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2. Significance of Indoleamine 2,3-Dioxygenase Expression in the Immunological Response of Kidney Graft Recipients

Author

Krzysztof Wiśnicki, Piotr Donizy, Agata Remiorz, Dariusz Janczak, Magdalena Krajewska, and Mirosław Banasik

Subjects
indoleamine 2,3-dioxygenase (IDO1), immune response, immunosuppression, rejection, immune tolerance, kynurenine pathway, Medicine (General), R5-920
Abstract

Kidney transplantation is unquestionably the most advantageous and preferred treatment when patients with end-stage renal disease are considered. It does have a substantially positive influence on both the quality and expectancy of their lives. Thus, it is quintessential to extend the survival rate of kidney grafts. On account of T-cell-focused treatment, this is being exponentially achieved. The kynurenine pathway, as an immunosuppressive apparatus, and indoleamine 2,3-dioxygenase (IDO1), as its main regulator, are yet to be exhaustively explored. This review presents the recognised role of IDO1 and its influence on the kynurenine pathway, with emphasis on immunosuppression in kidney transplant protection.

Published
2022
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3. Immunity after COVID-19 Recovery and Vaccination: Similarities and Differences

Author

Dorota Kamińska, Dominika Dęborska-Materkowska, Katarzyna Kościelska-Kasprzak, Oktawia Mazanowska, Agata Remiorz, Paweł Poznański, Magdalena Durlik, and Magdalena Krajewska

Subjects
COVID-19, vaccine, immune response, Medicine
Abstract

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with a robust immune response. The development of systemic inflammation leads to a hyperinflammatory state due to cytokine release syndrome during severe COVID-19. The emergence of many new SARS-CoV-2 variants across the world deteriorates the protective antiviral immunity induced after infection or vaccination. The innate immune response to SARS-CoV-2 is crucial for determining the fate of COVID-19 symptomatology. T cell-mediated immunity is the main factor of the antiviral immune response; moreover, SARS-CoV-2 infection initiates a rapid B-cell response. In this paper, we present the current state of knowledge on immunity after COVID-19 infection and vaccination. We discuss the mechanisms of immune response to various types of vaccines (nucleoside-modified, adenovirus-vectored, inactivated virus vaccines and recombinant protein adjuvanted formulations). This includes specific aspects of vaccination in selected patient populations with altered immune activity (the elderly, children, pregnant women, solid organ transplant recipients, patients with systemic rheumatic diseases or malignancies). We also present diagnostic and research tools available to study the anti-SARS-CoV-2 cellular and humoral immune responses.

Published
2022
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4. The prevalence of complementary and alternative methods and their impact on conventional cancer treatment among oncological patients in Poland – an institutional study

Author

Agata Walas, Urszula Staszek-Szewczyk, Konrad Reszka, Natalia Kierbiedź, Mateusz Guzik, Krzysztof Szewczyk, Łukasz Moskal, and Agata Remiorz

Subjects
medicine.medical_specialty, business.industry, medicine, Medicine, General Medicine, oncological patients, polish health care system, Intensive care medicine, business, Cancer treatment, complementary and alternative medicine
Published
2021

5. Usefulness of the C2HEST Score in Predicting the Clinical Outcomes of COVID-19 in Diabetic and Non-Diabetic Cohorts

Author

Damian Gajecki, Adrian Doroszko, Małgorzata Trocha, Katarzyna Giniewicz, Krzysztof Kujawa, Marek Skarupski, Jakub Gawryś, Tomasz Matys, Ewa Szahidewicz-Krupska, Piotr Rola, Barbara Stachowska, Jowita Halupczok-Żyła, Barbara Adamik, Krzysztof Kaliszewski, Katarzyna Kilis-Pstrusinska, Krzysztof Letachowicz, Agnieszka Matera-Witkiewicz, Michał Pomorski, Marcin Protasiewicz, Marcin Madziarski, Klaudia Konikowska, Agata Remiorz, Maja Orłowska, Krzysztof Proc, Małgorzata Szymala-Pedzik, Joanna Zorawska, Karolina Lindner, Janusz Sokołowski, Ewa A. Jankowska, and Katarzyna Madziarska

Subjects
SARS-CoV-2, C2HEST score, diabetes mellitus, COVID-19, outcomes, mortality, prediction, Medicine, General Medicine
Abstract

Background: Diabetes mellitus is among the most frequent comorbidities worsening COVID-19 outcome. Nevertheless, there are no data regarding the optimal risk stratification of patients with diabetes and COVID-19. Since individual C2HEST components reflect the comorbidities, we assumed that the score could predict COVID-19 outcomes. Material and Methods: A total of 2184 medical records of patients hospitalized for COVID-19 at the medical university center were analyzed, including 473 diabetic patients and 1666 patients without any glucose or metabolic abnormalities. The variables of patients’ baseline characteristics were retrieved to calculate the C2HEST score and subsequently the diabetic and non-diabetic subjects were assigned to the following categories: low-, medium- or high-risk. The measured outcomes included: in-hospital mortality; 3-month and 6-month all-cause mortality; non-fatal end of hospitalization (discharged home/sudden-deterioration/rehabilitation) and adverse in-hospital clinical events. Results: A total of 194 deaths (41%) were reported in the diabetic cohort, including 115 in-hospital deaths (24.3%). The 3-month and 6-month in-hospital mortality was highest in the high-risk C2HEST stratum. The C2HEST score revealed to be more sensitive in non-diabetic-group. The estimated six-month survival probability for high-risk subjects reached 0.4 in both cohorts whereas for the low-risk group, the six-month survival probability was 0.7 in the diabetic vs. 0.85 in the non-diabetic group—levels which were maintained during whole observation period. In both cohorts, receiver operating characteristics revealed that C2HEST predicts the following: cardiogenic shock; acute heart failure; myocardial injury; and in-hospital acute kidney injury. Conclusions: We demonstrated the usefulness and performance of the C2HEST score in predicting the adverse COVID-19 outcomes in hospitalized diabetic subjects.

Published
2022

6. Should the men be exempted from vaccination against human papillomavirus? Health disparities regarding HPV on the example of sexual minorities in Poland.

Author

Konrad Reszka, Łukasz Moskal, Agata Remiorz, Agata Walas, Krzysztof Szewczyk, Urszula Staszek-Szewczyk, Konrad Reszka, Łukasz Moskal, Agata Remiorz, Agata Walas, Krzysztof Szewczyk, and Urszula Staszek-Szewczyk

Abstract

Introduction: Social campaigns concerning vaccinations against human papillomavirus (HPV) in Poland are mainly addressed to women. In addition to cervical cancer, anal, penile, and oropharyngeal cancers can be caused by the virus, which clearly affects men as well. HPV vaccinations are voluntary and mostly not refunded in Poland. Methods: A survey was published on social media’s group gathering males and contained questions concerning epidemiological data, knowledge about HPV, and opinions of HPV vaccination. A questionnaire was enriched with educational note regarding HPV-dependent cancers and available vaccines against HPV in Poland. Results: Because of age limitations, 169 males (115 heterosexuals, 48 homosexuals) aged 14-39 were chosen for the study. Seventy-five percent of heterosexual and 88% of homosexual men were aware of HPV, but less than 4% and 17% (respectively) were vaccinated against the virus. Main sources of knowledge about HPV were the Internet (61%), media (28%) and relatives (27%). HPV infection was linked with the development of anal and oropharyngeal cancers by 28%, and 37% of heterosexual males, compared with 56.3% and 43.8% of homosexual males. The majority of respondents (88%) indicated that all genders should be vaccinated, although only 57% were aware of HPV vaccination availability in Poland. Conclusions: The men are at risk of HPV-related cancers and the danger is poorly understood amongst Polish men. Despite awareness of HPV vaccines, the vaccination rate is low. Consequently, there is a serious need to broaden educational with a special attention to LGBTQ+ communities.

Published
2021

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