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The relationship between man and horse goes back to prehistoric times. Horses are among the most significant human domesticated animals. Currently, due to mechanization, the role of horses as an economic resource has decreased, but their recreational role is still important. Taking into account frequent contact with humans, they are of great importance as a potential source of allergens, constituting a significant cause of various allergic reactions. The article describes a case of an acute allergic reaction in a patient with bronchial asthma after contact with a horse allergen, which was brought along with the clothing of a person who had contact with the animal. The frequency of allergies, the prevalence and types of allergens as well as anaphylactic reactions to horses are discussed. The application of diagnostics based on allergen components was discussed, as well as component diagnostics performed in the patient in the context of allergy to panallergens from the lipocalin group was described. [ABSTRACT FROM AUTHOR]

There are over 8 million dogs in Poland. Allergy to pets accounts for 2.5% of total allergy cases, while allergy to dogs constitutes 8% of the total pet allergies. About 6% of children with allergic rhinitis and 35% of the asthmatic children have positive SPTs to dog allergens. Avoiding of dog allergens is not feasible, since dog antigen is found at concentrations capable of producing allergic symptoms in all public places. There are 29 allergic proteins in dog hair, dander, urine, serum and saliva. Five major dog allergens have been identified: Can f1, Can f2, Can f3, Can f4. Can f5. Allergens Can f1 and Can f2 are found in dander, saliva and in skin. Can f3 is found in serum, Can f4 in hair, dander and skin. Can f5 is found in urine. Can f 1 and Can f5 are capable of binding 50-70% of IgE, while Can f2 and Can f3 bind 20-40% of IgE. Considerable differences have been observed in the quantity of dog allergens between various breeds, but it does not seem reasonable to regard any of the breed as hypoallergenic. Effect of influence of dog allergens and of being an owner of a dog on the development of allergy and asthma has not been yet clarified. Some authors stress the significance of constant contact with the animal and of breeding more than one dog at home. Up to now, it has not been possible to determine the effect of having a dog at home on development of allergy in children. [ABSTRACT FROM AUTHOR]

Food-dependent exercise-induced anaphylaxis (FDEIA) is a special type of anaphylaxis. Allergic reactions develop only when food is consumed with a cofactor. Cofactor of the reaction are exercise, nonsteroidal anti-inflammatory drugs, alcohol and infection. The frequency of FDEIA is different in the geographical area of the word. The pathogenesis of food- dependent anaphylaxis induced by exercise or other cofactors is not fully understood. In this case, the cause may be increased permeability of the gastrointestinal epithelium and greater bioavailability of allergens, or an increase in plasma osmolality during physical activity. In practice, every allergic reaction can be amplified by cofactors. There are allergens, such as ω-5-gliadin, lipid transport proteins, and tropomyosin, for which their role seems to be particularly important. In many cases of FDEIA, the allergen causing the reaction is not identified. The gold standard for diagnosing food allergy is the oral challenge test. In the case of FDEIA, conducting them is a challenge due to the need to introduce a cofactor into the test. It is necessary to explain to the patient the nature of FDEIA and the allergens that sensitize him. The most important thing is to completely avoid eating foods that trigger reactions 4 hours before and 2 hours after exercise. Biological drugs may become a new treatment method. [ABSTRACT FROM AUTHOR]

Hypersensitivity to Hymenoptera venom, occurring in approximately 3-5% of the population in Europe and the United States, is an important and difficult medical problem due to the fact that reactions after stings may pose a direct threat to life. In most cases, allergic reactions after stings are IgE-dependent, which is confirmed by the presence of specific IgE antibodies in the skin and/or serum against venom allergens. Diagnosing of hypersensitivity to Hymenoptera venom is often very difficult. This article presents the case of a patient who, as a result of her first bee sting, suffered a toxic-inflammatory reaction despite the presence of specific IgE antibodies to icarapine (rApi m10) detected in in vitro diagnostics. After a few years, the second sting, this time by a wasp, led to an anaphylactic reaction with abdominal symptoms predominating. Despite the lack of sIgE to wasp venom allergens in in vitro tests, hypersensitivity was confirmed in intradermal tests using wasp venom extract. After the final diagnosis was made, the patient was qualified for „ultra-rush” specific alergen immunotherapy using wasp venom extract. In each case, it is necessary to perform extensive diagnostics to confirm the immunological background of the reaction, which is also necessary to determine indications for the implementation of specific allergen venom immunotherapy. [ABSTRACT FROM AUTHOR]

The year 2011 marks exactly 100 years since two articles by Noon, Freeman and Cantab, fundamental for allergen immunotherapy, were published in The Lancet. It is difficult to decide which of them was more important, because they complemented each other. Most authors writing about the beginnings of the allergen immunotherapy cite only Freeman and Noon, though. It is worth mentioning there had also been earlier attempts of desensitization, undertaken by Wiliam Philipps Dunbar, Charles Blackley, H. Holbrook Curtis, Aleksandr Besredka and others, and the method invented in 1911 has been improved ever since. Its anniversary was celebrated at this year's congress of the American Academy of Asthma, Allergy and Immunology, in San Francisco, and during the Congress of the European Academy of Allergology and Clinical Immunology in Istanbul. [ABSTRACT FROM AUTHOR]

The cat is one of the most common animals that people keep in their homes. Cat allergens are among the strongest and most common respiratory allergens. They can be found even in public places where cats have never been. Many people, with clinical signs of cat allergies, do not want to get rid of the cat from home, anyway. A hypoallergenic cat that would be a safe alternative to allergy sufferers is sought. Many myths and hypotheses have arisen around the problem of hypoallergenic cats, which have often not been confirmed by any reliable research. The paper attempts to present various theories about cats with low allergenic potential. It has been noted that strategies to reduce the allergenicity of cats focus on attempts to lower the Feld 1 concentration in the saliva of the cat, on its fur and in the animal's environment. Feld 1, the main cat allergen, is widely regarded as a marker molecule for allergy to this animal. This secretory glycoprotein is primarily produced in the sebaceous, salivary and anal glands. Then it is spread on the cat's fur by licking. Along with the fur and exfoliated epidermis, it easily spreads in the environment. Feld 1 is commonly present in house dust and air, both in the presence and absence of an animal in a given place. Among the methods to reduce the concentration of Fel d 1 in cat's saliva, on his fur or in his surroundings, such as cat breed, bathing the animal, proper diet or sensitizing the cat's own Fel d 1 has been described. The most attractive, effective and supported by research appear to be those in which the secretion of active Fel d 1 into the environment is blocked by specific antibodies. This effect can be achieved irreversibly by immunizing the animal with the Fel d 1 antigen, or reversibly by supplementing the cat's diet with avian anti-Fel d 1 antibodies. Both methods seem to be similarly effective, but given the animal's welfare, actions seem to be better whose effects are reversible. It is also worth noting that a cat that secretes less Fel d 1 can be hypoallergenic only for people who are allergic to this allergen, not for people who are allergic to other cat allergens. [ABSTRACT FROM AUTHOR]

Basophil Activation Test (BAT) is a functional test, sometimes referred as "oral test tube challenge". Although component-resolved diagnosis contributed to a significant increase in the sensitivity and specificity of diagnostic tests, none of the currently used methods allows for differentiation between allergic but allergen tolerant patients and patients with symptoms of allergy. Therefore, BAT has clinical application in the diagnosis and monitoring of allergic diseases, including food allergy. This test can also serve as an additional tool for predicting the severity of a clinical reaction and assessing the threshold of reactivity in food allergies. BAT is characterized by very high sensitivity and specificity. The introduction of BAT for everyday clinical use would require the standardization of laboratory procedures and methods of data analysis and clinical validation of the test. Research using BAT requires continuation, primarily to determine its place in diagnostic algorithms. [ABSTRACT FROM AUTHOR]

Wstęp: Walidacja wiarygodnych biomarkerów klinicznych i laboratoryjnych ma ogromne znaczenie dla lepszej prospektywnej i retrospektywnej oceny skuteczności AIT (alergenowej immunoterapii swoistej). Obecnie do AIT kwalifikuje się pacjentów głównie na podstawie wywiadu chorobowego i spektrum uczuleń. Użytecznymi narzędziami stratyfikacji pacjentów są próby prowokacji alergenowej. Kabina Ekspozycji Środowiskowej (EEC - Environmental Exposure Chamber) zapewnia generowanie ekspozycji na alergen w dobrze kontrolowanych warunkach, stabilnych i niezależnych od czynników zewnętrznych. Cel: W badaniu oceniono skuteczność AIT u pacjentów uczulonych na alergeny roztoczy kurzu domowego (HDM - House Dust Mite) na podstawie poprawy klinicznej ocenianej „w terenie" za pomocą skali objawów i zużycia leków (CSMS - Combined Symptom Medication Score), a także po prowokacji alergenem donosowym (NAC - Nasal Allergen Challenge) i ekspozycji w EEC. Materiały i Metody: Do badania włączono 50 pacjentów z objawami alergicznego nieżytu nosa i spojówek wywołanego przez HDM, potwierdzonego za pomocą punktowych testów skórnych (SPT) oraz swoistych przeciwciał IgE (sIgE). Objawy oceniano za pomocą parametrów subiektywnych (skala objawów, skala zużycia leków, CSMS) i metod obiektywnych (rynometria akustyczna) zarówno podczas okresu wysokiego narażenia na HDM „w terenie", jak i poza sezonem dzięki NAC oraz EEC przed AIT i po 360 dniach AIT. Wyniki: Wykazano dodatnią korelację pomiędzy SPT z użyciem Dermatophagoides pteronyssinus (D.p.) i Dermatophagoides farinae (D.f.), p<0.05, r=0.65 oraz pomiędzy SPT D.f. a sIgE D.f. (p<0.05, r=0.73). Nie znaleziono statystycznie istotnych zależności pomiędzy SPT, sIgE a subiektywnymi lub obiektywnymi parametrami ocenianymi podczas NAC, ekspozycji w EEC lub CSMS „w terenie".Zarówno parametry subiektywne, jak i obiektywne wykazały znaczną poprawę po AIT w NAC i EEC. Objawy oceniane za pomocą CSMS w okresie wysokiego narażenia na HDM po 1 roku AIT był istotnie niższe (69%) w porównaniu do stanu sprzed leczenia (p<0.0001). Istotną statystycznie redukcję objawów po AIT zaobserwowano w NAC za pomocą metod subiektywnych (p<0.0001) oraz rynometrii akustycznej (p<0.0001, średnia redukcja MCA 32%, MID 13%). W EEC zaobserwowano 30% redukcję objawów ze strony nosa (p<0.005) i 58% redukcję objawów ze strony oczu (p<0.005) po AIT, natomiast nie zaobserwowano statystycznie istotnej różnicy w reakcji nosowej mierzonej w rynometrii akustycznej podczas ekspozycji w EEC. Nie stwierdzono statystycznie istotnej korelacji między CSMS ocenianym przed AIT a innymi parametrami ocenianymi w NAC lub EEC. Podsumowanie: Kliniczne punkty końcowe oceniane podczas ekspozycji w EEC i NAC znacząco odpowiadają analizie skuteczności AIT za pomocą CSMS podczas okresu wysokiego narażenia na alergen i mogą stanowić alternatywę dla tradycyjnych projektów badań naukowych i klinicznych. [ABSTRACT FROM AUTHOR]

Introduction. Impaired repair of airway epithelium may lead to persistence of inflammation and remodelling. Regeneration of injured epithelium is a complex phenomenon and the role of toll-like receptors (TLRs) and respiratory virus products in this process have not been established. Aim of the study. In this study we aimed to test if wound repair in nasal epithelial cells is modulated by microbial products and if this process was different in patients with allergic rhinitis and in healthy subjects. Materials and methods. Injured human nasal epithelial cells (hNECs) monolayers were incubated with the toll-like receptors agonists: poly (I:C) and lipopolisacharide (LPS); allergen Der p1, and supernatants from virus-infected epithelial cells. Regeneration of injured epithelium was assessed by measuring changes in the area of epithelial damage. Results. Addition of either poly (I:C) or LPS induced a dose dependant inhibition of wound repair in hNECs monolayers. Supernatants from RV1b-infected cells decreased epithelial cell regeneration after mechanical injury only in allergic patients. At baseline conditions the dynamics of epithelial repair was similar in allergic and non-allergic epithelium. However, inhibitory effects of innate stimuli on epithelial repair was stronger in patients with allergic rhinitis as compared to healthy individuals. Conclusions. This study showed that microbial products may affect regeneration of the nasal epithelium, and allergic patients are more susceptible to suppression of epithelial regeneration. [ABSTRACT FROM AUTHOR]

Chronic inflammation in asthma is accompanied by the increased vascular network in airways. Increased neovascularization occurs due to higher tissue demands for the oxygen and nutrients and results from the increased activity of proangiogenic factors released by tissues in airways (bronchial epithelium, smooth muscle cells, fibroblasts) as well as the immune cells and Th2-derived cytokines. Enhanced recruitment of progenitor endothelial cells occurs in response to allergen exposition. Intensified vascular network in asthma facilitates inflammation and supports bronchial remodeling leading to irreversible structural changes. In the future, modulation of angiogenesis may become another way of asthma treatment. [ABSTRACT FROM AUTHOR]

Food allergy is becoming an increasingly grave problem around the world. Every week there are reports of severe anaphylactic reactions to food. Actually, the victims knew about their allergies, avoided dangerous products, but did not realize that the dish that was served to them contained a hidden life-threatening allergen. The aim of the study is to present the current legal situation regarding the duty to provide the buyers with information about the contents of allergens in products. Attention was focused on the existing Regulation of the European Parliament and of the Council (EU), which will be soon put into practice in Poland. It also presents the current situation in chosen developed countries and possible measures to improve the safety and quality of life of people struggling with food allergies. [ABSTRACT FROM AUTHOR]

There are only few described cases of patients allergic to kaki. Kaki is the fruit of the Persimmon tree. Kaki allergens identified so far include: profilin Dio k 4, a protein, 17 kDa (homologous to Bet v 1), food-related allergen Bet v 6. A 74 year-old female experienced extensive skin lesions in the form of polymorphous urticaria on the upper extremities, lower extremities and neck, and oedema of both eyelids. The symptoms were followed by vomiting and diarrhea. Symptoms occurred 10 minutes after ingestion of the second half of a kaki fruit. The first half was consumed on the previous day without any side effects. Patient never experienced any symptoms of allergy and the family history of allergic diseases was negative. Symptoms resolved after steroids i.v. and antihistamine drugs. Skin prick tests (SPT) were performed with food allergens. The skin prick test using a standardized kaki allergen was not performed since the standardized allergen extract was not available. Prick by prick test with fresh kaki fruit was performed. The patient underwent detailed diagnostic testing using the immunoblotting method. Skin prick tests (SPT) with food allergens were negative. The prick by prick test with fresh kaki fruit was positive (Histamine 6/15mm, kaki 15/15mm). There was no positive signal obtained in immunoblotting. The prick by prick test enabled to objectively confirm the source of symptoms in our patient. Although there was no signal in immunoblotting, we presume that it did not exclude the presence of specific antibodies against kaki protein extract and the results may be a consequence of their low concentrations in the blood serum tested and partial change in allergen particles due to protein denaturation. [ABSTRACT FROM AUTHOR]

Wstęp: Alergia na białka mleka krowiego (ABMK) jest najczęstszą przyczyną alergii na pokarmy w populacji pediatrycznej. Zdecydowana większość dzieci nabiera tolerancję na białka mleka krowiego w pierwszych latach życia. Jednak coraz częściej obserwuje się przetrwałą postać ABMK, która cechuje się ciężkim przebiegiem i wysokim ryzykiem wystąpienia reakcji anafilaktycznej. Przez wiele lat jedyną strategią leczenia ABMK była eliminacja alergenu z diety dziecka. W ostatnich latach obiecującą metodą leczenia alergii pokarmowej jest alergenowo swoista doustna immunoterapia (oral immunotherapy, OIT). Przedstawiamy opis 5-letniego chłopca, u którego zastosowano odczulanie na mleko. Cel: Przedstawienie opisu pacjenta z ciężką postacią IgE-zależnej ABMK, u którego zastosowano immunoterapię doustną mlekiem. Opis przypadku: Chłopiec 5 letni jest objęty opieką alergologa z powodu ABMK. Z wywiadu i dokumentacji medycznej wynika, że u dziecka czterokrotnie wystąpiła reakcja anafilaktyczna po spożyciu mleka. Ostatnia reakcja miała miejsce w lutym 2020 r., po przypadkowym spożyciu ciastka, zawierającego śladowe ilości mleka. W lipcu 2020r. dziecko było hospitalizowane w Klinice CC UBCP Latitude Food Allergy (SFO, US), gdzie przeprowadzono doustną próbę prowokacyjną z mlekiem wypiekanym, której wynik był dodatni (pokrzywka uogólniona, rumień, senność). U chłopca rozpoznano ciężką postać alergii na białka mleka krowiego (alergia na mleko wypiekane, przebyte reakcje anafilaktyczne) i za zgodą rodziców dziecko zakwalifikowano do doustnego odczulania na mleko. Pierwszą dawkę OIT podano w SFO. Leczenie jest dalej kontynuowane w naszej Klinice, zgodnie z protokołem. Aktualnie chłopiec otrzymuje dawkę 160 mg białek mleka krowiego, z dobrą tolerancją. Objawów niepożądanych OIT dotychczas nie obserwowano. Dyskusja: Zgodnie z wytycznymi EAACI, OIT jest zalecane dla dzieci z przetrwałą IgE-zależną ABMK w wieku od około 4 do 5 lat, celem podwyższenia progu reaktywności klinicznej. Wskazaniem do OIT w ABMK są objawy anafilaksji u pacjentów z IgE-zależną ABMK, u których dieta eliminacyjna jest nieskuteczna, niechciana lub obniżająca jakość życia. Do tej pory unikanie alergenów odpowiedzialnych za wyzwalanie reakcji alergicznych było jedynym skutecznym sposobem leczenia ABMK u pacjentów, u których nie rozwija się naturalna tolerancja mleka. Warto podkreślić, że restrykcyjne unikanie ekspozycji na alergen nie zawsze jest możliwe i może prowadzić do zaburzeń odżywiania i narażać pacjenta na stały stres związany ryzykiem reakcji po przypadkowym spożyciu alergenu. Podsumowanie: OIT to obiecująca metoda leczenia alergii pokarmowej, odciążając pacjentów od stałego strachu przed nagłymi i poważnymi objawami po spożyciu „szkodliwego" pokarmu i niekończącą się walką o uniknięcie śladowych ilości tych pokarmów w życiu codziennym. [ABSTRACT FROM AUTHOR]

Introduction. Data on the importance of sensitization in atopic dermatitis (AD) is controversial. It is the question which AD is atopic disease. Aim. To analyze the impact of sensitization to aeroallergens in AD. Is there a similar pattern of sensitization in patients with AD, allergic rhinitis (AR) and asthma? Material and methods. We studied 4783 participants (29.46% 6-7 yo, 27.98% 13-14 yo, 22.73% adults) in 8 urban and 1 rural area. Allergologist diagnosed AD based on Hanifin-Rajka's criteria. Skin prick tests (SPT) was performed with the 15 most common aeroallergens. SPT was positive when the wheal was 3 - 5 mm, remarkable positive ≥ 6 mm. Results. AD was diagnosed in 6.5% of patients, asthma in 10.6%, AR in 28.9%. A positive SPT to at least one aeroallergen was in 45.8% (6-7 yrs 39.3% 48.6% 13-14 years of age, adults 48.2%). The most sensitizing were D. pteronyssinus (24.7%), D. farinea (21.6%) and grass/grain (22.3%). SPT was positive in 66.9% of patients with AD, 84.63% AR, 70.5% asthma. In patients with AD the most sensitizing were D. pteronyssinus (33.1%), D. farinea (33.2%) and grass/grain (30.6%). Sensitization to Cladosporium (OR 2.03), D. farinea (OR 2.0), cat (OR 2.01) and birch (OR 1.98) had the greatest impact on AD. Conclusions. We confirmed the high prevalence of sensitization to aeroallergens in patients with AD, although less than in AR and asthma. Sensitization to aeroallergens was a risk factor for AD. In the general population the greatest impact on the presence of AD was sensitization to Cladosporium, D. farinea, cat and birch. [ABSTRACT FROM AUTHOR]

Introduction. Elevated proliferative activity of mononuclear cells (MNCs) in peripheral blood of atopic patients may be associated with shorter cell survival. Aim. Assessment of the apoptosis of peripheral blood mononuclear cells (MNCs) from atopic patients before and during symptomatic pollen season as compared to non-atopic controls. Materials and methods. MNCs were obtained from 15 pollen-sensitive patients with seasonal rhinitis/asthma (SR/A) before and during the pollen season, and from 16 non-atopic controls. Apoptosis was assessed by fluorescent microscopy after staining with acridine orange and ethidium bromide, and confirmed by DNA fragmentation analysis. Both adherent and non-adherent MNCs were analysed. Results. Both before and during the pollen season, MNCs from pollen-sensitive patients, as compared to controls, demonstrated significantly enhanced spontaneous apoptosis at 24h, 48h and 72h of culture. MNCs isolated from atopic patients demonstrated also significantly enhanced ConA induced apoptosis as compared to non-atopic patients. During the pollen season in allergic patients, spontaneous apoptosis of MNCs and lymphocytes was significantly higher as compared with preseasonal values (p<0.05). Incubation of non-adherent MNCs with timothy allergen increased the cell apoptosis before the grass pollen season (on average by 33% at 48h), but significantly inhibited apoptosis of lymphocytes studied during the pollen season (on average by 27% at 48 h). Conclusion. Peripheral blood mononuclear cells from asymptomatic pollen-sensitive patients exhibit increased apoptosis, and this process is modulated by in vitro stimulation with specific allergen and by the exposure during natural pollen season. [ABSTRACT FROM AUTHOR]

Introduction. Granzyme B (GzmB) is mainly synthesized by cytotoxic T cells (CTL) and Natural Killer cells (NK), as well as by mast cells. Aim of the study. The aim of the study was to investigate granzyme B release from peripheral blood leukocytes in patients with hymenoptera venom allergy before and after ultra-rush immunotherapy. Material and methods. 9 patients allergic to wasp venom were recruited to the study, out of which 8 patients qualified for ultra-rush specific immunotherapy. Leukocytes were isolated from blood and stimulated with wasp venom allergen bee venom allergen and fMLP GzmB m supernatants after cell stimulation was determined by the method, ELISA. immunoenzymatic Results. One hour after clinical tolerance to the venom dose of 100 μg/ml was induced during rush immunotherapy, more than a 50% decrease in GzmB release was observed (non-significant). Stimulation with wasp venom did not change the mean GzmB concentration in supernatants. However, in some patients remarkable enhancement of GzmB release was noticed after stimulation with bee venom allergen at the concentration of 1 ug. Bee venom stimulation (non-specific allergen) increased the mean GzmB concentration both before and after immunotherapy. Conclusion. Granzyme B is released from peripheral blood leukocytes of patients with wasp venom allergy. Wasp venom and bee venom allergens may stimulate GzmB release in a non-specific way. [ABSTRACT FROM AUTHOR]

Introduction. Patients with generalized reactions to a hymenoptera sting require special medical attention due to the high-severity of reactions and the risk of death. Aim of the study. This study attempts to provide a clinical analysis of hymenoptera sting hypersensitivity with special regard to reaction dynamics occurring after the sting. Material and methods. 272 patients were enrolled in the study after being referred to allergology centre following hymenoptera stings. The analysis was based on data compiled using the Mueller questionnaire and on results of skin prick tests for inhaled allergens. Results. A generalised reaction to stings occurred in 242 patients (89%) and large local reaction in 30 patients (11%). The severity of the generalized reaction was not related to the sex or age of the patients, or to the insect type. Mueller grade IV symptoms occurred in 69 (28.5%) of the patients with a generalized reaction, including 25 patients (10.2%) suffering a loss of consciousness. In 20 patients (7.4%), a biphase reaction was observed - regression or mitigation of symptoms followed by their recurrence. No significant correlation was observed between reaction phasing and reaction severity, insect type, sex or age of the patient or atopic features. The results of the skin prick tests for inhaled allergens showed that out of 214 patients, 139 (65%) revealed a positive result to at least one allergen. Conclusions. The clinical pictures of allergic reactions to bee and wasp stings are similar and the presence of atopic features does not predispose to severe reaction to stings. Patients with a generalised reaction to a sting should be hospitalised, since 7.4% of them may have a biphase reaction. [ABSTRACT FROM AUTHOR]

P-phenylodiamine is a dye called "black henna". During the last few years the increase of allergy to this allergen is observed. The higher frequency of contact dermatitis diagnosis to corticosteroids topical drugs is also an alarming phenomenon. The authors present the case of a 9-year-old boy with tree pollen allergy diagnosis. Allergy to p-phenylodiamine complicated by allergy to topical corticosteroids was diagnosed only after a few-years treatment at specialist centers and after 4 hospitalizations. The patient is currently treated by allergen specific immunotherapy. [ABSTRACT FROM AUTHOR]

Allergy to soy is still a big diagnostic and therapeutic problem. It seems that this problem will not lose its significance in the coming years, because soy proteins, mainly due to their prevalence and unique amino acid composition, are still extremely popular in food production, processing and breeding. Allergy to soy is most often manifested clinically as gastrointestinal symptoms, but other ailments are not uncommon. Despite the availability of many diagnostic methods, the diagnosis of soy allergy is not easy. A double-blind placebo-controlled oral provocation test remains the gold standard. However, the future certainly belongs to the molecular methods that allow to assess the sensitivity to specific allergen components, which opens up new possibilities both in predicting the course of natural disease and its treatment, and also in identifying patients at the highest risk of severe anaphylactic reactions. [ABSTRACT FROM AUTHOR]

Commonness of citrus fruits as food products and additives for cosmetics and cleaning products contribute to the increase of the number of people suffering from citrus allergy. Citrus allergens can cause gastrointestinal, respiratory and skin symptoms. Citrus allergens are cross-reactive with many allergens from different sources. This makes diagnostics of citrus allergy problematical and determination of the allergen responsible for allergy symptoms is difficult. The purpose of this article is systematization of information available in literature on citrus allergens, clinical symptoms of citrus allergy, its diagnostics and diagnostics-related problems. [ABSTRACT FROM AUTHOR]

Peach allergy is particularly common in the Mediterranean countries, but in other parts of the Europe, including Poland, this is a growing problem. The main peach allergen is the non-specific, low molecular weight lipid transfer protein (LTP) Pru p 3, belonging to the prolamin superfamily, mainly found in the peach skin. The most common clinical manifestation of peach allergy is oral allergy syndrome (OAS), which occurs in 79% of peach allergic patients. The diagnostic gold standard in peach allergy remains the double blind placebo controlled food challenge (DBPCFC). The future lies with molecular diagnostics, which is becoming more and more popular nowadays. It enables precise determination of allergic components to which a patient is hypersensitive. It has crucial in predicting the patient's allergic disease's natural course, and is useful in identifying patients with higher risk of anaphylactic reactions. [ABSTRACT FROM AUTHOR]

Wstęp: Wiedza i praktyczne umiejętności rozpoznawania oraz leczenia anafilaksji stanowią kluczowy element kształcenia kadr medycznych z uwagi na powszechność tej jednostki chorobowej, a także krytycznie wąskie okno terapeutyczne. Cel: Głównym celem pracy była ocena studentów kierunków medycznych w obszarze wiedzy podstawowej oraz zasad postępowania w anafilaksji i wstrząsie anafilaktycznym. Celem dodatkowym było określenie samooceny badanej populacji w wyżej wymienionym zakresie. Materiał i metody: Badanie przeprowadzono na grupie 252 studentów Warszawskiego Uniwersytetu Medycznego z wykorzystaniem anonimowej ankiety internetowej utworzonej na potrzeby projektu. Wyniki: Zdecydowana większość uczestników badania poprawnie określiła definicję anafilaksji, jej potencjalne przyczyny i objawy (odpowiednio 86,5%, 75,4% i 100%). Podobnie większość studentów prawidłowo wskazała sekwencję postępowania w anafilaksji, a także lek pierwszego rzutu i drogę jego podania (kolejno 90,5%, 97,2% i 98%). Z drugiej strony, jedynie 12% uczestników uznało, że jest całkowicie pewna swoich umiejętności postępowania w anafilaksji, zaś aż 52% poważnie w nie wątpi. Zdecydowana większość badanych wskazała na konieczność zwiększenia liczby zajęć praktycznych w tym zakresie. Podsumowanie: Choć stan wiedzy teoretycznej studentów kierunków medycznych wydaje się pozostawać na wysokim poziomie, to uwagę zwraca konieczność zwiększenia w toku studiów nacisku na praktyczne umiejętności diagnozowania i leczenia anafilaksji. [ABSTRACT FROM AUTHOR]

Wstęp: Zespół Schwartza-Battera, określany inaczej jako SIADH (ang. syndrome of inappropriate antidiuretic hormone secretion), jest chorobą wywołaną niedakwatnym bądź ektopowym wydzielanem wazopresyny. Do przyczyn tego zespołu zalicza się między innymi choroby płuc, w tym ich zapalenie. Cel:Celem pracy jest przedstawienie przypadku 68-letniego chorego hospitalizowanego z powodu COVID-19 w Klinice Chorób Infekcyjnych i Alergologii WIM. Opis przypadku: Pacjent został przyjęty do Kliniki z powodu narastających objawów niewydolności oddechowej ze spadkami saturacji krwi tętniczej do 84% w przebiegu śródmiąższowego zapalenia płuc. Badanie genetyczne potwierdziło obecność SARS-CoV-2. W leczeniu zastosowano remdesiwir, deksametazon, osocze ozdrowieńców, enoksaparynę, tocylizumab, tlenoterapię bierną, a także antybiotykoterapię - początkowo ceftazydym, a następnie piperacylinę z tazobaktamem. Uzyskano poprawę stanu ogólnego, ustąpienie dolegliwości i normalizację wydolności oddechowej. Mimo suplementacji sodu utrzymywała się jednak hiponatremia, a ponadto wystąpiła poliuria do 10 litrów na dobę. Po przeprowadzeniu diagnostyki, w tym badań hormonalnych oraz jonowych krwi i moczu, rozpoznano zespół Schwartza-Battera i włączono skuteczne leczenie - hydrochlorotiazyd i indometacynę. Dyskusja: Wysokie stężenie cytokin prozapalnych oraz związana z nim hipoksja w przebiegu COVID-19 mogą prowadzić do nieadekwatnego wydzielania hormonu antydiuretycznego poprzez mechanizm nieosmotyczny. Dodatkowo wydaje się, że obniżony przepływ przez krążenie płucne może dodatkowo stymulować wydzielanie wazopresyny. Pewną rolę może odgrywać również związana ze stresem i napięciem emocjonalnym aktywacja osi podwzgórzowo-przysadkowej. [ABSTRACT FROM AUTHOR]