodies anti-TPO) occurrence against clinical and laboratory determinants of thyroid function is demonstrated in children with coeliac disease. MATERIAL AND METHODS: The study was conducted on 34 IgA-EmA positive children; control group consisted of 28 children with negative screening tests for coeliac disease. RESULTS: In both groups, the level of antithyroid antibodies (TMA, ATG, anti-TPO) and determinants of thyroid gland function (TSH, fT3, fT4) were evaluated; USG examination of thyroid gland was also performed. Elevated titres of antithyroid antibodies observed in children with coeliac disease (41.1%) in comparison to control group (3.56%) indicate the need for performing the screening tests for antithyroid antibodies in children with CD.

Neurogenic pulmonary oedema in a 13-year-old boy in the course of symptomatic epilepsy--case report.

Pulmonary oedema with severe, dramatic course following CNS injury was termed neurogenic pulmonary oedema (NPO). NPO was mainly described as a consequence of grand mal seizures, subarachnoid bleeding, intracranial bleeding or head injury. However, the pathogenesis of NPO is not entirely clear yet. In the majority of cases, early or classic symptoms of pulmonary oedema are evident from several minutes up to several hours after CNS damage. Dyspnoea, chest pain, bloody expectoration are observed shortly after consciousness disorders, although NPO may occasionally be diagnosed on the basis of chest x-ray in patients with no clinical symptoms. Tachypnoea, tachycardia, rales without any changes in cardiac system are usually observed during physical examination. The ailments withdraw quickly in the majority of patients, who may require oxygen therapy at most. NPO has been well-known in adults, but our knowledge of its occurrence in children is still rather sparse. The current work presents a case of a 13-year-old boy with pulmonary oedema as a post-seizure complication.

[Morphological, microstereological and immunohistoenzymological studies of the jejuni of infants with recurrent constructive bronchitis and chronic diarrhea due to cow's milk protein allergy]. / Badania morfologiczne, mikrostereologiczne i immunohistoenzymatyczne w blonie sluzowej jelita czczego u niemowlat z nawracajacymi obturacyjnymi zapaleniami oskrzeli i towarzyszaca biegunka przewlekla na tle uczulenia na bialka mleka krowiego.

Morphological, microstereological and immunohistoenzymatic technique were used to assess jejunal biopsy samples obtained from 17 infants suffering from chronic diarrhoea and bronchitis spastica (the study group), and 5 infants with chronic diarrhoea and weight deficiency (group G). In the first group, histopathological studies revealed a small degree of villous atrophy (II degree) in 12/17 of cases, and in 5/17, a moderate atrophy (III degree). The microstereological technique disclosed infiltration of the submucosa which was significantly more marked in the study group as compared with group G (p < 0.05). Positive immunohistoenzymatic reactions in mononuclear cells of the submucosa infiltration were observed in all cases, but was more distinct in the first group. The results of the study show jejunal biopsy to be helpful in confirming the allergic etiology of the disease in the study group.

[Diagnostic value of immunoglobulin E in serum of infants with spastic bronchitis and cow milk protein allergy depending on the method of examination]. / Wartosc diagnostyczna oznaczen immunoglobuliny E w surowicy u niemowlat z obturacyjnym zapaleniem oskrzeli i alergia na bialka mleka krowiego w zaleznosci od zastosowanej metody badawczej.

We examined 83 infants suffering from spastic bronchitis and cow milk protein allergy and analyzed the diagnostic value of two allergic tests (Mancini, FAST) commonly used for measuring total IgE (t-IgE) level in serum. The aim of the study was to establish the sensitivity of these two methods. Our statistical analysis proved FAST test to be more sensitive than Mancini one (p < 0.01).

Functional studies of intestinal mast cells in children with food intolerance.

The aim of this study was to characterize some functional properties of intestine mast cells taken from children with food intolerance. The cells were obtained from tissue specimens by the use of the enzymatic method and the sensitivity of mast cells to anti-IgE, substance P (SP) and vasoactive intestinal peptide (VIP) was studied in vitro. We have noticed that (1) mast cells were sensitive to the action of anti-IgE, but there was no correlation with total IgE level, (2) although mast cells were challenged with SP and VIP histamine release was low.

Diamine oxidase plasma activity and jejunal mucosa integrity in children with protracted diarrhoea.

The aim of this study was to answer the question whether diamine oxidase (DAO) plasma activity reflects jejunal mucosa integrity in children with protracted diarrhoea. DAO activity was estimated with the radioisotopic method described by Fogel [14]. Postheparin DAO plasma activity was significantly lower in children with jejunal mucosa atrophy compared to control subjects.