Franciszek Halkiewicz

Staphylococcus aureus skin colonization in atopic dermatitis children is associated with decreased IFN-γ production by peripheral blood CD4+ and CD8+ T cells

Atopic dermatitis (AD) is a chronic inflammatory skin disorder, which is associated with an increased expression of Th2 cytokines with concomitant decrease in IFN‐γ production by circulating CD4+ and CD8+ T cells. The skin of patients with AD is often colonized by Staphylococcus aureus, which may reflect in changes in immunological parameters. The aim of the study was flow cytometric measurement of some peripheral blood lymphocyte subsets expressing naive/memory marker (RA/RO) and activation marker (CD25) as well as intracellular production of IFN‐γ by peripheral blood CD4+ and CD8+ T cells from varied severity AD children and determine the impact of S. aureus skin colonization on cytokines profiles. There was a significant increase in the percentage of CD4+ and CD8+ T cells producing IL‐4 and IL‐13 and decrease in the percentage of CD4+ and CD8+ T cells producing IFN‐γ upon in vitro stimulation with phorbol 12‐myristate 13‐acetate and ionomycin in children with AD compared to healthy ones. The absolute number of CD4+ and CD8+ T cells expressing memory marker CD45RO was elevated as compared with controls. The severity of AD was positively correlated with the percentage of lymphocyte subsets: CD45RO+, CD4+CD45RO+, and the percentage of CD3+ and CD4+ expressing CD25 as well as the number of S. aureus on the skin. In conclusion, both CD4+ and CD8+ memory T cells are involved in the immunopathogenesis of AD. S. aureus skin colonization is related with disease severity and changes in expression of CD45RO and CD25 on T cells. A decrease in the percentage of CD4+ and CD8+ T cells producing IFN‐γ in AD children may explain propensity for skin infection.

Clinical features of asthma in children differ with regard to the intensity of distal gastroesophageal acid reflux.

Background. The prevalence of gastroesophageal reflux (GER) in children with asthma is higher than in healthy controls, but the nature and direction of this association is unclear. Objective. The aim of our study was to assess the relationship between esophageal acid exposure and the clinical features of asthma in children. Methods. In total, 66 children (mean age 122.8 months [SD 44.89 months]) with chronic pulmonary symptoms, fulfilling diagnostic criteria of persistent asthma, underwent 24-hour esophageal pH monitoring and answered a detailed questionnaire-based survey. The questionnaire topics included environmental factors, familial history, current and previous clinical symptoms, atopy, asthma severity, and medication. Results. Abnormal results of 24-hour esophageal pH monitoring were found in 28 out of 66 children (42.4%). Age, sex, severity of asthma, environmental factors, spirometry results, and the type of medication did not correlate with esophageal acid exposure. However, children with abnormal pH results developed asthma significantly earlier (asthma onset 3.63 years [SD 2.52 years] vs 5.77 years [SD 3.82 years]; p < .01). Nonatopic individuals had more intensive esophageal acid exposure than atopic ones (Boix-Ochoa score 28.19 [SD 18.26] vs 18.26 [SD 12.84]; p < .048). The intensity of GER was also significantly correlated with frequent or difficult-to-control nighttime asthma attacks. Conclusions. There are differences in clinical features of asthma in children with regard to the intensity of esophageal acid exposure. Symptoms of asthma in nonatopic individuals with early onset and difficult-to-control nighttime asthma attacks suggest the possibility of concomitant, clinically relevant GER.

Evaluation of adipokines in children with cystic fibrosis

INTRODUCTION Patients with CF present numerous pathological conditions such as malnutrition, depletion of fat-free mass, metabolic disturbances (abnormal glucose metabolism, increased insulin resistance, chronic energy deficit, local and chronic inflammation), which could affect or be associated with altered adipokines concentration Material and Methods: We aimed in this study to investigate the levels of selected adipokines such as resistin, apelin, adiponectin to demonstrate their application as possible markers of inflammation. RESULTS Serum level of resistin was higher (p < 0.001) and adiponectin - lower (p=0.02) in CF children than in healthy children. There was no difference in serum apelin level between two examined groups. However, values of adiponectin/BMI and apelin/BMI ratios in CF did not differ significantly from controls. Higher values of resistin/BMI ratio in CF in comparison to controls were observed Serum resistin/adiponectin ratio was significantly higher in CF patients than in controls (p < 0.0001). Resistin/BMI ratio correlated negatively with FEV1 (R:-48,p < 0.043). Serum resistin/adiponectin ratio correlated negatively with FEV1/FVC (R:-49, p=0.04), Adipokines showed no correlation with BMI and BMI-SDS, glucose, total cholesterol, and LDL-, HDL-cholesterol, triglyceride serum levels. Spirometric parameters FEV1, FVC, VC correlated negatively with serum glucose levels (R: -0.55, p < 0.018; R: -0.65 p < 0.0025; R:-0.76, p < 0.0008 respectively). FEV1 and FVC correlated positively with BMI-SDS (R:0.58, p < 0.01; R:0.5, p < 0.036, respectively). CONCLUSIONS A significant increase in resistin concentration expressed also as resistin/BMI, and resistin/adiponectin ratios, observed in children with CF may suggests that this adipokine is involved in the inflammatory process underlying the disease and is related to worse spirometric parameters describing airways obstruction.

Profil lipidów w surowicy krwi u dzieci chorych na astmę i atopowe zapalenie skóry

Streszczenie Wstep Badania oceniające profil lipidow w astmie i atopowym zapaleniu skory (AZS) są nieliczne, a ich rezultaty są sprzeczne. Cel Celem pracy byla ocena surowiczego stezenia trojglicerydow (TG), cholesterolu calkowitego (TC), HDL-C i LDL-C w surowicy krwi u dzieci chorych na astme i atopowe zapalenie skory (AZS). Material i metody U 100 dzieci chorych na astme atopową, 27 dzieci chorych na AZS i 46 dzieci zdrowych (średni wiek 10,9±0,9 roku) oceniono BMI i BMI-SDS oraz oznaczono stezenie TG, TC, HDL-C, LDL-C. Wyniki Odsetek dzieci otylych byl wyzszy w grupie badanej (astma – 33%, AZS – 25,79%) niz w grupie kontrolnej (13,04%). U chorych na astme byly najwyzsze średnie wartości wskaźnika BMI (astma: 20,0±0,43, AZS: 18,1±1,44, grupa kontrolna: 18,76±0,56) i BMI-SDS (astma: 1,47±26, AZS: 0,83±0,41 grupa kontrolna: 0,18±0,26). W grupie chorych na astme BMI korelowalo dodatnio ze stezeniem TG (r: 0,41, p=0,011), a ujemnie ze stezeniem HDL-C (r: −0,35, p=0,037). Ponadto stezenie LDL-C korelowalo dodatnio z BMI-SDS (r: 0,34, p=0,044). Po wyeliminowaniu dzieci otylych wykazano, ze stezenie TG i LDL u chorych na astme (p Wnioski 1. U dzieci z prawidlową masą ciala, chorych na astme atopową i AZS stwierdza sie odmienny profil lipidow niz u zdrowych, niezaleznie od stopnia uczulenia i ciezkości choroby. 2. Zaburzenia w surowiczym stezeniu TG i frakcji cholesterolu w astmie powiązane są ze wskaźnikami masy ciala.

Wrodzona wada torbielowata płuc – opis przypadku

Streszczenie Wrodzone wady torbielowate pluc obejmują kilka jednostek chorobowych o roznych cechach anatomicznych i histopatologicznych. Nalezą do nich: wrodzona gruczolakowatośc torbielowata pluc, sekwestracja pluc, wrodzona rozedma platowa oraz torbiel bronchogenna. Obraz kliniczny wad rozni sie znacznie w zalezności od rozmiaru torbieli, lokalizacji i typu histopatologicznego. Do rozpoznania najcześciej dochodzi prenatalnie lub przy urodzeniu. W piśmiennictwie opisywane są rowniez zmiany o tzw. poźnym początku choroby (powyzej 6. miesiąca zycia), wykrywane przypadkowo lub w wyniku rozwijających sie powiklan. Przedstawiamy przypadek 3,5-letniej dziewczynki, u ktorej pierwszym objawem choroby bylo zapalenie pluc w czwartym roku zycia. W wykonanych badaniach obrazowych (RTG i TK klatki piersiowej) potwierdzono obecnośc licznych zmian torbielowatych w dolnym placie pluca prawego. Wniosek Wrodzone wady pluc powinny byc brane pod uwage w diagnostyce roznicowej zakazen dolnych drog oddechowych u dzieci.