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Unlabelled: The aim of the study was to assess the role of costimulatory molecules in pathogenesis of nonallergic bronchial asthma., Material: The studied group consisted of 30 patients with nonallergic asthma, 24 with nonallergic asthma and recurrent respiratory tract infections and 20 healthy controls., Results: In nonstimulated and lipopolysaccharide (LPS) stimulated cultures of control group the mean value of CD16+ + 56+ CD28+ subpopulation were significantly decreased compared to values in both types of asthma. Similar dependence was observed in cultures of asthmatic patients with infection and healthy person, stimulated with IL-15 and in CD4+CD28+, CD8 +CD28+ and NKCD28+ cultures from all studied groups, stimulated with LPS plus IL-15. In nonallergic asthma and infection asthma mean values of CD4 +CD152+ and CD16+ +CD56 +CD152+ from nonstimulated and IL-15 stimulated cultures were significantly increased compared to analogical values in control group., Conclusion: The results of our studies suggest that in nonallergic asthma the disturbed expression of costimulatory molecules may play an important role in pathomechanism of disease.

Chronic obstructive pulmonary disease (COPD) is considered one of the most common chronic diseases in the world. It is characterized by the progressive reduction of the respiratory parameters, relatively low effectiveness of recommended treatment as well as serious prognosis especially in the group of patients with advanced disease. The beta2-adrenergic receptor agonists are first-line therapeutics in the treatment of COPD patients. Due to their diverse pharmacokinetic characteristic beta2-mimetics are recommended both for regular or "rescue" treatment to prevent or to restrain dyspnea symptoms. This paper evaluates main differences between the mechanism of action and pharmacokinetic profile of the key beta2-mimetics, discusses consequences of those diversities for their the clinical application and potential side effects.

The aim of this study was to compare the effects of 6 months therapy with salmeterol or ipratropium bromide on lung function (resting and dynamic parameters), exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). In open, randomised study patients at visit 1 were included into trial, at visit 2 and, after 6 months therapy, at visit 3 lung function measured by a pressure body plethysmography, exercise tolerance was investigated by 6 minute walking test and dyspnoea was analysed by the means of Borg scale. We studied 24 patients (18 males, 6 females, range age 45-76 yrs, mean: 60.2+/-10.46) with stable COPD. 13 subjects (mean FEV1 = 63.61% predicted, SD = 15.66%) received salmeterol (2 x 50 microg/day) and 11 subjects (mean FEV1 = 62.52% predicted, SD = 12.39%) received ipratropium bromide (4 x 40 microg/day). There were no significant changes in lung function parameters (FEV1, VC, Rtot, TLC, RV and RV%TLC) after 6 months therapy with both drugs, but the treatment with salmeterol significantly improves exercise tolerance in 6 minute walking test (p=0.048) and Borg dyspnea ratings (p=0.008).

148 outpatients with asthma and COPD were treated with inhaled steroids and salmeterol. 48 patients were estimated after 30 days treatment and other 100, who accepted salmeterol after 1 year treating. In these two groups of patients inhalations of other beta-mimethics, dyspnoe during the nights and early mornings, change of FEV1, side effects and acceptation of salmeterol were observed. After 1 months of treatment in 45% and after 1 year in 73% increase of FEV1 were noticed. In asthma group in 66% and in 15% COPD patients increase of MEV50 was observed. After 30 days 22% asthma patients and 30% COPD patients did not accept salmeterol. 6 persons had adverse effects/tachycardia, sore throat, exacerbation of dyspnoe/. After 12 months 87% accepted treatment with salmeterol. In 13 cases therapy with salmeterol was stopped, because results were poor.

Evaluation of differential cell count and biochemical parameters in sputum seems to be a valuable method in asthma studies. The purpose of the paper was to evaluate the effects of sputum induction alone and after fenoterol and salmeterol premedication, on spirometry in asthma patients. The another aim of the study was to observe the correlation between bronchial hyperreactivity and decreases in FEV1 and MEF50 in asthmatics during sputum induction. The studies were carried out on 20 mild to moderate asthma patients (FEV1 baseline 79 +/- 16% of the predicted values) who inhaled an increasing concentration of hypertonic saline (3%, 4% and 5%), using an ultrasonic nebuliser. The forced expiratory volume in one second and MEF50, as the good indicators of bronchial obturation, were evaluated. During the sputum induction significant decreases in FEV1 and MEF50 were observed, which were proportional to the concentration of NaCl. After inhalation of 3% of NaCl the mean of FEV1 was 87.2 +/- 12.7% of the baseline, after 4%--84.3 +/- 16.9% and 5%--77.4 +/- 19.8%. No significant correlation between bronchial hyperreactivity and the induced decreases in FEV1 and MEF50 were found. Fenoterol and salmeterol fully prevented bronchial obturation during sputum induction.

The aim of the research was to show the influence of Salmeterol on the ventilatory parameters in patients with chronic obstructive pulmonary disease (bronchitis chronica spastica). In all the patients full lung function test was made with the MasterLab-Transfer of the firm Jaeger contains spirometry, flow-volume and airway resistance. The examination have shown that the average values off all analysed indices were higher in the particular examinations than in the initial one. Estimating these differences with the test "t Student" it has been demonstrated that referring to basic indices the differences were statistically essential. We can observe from the comparison of the obtained data that the growth of the indices took place in the substantial majority of patients.

The aim of this study was to assess an influence of 4-week treatment with salmeterol on quality of life in asthmatic patients. It was a double blind, placebo controlled study. On the first visit spirometer parameters and PC20H were measured. Within one week of observation all patients recorded scores of asthma symptoms and after that time 22 patients were randomised to the treatment with salmeterol or placebo. On the fourth visit 4-week salmeterol or placebo therapy was finished and all parameters were carried out as on the first visit. Symptoms severity recorded in diary cards was reduced after 4-week of salmeterol therapy. Four week treatment with salmeterol did not change PC20H. Treatment with salmeterol reduced severity of asthma symptoms and use of short-acting beta 2-agonists. The reduction of asthma severity and the use of bronchodilators was more pronounced in the group of patients treated with salmeterol than in the placebo group, but the differences were not significant.

The purpose of the study was to evaluate the efficacy of salmeterol in asthma therapy. The study was performed on a group of 16 allergic asthma patients sensitive to house dust mite allergens. After a run-in period the patients were treated with salmeterol, 2 x 50 micrograms, for a period of 12 weeks. They noted an intensity of asthma symptoms, morning and evening PEF, beta 2-agonist consumption and adverse in their diary cards. On the visit to the clinic spirometry was performed. During the treatment a significant reduction in the symptom score, PEF variation, beta-agonist consumption and an increase in the value of morning and evening PEF were noted. The above results indicate the great efficacy of salmeterol in asthma therapy.

The aim of the study was to compare bronchodilatating effect of inhaled salmeterol, salbutamol and both drugs administered simultaneously. 14 subjects (7 females, 7 men), aged 30-65 years (mean 49 yrs), suffering from moderate to severe asthma were examined. The improvement of FEV1 greater than 15% within 15 minutes of inhaling 200 micrograms of salbutamol was demanded. The study was performed in randomized, double-blinded, placebo controlled design. Throughout the study, all patients kept a daily score of symptoms and treatment. Each day of the trial, FEV1 in 30, 60, 120, 180 and 240 minute was measured. The statistically significant increase of FEV1 was noted only in 30 minute after salbutamol and in 180 minute after inhaling of salmeterol in comparison to salbutamol alone. No significant advantage of adding salbutamol to the patients previously treated with salmeterol was observed.

The effect of a single dose of salmeterol, long-term, regular treatment with salmeterol and a termination of the therapy on specific and non-specific bronchial reactivity were evaluated. The effect of the therapy on serum ECP level was studied too. The studies were carried out in a group of 16 mild asthmatics sensitive to mite allergens. Both types of bronchial challenges were performed according to Ryan's method. Blood samples to evaluate the ECP level were collected before treatment and on the day before the last day of the study. The single dose of 50 micrograms of salmeterol taken 3 hours before bronchial challenge significantly decreased the bronchial response to histamine (the average PC20FEV1 value increased about a four fold after salmeterol) and to the Dpt allergen (PD20FEV1 increased 3.5 fold). No effect of salmeterol on LAR was observed. Bronchial reactivity to histamine was significantly lower in the period of the therapy and did not differ from the baseline 12 hours after stopping the treatment. PD20FEV1 Dpt during the therapy was about 3 fold higher than the baseline but 36 hours after stopping the treatment did not differ from the baseline. Although the patients had inhaled a 3-fold higher dose of allergen to induce EAR, the frequency of LAR did not change. No anti-inflammatory effect of salmeterol was observed.

Clinical observations of disodium cromoglycate with salmeterol were analyzed in children with atopic bronchial asthma. The efficacy of the therapy were monitored by clinical score of symptom and values of PEF. Authors suggest that observed improvement in clinical score symptoms were caused by salmeterol.

Unlabelled: The aim of the study was to compare the influence of salmeterol xinofoate on blood hypodense eosinophil numbers ECP level in serum and sputum, and on lung function tests (VC, FEV1), bronchial hyperresponsiveness (PC20) Lung function tests (FEV1, VC), bronchial histamine challenge (PC20) and measurements of hypodense eosinophils number and ECP level in sputum and serum were done before two and six weeks after treatment with 50 micrograms salmeterol twice daily. Hypodense eosinophils were measured by Kuo et all, ECP by radioimmunosorbent assay using ECP RIA kit Pharmacia. Normal range of ECP is 2.3-15 micrograms/L Hyperreactivity by standard bronchial provocation techniques. The lung function tests (VC, FEV1, FEV1%VC) were measured with Pneumoscreen., Result: Eosinophil number decrease after treatment: 42.7 +/- 18.3 before vs 23.4 +/- 8.7 after. ECP level had decreased in serum 53 +/- 24 micrograms/L before and 32 +/- 12 micrograms/L after 2 weeks and 36 +/- 13 micrograms/L after 6 weeks: in sputum 2345 +/- 489 micrograms/g before and 1342 +/- 894 micrograms/g after 2 weeks 1741 micrograms/g after 6 weeks. Lung function tests had improved during the observation and hyperresponsiveness had decreased (0.08 +/- 0.1 microgram/ml before 0.24 +/- 0.2 microgram/ml after 2 week sand 0.4 +/- 0.16 after 6 weeks., Conclusion: ECP in serum and sputum in asthmatic patients is higher then in normal patients. Salmeterol improved lung function tests, decreased bronchial responsiveness, decreased hypodense eosinophils number and ECP concentration in serum and sputum., Clinical Implications: This date suggested that salmeterol modified bronchial responsiveness and protected the bronchial inflammation.

Patients treated for severe bronchial asthma often suffer from attacks of bronchoconstriction despite appropriate anti-inflammatory treatment. The aim of this study was to find out whether the use of salmeterol (Serevent) in this group of patients might significantly improve the course of asthma. Patients with a stable course of asthma for last 4 weeks prior to the start of study were included. All had been treated with inhaled corticosteroids and some had been on oral corticosteroids as well, but they had also needed either regular treatment with short-acting beta 2-agonists or had taken them "on demand", at least 4 puffs/24 h. One hundred and three patients were included in the study. Their ages ranged from 6 to 60 years (mean, 24 +/- 17.7); the mean duration of asthma was 11.7 +/- 7.7 years and they had been treated with corticosteroids for a mean period of 4.4 +/- 4.8 years. Addition of salmeterol to therapy produced a rapid significant improvement of all parameters investigated, which was gradual and reached its peak at the end of the fourth (last) week of treatment. All the parameters measured, symptom index, PEF and spirometry findings significantly improved in the course of treatment. After discontinuation of treatment, deterioration was observed, although even at two weeks the mean values of the parameters measured were significantly better compared to the pre-treatment findings. The study has demonstrated that a regular treatment with salmeterol in patients with serve bronchial asthma allows very good control of symptoms in most patients while spirometry findings return to normal. The beneficial effect of salmeterol can be observed many days after discontinuation, which might suggest certain anti-inflammatory effects of salmeterol in addition to its bronchorelaxant action.

10 children 8-16 years old (mean = 12.9) received at least 4 inhalations of short acting beta-2-mimetics and up to 100 mcg inhaled corticosteroids or/and 5 mg oral prednisone daily. Lung function test values indicated mild/severe asthma in these patients (PEFF 50-80%, FEV1 50-80%, FEV1/VC less or equal 60%). Reversibility of obstruction was at least 15% comparing to the initial values. After two weeks of this treatment resolution of dyspnoea in the night-time and significant decrease of dyspnoea in the day-time were observed. The best bronchodilatation effect was noticed in the third and fourth week of therapy. After discontinuation of Serevent significantly milder course of dyspnoea was observed.

The aim of the study was to compare the influence of salmeterol on lung function tests (VC, FEV1), bronchial hyperreactivity (PC20) and eosinophil cationic protein (ECP) level in serum and in sputum in 10 patients with COPD. FEV1 was less than or equal 70% of predicted values but greater than 0.6 L. FEV1%VC less or equal 60% (reversibility after 200 micrograms salbutamol between 5-15%. Patients were treated with 2 x 50 micrograms salmeterol for 16 weeks. Lung function test didn't change during the observation but hyperreactivity had decreased (0.08 + 0.1 microgram/ml before, 0.24 + 0.2 microgram/ml after 4 weeks and 0.4 + 0.16 microgram/ml after 16 weeks) ECP level had decreased in serum (53 +/- 24 micrograms/l before, 32 +/- 12 micrograms/l after 4 weeks and 36 +/- 13 micrograms/l after 16 weeks) and in sputum (2345 +/- 789 micrograms/g before 1342 +/- 894 micrograms/g after 4 weeks, 1742 mu 698 micrograms/g after 16 weeks). We concluded that salmeterol didn't change lung function test but decreased bronchial hyperreactivity and decreased ECP level in serum and sputum.