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Haloperidol is an antipsychotic agent that primarily acts as an antagonist of D2 dopamine receptors. Besides other receptor systems, it targets sigma 1 receptors (σ1Rs) and inositol 1,4,5-trisphosphate receptors (IP3Rs). Aim of this work was to investigate possible changes in IP3Rs and σ1Rs resulting from haloperidol treatment and to propose physiological consequences in differentiated NG-108 cells, i.e., effect on cellular plasticity. Haloperidol treatment resulted in up-regulation of both type 1 IP3Rs (IP3R1s) and σ1Rs at mRNA and protein levels. Haloperidol treatment did not alter expression of other types of IP3Rs. Calcium release from endoplasmic reticulum (ER) mediated by increased amount of IP3R1s elevated cytosolic calcium and generated ER stress. IP3R1s were bound to σ1Rs, and translocation of this complex from ER to nucleus occurred in the group of cells treated with haloperidol, which was followed by increased nuclear calcium levels. Haloperidol-induced changes in cytosolic, reticular, and nuclear calcium levels were similar when specific σ1 blocker -BD 1047- was used. Changes in calcium levels in nucleus, ER, and cytoplasm might be responsible for alterations in cellular plasticity, because length of neurites increased and number of neurites decreased in haloperidol-treated differentiated NG-108 cells.

Background: Chronic obstructive pulmonary disease (COPD) is a disease that is characterized by a persistent blockage of airflow from the lungs. It is an under-diagnosed, life-threatening disease which is not fully reversible. COPD is not only global health problem, the disease is also serious economic problem. Objective: The aim of this study was to evaluate the effects of implementation of new guidelines Global Initiative for Chronic Obstructive Lung Disease (GOLD) for diagnosis and treatment of chronic obstructive pulmonary disease (COPD). Design: Consecutive, observational, retrospective, mono-centric study. Methods: Into the study were included all patients admitted with COPD exacerbations to Department of Pneumology and Phtiseology, Jessenius Faculty of Medicine in Martin and University Hospital, separately in year 2008 and year 2013, who have satisfied the inclusion criteria. Those years were chosen specifically from the reason of biennial application of diagnosis and treatment, according to recommended guidelines GOLD 2006 and GOLD 2011, in practice. The study was focused on the basic anthropometric parameters, data of medical history, complications of underlying disease, comorbidities, laboratory parameters, treatment strategy of patients after release from hospital and mortality within one year were evaluated. Results: Patients in group 2013, when were applied guidelines GOLD 2011 had a higher average oxygen saturation and higher pO2 at all stages of the disease, significantly in GOLD D. They had higher values of FEV1 and FVC significantly in GOLD B. There was decrease of overuse of inhalation corticosteroids in group GOLD B from 53.34% to 28.57%. There was a downturn in use of theophylline, significantly in GOLD C. The average number of exacerbations leading to hospitalizations was lower in group 2013 in all stages of the disease. One-year mortality of patients in group 2013 was lower. Conclusions: The implementation and application of guidelines GOLD 2011 in practice is a challenging and complex process, which is in region of University hospital Martin gradually and successfully implemented. The achievement the objectives of the GOLD 2011 not only contributes to the efficiency of prevention and timely diagnosis, but mainly on setting of adequate treatment, improves survival and quality of life of patients with COPD.

Background and Aims Alpha1-antitrypsin deficiency (AATD) predisposes individuals to early-onset emphysema. Despite its prevalence, especially among patients with chronic obstructive pulmonary disease, AATD is still underdiagnosed. The aim of this study is to identify individuals with lung disease and severe AATD in central-eastern Europe. Methods Subjects with respiratory symptoms that could be indicative of AATD provided blood samples as dried blood spot. The alpha1-antitrypsin (AAT) concentration was determined by nephelometry and, if lower than 1.70 mg/dL in dried blood spot (equivalent to 1.04 g/L in serum), polymerase chain reaction was used to detect the PiS and PiZ alleles. Isoelectric focusing was used for confirmation of doubtful genotype results. Results From 13 countries, 11 648 subjects were included. Genotyping of 1404 samples with AAT levels

In December 2011, a major revision of GOLD 2011 guidelines was published based on the evidence-based medicine. The goal of GOLD 2011 is to determine the severity of the disease, its impact on the patient’s health, and the risk of future events; all of which eventually guide therapy. A combined COPD assessment according to GOLD 2011 considers the patient’s level of symptoms, spirometry abnormalities, risk of exacerbation, and the presence of comorbidities. GOLD 2011 stratifies patients into four basic groups labeled A, B, C, and D. The aim of the present study was to assess the importance of updated GOLD guidelines for the diagnosis, treatment, and prevention of COPD. We found that the multicomponent 2011 guidelines offer a significant advantage over the previous mono-component COPD assessment according to GOLD 2006 in terms of disease control and therapy management, with patients enjoying better spirometry values and a higher arterial oxygen content considered the primary outcomes of interest.

Haloperidol is an antipsychotic agent that primarily acts as an antagonist of D2 dopamine receptors. Besides other receptor systems, it targets sigma 1 receptors (σ1Rs) and inositol 1,4,5-trisphosphate receptors (IP3Rs). Aim of this work was to investigate possible changes in IP3Rs and σ1Rs resulting from haloperidol treatment and to propose physiological consequences in differentiated NG-108 cells, i.e., effect on cellular plasticity. Haloperidol treatment resulted in up-regulation of both type 1 IP3Rs (IP3R1s) and σ1Rs at mRNA and protein levels. Haloperidol treatment did not alter expression of other types of IP3Rs. Calcium release from endoplasmic reticulum (ER) mediated by increased amount of IP3R1s elevated cytosolic calcium and generated ER stress. IP3R1s were bound to σ1Rs, and translocation of this complex from ER to nucleus occurred in the group of cells treated with haloperidol, which was followed by increased nuclear calcium levels. Haloperidol-induced changes in cytosolic, reticular, and nuclear calcium levels were similar when specific σ1 blocker -BD 1047- was used. Changes in calcium levels in nucleus, ER, and cytoplasm might be responsible for alterations in cellular plasticity, because length of neurites increased and number of neurites decreased in haloperidol-treated differentiated NG-108 cells.

Evidence showed, that free radical species and nitric oxide (NO) or its derrivates are the key dominators in carcinogenesis. The aim of our study was to determine the alteration of NO derivates- nitrites, nitrates and 3-nitrotyrosine, as markers of oxidative/nitrosative stress in blood samples of lung cancer (LC) patients and to asses the importance of exhaled nitric oxide measurement (FeNO) in LC patients and and their relationship to type of cancer and smoking status. 54 newly diagnosed patients with LC and 43 healthy controls (HC) were studied. FeNO levels were measured by analyzer NIOX. Concentrations of NO 2- /NO 3– were assesed using the modified cadmium-reduction method based. 3-nitrotyrosine was assesed using specific antibody. Our results have shown that plasma nitrites concentrations in patiens with LC were significantly higher (4,41+/-2,24 µM) when compared with HC (2,53+/-1,39 µM). There was not difference between male and female, smokers and nonsmokers and LC types. There was not stastisticaly significant difference in level of nitrates in patients with LC (6,71+/-6,04 µM) and in HC (8,53+/-2,36 µM) regardless of gender, smoking status and type of cancer. Levels of 3-nitrotyrosin in patients with LC (0,22+/-0,17ng/ml) were significantly higher than in HC (-2,85 +/-0,34 ng/ml) regardless of type of cancer and smoking status. Patients with LC had significantly higher levels of FeNO (13ppb, IQR 8) than HC (10,1ppb, IQR 3,05) not depending on cancer type and smoking status. The prognosis of lung cancer is still poor because of the absence of valid approaches to its early detection. Exhaled breath analysis and measurements of NO derivates may provide useful assays in this field.

Clear cell renal cell carcinoma (ccRCC) is the most frequent type of kidney cancer. In order to better understand the biology of ccRCC, we accomplished the gene profiling of fresh tissue specimens from 11 patients with the renal tumors (9 ccRCCs, 1 oncocytoma and 1 renal B-lymphoma), in which the tumor-related data were compared to the paired healthy kidney tissues from the same patients. All ccRCCs exhibited a considerably elevated transcription of the gene coding for carbonic anhydrase IX (CAIX). Moreover, the ccRCC tumors consistently displayed increased expression of genes encoding the glycolytic pathway enzymes, e.g. hexokinase II (HK2) and lactate dehydrogenase A (LDHA) and a decreased expression of genes for the mitochondrial electron transport chain components, indicating an overall reprogramming of the energetic metabolism in this tumor type. This appears to be accompanied by altered expression of the genes of the pH regulating machinery, including ion and lactate transporters. Immunohistochemical staining of tumor tissue sections confirmed the increased expression of CAIX, HK2 and LDHA in ccRCC, validating the microarray data and supporting their potential as the energetic metabolism-related biomarkers of the ccRCC.

Objective Exhaled nitric oxide (eNO) has been suggested as a marker of airway inflammatory diseases. The level of eNO is influenced by many various factor including age, sex, menstrual cycle, exercise, food, drugs, etc. The aim of our study was to investigate a potential influence of circadian variation on eNO level in healthy subjects. Methods Measurements were performed in 44 women and 10 men, non-smokers, without respiratory tract infection in last 2 weeks. The eNO was detected at 4-hour intervals from 6 a.m. to 10 p.m. using an NIOX analyzer. We followed the ATS/ERS guidelines for eNO measurement and analysis. Results Peak of eNO levels were observed at 10 a.m. (11.1 ± 7.2 ppb), the lowest value was detected at 10 p.m. (10.0 ± 5.8 ppb). The difference was statistically significant (paired t-test, P < 0.001). Conclusions The daily variations in eNO, with the peak in the morning hours, could be of importance in clinical practice regarding the choice of optimal time for monitoring eNO in patients with respiratory disease.

Inhibition of phosphodiesterase 4 (PDE4) represents an approach to anti-inflammatory therapy in chronic obstructive pulmonary disease (COPD). GSK256066 is a potent and selective inhaled PDE4 inhibitor. The aim of this study was to investigate the safety and tolerability of 28 days repeat inhaled dosing with GSK256066 in moderate COPD.This was a Phase IIa, multicenter, parallel-group, double-blind, three-arm, placebo-controlled, four-week, randomized study with two doses of GSK256066 (25 μg, 87.5 μg). The primary endpoint was safety and tolerability. Secondary endpoints included changes in inflammatory markers in induced sputum and blood, lung function (spirometry, body plethysmography, impulse oscillometry), and pharmacokinetics.104 patients were randomized and 94 patients completed the study. The incidence and intensity of treatment-related adverse events were similar between treatment groups. The most frequent adverse event was nasopharyngitis and there were no serious adverse events in patients receiving GSK256066. The overall incidence of gastrointestinal adverse events was low in all treatment groups. There were no statistically significant changes in inflammatory markers in induced sputum and blood following treatment with GSK256066. Analysis of sputum mRNA suggested engagement of pharmacology, based on increased expression of cAMP-dependent genes including amphiregulin and CREM in subjects receiving GSK256066. There was a trend for an increase in post-bronchodilator FEV1 for both doses of GSK256066; in addition, for the 87.5 μg group, there was a mean reduction in residual volume of 0.367 L (95% confidence interval: 0.112, 0.622 L) relative to placebo.Administration of inhaled GSK256066 was well-tolerated in patients with moderate COPD. Further studies would be required to confirm the favorable safety profile and to demonstrate clinical efficacy of this compound. (ClinicalTrials.gov identifier: NCT00549679).

The role of the beta2-adrenergic receptor (ADRB2) genotype in patients with chronic obstructive pulmonary disease (COPD) is unclear. In patients with acute exacerbations of COPD (AECOPD), we assessed the role of ADRB2 haplotypes in morning lung function and in the bronchodilator response to salbutamol.In 107 patients with AECOPD, polymorphisms in the amino acid position 16 (Arg16/Gly16) and 27 (Gln27/Glu27) of the ADRB2 gene were assessed by allele-specific polymerase chain reaction, identifying 31 subjects with the Gly16/Glu27-negative and 76 with the Gly16/Glu27-positive ADRB2 haplotype. Pulmonary function and bronchodilator response to salbutamol were assessed using bodyplethysmography.Forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF) were significantly higher in the Gly16/Glu27-negative compared to the Gly16/Glu27-positive haplotype group at baseline (49.7+/-2.9% vs 42.4+/-1.8% predicted, P=0.037; 44.0+/-2.2% vs 36.4+/-1.6% predicted, P=0.008, respectively). FEV1, PEF, and forced vital capacity (FVC) increased from baseline to after salbutamol treatment in both the Gly16/Glu27-negative and the Gly16/Glu27-positive ADRB2 haplotype groups (P0.001 for all comparisons). Values for FEV1 and PEF after administration of the bronchodilator were significantly higher in the Gly16/Glu27-negative haplotype group compared with the Gly16/Glu27-positive haplotype group (P=0.030 and P=0.034, respectively). No differences were observed in DeltaFEV1, DeltaPEF, or DeltaFVC after bronchodilation between the 2 ADRB2 haplotype groups (12.2+/-1.8% vs 14.5+/-1.5% predicted, P=0.393; 12.2+/-3.3% vs 20.8+/-3.2% predicted, P=0.117; 9.1+/-2.3% vs 10.4+/-1.9% predicted, P=0.707, respectively).The present findings suggest that the ADBR2 gene haplotypes may affect the severity of obstructive ventilatory impairment but not the immediate response to salbutamol during AECOPD.

In several studies, hemodialysis (HD) patients treated with recombinant human erythropoietin (rHuEPO) because of renal anemia showed increased levels of soluble adhesion molecules. The purpose of the study was to investigate the changes of soluble P-selectin (sSELP) and its relationship to platelet activation during a single HD session in patients with long-term rHuEPO treatment. Fifty-two HD patients with chronic renal failure were involved—26 with rHuEPO treatment (EPO group) and 26 without (non-EPO group). Thirty healthy subjects served as the control group. The sSELP, β-thromboglobulin, and platelet factor 4 plasma levels were measured before and after a single 4-hour HD session on a cuprophane dialyzer. The basal β-thromboglobulin and platelet factor 4 plasma levels were significantly increased in both HD groups compared with healthy controls but did not change after a single HD session, except for a significant decrease of platelet factor 4 in the non-EPO group. The predialysis sSELP plasma levels did not differ significantly compared with those of the healthy controls, but there was a significant increase of sSELP levels after a single HD session in both groups (EPO, P < .005; non-EPO, P < .05, respectively). These results suppose that the increased sSELP level was released from platelets during the course of a single HD session. The more significant increase of the sSELP plasma levels in EPO group during HD indicates that platelets are more activated in patients with long-term rHuEPO treatment, and this fact could partially explain the suspected tendency for thrombosis in these patients.

Medical doctors should be the leaders in tobacco prevention activities. As role models for their patients and as helpers, leaders and activists, they are needed in campaigns to reduce smoking. We were interested in the smoking behaviour and attitudes towards smoking of Slovak medical students, who represent the next generation of medical doctors.

Objective Exhaled nitric oxide has been proposed as a noninvasive marker of eosinophilic airway inflammation in lower airways. The aim of the study was to investigate the impact of atopy, pollen exposure, and pharmacological treatment on NO production in lower airways of patients with allergic rhinitis. Subjects and methods Measurements of exhaled NO were performed in 79 non-asthmatic subjects with seasonal allergic rhinitis outside and in pollen season, before and after pharmacological treatment, and in 54 healthy controls. Results Patients with allergic rhinitis had significantly higher levels of exhaled NO (18.3 ± 11.0 ppb) than healthy controls (13.0 ± 7.2 ppb) measured outside the pollen season (P = 0.0024). Increased exhaled NO levels were also found in patients with allergic rhinitis in the pollen season (27.0 ± 20.0 ppb) compared with the levels outside pollen season (P = 0.0001), before pharmacological treatment. In rhinitic patients treated by nasal corticosteroids and antihistamines in the pollen season, the levels of exhaled NO were significantly lower (17.0 ± 16.4 ppb; P = 0.045) than those before treatment. No difference was found in NO levels in rhinitic patients outside and in pollen season after pharmacological treatment. Conclusions This study has shown the presence of eosinophilic airway inflammation in the lower airways in allergic rhinitis patients. A significant increase of exhaled NO after pollen exposure in rhinitic patients underlies the impact of inflammation on the upper respiratory tract. A bidirectional link between upper and lower airways is confirmed by a decrease in exhaled NO in the pollen season, almost to the starting levels, after application of topic corticosteroids and antihistamines.