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Rheumatoid arthritis (RA) is a chronic, systemic inflammatory connective tissue disease affecting 0.5–1% of the general population. Interstitial lung disease (ILD) is a serious complication of RA, leads to a deterioration in the quality of life, increases the risk of hospitalization and premature death. The clinical course of RA-associated ILD (RA-ILD) varies from interstitial lesions involving little areas of the lung which do not lead to clinical symptoms, to progressive interstitial lesions that may lead to acute respiratory exacerbation, development of respiratory failure, and death. The main risk factor for the development of ILD in the course of RA, apart from older age and male sex, is the high activity of the underlying disease. Effective treatment of RA, aimed at the goal of remission, may therefore be a preventive method for the development of RA-ILD. Due to non-specific symptoms, the diagnosis of RA-ILD is often overlooked. Despite significant morbidity and increased risk of death due to RA-ILD, currently, we do not have any guidelines on the management of this clinical situation. Moreover, the problem is even more complicated due to the possibility of potential pneumotoxicity of many disease-modifying drugs and their unclear effectiveness regarding lung involvement in RA. Taken together, optimal management of a patient with RA-ILD is a clinical challenge. There is an urgent need to clarify several clinical aspects concerning the early diagnosis, monitoring, establishing indications for treatment, and choice of appropriate therapeutic management. In this work, we performed a scientific review of the current state of knowledge on RA-ILD and indicated the directions of future research needed aiming at improving patients’ care.

Introduction: Cough is one of the most frequent symptoms reported to pulmonologists. The role of bronchoscopy in the diagnostic work-up of chronic cough is not clearly defined. The aim of this study was to evaluate the utility of fiberoptic bronchoscopy (FOB) and additional testing of samples collected during FOB in the differential diagnosis of chronic cough in adults. Material and methods: This was a single-center retrospective study. Out of 7115 conventional white light FOB examinations, we finally selected 198 with cough as the only indication. Results: In 40.9% of bronchoscopic examinations, no visible cause of cough was found. Visual signs of chronic bronchitis (CB) were detected in 57.6% of reports. Only in 3 cases (1.5%) bronchoscopy revealed a potential cause of chronic cough other than CB. Mycobacterium tuberculosis or other mycobacteria were spotted in none of the samples. In 91.1% of bronchoalveolar lavage (BAL) cytologic examinations, at least one cell count abnormality was detected, but only in case of increased percentage of eosinophils, it might be considered clinically relevant. In 53% of bacteriological culture results, at least one potentially pathogenic bacterium was isolated. Conclusions: The present study results strengthen the evidence that FOB combined with additional testing of airway specimens obtained during FOB is not a powerful tool in the differential diagnosis of chronic cough, and FOB as a diagnostic tool may be overused. The appropriate timing and decision regarding referral for FOB and additional testing of achieved material requires careful clinical consideration.

Traditional finance explains all human activity on the ground of rationality and suggests all decisions are rational because all current information is reflected in the prices of goods. Unfortunately, the development of information technology and a growth of demand for new, attractive possibilities of investment caused the process of searching new, unique signals supporting investment decisions. Such a situation is similar to risk-taking, so it must elicit the emotional reactions of individual traders.The paper aims to verify the question that the market risk may be the determinant of traders’ emotions, and if volatility is a useful tool during the investment process as the measure of traders’ optimism, similarly to Majewski’s work (2019). Likewise, various econometric types of models of estimation of the risk parameter were used in the research: classical linear using OLS, general linear using FGLS, and GARCH(p, q) models using maximum likelihood method. Hypotheses were verified using the data collected from the most popular world stock exchanges: New York, Frankfurt, Tokyo, and London. Data concerned stock exchange indexes such as SP500, DAX, Nikkei, and UK100.

Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic fibrosing interstitial pneumonia that has an unknown etiology. The natural history of the disease is characterized by a progressive decline in pulmonary function and overall health and well-being. The median survival time is between 2–3 years; however, the disease course is variable and unpredictable. The twelve-minute walking test (12MWT) and six-minute walking test (6MWT) are two fixed time tests that are commonly used in clinical practice. Our short and clinically oriented narrative review attempted to summarize current evidence supporting the use of fixed time, self-paced walking tests in predicting the outcome of patients diagnosed with IPF. A number of studies have justified that the 6MWT is a simple, cost-effective, well documented, fixed time, and self-paced walking test which is a valid and reliable measure of disease status and can also be used as a prognostic tool in patients with IPF. However, there is a need for dedicated and validated reference equations for this population of patients. It is also necessary to fill the knowledge gap about the role of the 12MWT. We hypothesize that it would be useful in evaluating patients that are in the early stages of the disease.

Introduction: Currently, only two drugs have been shown to modify the inevitable natural history of idiopathic pulmonary fibrosis (IPF). Changes in the reimbursement policy for antifibrotic drugs in Poland have led to the availability of pirfenidone from January 2017 and nintedanib from March 2018 for the treatment of Polish patients with IPF. This study aimed to evaluate the possible changes and shortcomings in the clinical practice standards in IPF in the era of access to antifibrotic therapy in Poland. Material and methods: A real-world data survey was performed among physicians attending the Polish Respiratory Society Congress held in May 2018. The present survey was a follow-up to the previous survey undertaken in 2016, before the availability of antifibrotics in Poland. Results: A total of 99 physicians participated in the survey, among which 80% were pulmonologists. The majority of participants (83%) represented hospital-based clinicians and most of them (93%) were involved in interstitial lung diseases (ILD) management. As many as 63% of the respondents elaborate the final diagnosis of IPF working with the expert radiologist routinely, 47% do that in the cooperation with other pulmonologists, and if a biopsy was performed 39% discuss its results with the expert pathologist. Bronchoalveolar lavage (BAL) and surgical lung biopsy (SLB) would never be recommended in the differential diagnosis of IPF by 9% and 16% of the respondents, respectively. Corticosteroids (CS) or a combination of CS and immunosuppressants (IS) is still recommended by 22% of participants. Proton pump inhibitors (PPI) in the case of symptomatic GERD are prescribed by 44% of the respondents, and 12% prescribe PPI regardless of GERD symptoms. Pirfenidone is used by 70%, and nintedanib by 48% of the respondents. Only 39% of the respondents refer patients with IPF to professional rehabilitation centers. Conclusions: The level of cooperation between pulmonologists and other specialists in the diagnostic workup of IPF is unsatisfactory. IPF treatment practices in the era of access to effective drugs in Poland require immediate improvement. There is an urgent need to develop the local Polish practical Guideliness to improve the management of IPF.

Background Several registries of idiopathic pulmonary fibrosis (IPF) have been established to better understand its natural history, though their size and duration of follow-up are limited. Here, we describe the large European MultiPartner IPF Registry (EMPIRE) and validate predictors of long-term survival in IPF. Methods the multinational prospective EMPIRE registry enrolled IPF patients from 48 sites in 10 Central and Eastern European countries since 2014. Survival from IPF diagnosis until death was estimated, accounting for left-truncation. the Cox proportional hazards regression model was used to estimate adjusted hazard ratios (HR) of death for prognostic factors, using restricted cubic splines to fit continuous factors. Results the cohort included 1620 patients (mean age at diagnosis 67.6 years, 71% male, 63% smoking history), including 75% enrolled within 6 months of diagnosis. Median survival was 4.5 years, with 45% surviving 5 years post-diagnosis. Compared with GAP stage I, mortality was higher with GAP stages II (HR 2.9; 95% CI: 2.3-3.7) and III (HR 4.0; 95% CI: 2.8-5.7) while, with redefined cut-offs, the corresponding HRs were 2.7 (95% CI: 1.8-4.0) and 5.8 (95% CI: 4.0-8.3) respectively. Mortality was higher with concurrent pulmonary hypertension (HR 2.0; 95% CI: 1.5-2.9) and lung cancer (HR 2.6; 95% CI: 1.3-4.9). Conclusions EMPIRE, one of the largest long-term registries of patients with IPF, provides a more accurate confirmation of prognostic factors and co-morbidities on longer term five-year mortality. It also suggests that some fine-tuning of the indices for mortality may provide a more accurate long-term prognostic profile for these patients., Boehringer IngelheimBoehringer Ingelheim, The EMPIRE registry is supported by a grant from Boehringer Ingelheim (since 2014). the sponsor did not have any involvement in the collection, analysis, and interpretation of the data or in the writing of or commenting on this manuscript

Idiopathic pulmonary fibrosis (IPF) is a progressive and inevitably fatal disease with a heterogeneous clinical course. This study aimed to evaluate the usefulness of circulating biomarkers in routine IPF clinical practice. We conducted an exploratory study in a cohort of 28 IPF subjects qualified for anti-fibrotic therapy with up to 24 months serial measurements of seven IPF biomarkers, including those that are well-established, Krebs von den Lungen-6 (KL-6), surfactant protein D (SP-D), matrix metalloproteinase 7 (MMP-7), and more recently introduced ones, cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA-125), chemokine (C-C motif) ligand 18 (CCL18), and periostin. Among studied biomarkers, SP-D had the highest diagnostic accuracy to differentiate IPF subjects from controls, followed by MMP-7 and KL-6. At each study timepoint, KL-6 levels correlated inversely with forced vital capacity % predicted (FVC% pred.), and transfer factor of the lung for carbon monoxide % predicted (TL,CO% pred.), while SP-D levels correlated inversely with FVC% pred. and TL,CO% pred. at 24 months of anti-fibrotic therapy. Baseline KL-6 and CA19-9 concentrations were significantly elevated in patients with progressive disease in comparison to patients with stable disease. In addition, in the progressors subgroup CA19-9 concentrations significantly increased over the second year of study follow-up. In patients with progressive disease, we observed a significant inverse correlation between a change in SP-D levels and a change in FVC% pred. in the first year of treatment, whereas in the second year a significant inverse correlation between a change in KL-6 levels and a change in FVC% pred. was noted. Our study findings support the view that both well-established IPF biomarkers, including KL-6, SP-D, and MMP-7, and more recently introduced ones, like CA19-9, have the potential to support clinical practice in IPF.

Background COPD has been regarded as a global epidemic due to an increase in pollution and tobacco exposure. Therefore, the study of molecular mechanism as the basis for modern therapy is important. Objective The aim of the study was the assessment of gene expression levels, IL-6, IL-6ST, PIAS3, STAT3, and miRNAs, miR-1, miR-106b, miR-155, in patients with COPD. Methods Induced sputum as well as PBMC were collected from 40 patients clinically verified according to the GOLD 2017 (A-D) classification and from the control group (n = 20). The levels of gene and miRNA expression were analysed by qPCR. Results Statistically significant differences between the study group vs. control group were observed for IL-6 (P = 0.008, Mann-Whitney U test), and miR-155 (P = 0.03, Mann-Whitney U test). There were statistically significant differences between patients: current smokers vs. ex- smokers for STAT3, (P = 0.04, Mann-Whitney U test) and miR-155 (P = 0.03, Mann-Whitney U test) with a higher expression in current smokers. Conclusions Differences in gene expression levels of the IL-6 / gp130 / STAT3 pathway and miRNA depending on the smoking status and classification of patients according to GOLD suggest the importance of these genes in the pathogenesis of COPD and may indicate their potential utility in monitoring the course of the disease.

Interstitial lung diseases (ILDs) are a diverse group of disorders, which differ significantly with respect to aetiopathogenesis, clinical, radiological, and pathological picture. Idiopathic pulmonary fibrosis (IPF) and sarcoidosis represent two distinctive examples of ILDs [1]., Proximity extension assay proves feasible for multiplex analysis of proteins in bronchoalveolar lavage. Small exploratory study found multiple inflammatory proteins that differed between patients with sarcoidosis and idiopathic pulmonary fibrosis. https://bit.ly/3nW14nF

COPD has been regarded as a global epidemic due to an increase in pollution and tobacco exposure. Therefore, the study of molecular mechanism as the basis for modern therapy is important. The aim of the study was the assessment of gene expression levels, IL-6, IL-6ST, PIAS3, STAT3, and miRNAs, miRNA-1, miRNA-106b, miRNA-155, in patients with COPD. Induced sputum as well as PBMC were collected from 40 patients clinically verified according to the GOLD 2021 (A–D) classification and from the control group (n = 20). The levels of gene and miRNA expression were analysed by qPCR. In induced sputum IL6 was significantly down-regulated in COPD group compared with control (p = 0.0008), while IL6ST were up-regulated (p = 0.05). The results were also statistically significant for STAT3 (p = 0.04) and miRNA-155 (p = 0.03) with higher expression in the current smokers compared to ex-smokers. Higher expression levels for IL6ST (p = 0.03) in COPD patients with the exacerbation history compared to COPD patients without the exacerbation history were noted. Compared induced sputum and PB lymphocytes we observed higher expression of IL6 (p = 0.0003), STAT3 (p = 0.000001) miRNA-106b (p = 0.000069 and miRNA-155 (p = 0.000016) in induced sputum with lower expression of PIAS3 (p = 0.006), IL6ST (p = 0.002) and miRNA-1 (p = 0.001). Differences in gene expression levels of the IL-6/IL6ST/STAT3 pathway and miRNA depending on the smoking status and classification of patients according to GOLD suggest the importance of these genes in the pathogenesis of COPD and may indicate their potential utility in monitoring the course of the disease.

Objective There is controversy regarding the significance of radiological consolidation in the context of COPD exacerbation (eCOPD). While some studies into eCOPD exclude these cases, consolidation is a common feature of eCOPD admissions in real practice. This study aims to address the question of whether consolidation in eCOPD is a distinct clinical phenotype with implications for management decisions and outcomes. Patients and Methods The European COPD Audit was carried out in 384 hospitals from 13 European countries between 2010 and 2011 to analyze guideline adherence in eCOPD. In this analysis, admissions were split according to the presence or not of consolidation on the admission chest radiograph. Groups were compared in terms of clinical and epidemiological features, existing treatment, clinical care utilized and mortality. Results 14,111 cases were included comprising 2,714 (19.2%) with consolidation and 11,397 (80.8%) without. The risk of radiographic consolidation increased with age, female gender, cardiovascular diseases, having had two or more admissions in the previous year, and sputum color change. Previous treatment with inhaled steroids was not associated. Patients with radiographic consolidation were significantly more likely to receive antibiotics, oxygen and non-invasive ventilation during the admission and had a lower survival from admission to 90-day follow-up. Conclusions Patients admitted for COPD exacerbation who have radiological consolidation have a more severe illness course, are treated more intensively by clinicians and have a poorer prognosis. We recommend that these patients be considered a distinct subset in COPD exacerbation.

Air pollution is a major environmental risk to health and a global public health concern. In 2016, according to the World Health Organization (WHO), ambient air pollution in cities and rural areas was estimated to cause 4.2 million premature deaths. It is estimated that around 91% of the world’s population lives in places where air pollution exceeds the limits recommended by the WHO. Sources of air pollution are multiple and context-specific. Air pollution exposures are established risk factors for development and adverse health outcomes in many respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), or lung cancer. However, possible associations between air pollution and idiopathic pulmonary fibrosis (IPF) have not been adequately studied and air pollution seems to be an underrecognized risk factor for IPF. This narrative review describes potential mechanisms triggered by ambient air pollution and their possible roles in the initiation of the pathogenic process and adverse health effects in IPF. Additionally, we summarize the most current research evidence from the clinical studies supporting links between air pollution and IPF.

Introduction and Aim: Sarcoidosis is widely considered to be a disease with dominant Th1 response. However, results of several recent studies suggested similar prevalence of Th2-dominant allergic diseases in patients with sarcoidosis and general population. The aim of our study was to assess the occurrence of atopic disorders in patients with sarcoidosis and compare it with local population. Material and Methods: We created a questionnaire focusing on sarcoidosis and allergy and surveyed all adults treated for sarcoidosis in our tertiary pulmonary clinic. We combined the results with our medical records to create a comprehensive database for statistical analysis. We compared the results with previously published local data of the ECAP study (Epidemiology of the Allergic Diseases in Poland). Results: Among 329 adults who answered the survey, 114 (34%) reported at least 1 allergic disease. Asthma, atopic dermatitis and food allergy rates were similar to those of local population reported in epidemiological data (11,9% vs 9%, 2,7% vs 4% and 4,9% vs 5,0%, respectively). Urticaria was more frequent in sarcoidosis patients (15,5% vs 8%) and allergic rhinitis was nearly 3 times less common (11,5 vs 30%). Interestingly, within surveyed group, asthmatics reported more severe sarcoidosis symptoms and all patients with atopic diseases were more likely to report seasonal fluctuations in their perception of sarcoidosis symptoms, compared to those with no allergic disorders (23% vs 7%, respectively, p Conclusions: Prevalence of allergy among sarcoidosis patients is lower than in general population, but patients with allergic diseases tend be more symptomatic and perceive their sarcoidosis as more severe.

Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPDs) are one of the most important clinical aspects of the disease, and when requiring hospital admission, they significantly contribute to mortality among COPD patients. Our aim was to assess the role of eosinopenia and neutrophil-to-lymphocyte count (NLR) as markers of in-hospital mortality and length of hospitalization (LoH) among patients with ECOPD requiring hospitalization. We included 275 patients. Eosinopenia was associated with in-hospital deaths only when coexisted with lymphocytopenia, with the specificity of 84.4% (95% CI 79.6–88.6%) and the sensitivity of 100% (95% CI 35.9–100%). Also, survivors presented longer LoH (P

Background Pirfenidone is an antifibrotic agent approved for the treatment of idiopathic pulmonary fibrosis (IPF). The drug is available for Polish patients with IPF since 2017. The PolExPIR study aimed to describe the real-world data (RWD) on the Polish experience of pirfenidone therapy in IPF with respect to safety and efficacy profiles. Methods This was a multicentre, retrospective, observational study collecting clinical data of patients with IPF receiving pirfenidone from January 2017 to September 2019 across 10 specialized pulmonary centres in Poland. Data collection included baseline characteristics, pulmonary function tests (PFTs) results and six-minute walk test (6MWT). Longitudinal data on PFTs, 6MWT, adverse drug reactions (ADRs), treatment persistence, and survival were also collected up to 24 months post-inclusion. Results A total of 307 patients receiving pirfenidone were identified for analysis. The mean age was 68.83 (8.13) years and 77% were males. The median time from the first symptoms to IPF diagnosis was 15.5 (9.75–30) months and from diagnosis to start of pirfenidone treatment was 6 (2–23) months. Patients were followed on treatment for a median of 17 (12–22.75) months. Seventy-four patients (24.1%) required dose adjustments and 35 (11.4%) were chronically treated with different than the full recommended dose. A total of 141 patients (45.92%) discontinued therapy due to different reasons including ADRs (16.61%), death (8.79%), disease progression (6.51%), patient’s own request (5.54%), neoplastic disease (3.91%) and lung transplantation (0.33%). Over up to 24 months of follow-up, the pulmonary function remained largely stable. The median annual decline in forced vital capacity (FVC) during the first year of pirfenidone therapy was −20 ml (−200–100) and during the second year was −120 ml (−340–30). Over a study period, 33 patients (10.75%) died. Conclusions The PolExPIR study is a source of longitudinal RWD on pirfenidone therapy in the Polish cohort of patients with IPF supporting its long-term acceptable safety and efficacy profiles and reinforce findings from the previous randomised clinical trials and observational studies.

Introduction: This document presents the Guideliness of the Polish Respiratory Society (PTChP, Polskie Towarzystwo Chorób Płuc) for diagnosis and treatment of idiopathic pulmonary fibrosis (IPF), developed by agroup of Polish experts. Material and methods: The recommendations were developed in the form of answers to previously formulated questions concer-ning everyday diagnostic and therapeutic challenges. They were developed based on acurrent literature review using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Results: We formulated 28 recommendations for diagnosis (8), pharmacological treatment (12) as well as non-pharma-cological and palliative therapy (8). The experts suggest that surgical lung biopsy (SLB) not be performed in patients with the probable usual interstitial pneumonia (UIP) pattern, with an appropriate clinical context and unanimous opinion of a multidisciplinary team. The experts recommend using antifibrotic agents in IPF patients and suggest their use irrespective of the degree of functional impairment. As regards non-pharmacological and palliative treatment, strong re-commendations were formulated regarding pulmonary rehabilitation, oxygen therapy (in patients with chronic respiratory failure), preventive vaccinations as well as referring IPF patients to transplant centres. Table 1 presents an aggregate list of recommendations. Conclusions: The Polish Respiratory Society Working Group developed Guideliness for IPF diagnosis and treatment.

Background Interleukin(IL)-33 is an epithelial alarmin important for eosinophil maturation, activation and survival. The aim of this study was to examine the association between IL-33, its receptor expression and airway eosinophilic inflammation in non-atopic COPD. Methods IL-33 concentrations were measured in exhaled breath condensate (EBC) collected from healthy non-smokers, asthmatics and non-atopic COPD subjects using ELISA. Serum and sputum samples were collected from healthy non-smokers, healthy smokers and non-atopic COPD patients. Based on sputum eosinophil count, COPD subjects were divided into subgroups with airway eosinophilic inflammation (sputum eosinophils > 3%) or without (sputum eosinophils ≤3%). IL-33 and soluble form of IL-33 receptor (sST2) protein concentrations were measured in serum and sputum supernatants using ELISA. ST2 mRNA expression was measured in peripheral mononuclear cells and sputum cells by qPCR. Hemopoietic progenitor cells (HPC) expressing ST2 and intracellular IL-5 were enumerated in blood and induced sputum by means of flow cytometry. Results IL-33 levels in EBC were increased in COPD patients to a similar extent as in asthma and correlated with blood eosinophil count. Furthermore, serum and sputum IL-33 levels were higher in COPD subjects with sputum eosinophilia than in those with a sputum eosinophil count ≤3% (p

Sebastian Majewski,1,2 Anna Pietrzak,3 Damian Tworek,4 Karolina Szewczyk,5 Anna Kumor-Kisielewska,1 Zofia Kurmanowska,5 Paweł Górski,1,2 Anna Zalewska-Janowska,3,* Wojciech Jerzy Piotrowski1,2,* 1Department of Pneumology and Allergy, Medical University of Lodz, Lodz, Poland; 2Healthy Ageing Research Centre (HARC), Lodz, Poland; 3Department of Psychodermatology, Medical University of Lodz, Lodz, Poland; 4Department of General and Oncological Pulmonology, Medical University of Lodz, Lodz, Poland; 5Department of Molecular Bases of Medicine, Medical University of Lodz, Lodz, Poland *These authors contributed equally to this work Background: The systemic (extrapulmonary) effects and comorbidities of chronic obstructive pulmonary disease (COPD) contribute substantially to its burden. The supposed link between COPD and its systemic effects on distal organs could be due to the low-grade systemic inflammation. The aim of this study was to investigate whether the systemic inflammation may influence the skin condition in COPD patients. Materials and methods: Forty patients with confirmed diagnosis of COPD and a control group consisting of 30 healthy smokers and 20 healthy never-smokers were studied. Transepidermal water loss, stratum corneum hydration, skin sebum content, melanin index, erythema index, and skin temperature were measured with worldwide-acknowledged biophysical measuring methods at the volar forearm of all participants using a multifunctional skin physiology monitor. Biomarkers of systemic inflammation, including high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α), were measured in serum using commercially available enzyme-linked immunosorbent assays. Results: There were significant differences between COPD patients and healthy never-smokers in skin temperature, melanin index, sebum content, and hydration level (P

Background: Recently, epithelial alarmins have been shown to play important roles in non-allergen driven respiratory diseases like idiopathic pulmonary fibrosis (IPF). Little is known about the expression of the epithelial alarmins in IPF. Methods: This study aimed to prospectively examine interleukin (IL)-25, IL-33, and thymic stromal lymphopoietin (TSLP) levels in the serum and exhaled breath condensate (EBC) in patients with IPF before and after one-year of antifibrotic treatment. A total of 82 volunteers, including 52 patients diagnosed with IPF that qualified for antifibrotic therapy as well as 30 controls, were examined. All study participants underwent baseline peripheral blood and EBC sampling. In 35 out of 52 IPF subjects, a follow-up sampling was performed after 12 months of antifibrotic treatment. Concentrations of alarmins in the serum and EBC were evaluated by means of ELISA. Results: Baseline TSLP concentrations were significantly elevated in patients with IPF compared to controls both in the serum (p &lt, 0.05) and EBC (p &lt, 0.0001). Baseline IL-25 and IL-33 serum and EBC levels did not differ significantly between IPF subjects and controls. Prospective analysis of changes in the epithelial alarmin levels showed significantly decreased IL-25 and TSLP EBC concentrations after 12 months of antifibrotic treatment (p &lt, 0.05), which was observed in the subgroup of IPF patients treated with pirfenidone, but not in those treated with nintedanib. In stable patients with IPF over a study period (absolute forced vital capacity (FVC) % of predicted decline/year &le, 5%, n = 25), a significant decrease in the EBC levels of both IL-25 and TSLP after 12 months of antifibrotic treatment was noted (p &lt, 0.05), whereas, in progressor IPF patients (absolute FVC % of predicted decline/year &gt, 5%, n = 10), a significant decrease was noted in the IL-25 EBC levels only (p &lt, 0.05). Conclusions: Elevated TSLP levels in patients with IPF and their significant decrease in the lung compartment during antifibrotic therapy in stable patients with IPF, but not in progressors, support its significant contribution to pro-fibrotic type 2 immune responses in IPF. Noted changes in the epithelial alarmins concentration in the lung compartment during pirfenidone therapy may suggest its possible interaction with epithelial alarmins pathways in IPF.

Sebastian Majewski,1 Damian Tworek,2 Karolina Szewczyk,1 Justyna Kiszałkiewicz,3 Zofia Kurmanowska,1 Ewa Brzeziańska-Lasota,3 Hanna Jerczyńska,4 Adam Antczak,2 Wojciech Jerzy Piotrowski,1 Paweł Górski11Department of Pneumology and Allergy, Medical University of Lodz, Lodz, Poland; 2Department of General and Oncological Pulmonology, Medical University of Lodz, Lodz, Poland; 3Department of Molecular Bases of Medicine, Medical University of Lodz, Lodz, Poland; 4Central Scientific Laboratory (CoreLab), Medical University of Lodz, Lodz, PolandBackground: Despite the absence of endogenous chitin in humans, chitinases are present in the serum of healthy subjects and their levels are increased in a variety of chronic inflammatory conditions. It has been shown that chitotriosidase and structurally related chitinase-like protein-YKL-40 contribute to the pathogenesis of COPD. However, details regarding the relation of their systemic and local airways levels remain unknown.Objectives: To examine peripheral blood and sputum chitotriosidase and YKL-40 expression in smokers and patients with COPD.Methods: Forty patients with COPD, 20 healthy smokers and 10 healthy never-smokers were studied. Serum and induced sputum chitotriosidase protein and activity levels, YKL-40 concentrations, and their gene expression in sputum cells and peripheral blood mononuclear cells (PBMC) were evaluated.Results: Both chitotriosidase protein levels and activity were higher in sputum obtained from COPD subjects compared to healthy never-smokers (P

INTRODUCTION Interleukin (IL)-25, IL-33 and thymic stromal lymphopoietin (TSLP) are epithelial alarmins involved in innate immune responses and have been shown to play an important role in chronic lung diseases. No data are available regarding their levels in exhaled breath condensate (EBC) in idiopathic pulmonary fibrosis (IPF). OBJECTIVES To examine IL-25, IL-33 and TSLP levels in the EBC obtained from patients with IPF and compare them to those in healthy controls, patients with asthma and chronic obstructive pulmonary disease (COPD). METHODS Twenty-three patients with asthma, 25 patients with COPD, 15 patients with IPF and 16 healthy controls were studied. Concentrations of alarmins in the EBC were evaluated by means of ELISA. RESULTS IL-25 EBC levels were numerically lowest in IPF (25.33 ± 8.84 pg/ml). However, they did not differ significantly from healthy subjects (43.18 ± 5.53 pg/ml), but were significantly lower compared to asthma (72.07 ± 6.03 pg/ml; P

Background Cardiovascular diseases play an important role in the morbidity and mortality of patients with obstructive lung diseases. Impaired vascular endothelial function seems to be a key element linking obstructive lung disease and cardiovascular disease. Recently developed technique named flow mediated skin fluorescence (FMSF) is a novel, non-invasive tool to study microvascular function. Methods Total of 69 volunteers including 26 patients with chronic obstructive pulmonary disease (COPD), 23 patients with asthma and 20 healthy subjects underwent microvascular function assessments using FMSF. FMSF assessments were composed of measurements of reduced form of nicotinamide adenine dinucleotide (NADH) fluorescence intensity signal during brachial artery occlusion – ischemic response (IRmax) and immediately after release of occlusion – hyperemic response (HRmax). Associations of microvascular function with clinical and biochemical characteristics of studied subjects were also evaluated. Results The median value of IRmax was significantly lower in COPD subjects (2.4 [1.0–6.7] %) compared with healthy subjects (9.6 [3.7–13.5] %; p Conclusions The FMSF technique makes it possible to identify impairments of the microvascular function in patients with COPD, but not in asthma patients. These exploratory findings require further validation in a larger patients cohort.

Pulmonary hypertension (PHTN) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance, which eventually leads to right ventricular failure and death. At present there is no cure for pulmonary arterial hypertension (PAH); however over the past decade targeted pharmaceutical options have become available for the treatment of PAH. Prior to evaluation for therapeutic options a definitive diagnosis of pulmonary arterial hypertension must be made via comprehensive physical exam and definitive diagnostic testing. Screening test of choice remains echocardiography and gold standard for definitive diagnosis is right heart catheterization. Once the establishment of a diagnosis of PAH is made therapeutic options may be a possibility based on a diagnostic algorithm and disease severity of the PAH patient. There are different classes of medications available with different mechanisms of actions which net a vasodilatory effect and improve exercise tolerance, quality of life as well and survival.

Inflammatory phenotype classification using induced sputum appears attractive as it can be applied to inflammation-based management of the patients with asthma. The aim of the study was to determine the reproducibility of inflammatory phenotype over time in patients with asthma. In 66 adults asthma was categorized as steroid-naïve (SN,n=17), mild to moderate (MMA,n=33), and refractory treated with oral corticosteroids (RA,n=16). Clinical assessment, skin prick testing, spirometry, and two sputum inductions in 4–6-week interval were done. Inflammatory phenotypes were classified as eosinophilic (EA), consisting of eosinophilic and mixed granulocytic phenotypes, and noneosinophilic (NEA) consisting of paucigranulocytic and neutrophilic phenotypes. During study asthma treatment remained constant. In SN group 25% of patients changed phenotype from EA to NEA and 44% changed phenotype from NEA to EA. In MMA group 26% of patients changed phenotype from EA to NEA and 50% changed phenotype from NEA to EA. In 29% of RA patients inflammatory phenotype changed from EA to NEA and in 22% it changed from NEA to EA. Inflammatory classification, using induced sputum, is not fully reproducible in adults with asthma in short-term evaluation. EA seems to be more stable phenotype across all subgroups whereas NEA remained stable only in RA group.

Most patients with IPF have comorbidities, which affect functional status, quality of life and survival. Our study aims are to analyze comorbidities in a series of 1210 IPF patients from the EMPIRE registry (European Multipartner IPF registry). Comorbidities were noted in 85.6% (1036pts), one in 23.5%, 2 in 23.0% and 3 or more in 53.5%. Median age at diagnosis was 67.2 years (range 50.0-82.2). Male to female ratio 68.8%:31.2%. The most frequent were cardiovascular diseases 68.1% (824pts), significantly more than in general population (GP) of similar age. Most common comorbidities were arterial hypertension 52.2% (632pts), diabetes 20.7% (251pts), coronary disease 20.1% (243pts), hyperlipidaemia 18.0% (218pts), GERD 14.0% (169pts), osteoporosis 11.6% (135pts), arrhythmias 8.8% (106pts), prostatic hypertrophy 10.3% of males (86pts), thyroid diseases 6.1% (74pts), pulmonary hypertension 5.3% (64pts), COPD 5.2% (63pts), depression 4.4% (53pts), asthma 3.3% (40pts), nephropathy 2.6% (31pts) etc. Sleep breathing disorder was registered in 1.0% (12pts), lung cancer 0.4% (5pts) and tuberculosis in 1.4% (17pts). The prevalence of arterial hypertension, coronary disease, arrhythmias, pulmonary hypertension, diabetes, osteoporosis, thyroid diseases and lung cancer was much higher than in European GP, as well as tuberculosis, while the prevalence of COPD, sleep breathing disorder, asthma, nephropathy, hyperlipidaemia, prostatic hypertrophy and depression was strikingly lower than in GP. Surprisingly the frequency of GERD was within the range of GP. Conclusion: Management of IPF requires a comprehensive approach, which includes the identification and treatment of comorbid conditions to optimize patient outcomes.

Key feature of IPF is decline in forced vital capacity (FVC) and CO diffusion (DLco), but data on clinical determinants of this change in patients who have established disease are scarce. For a given patient it is unknown if different natural histories represent distinct phenotypes of IPF or if geographic, ethnic or other factors might have influence on progression. The EMPIRE (European Multipartner IPF Registry) is a multicountry IPF register in the CEE region. Out of 1229 patients from the registry 324 with available data on FVC and DLco at inclusion and at 6 months rapid decliners (RD: FVC >10% or DLco >10% in 6 months) and controls (C) were included into the analysis. Clinical characteristics at inclusion were analyzed between groups to find clinical determinants of RD. Average age was 67,4±9.7 years, more males were affected than females (male:female 221:103) most patients had classic signs of UIP on HRCT. Most common comorbidity was hypertension (50.9%), coronary heart disease (20.5%), diabetes (20.1%) and hyperlipidaemia (20.1%). RD of FVC was present in 33.7%, while RD of DLco in 53.3% of patients. Comparison of RD and C patients for smoking status, dyspnoe severity, comorbidities, HRCT pattern, lung function parameters at inclusion, 6 minute walk distance or the presence of pulmonary hypertension did not show any difference between groups. The rate of change in FVC or DLco among IPF patients is highly variable, with 34-53 % of patients showing increased rates of decline in FVC and/or DLco. No clinical characteristics could be identified which can predict rapid decline using the data of EMPIRE registry.

Aims: Many patients with idiopathic pulmonary fibrosis (IPF) have a delay in diagnosis and thus also in treatment. We investigated whether such delay influenced survival and treatment response to pirfenidone and nitedanib. Methods: The retrospective study used data from European Multipartner IPF registry (EMPIRE). 1170 IPF patients were divided to the 2 groups: 1) patients diagnosed within (824) and 2) patients diagnosed after 12 months (346) from initiation of symptoms. The groups did not differ in demographic data, and in proportion of the patients treated with antifibrotic drugs. Survival from diagnosis up to 120 months was evaluated by Kaplan-Meier curve. The vital capacity (VC) initial values (% PV) and VC decline (l) in 6, 12, and 18 months of follow-up were evaluated and compared between both groups using t-test. Results: VC at the time of diagnosis was higher in earlier diagnosed group (2.72 l (2.63; 2.80) versus 2.49 l (2.37; 2.61); p=0.002). The Kaplan-Meier survival curve showed longer median survival in the earlier diagnosed patients (74.4 vs. 50.9 months (P=0.001)). The patients treated with pirfenidone showed longer median survival versus those without antifibrotic treatment (46.9 vs. 39.6 months; p=0.014), nintedanib showed similar tendency. Treatment with antifibrotic drugs similarly reduced decline of VC and TLCO in both early and later diagnosed patients. Conclusion: The patients with IPF diagnosed within 1 year from symptoms have longer survival than those diagnosed later. Antifibrotic treatment in real-world prolongs survival in IPF and slows down decline of lung function irrespective of timeliness of diagnosis.

Football, called in USA soccer, has the huge impact on everyday life especially during big events such as European Championships and World Championships. Information about results, players and teams appear everywhere and with every occasion. During near 30 days media exists thanks to football events (not only matches). The recent work of Edmans et al. (J Finance 62:1967–1998, 2007) indicate that there is a strong relation between soccer games and local stock exchange. The aim of the chapter is to verify hypothesis that there exists the effect of UEFA EURO cups on the Warsaw Stock Exchange. The research was conducted on the example of stock exchange indexes: WIG, WIG20 and WIG30. The case study is an example of an activity of irrational factors during the process of making investment decisions.

Papuloerythroderma, described by Ofuji in 1984, is characterized by the occurrence of polygonal, erythematous-brown papules, covering the entire skin surface, except skin folds; these changes are accompanied by pruritus and eosinophilia. We report a case of a 41-year-old female patient with melanoerythroderma that has been intensifying since August 2010. The patient's personal and family history for atopy were negative. No triggering factors were identified in the course of hospitalizations. Preceding infections and neoplasms were excluded. The diagnosis of papuloerythroderma of Ofuji was established on the basis of major and minor criteria proposed by Torchia et al. The patient met all the five major criteria: 1) erythroderma-like eruption formed by coalescence of flat-topped, red-to-brown papules with a cobblestone-like appearance, 2) itch, 3) sparing of skin folds and creases, 4) histopathological exclusion of cutaneous lymphoma and other skin diseases, 5) absence of the causative factors such as tumors, infections, drugs and atopy. Regarding the 5 minor criteria, the patient met the following three: 1) peripheral (33.8%) and tissue eosinophilia, 2) elevated level of the total serum IgE (10935 IU/ml), 3) lymphopenia (6.6%). The patient went into remission after 9-month treatment with cyclosporine at a dose of 3 mg/kg.

This work aims to design a proposed decision support system (DSS) for helping investors in making investment decision by using rule text-mining based algorithm to analyze news headline and implement analyzing pro-gram based on a manual analyzed headlines. The news analysis program (NAP) was used as an important stage in making investment decision on sample of the Gulf Cooperation Council (GCC) stock markets using Alarabia.net and Reuters.com which treated as a source of media noise that has an influence on the value of stock quoted stock market. The second kind of data that proposed to use in this system is the financial data of GCC stock market. The resulted data can be used in further steps to make better understanding of stock market companies behavior such as the statistical, data mining calculation for choosing the best period of time that give the best reaction of stock market ratios to the news indicators and using the vector measure construction method (VMCM) for classifying companies according to their response to the news.

There is substantial evidence that heart rate (HR) is a powerful predictor of mortality in both normal individuals and in patients with cardiovascular disease. The use of β-adrenoceptor antagonists (β-blockers) has confirmed the importance of lowering elevated HR in a patient's prognosis. However, these agents can have undesirable adverse effects (AEs) and due to the risk of bronchoconstriction are contraindicated in patients with obstructive airway disease. A selective bradycardic agent, without such undesirable effects, could be of therapeutic interest. Ivabradine, a new I(f) inhibitor that acts specifically on the sino-atrial node, is a pure HR-lowering agent.The objective of this study was to assess HR-lowering efficacy and respiratory safety of ivabradine in patients with asthma and chronic obstructive pulmonary disease (COPD).This was a randomized, single-center, double-blind, placebo-controlled, crossover trial. Enrolment began in May 2009, and the last patient completed the study in January 2011. The study was conducted in an ambulatory setting. A total of 40 patients completed the study (20 asthmatic patients and 20 COPD patients). Inclusion criteria were: documented diagnosis of asthma or COPD according to international guidelines, age 18-75 years, and mean HR on Holter ECG recording of ≥60 beats/min. Exclusion criteria included disease exacerbation in a previous month or inability to understand instructions on the study procedures. All patients received ivabradine 7.5 mg twice daily for 5 days and placebo twice daily for 5 days in a crossover manner, in one of the two arms of the study, with at least 2 days of washout between treatments. The main outcome measures included the difference in HR between ivabradine and placebo treatment and change in HR in comparison with baseline. Other evaluated outcomes were differences in the peak expiratory flow rate (PEFR), the daily symptom score, rescue medication consumption, and AEs.Ivabradine produced significantly lower mean HR than placebo in both groups of patients: asthma 67.4 ± 8.38 versus 82.85 ± 11.19 beats/min (p0.001) and COPD 69.75 ± 8.9 versus 81.05 ± 9.75 beats/min (p0.001). Similar results were observed for the minimal HR as well as for the maximal noted HR. In comparision with baseline, ivabradine significantly reduced HR in both groups of studied patients (all p0.05), whereas placebo did not have such an effect. No significant difference, in either the asthma or the COPD group, was found between ivabradine and placebo in morning and evening peak expiratory flow rate, peak expiratory flow diurnal variability, daily symptom scores, and rescue medication usage (all p0.05). Both treatments were well tolerated. The incidence of AEs was low and generally similar in both periods of treatment, except for visual symptoms during treatment with ivabradine, which was reported by 5% of the patients.Our study demonstrated that selective HR reduction with ivabradine is effective in patients with asthma and COPD, with no alteration in respiratory function or symptoms over the duration of the study. Ivabradine offers an interesting alternative, as an HR-lowering agent, in patients with respiratory disease and contraindications to β-blockers.Registered at www.clinicaltrials.gov (NCT01365286).

INTRODUCTION: Induced sputum is widely used in clinical practice and scientific studies. This technique has become enormously useful in assessment of airway inflammation. However, some asthmatics are unable to expectorate sputum of sufficient quality and quantity necessary for further processing, therefore not providing reliable results. This research study aimed to examine whether asthma control and asthma quality of life influence the results of sputum induction. MATERIAL AND METHODS: Fourty-seven adult subjects, current non-smokers with symptomatic asthma, were studied. All participants underwent clinical assessment, skin prick testing, spirometry and sputum induction. Before sputum induction, subjects were asked to fill in the Mini Asthma Quality of Life Questionnaire (MiniAQLQ) and Asthma Control Questionnaire (ACQ). RESULTS: Twenty-nine (62%) subjects produced sputum eligible for processing. This group had a significantly lower ACQ score (0.83 ±0.65 vs. 1.37 ±0.77; p = 0.02), higher MiniAQLQ total score (5.67 ±0.99 vs. 4.86 ±1.07; p = 0.011), higher MiniAQLQ symptoms domain score (5.54 ±1.13 vs. 4.63 ±1.24; p = 0.013) and higher MiniAQLQ activity limitations domain score (6.08 ±0.92 vs. 5.07 ±1.37; p= 0.014). The noted differences between groups of patients were not only statistically but were clinically important. CONCLUSIONS: The study results suggest that successful sputum induction may be expected in patients with better asthma control and better quality of life.

W artykule została przedstawiona jedna z możliwości aplikacyjnych drzew klasyfikacyjnych - określanie preferencji inwestora w procesie podejmowania decyzji. Dane, na podstawie których przeprowadzona została analiza, pochodziły z ankiety internetowej przeprowadzonej przez autora od stycznia do marca 2009 r. Ankieta była umieszczona na stronach internetowych dwóch ogólnopolskich biur maklerskich BOŚ SA oraz BDM. Narzędziem służącym osiągnięciu założonego w badaniu celu były drzewa klasyfikacyjne. (abstrakt oryginalny)

The main goal of this article is to verify the hypothesis on the behavioural character of the relationships between enterprises financing football in Poland and the fans of this sport. In his research, the author analyses selected companies listed on the Warsaw Stock Exchange which are engaged in financing football in the Polish Ekstraklasa. The author uses the quotations of such companies as: Ruch Chorzow, Comarch, KGHM, Tauron, Lotos and Police. It is possible to divide these companies into three groups: owners (Comarch, KGHM), sponsors (Tauron, Lotos, Police) and one public company (Ruch). In the research, ARCH models are used based on econometric models with independent variables: sporting results and betting odds. W książce „Soccernomics” S. Szymanski i S. Kuper piszą o obalaniu popularnych mitów związanych z piłką nożną. Jednym z większych mitów, jak piszą autorzy, jest stwierdzenie, że piłka nożna to wielki biznes. Jeżeli piłka nożna nie jest wielkim biznesem, to należy się zastanowić dlaczego skupia wokół siebie tak wielkie pieniądze – jak podaje raport Deloitte’a w 2014 r., przychody tylko 20 największych klubów na świecie najprawdopodobniej przekroczą 6 miliardów euro. Stąd pytanie, które postawiono w tym artykule – czy piłka nożna to biznes, który wykorzystuje emocje czy może kaprys altruistycznych biznesmenów? Celem artykułu jest weryfikacja hipotezy o behawioralnym charakterze związków między przedsiębiorstwami finansującymi kluby piłkarskie a klubami i sympatykami tych klubów. Analizie zostaną poddane spółki giełdowe, które są zaangażowane w finansowanie funkcjonowania klubów najwyższej ligi rozgrywkowej w Polsce – Ekstraklasy. W analizie były wykorzystywane kursy akcji następujących spółek giełdowych: Comarch, KGHM, Zakłady Chemiczne Police Grupa Azoty, Tauron, Energa i Lotos. Wśród tych spółek można wyróżnić dwie grupy: właścicieli klubów piłkarskich (Cracovia, Zagłębie Lubin) oraz sponsorów piłki nożnej (Pogoń Szczecin, Lechia Gdańsk, Śląsk Wrocław). Do badania zostaną użyte kursy akcji, wyniki sportowe klubów oraz prawdopodobieństwa bukmacherskie. The project implemented with Narodowy Bank Polski under the Economic Education Programme.

The article presents the analysis of performance persistence of quasi-hedge funds operating on Polish capital market in the years 2005–2015 with the use of authors’ ARI-WIG index (Absolute Return Index). The article consists of four parts. The first chapter is preceded by introduction and presents the essence and ways of determining performance persistence of investment funds. The second chapter is a review of foreign and Polish literature on the subject. The third chapter presents the methodology of research on the performance persistence of quasi-hedge funds on Polish capital market. Finally, in the last chapter, the authors analyse the performance persistence of quasi-hedge funds. The authors conclude that the phenomenon under analysis determines the possibility of predicting the performance of funds, which has a profound effect on decisions taken by investors and fund managers, who want to achieve above-average trading performance, about allocating their resources.

Reactive arthritis-like pattern is a constellation of clinical symptoms. The most important one is a psoriasiform dermatitis, arthritis usually resistant to topical treatment, accompanied with keratoderma blenorrhagicum, balanitis and onychodystrophy. The key influential factor is HIV infection. We describe a patient who fulfils the new and controversial criteria of this medical condition.

Bronchopulmonary signs and symptoms are examples of variable extraintestinal manifestations of the inflammatory bowel diseases (IBD). These complications of Crohn's disease (CD) and ulcerative colitis (UC) seem to be underrecognized by both pulmonary physicians and gastroenterologists. The objective of the present review was to gather and summarize information on this particular matter, on the basis of available up-to-date literature. Tracheobronchial involvement is the most prevalent respiratory presentation, whereas IBD-related interstitial lung disease is less frequent. Latent and asymptomatic pulmonary involvement is not unusual. Differential diagnosis should always consider infections (mainly tuberculosis) and drug-induced lung pathology. The common link between intestinal disease and lung pathology is unknown, but many hypotheses have been proposed. It is speculated that environmental pollution, common immunological mechanisms and predisposing genetic factors may play a role.

Background Nitric oxide (NO) is the endogenous molecule involved in regulatory, protective, and defensive mechanisms. Although exhaled NO (ENO) has been used to monitor patients with asthma, possible usage of ENO in allergic rhinitis (AR) still needs to be evaluated. The authors wanted to determine the levels of NO exhaled orally both out of the pollen season and during the natural pollen exposure in patients with AR without asthma. Methods Forty-six patients without asthma, with seasonal AR (SAR) and 15 healthy, nonreactive, nonatopic subjects as a control group were investigated. ENO, congestion score, and peak nasal inspiratory flows (PNIFs) were measured in all subjects 6 weeks before the pollen season, at the height of the pollen season, and 6 weeks after the end of the pollen season. Results Patients with SAR had significantly higher basal ENO values compared with healthy control. The number of parts of NO increased in both groups during the pollen season but only in AR patients was the increase significant compared with the levels before the pollen season. Those with SAR and high levels of NO in exhaled air at the height of the pollen season had significantly lower PNIF rates and higher obstruction scores than out of the pollen season and in the healthy group. Conclusion Natural exposure may lead to an elevation of ENO in the patients with SAR without asthma. We estimate that the increased ENO may result from subclinical allergic inflammation present within the lower airways of nonasthmatic patients with SAR.

INTRODUCTION Increased generation of superoxide anion (O(2)(-).) by bronchoalveolar lavage (BAL) cells has been reported in various inflammatory disorders. However, the clinical relevance of this phenomenon is unclear. OBJECTIVES The aim of the study was to investigate whether production of O(2)(-). is enhanced in smoking-related chronic bronchitis and sarcoidosis, and to assess a relationship between O(2)(-). generation and lung function impairment and changes in BAL cellular pattern. PATIENTS AND METHODS Forty-two patients with sarcoidosis, 24 smokers with chronic bronchitis, and 17 controls were examined. A number/percentage of BAL cells was calculated. Spontaneous and phorbol myristate acetate (PMA)-stimulated O(2)(-). production was measured in BAL cells. Spirometry was performed. RESULTS Patients with smoking-related chronic bronchitis produced more O(2)(-). spontaneously (6.42 -/+1.24 vs. 15.39 -/+2.47 nmol/106 cells, P = 0.003) and after stimulation (3.73 -/+1.32 vs. 14.76 -/+2.79 nmol/106 cells; P = 0.001). PMA-stimulated excess production correlated with the percentage of neutrophils (r = 0.66, P = 0.0005). In sarcoidosis, only spontaneous production of O(2)(-). was higher (vs. 18.07 -/+2.49 nmol/106 cells, P = 0.004) and correlated with the percentage of BAL lymphocytes. There was no correlation between O(2)(-). production and lung function parameters. CONCLUSIONS Patients with smoking-related chronic bronchitis produce more O(2)(-)., and this phenomenon is related to BAL neutrophils. In sarcoidosis, spontaneous release of O(2)(-). from BAL cells is related to the extent of lymphocytic alveolitis. Higher O(2)(-). generation did not impair lung function.

The economists’ recognition that sport is a commercial field of business caused the necessity of treating main elements of a sport event as the commercial product. The football match as an event became a place of trading of entertainment services, which are the better the more brands (famous footballers) participate in these events. Thus spectators are not the clubs fans but they are clients buying a service, in eyes of economists. The Sloane’s approach to football treating football clubs as enterprises and professional football as the industry is adjusted to the proposition of using the product life cycle theory in the analysis of changes in football players’ performance rights. The main goal of an article is to prove that theory of product life cycle could be successfully used in analysis and diagnosis of the market value of footballers. Therefore, there is the hypothesis raised – the compilation of different analytical functions helps in diagnosis of the life cycle of the professional football player. The data of market values of chosen Polish national team players are taken from the web page www.transfermarkt.de .