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Bronchial asthma is a chronic disease of the respiratory tract. Search for alternative to presently used therapies seems to be the way to obtain a better control of asthma. Heparin is an acidic mucopolysaccharide and in the past years there has been a number of reports on the role of heparin and low-molecular-weight heparin (LMWH) in chronic inflammatory disorders of the respiratory tract. Our aim was to estimate the effect of long-time LMWH nebulization on selected parameters in asthmatic patients. Twenty-four patients entered the study. All of them were subjected to bronchoscopy with BAL, in 8 patients this procedure was performed twice: before and after heparin treatment. After 14 days of treatment we observed an increase in FEV1 (from 73.93 +/- 14.14% (in % of nominal value) to 89.62 +/- 10.08% (p = 0.0049). Additionally we noted a decrease in the percentage of eosinophils and lymphocytes in BAL sediments, from 4.86 +/- 3.48% to 1.25 +/- 2.76%; p = 0.0006 and from 5.39 +/- 2.25% to 2.94 +/- 1.23%; p = 0.0209, respectively. This changes were paralleled by a drop of EG2 in BAL supernatant from 1.00 +/- 0.99 to 0.13 +/- 0.35, p = 0.0256. In blood serum level of histamine 0.74 +/- 0.77 to 0.1 +/- 0.22; p = 0.0493. We did not observe significant changes in IL-5, sVCAM-1 or ECP concentrations in serum. Also different LMWH dosing (5-10 kUIC anti-Xa b.i.d.) did not produce any dose-response effect. We conclude, that LMWH in nebulization can be a valuable add-on treatment in bronchial asthma, and its most likely mechanisms of action are: prevention of mast cell degranulation (histamine decrease), decreased eosinophil activation (lower EG2), and modification of inflammatory cells influx (decreased percentages of eosinophils and lymphocytes in BAL).

Classification of severity of bronchial asthma is a basic point for therapeutic management in adults. In the paper definitions of severe and difficult asthma are presented. The therapeutic possibilities are pointed according to new guidelines published in the recent period and own Author's clinical experience.

Unlabelled: The ARIA study demonstrates the correlation between bronchial asthma (BA) and perennial rhinitis (PR) with mite or animal fur allergies. There are no reports concerning correlation between BA and PR with mould allergy. The authors of this study estimated the prevalence of BA in patients with PR, allergic to moulds in comparison with patients allergic to other aeroallergens. 460 patients suffering from PR were investigated: 102 were allergic to moulds (mono- or multisensitization type) and 358 were allergic to other allergens. The prevalence of BA in mould-sensitive and insensitive patients was 70.6% and 43.6%, respectively; it was significantly higher in the mould-sensitive group (p = 0.004) regardless of the type of mould hypersensitivity (mono- or multisensitization). The higher prevalence of BA in mould-sensitive patients was found to be valid only for adults. The adult PR patients with diagnosed BA were most frequently allergic to Alternaria (47.1%) and Cladosporium (30.8%)., In Conclusion: mould allergy may be a risk factor for BA development.

Ampicillin belongs to the drugs causing most frequently IgE-dependent allergic reactions, but the current specificity of these reactions is poorly known. Some experimental data suggest that the side chain of ampicillin may induce synthesis of drug-specific IgE antibodies. In our study we have decided to explain the specificity of ampicillin-induced allergic reactions type I appearing in patients after drug administration. Thirty-eight subjects developing an immediate response after administration of ampicillin entered the study. In all the patients skin tests with penicillin, ampicillin and amoxicillin determinants were performed. We have observed positive skin tests results with penicillin determinants in 23 subjects, in 32 subjects with ampicillin and in 17 cases with amoxicillin. Only in three persons the results were positive exclusively to ampicillin. The results of our study indicate that in the Polish population ampicillin induces an immediate IgE response with variable degree of cross-reactivity to other tested drugs, and selective response to ampicillin is uncommon.

In this study we have decided to explore the diagnostic usefulness of CAST-ELISA test in patients with immediate allergic reactions caused by penicillin. Peripheral blood leukocytes were stimulated by commercially available penicillin allergens--Penicillin G, Benzyl-penicillin--Polylysine and specially performed Penicillin G conjugated to human serum albumin. Test was performed in 33 allergic persons and in 13 control healthy persons well tolerated penicillin antibiotics with negative skin tests results. CAST-ELISA test gave the positive results in 30.3% when unconjugated penicillin was used and in 18.18% with penicillin--polylysine. The best results were obtained when cells were stimulated with penicillin conjugated to human serum albumin--positive results were observed in 47.82%. Accumulate percentage of positive results was 73.91%. In our opinion CAST-ELISA test is reliable method in diagnosis of immediate allergic reactions caused by penicillin and inclusion of penicillin conjugated to human serum albumin seems to be justifiable.

Metals are known as a common cause of contact allergies. The prevalence of sensitisation to the composite metals makes for a potential risk of osteosynthesis complications in patients suffering from long bones fractures. In the study the prevalence of delayed allergy to nickel sulphate, potassium dichromate and cobalt was estimated as well as the relation to the osteosynthesis complications. The atopy prevalence was estimated too. Persons under examination were divided into 3 groups. I--treated with osteosynthesis without complications (n = 20), II--treated with osteosynthesis with synostosis complications (n = 16) and III--negative controls (n = 34). We estimated 5% prevalence of delayed allergy to nickel in group I, 6.25% in group II and 5.8% in group III. In patients exposed to chromium we observed delayed allergy prevalence of 5.8% in group I and 3% in group III. No allergy to chromium in group II was revealed. No allergy to cobalt in all groups was revealed. The prevalence of atopy in group II was rare (6.35%) when in group I it was 45% and in controls 32%. The more frequent occurrence of type IV allergy to metals in atopic patients was not confirmed. There was no difference between the prevalence of delayed allergy to metals in groups I and II. Only one case of secondary allergy to chromium was observed.

Asthma was known already in ancient times. International Consensus Report on Diagnosis and Management of Asthma published in 1993 gives its updated definition, classification and treatment, but pathomechanism and pathophysiological differences between atopic and non-atopic asthma remain unclear. Most commonly accepted is the inflammatory conception of asthma presented by Kay in 1983. Eosinophil, lymphocyte and their products seem to play an important role in allergic inflammation. A raise of interest toward adhesion molecules role has been observed lately.