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Purpose While most coronavirus disease 2019 (COVID-19) cases are mild, the risk of heart dysfunction remains unknown. The objective of this observational study was to assess the impact of mild COVID-19 on heart function in a short-term follow-up using advanced echocardiography. Methods Our study cohort comprised patients diagnosed with COVID-19 who did not require hospitalization. Speckle tracking echocardiography (STE) was used to assess heart chambers function in the 31 recovered COVID-19 patients, and the results were compared with those of the control group (28 healthy participants). Results Left ventricular (LV) and right ventricular (RV) systolic function was assessed using standard and STE methods and was found to be normal and comparable in both groups (LV ejection fraction [p = 0.075], LV global longitudinal strain [p = 0.123], LV global radial strain [p = 0.630], LV global circumferential strain [p = 0.069], tricuspid annular plane systolic excursion [p = 0.417], tricuspid S' peak systolic velocity [p = 0.622], and RV free wall longitudinal strain [p = 0.749]). Similarly, atrial function was not impacted when assessed using advanced STE. Conclusions The heart function of patients with mild COVID-19 symptoms, assessed using standard and advanced echocardiographic methods, was observed to be normal after a short-term follow-up.

Studying the dynamics changes of neutrophils during innate immune response in coronavirus 2019 (COVID-19) can help understand the pathogenesis of this disease. The aim of the study was to assess the usefulness of new neutrophil activation parameters: Immature Granulocyte (IG), Neutrophil Reactivity Intensity (NEUT-RI), Neutrophil Granularity Intensity (NEUT-GI), and data relating to granularity, activity, and neutrophil volume (NE-WX, NE-WY, NE-WZ) available in hematology analyzers to distinguish convalescent patients from patients with active SARS-CoV-2 infection and healthy controls (HC). The study group consisted of 79 patients with a confirmed positive RT-PCR test for SARS-CoV2 infection, 71 convalescent patients, and 20 HC. We observed leukopenia with neutrophilia in patients with active infection compared to convalescents and HC. The IG median absolute count was higher in convalescent patients than in COVID-19 and HC (respectively, 0.08 vs. 0.03 vs. 0.02, p &lt, 0.0001). The value of the NEUT-RI parameter was the highest in HC and the lowest in convalescents (48.3 vs. 43.7, p &lt, 0.0001). We observed the highest proportion of NE-WX, NE-WY, and NE-WZ parameters in HC, without differences between the COVID-19 and convalescent groups. New neutrophil parameters can be useful tools to assess neutrophils’ activity and functionalities in the immune response during infection and recovery from COVID-19 disease.

Introduction The literature describes the influence of venom immunotherapy (VIT) on the subpopulation of T regulatory cells (CD4+ CD25+ Foxp3+) and the synthesis of IL-10, TGF-β1 as well as many other cytokines at various times after immunotherapy. Aim To assess changes in the percentage of cells of CD4+ and CD25+ in peripheral blood and serum concentrations of IL-10, IL-21 and TGF-β1 in the early stages of VIT. Material and methods The study included 18 patients who were allergic to wasp venom and who in the past underwent systemic anaphylactic reaction after stinging, meeting the criteria to qualify for VIT. The immunoenzymatic method (ELISA) was used to assess concentrations of cytokines IL-10, IL-21 and TGF-β1 and the surface antigens CD4 and CD25 on the cells. The concentrations were determined by flow cytometry method at baseline (before VIT) and after 2.5 and 24 h from the VIT starting point. Results The mean values of the activity of T lymphocytes CD4+ CD25+ FoxP3+ and concentrations of the cytokines IL-10, IL-21 and TGF-β1 are shown in table. Conclusions A 24-hour activation assessment of serum concentrations of cytokines IL-10, IL-21 and TGF-β1 during the first day of the Hymenoptera venom immunotherapy by ultra-rush protocol does not show the significant dynamics of change of the examined parameters.

Ambient air pollution impairs lung development in children, particularly in industrialized areas. The air quality in Zabrze, a city located in the Upper Silesian Industrial Region of Poland, is among the worst in Europe. We compared lung function and the frequency of respiratory or allergic symptoms between children living in Zabrze and those living in Gdynia, a city on the Baltic coast, which has the best long-term air quality in Poland. We enrolled children aged 9–15 years from both cities who were able to perform a spirometry. The following spirometry variables were measured for all participants: forced vital capacity (FVC), forced expiratory volume during the first second of expiration (FEV1), FEV1/FVC index, and peak expiratory flow (PEF). The frequencies of respiratory or allergic symptoms were taken from a survey completed by the participants’ parents. In total, 258 children from Gdynia and 512 children from Zabrze were examined. The mean values of FVC, FEV1, and PEF were significantly greater among children in Gdynia than those reported in Zabrze (p ≤ 0.032), and the frequencies of seasonal rhinorrhea (p = 0.015) or coughing episodes (p = 0.022) were significantly higher in Zabrze than in Gdynia. In conclusion, lung function was significantly impaired in children living in Zabrze, an area which is associated with poor air quality. Strategies to improve air quality in the Silesia region are urgently needed.

The role of the adaptive microenvironment components in severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection is widely researched, but remains unclear. Studying the common dynamics of adaptive immune response changes can help understand the pathogenesis of coronavirus disease 2019 (COVID-19), especially in critical patients. The aim of the present study was to determine the cytokines concentration and leukocyte subpopulations profiles in the severe COVID-19 (n = 23) and critical (n = 18) COVID-19 group distinguished by the computed tomography (CT) severity score. We observed lower percentage of lymphocyte subpopulation, higher neutrophils to lymphocytes ratio (NLR) and higher IL-6 concentration in critical COVID-19 group than in severe group. CT severity score was negative correlated with proportion of lymphocytes, lymphocytes T, CD4+ cells, Treg cells and NK cells and positive correlated with neutrophils, NLR, and IL-6. In critical group more correlations between cytokines and lymphocytes were observed, mainly between TNF-α, IL-1β and lymphocyte subpopulations. The collective assessment of the cytokine profile, leukocyte subpopulations and the CT severity score can help to characterize and differentiate patient in advanced COVID-19 than the study of single parameters. We have shown that the interconnection of elements of the adaptive microenvironment can play an important role in critical COVID-19 cases.

Introduction Platelet-activating factor (PAF) has a direct role as a mediator in the pathogenesis of various disorders with an inflammatory component, including those with allergic aetiology. The peripheral blood concentration of PAF is dynamically regulated by plasma PAF acetylhydrolase (PAF-AH). Previous research suggest that low activity of plasma PAF-AH could be a predictive marker for increased severity of some types of allergic hypersensitivity reactions–especially anaphylaxis. The purpose of the study was to evaluate the association between plasma PAF-AH activity and severity in patients with anaphylactic reactions following a wasp or bee sting. Materials and methods The study group of 89 patients was divided into two subgroups depending on the increasing severity of the most severe anaphylactic reaction in the past, which was assessed according to the Müller’s scale. The first subgroup included participants with a history of hypersensitivity reactions up to grade II. The second subgroup consisted of patients who have experienced at least one grade III or IV reactions in the past. A control group of 20 people was established. Plasma PAF-AH activity was measured using a colorimetric method. Results It has been observed that plasma activity of platelet-activating factor acetylhydrolase was significantly lower in patients with anaphylaxis history compared to the control group with negative atopic history (on average 21.38 nmol/min/ml for the control group, 9.47 nmol/min/ml for the first subgroup and 10.16 nmol/min/ml for the second subgroup, in both cases p < 0.0001). Conclusion The plasma activity of PAF-AH is a promising parameter that can help to distinguish a group of patients not threatened with development of anaphylaxis and not requiring laborious or expensive prophylactic procedures.

Objectives The aim of the study was to assess the influence of different factors, including treatment, on the risk of ILD in the course of RA. Methods A total of 109 RA patients were included in the analysis. High-resolution computed tomography (HRCT) of chest was obtained in each patient. Patients were classified as having ILD (ILD group) or not (N-ILD group). The ILD was graded using the semi-quantitative Warrick scale of fibrosis. Warrick extent score (WES) and Warrick severity score (WSS) were calculated separately for each patient, then combined to obtain a global score (WGS). Results In univariate analysis the presence of ILD was associated positively with age (P = 5x10-6) and negatively with MTX treatment (P = 0.0013), mean MTX dose per year of treatment (P = 0.003) and number of DMARDs used (P = 0.046). On multivariate analysis only age and treatment with MTX were independently associated with the presence of ILD. WGS was significantly lower in patients treated with MTX in a dose of ≥15 mg/week (MTX≥15 group) as compared to patients treated with lower doses of MTX (0P = 0.04 and P = 0.037, respectively). The ILD prevalence was higher in N-MTX group than in 0P = 0.0036) and MTX≥15 group (0.0007). The difference in ILD prevalence between MTX≥15 and 0P = 0.044) and trended to have higher WSS and WGS. Consclusions We found a beneficial effect of MTX on RA-ILD. Importantly, this effect seems to be dose dependent.

Cell response to novel coronavirus disease 19 (COVID-19) is currently a widely researched topic. The assessment of leucocytes population and the maturation of both B and T lymphocytes may be important in characterizing the immunological profile of COVID-19 patients. The aim of the present study was to evaluate maturation of B and T cells in COVID-19 patients with interstitial lesions on chest X-ray (COVID-19 X-ray (+)), without changes on X-ray (COVID-19 X-ray (&minus, )) and in healthy control. The study group consisted of 23 patients divided on two groups: COVID-19 X-ray (+) n = 14 and COVID-19 X-ray (&minus, ) n = 9 and control n = 20. The flow cytometry method was performed. We observed a significantly higher percentage of plasmablasts and lower CD4+ lymphocytes in COVID-19 X-ray (+) patients than in COVID-19 X-ray (&minus, ) and control. In the COVID-19 X-ray (+) patients, there was a lower proportion of effector CD4+ T cells, na&iuml, ve CD8+ T cells and higher central memory CD4+ cells and effector CD8+ T cells than control. The above results showed that the assessment of selected cells of B and T lymphocytes by flow cytometry can distinguish patients with COVID-19 and differentiate patients with and without changes on chest X-ray.

Objective: The aim of the study was to assess the exposure of healthy adults on ambient and indoor PM2.5 and PM2.5-bound PAHs and analyse seasonal differences in pulmonary function (PF) and cytokines concentrations (CC) which may appear due to variable exposure to air pollution. Material and Methods: Concentration of PM2.5 and PAHs (polycyclic aromatic hydrocarbons) has been measured outdoor and indoor, in the heating and non-heating season in selected households of 81 people living >20 years in the city of Legionowo (with one of the highest PM2.5 in Central Poland). Study participant underwent PF tests and measurement of serum CC (IL-1β, IL-4, IL-5, IL-6, IL-8, IL-10, TNF-α) in both seasons. Results: Seasonal statistically significant differences in PM2.5 and PAHs concentrations has been observed. Spirometric parameters in both seasons met the limits, however higher values were observed in summer. The investigation focused on healthy adults, thus statistically significant (p Conclusion: Exposure to PM2.5-bound PAHs may be associated with subclinical decrement especially in distal lung function and stimulation of systemic inflammatory processes by proinflammatory cytokines production.

Background: The emergence of tolerance during Hymenoptera venom immunotherapy (VIT) is a complex process. The main goal of VIT is to induce a change from proinflammatory Th2 response to the Th1 response. The immune mechanism of acquiring rapid tolerance during VIT has not yet been fully understood. Methods: We have analyzed (in 4 time points: 0, 2, 6 and 24 weeks after treatment) concentration of 30 cytokines and chemokines in serum using Luminex system, complement system, lymphocyte subpopulations (flow cytometry), and histamine and tryptase serum concentrations of 40 patients with Hymenoptera venom allergy (III and IV Muller grade) classified to ultra-rush treatment and 40 volunteers as control group (CG). Results: We have found that VIT influences the immune system by inducing changes in the complement system, cytokine secretion, histamine and tryptase concentration, and lymphocyte subpopulations. The study group (SG) at time 0 has higher percentage of T and B cells compared to the CG. The SG at time 0 is characterized by a decreased percentage of neutrophils. VIT decreased C3, C4, C5 concentration in the SG. The SG is also characterized by decreased IL-4 and MCP-1 concentrations. Patients with venom allergy have a higher percentage of CD3+ CD4+ T cells compared to the CG. VIT leads to normalization of the number of these cells 2 weeks after the first dose. The decreased concentrations of G-CSF and TGF-beta2 in patients at time 0 has normalized in two weeks after treatment. Conclusions: Preliminary test results suggest that VIT has immunoregulatory properties influencing G-CSF, TGF-beta2 concentration, and CD3+ CD4+ helper T cells percentage.

Introduction Hymenoptera venom allergy (HVA) in some patients occurs with general symptoms involving respiratory and cardiovascular system with anaphylactic shock with constitutes a significant threat to life. Aim Assessment of the prevalence of HVA in our own material. Material and methods There were 498 patients after a general reaction to wasp and/or bee venom. The survey included questions: the type of stinging insect, body parts stung by insects, profession, frequency of stings by wasps and bees depending on professional activity, places of stings, clinical symptoms using the scale according to Muller, and the treatment following the sting. Among 498 patients, there were 281 women and 217 men. Results Wasp stings were more frequent and affected 382 (77%) persons, while bee stings affected 116 (23%) persons. Limbs constituted the most common area of the body stung by both wasps and bees. The sting was more frequent in rural areas and during summer rest. A severe systemic reaction (class III and IV according to Muller) occurred more often in people stung by bees. The most common medications included intravenous glucocorticosteroids, calcium preparations and antihistamines. Intramuscular Adrenaline injection was used in 48% of patients, while only 15% received its prescription as an emergency medication. Bee stings were the most common cause of severe systemic symptoms. Conclusions The treatment after the sting in a significant percentage of episodes still deviates from the recommendations of the guidelines, especially in the field of adrenaline recommendations for patients in case of a resting by an insect.

Objective: The aim of the study was to assess the effects of air pollutants exposure (especially PM2.5), in winter and summer, on respiratory tract function and inflammation parameters in healthy people. Material and methods: 81 healthy people living more than 20 years in one of the most polluted city in Central Poland were examined. During the heating and non-heating season pulmonary function tests and serum cytokine (IL-1β, IL-4, IL-5, IL-6, IL-8, IL-10) concentration has been conducted. Outdoor and indoor PM2.5 and polycyclic aromatic hydrocarbons (PAHs) concentration has been measured. Results: Statistically significant differences between PM2.5 and PAHs concentrations between the heating and non-heating seasons has been observed. Spirometric parameters in both seasons met the limits, however higher values were observed in summer. There were statistically significant (p Results: The results of the study indicate that exposure to PM2.5 may be associated with subclinical decrement especially in distal lung function and cause stimulate to systemic inflammatory processes by pro-inflammatory cytokines production.

Identification of patients with activation of the immune system which indicates the presence of infection is essential, especially in the times of the global coronavirus 2019 (COVID-19) pandemic. The aim of the present study was to evaluate the reactive lymphocytes (RE-LYMP) parameter in COVID-19 and to correlate it with activation lymphocytes markers by flow cytometry. The study group consisted of 40 patients: with COVID-19 infection (n = 20) and with others virus infections without COVID-19 (COVID-19(&minus, ) virus (n = 20)) and 20 healthy donors (HC). Blood count and flow cytometry were performed. The COVID-19(+) group had significantly lower RE-LYMP parameter than the COVID-19(&minus, ) virus group (5.45 vs. 11.05, p &lt, 0.05). We observed higher proportion of plasmablasts in the COVID-19(+) and COVID-19(&minus, ) virus groups than HC (8.8 vs. 11.1 vs. 2.7, p &lt, 0.05). In the COVID-19(+) there was a lower proportion of CD4+ CD38+ cells than in the other groups (significant differences between COVID-19(+) and COVID-19(&minus, ) virus groups). RE-LYMP correlated with activated T lymphocytes CD38+ and HLA-DR+ in the COVID-19(&minus, ) virus group, however in the COVID-19(+) group correlations with T lymphocytes CD25+ and CD45RO+ were observed. In summary the analysis of the RE-LYMP together with flow cytometric activation markers can be helpful in identifying and distinguishing patients with COVID-19(+) from other viruses and HC.

Because the optimal treatment for COVID-19 is still unknown, it is important to explore every potential way of improving the chances of survival for COVID-19 patients. The aim of the study was to analyze the effectiveness of convalescent plasma on COVID-19 patients. The study population consisted of 78 patients diagnosed with COVID-19, selected from the SARSTer national database, who received convalescent plasma. The impact on clinical and laboratory parameters was assessed. A clinical improvement was observed in 62 (79%) patients, and 10 (13%) patients died from COVID-19. No side effects of the convalescent plasma treatment were observed. When plasma was administered earlier than 7 days from diagnosis, the total hospitalization time was shorter (p &lt, 0.05). Plasma efficacy was inferior to remdesivir in endpoints such as the necessity and duration of oxygen therapy, the duration of hospitalization, and mortality rate, and inferior to other drugs in the case of the duration of hospitalization and the necessity of constant oxygen therapy, but comparable in most other measured endpoints. A comparison of a 30-day mortality rate in patients who received plasma and remdesivir (4/25, 16%) and who received only plasma (6/53, 11%) showed no significant difference. Convalescent plasma efficacy is inferior to remdesivir when treating COVID-19 patients but the addition of remdesivir to plasma does not improve the treatment effectiveness. In most endpoints, plasma was comparable to other treatment options. In our opinion, convalescent plasma may be used as a supportive treatment in COVID-19 patients because of the low frequency of adverse effects and availability, but must be given as early from the diagnosis as possible.

The aim of the study was to assess the need for changes in spirometry reference values in the Polish population with time lapse, as the aftereffect of a radical socioeconomic overturn of the 1990. We retrospectively analyzed data files on forced expiratory volume in 1 s (FEV1), vital capacity (VC), and forced VC (FVC) in healthy, never-smoking Caucasians (731 females and 327 males) obtained in in 1993–1998. We assessed a discrepancy between the then measured values of these variables, on the one side, and the corresponding European Community for Steel and Coal (ECSC) predicted values or the current updated predicted values for the Polish population, on the other side. We found that those old measured values approximately corresponded to the ECSC reference, but they were appreciably lower than the current Polish reference values; the younger the subjects the greater the difference. The current Polish reference values of FVC were much closer to the old measured VC than to the old measured FVC values, which introduces a substantial discrepancy between the past and present FVCs. We conclude that the spirometry reference values may change with time lapse. Thus, accuracy of prediction equations should be periodically updated, which seems to particularly concern the equations elaborated for the nations that undergo rapid economic developments connected with changes in living standards.

Objective: SMOG episodes appear due to high air pollutants concentration and specific meteorological conditions (thermal inversion, high atmospheric pressure, no wind, no precipitation). In Poland above 50% of PM emission originates from coal and wood burning in individual households which, according to Badyda et al. (10.1183/1393003.congress-2017.OA1777), increase the risk of respiratory diseases. Materials and Methods: Data on hospital admissions, visits to primary and specialist outpatient health care (from the National Health Fund) as well as PM2.5 and PM10 concentrations in Warsaw (from the Chief Inspectorate of Environmental Protection) in January 2017 has been compared with the situation in January 2016. Analysis of variance has been conducted (with statistical significance p Results: PM10 concentration in 01.2017 exceeded the 24-hour WHO recommended value for 19-22 days and PM2.5 for 25-28 days (depending on station). Comparing to 01.2016 significant (p Conclusion: During 15 years of air quality monitoring history in Poland such smog episode has not been observed. Increase in the number of people hospitalized and demanding other medical care due to exacerbations of asthma or other respiratory disorders most likely resulted from the increase of PM concentration.

Introduction : Chronic urticaria (CU), in view of its manifestations (pruritus, wheals), chronic and recurrent nature is very bothersome for patients and significantly influences their quality of life. Aim : To assess the importance of sleep problems and sleep-related breathing disorders (SRBDs) declared by CU patients, for their quality of life. Material and methods : Twenty-eight patients with CU at an asymptomatic stage or with minimal symptoms and signs were qualified for the study. In these patients, assessment of urticaria severity, QoL and SRBDs incidence was carried out. Results : In a questionnaire study (CU-Q2oL), about 54% of the patients with CU complained of sleeping problems, about 80% reported significant fatigue and lack of concentration in the daytime. Respiratory polygraphy, an objective measure of sleep-related breathing disorders (SRBDs) demonstrated their higher incidence in patients with CU than in the general population, but these disorders were mild and had no influence on the reduced quality of life of the study patients, compared with a group of patients without SRBDs. Conclusions : The occurrence of SRBDs was found in 25% of patients with CU at asymptomatic or oligosymptomatic stages. The SRBDs in those patients were mild, required no treatment and their occurrence did not cause any significant reduction in their quality of life.

Coronary heart disease is the most common cardiovascular disease. Primary prevention, medication, and invasive approach, along with the coronary artery bypass graft (CABG), are used in cardiovascular prophylaxis. Pulmonary rehabilitation, whose main task is to restore the patient’s optimum efficiency and prevent complications of the respiratory system, particularly resulting from limited physical activity and immobilization, plays an important role in the postsurgical treatment. The aim of this study was to evaluate the influence on lung function of proprioceptive neuromuscular facilitation (PNF) vs. standard physiotherapy in patients undergoing CABG surgery. The study included 42 patients scheduled for surgery, divided into PNF (n = 22; aged 62.3 ± 8.4) and standard rehabilitation (n = 20; aged 62.0 ± 7.4) groups. The findings demonstrate a decrease in post-surgery lung function in both groups. The increased ratios of FEV1/FVC and RV%TLC speak for a transient postoperative disturbance in lung function after surgery of restrictive character, accompanied by air trapping. We found a gradual improvement after 2 months of home rehabilitation, with a significant trend for a better outcome using PNF. We conclude that PNF holds a potential for optimizing the outcome of pulmonary rehabilitation after coronary bypass surgery.

Background: 69.3% of individual households in Poland produces thermal energy from coal burning (in 13.7% there are also fireplaces for wood and biomass). They are responsible for 55.8% of fine particulate matter (PM2.5) emission. As mentioned by Badyda et al. Adv Exp Med Biol 2016;944:1-9 in Polish cities PM2.5 is responsible for 10-33% of cardiopulmonary mortality. Material and Methods: 500 people from a small city in the agglomeration of Warsaw were surveyed in an ongoing study on the exposure to PM2.5 from individual households. A questionnaire was conducted and selected 100 people are undergoing medical examination (spirometry test, induced sputum composition, FeNO, CO in the exhaled air, skin prick tests, total and specific IgE, hemodynamics, vascular endothelial function). Statistical analysis was completed (e.g. ANOVA, GRM, PCA). Results: PM2.5 standards in the city are not met (in 2015 were >32 μg/m3). Though only 21% of the investigated inhabitants suppose that air quality is low or very low. Significant fraction of never-smokers (56.4% of the whole examined group) demonstrate symptoms typical for people exposed to air pollutants (PM), like conjunctivitis (21.5% of the non-smokers), rhinitis (34.2%), larynx inflammation (18.1%), frequent respiratory infections (16.1%) but also breathlessness/tightness and pain behind the breastbone (14.8%). Pulmonary symptoms significantly more often occur in people with FEV1 Conclusion: Exposure to PM2.5 in never smokers may increase the prevalence of respiratory and cardiovascular diseases.

Highlights ► Soldiers are at high risk of respiratory infections when on duty in a harsh environment. ► An increase in air-borne diseases can be observed among participants in combat operations. ► Physical and psychological factors result in a broad spectrum of changes in the immune system., Combat operations in contemporary theaters of war, as well as combat training, are carried out in all parts of the world, typically in a harsh environment. Specific environmental conditions, such as heat, cold, high-altitudes, desert climates, as well as chemical and biological pollution of both the atmosphere and soil, together with over-exertion, food restrictions, sleep deprivation, and psychological stress can all result in changes in the immune system and the occurrence of associated diseases. Respiratory diseases are one of the most common health problems among military personnel participating in combat training or deployed to operations in areas characterized by difficult climatic and sanitary conditions. They are, therefore, one of the main reasons for military personnel requiring ambulant and hospital treatment. The aim of the study was to discuss the influence of environmental factors and the conditions in which active duty is performed on changes in the immune system and the occurrence of respiratory tract diseases in a military environment.

Inflammation in the bronchial respiratory tract and lung parenchyma underlies the pathogenesis of chronic obstructive pulmonary disease (COPD). It consists of effector cell infiltration, changes in reticular basement membrane (RBM) thickness, and the content of inflammatory mediators. The aim of this study was to assess the influence of inhaled corticosteroids (ICS) on the number of inflammatory cells and RBM thickness in bronchial biopsies, and pulmonary function in patients with moderate COPD. Twenty four patients with newly diagnosed COPD were included into the study. Pulmonary function tests and fiber optic bronchoscopy with bronchial biopsies were performed before and after 12-month treatment in two groups: ICS– group (LABA plus anticholinergics) and ICS+ group (LABA plus anticholinergics plus ICS). We found that the addition of inhaled corticosteroids to the therapeutic regimen contributed to a reduction of RBM thickness, inflammation, and lung hyperinflation. The intensity of bronchial inflammatory infiltration had little effect on lung function. In conclusion, RBM thickness, an airway wall remodeling element, does not significantly affect the degree of airflow limitation.

Background: Due to the widespread use of coal and wood in households for heating purposes, Poland has one of the weakest air quality in the EU. Moreover in East-Central Europe there is still relatively little evidence on the relationship between air pollution, respiratory efficiency and the occurrence of obstructive diseases. Material: 500 people living in a small city in the Warsaw area were surveyed in the ongoing investigation focused on exposure to fine PM originating from the low-stack emission sources. A questionnaire was conducted followed by selected pulmonary, allergy and cardiology examinations (e.g. spirometry, induced sputum, FeNO, SPT, IgE, hemodynamics, vascular endothelial function). Stochastic-exploratory analysis (e.g. ANOVA, GRM or PCA) was conducted. Results: PM 2.5 concentration in the city does not meet the EU standards (in 2014 exceeded 31 ug/m 3 -the highest in the region). Though only 21% of the investigated inhabitants suppose that air quality is low or very low. Significant fraction of never-smokers (56.4% of the whole examined group) demonstrate symptoms typical for people exposed to polluted air, like conjunctivitis (21.5% of the non-smokers), rhinitis (34.2%), larynx inflammation (18.1%) but also breathlessness/tightness and pain behind the breastbone (14.8%). 16.1% of the never-smokers suffer from frequent respiratory infections. Asthma was diagnosed in 8.1%, CHD in 4.7% and COPD in 2% of the group. Conclusion: The initial results may indicate a relationship between continuous exposure to PM 2.5 and the prevalence of respiratory and circulatory systems diseases in never smokers. Ongoing research will help to verify this thesis.

BACKGROUND: Different forms of chronic airway inflammation may involve diverse pathogenic elements. In general, deficient defence response is a feature of chronic obstructive pulmonary disease (COPD), whereas distorted immunoregulatory mechanisms lead to development of asthmatic symptoms. In addition to diverse effector mechanisms, the cellular and humoral elements participating in the development of immune response may appear to be different in COPD and bronchial asthma (BA) patients. AIMS: To evaluate the immunoregulatory properties of T cells and monocytes in cultures of peripheral blood mononuclear cells (PBMC) and to determine the chosen cytokine profiles in COPD and BA patients. METHODS: The microcultures of PBMC from COPD and BA patients were assessed for the T-cell response to mitogens, saturation of interleukin (IL)-2 receptors, T-cell suppressive activity and monokine influence on lymphocyte proliferation. Concomitantly, the cytokine (IL-1beta, interleukin-1 receptor antagonist, tumour necrosis factor-alpha, IL-4, IL-6, IL-8) concentrations were determined in the serum, the broncho-alveolar lavage fluid and in the culture supernatants. RESULTS: The T-lymphocyte reactions (response to phytohaemagglutinin, IL-2 receptor saturation, suppressive activity) were lower in BA patients than in COPD patients. Reversely, the immunogenic activity of monocytes (IL-1beta versus IL-1ra production) was higher in BA patients than in COPD patients. The highest values of cytokine concentrations were found in the culture supernatants. The concentrations of tumour necrosis factor-alpha, IL-4, IL-6 and IL-8 were significantly higher and the concentration of IL-1ra was lower in BA patients than in COPD patients. CONCLUSION: The assessments of cellular immunoregulatory properties and cytokine profiles in the cultures of blood mononuclear cells may prove helpful for diagnostic and therapeutic discrimination between BA and COPD patients.

The chapter presents the results of pulmonary function tests conducted as part of the Polish Spirometry Day of 2011, an initiative aimed at increasing the awareness of causes, symptoms, and delayed effects of common respiratory diseases, in particular of bronchial asthma and chronic obstructive pulmonary disease, and at demonstrating the role of regular examinations, especially in higher risk groups. The results show that there was a relatively substantial group of persons, 11.2 % of the population sample studied, not being aware of a respiratory disease they had. Furthermore, the results show that quite often, 12.4–16.0 % of the population studied, obstruction was diagnosed in persons who did not have any spirometry tests done before, despite some respiratory symptoms that should raise the attention of general practitioners to perform such tests.

We investigated the influence of traffic-related air pollutants on respiratory function, with a focus on the non-smoking residents of the capital city of Warsaw in Poland, who lived close to busy streets. The results demonstrate that people living in some parts of the city show symptoms of bronchial obstruction over four times more often than those from the control group consisting of the inhabitants of a remote region in eastern Poland, with considerably less air pollution. Using multiple regression models it was shown that, apart from the place of living, the floor the apartment is situated on, the length of residence, allergy, and physical activity are the factors that significantly influence the forced expiratory volume in 1 s (FEV1) and the pseudo-Tiffenau index (FEV1/FVC).

Pneumonia is the second most common cause of pleural effusion. The presence of pleural fluid makes the prognosis in patients with pneumonia worse and causes a higher mortality rate. This is why it is very important to undertake suitable treatment as soon as possible. Most parapneumonic pleural effusions resolve with antibiotic alone, but sometimes more invasive treatment is necessary. Therapeutic decisions are based on different criteria. For many years determining biochemical fluid characteristics has been used for this purpose. Presentlythe usefullness of new parameters is being evaluated. Their application in diagnostics was possible thanks to better knowledge of mechanisms that participate in the development of parapneumonic pleural effusion.

BACKGROUND: Human peripheral blood mononuclear cells (PBMC) left in microcultures for 24h without mitogen do not respond to subsequent stimulation with PHA. They regain reactivity if the native culture medium is absorbed with other party lymphocytes or partially replaced with the medium from a PHA-stimulated culture. The observations suggest that, during the incubation, some inhibitory agent had accumulated in the culture medium. AIM: The study was performed to determine the nature of the observed phenomenon in respect of the possible role of monocytes and their products IL-1 and IL-1 receptor antagonist (IL-1ra), and to test for immunodiagnostic purposes the significance of quantifying the lymphocyte response to delayed stimulation with PHA in patients suffering from inflammatory prosesses. METHODS: Lymphocyte response to delayed stimulation with PHA, calculated as the lymphocyte-monokine interaction (LM) index, was determined in the microcultures of PBMC isolated from the blood of healthy donors or of patients with acute tonsilitis. The values of LM indices were compared with the ratios of IL-1ra/IL-1beta concentration estimated by enzyme-linked immunosorbent assay method in the culture supernatants. The influences of exogenous IL-1beta, IL-1ra, anti-IL1ra antibodies and antibiotic cefaclor on the monokine concentrations and on the values of LM index were tested. RESULTS AND CONCLUSIONS: The results show that the level of lymphocyte response to delayed stimulation with PHA (LM index) is inversely proportional to the ratio of IL-1ra/IL-1beta concentration in the culture. The low LM values at high IL-1ra/IL-1beta ratios in PBMC cultures from healthy donors, reversed proportions found in patients' PBMC (acute tonsilitis), and the cefaclor-induced reduction of LM value with correlated increase of the IL-1ra/IL-1beta ratio suggest that the LM assay may prove to be useful for immunodiagnostic purposes.

Background Recent studies have showed that FEV1/FVC describing correspondence between the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) depends significantly on age. However, the nature of this dependence is uncertain. The study aim is to analyze mathematically the relationship between FEV1 and FVC to find a cause of the FEV1/FVC dependence on age in healthy subjects. Methods The relationship was examined for 1,120 males and 1,625 females – Polish (Caucasian) population, healthy, never-smoking, aged 18 – 85 years, who performed a technically adequate spirometry maneuver. Lung functions were measured using the LungTest1000 (MES, Poland) with maximal effort according to the ATS/ERS guidelines. Results A very strong, age-independent linear relationship between FEV1 and FVC was found in healthy individuals (the correlation coefficient r = 0.96). It can be described with the equation FEV1 = A x FVC + C, where A = 0.84 and C = −0.23 (−0.36) for females (males). As C is different from zero, FEV1/FVC depends on FVC because FEV1/FVC = A + C/FVC, in average. And thus, since FVC is significantly age-dependent, FEV1/FVC has to be also age-dependent because of the term C/FVC. In particular, the smaller the FVC value because of advanced age, the more significant the fall of FEV1/FVC. Conclusions FEV1/FVC dependence on age in healthy individuals is of mathematical rather than biological nature. Due to the strong correlation between FEV1 and FVC in healthy subjects, the difference between patient’s FEV1 and the FEV1 value expected for patient’s FVC seems to be a more natural, age-independent description of the correspondence between patient’s FEV1 and FVC.