Venom Immunotherapy Does Not Affect Survival of Patients with Malignant Tumor in Poland.

Background: Allergen immunotherapy (AIT) is a well-established and efficient method of causative treatment for allergic rhinitis, asthma and insect venom allergy. Traditionally, a recent history of malignant neoplasm is regarded as a contraindication to AIT due to concerns that AIT might stimulate tumor growth. However, there are no data confirming that the silencing of the Th2 response affects prognosis in cancer. Objectives: The aim of this study was to investigate frequency of malignant tumors in patients undergoing AIT and the association between AIT and cancer-related mortality. Patients and Methods: A group of 2577 patients with insect venom allergy undergoing AIT in 10 Polish allergology centers was screened in the Polish National Cancer Registry. Data on cancer type, diagnosis time and patients' survival were collected and compared with the general population. Results: In the study group, 86 cases of malignancies were found in 85 patients (3.3% of the group). The most common were breast (19 cases), lung (9 cases), skin (8 cases), colon and prostate cancers (5 cases each). There were 21 cases diagnosed before AIT, 38 during and 27 after completing AIT. Laplace's crude incidence rate was 159.5/100,000/year (general population rate: 260/100,000/year). During follow-up, 13 deaths related to cancer were revealed (15% of patients with cancer). Laplace's cancer mortality rate was 37.3/100,000/year (general population rate: 136.8/100,000/year). Conclusions: Malignancy was found in patients undergoing immunotherapy less often than in the general population. Patients with cancer diagnosed during or after AIT did not show a lower survival rate, which suggests that AIT does not affect the prognosis.

How fast does wasp venom immunotherapy affect a regulatory T cell subpopulation (CD4+ CD25+ Foxp3+) and the synthesis of interleukins 10, 21 and transforming growth factor ß1?

INTRODUCTION: The literature describes the influence of venom immunotherapy (VIT) on the subpopulation of T regulatory cells (CD4+ CD25+ Foxp3+) and the synthesis of IL-10, TGF-ß1 as well as many other cytokines at various times after immunotherapy. AIM: To assess changes in the percentage of cells of CD4+ and CD25+ in peripheral blood and serum concentrations of IL-10, IL-21 and TGF-ß1 in the early stages of VIT. MATERIAL AND METHODS: The study included 18 patients who were allergic to wasp venom and who in the past underwent systemic anaphylactic reaction after stinging, meeting the criteria to qualify for VIT. The immunoenzymatic method (ELISA) was used to assess concentrations of cytokines IL-10, IL-21 and TGF-ß1 and the surface antigens CD4 and CD25 on the cells. The concentrations were determined by flow cytometry method at baseline (before VIT) and after 2.5 and 24 h from the VIT starting point. RESULTS: The mean values of the activity of T lymphocytes CD4+ CD25+ FoxP3+ and concentrations of the cytokines IL-10, IL-21 and TGF-ß1 are shown in table. CONCLUSIONS: A 24-hour activation assessment of serum concentrations of cytokines IL-10, IL-21 and TGF-ß1 during the first day of the Hymenoptera venom immunotherapy by ultra-rush protocol does not show the significant dynamics of change of the examined parameters.

Angioneurotic edema: a rare case of hypersensitivity to metoclopramide.

The case of a 30-year-old woman who had already experienced two incidents of angioneurotic edema and urticaria caused by drugs during the acute gastroenteritis. The allergological workup revealed hypersensitivity to metoclopramide. This case documents that metoclopramide, a drug commonly used to inhibit the vomiting, may cause not only bronchospastic reaction in an asthmatic patient but also angioneurotic edema of the tongue and larynx as well as urticaria. No similar cases in the literature were found.

[Vitamins E, A and C as antioxidatives]. / Witaminy E, A i C jako antyoksydanty.

It has been found during last years that vitamins A, C, E and carotenoids, besides previously recognized functions of preventing particular lipido- and avitaminosis, significantly participate in the protection of the human body against oxidation stress that is characterized by balance disturbance between speed of free radical creation and reactive oxygen forms with pace of their neutralization by enzymes and antioxidants. The antioxidative system creates special protective barrier which includes numerous chemical form with antiperoxidative proprieties and vitamins are the most important part of it. The aim of this work was the profile of occurrence and antioxidative action of the vitamins A, C and E.

[The influence of antileukotrienes on the skin reactivity induced by histamine and allergens by visual evaluation and laser Doppler flowmetry]. / Wplyw leków przeciwleukotrienowych na wczesna reaktywnosc skóry na histamine i alergeny oceniana wizualnie i przy uzyciu wlosniczkowej przeplywometrii laserowej.

UNLABELLED: There is different opinion whether antileukotrienes can influence skin prick tests (SPT) results. AIM OF THE STUDY: Estimation of SPT results with laser Doppler flowmetry (LDF) for histamine solutions and allergens before and after usage of antileukotrienes. MATERIAL AND METHODS: The study group consisted of 27 patients with allergic diseases. Before and after 4 days of zafirlukast or placebo usage, there were done SPT on the skin of the back with three histamine solutions (0.1 mg/ml, 1.0 mg/ml, 10.0 mg/ml) and with standard inhalant allergens. The estimation of SPT was done visually and with use of LDF. The cutaneous blood flow was measured after 15 minutes using Periflux PF 3 (PERIMED, Sweden) in point 5 mm of distance from prick center. RESULTS: Both visual estimations and flow rate didn't show the statistical differences between SPT with histamine solutions and allergens before and after 4 days use of antileukotrienes. CONCLUSIONS: Zafirlukast usage in dose 20 mg twice daily for 4 days does not influence on immediate skin reactivity on histamine solutions or allergens in visual evaluations as well laser Doppler flowmetry. There is no need of zafirlukast discontinuation before skin prick tests.

[The use of laser Doppler flowmetry for assessment of skin prick tests with histamine solutions and allergens]. / Zastosowanie wlosniczkowej przeplywometrii laserowej do oceny punktowych testów skórnych z roztworami histaminy i alergenami.

UNLABELLED: The lately noted growth of the allergy diseases morbidity requires improvement of their diagnosis methods. The skin prick test (SPT) is still the most frequently applied method in this field. The usually used visual evaluation is sufficient for daily practise but unfortunately is not error free. To minimise these errors and to make the evaluation more objective an attempt of applying of different technics such as LDF has been initiated. AIM: The present study has dealt with usefulness of an application of LDF method to evaluate SPT method using different allergens, solutions of histamine. MATERIAL AND METHODS: The study was conducted on a group of 22 individuals. These individuals underwent SPT with a use of three different solutions of histamine (10.0 mg/ml, 1.0 mg/ml, 0.1 mg/ml) and allergens and the results of the test were evaluated with an application of the classic and LDF methods. RESULTS: Based on the results of the study an optimal distance from a prick point and time of the LDF measurement (5 mm, 15 min.) were selected. The results of the SPT were analysed with a parallel use of both of the above mentioned methods, and the relation between SPT results evaluated by visual method and the results obtained with the use of LDF was found. The highest value of correlation was obtained for the diameter and area of both--wheal and flare for the histamine solution of 1.0 mg/ml, the lower value for 0.1 mg/ml, and the lowest for the solution of 10.0 mg/ml and allergen (p < 0.05). CONCLUSION: The results of the study shown that the optimal time for evaluation of SPT by LDF method is 15 minutes and distance from prick point is 5 mm. In such a case correlation between the parameters of visual evaluation and LDF values is most significant.