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Introduction. The early effects of allergen-specific immunotherapy (SIT) in asthmatic children are still discussed. Currently the best available approach in the study of effectiveness of SIT is the clinical evaluation based on asthma symptoms scale and medication use. Aim of the study. The purpose of this study was to assess the early effectiveness of allergen immunotherapy in children with asthma allergic to house dust mite based on asthma symptoms, asthma medication use and lung function. Materials and methods. Sixty children with asthma recruited from our outpatient allergy clinic participated in the trial. All patients were allocated into the two study groups: receiving immunotherapy with dust allergens - the SIT group (n=30), and not receiving immunotherapy because of the lack of consent - control group (n=30). We analyzed the effect of SIT on asthma symptoms, the use of ICS (inhaled corticosteroids) and lung function. Results. Fifty eight patients completed the study (30 from SIT group and 28 from control group). After 12 months of immunotherapy we observed differences in changes in asthma symptom score between two groups; in the control group there was an increase in asthma symptom score and no changes in SIT group. There were no changes in asthma symptom score within groups. There were no changes in lung function between and within groups. After 12 months of SIT, a reduction in ICS dose, necessary to control asthma symptoms, was 50% and no changes were observed in control group. Conclusion. After 12 months of subcutaneous immunotherapy in asthmatic children allergic to house dust mite there was a 50% reduction in daily ICS dose necessary to control asthma symptoms in SIT group. The results confirm high efficacy of SIT and its effect on natural history of asthma in children. [ABSTRACT FROM AUTHOR]

Asthma is the most common pulmonary disease in children worldwide. As its prevalence significantly increases from 30% to 50% every 10 years it seems that finding the exact form of treatment is crucial to achieve a long-term-benefit effect. Sometimes it appears hard, especially in case of difficult and severe asthma when a standard therapy is not sufficient. The success of omalizumab inspired further studies which turned the spotlight on other pro-inflammatory cytokines such as TNF-alpha. After the success of anti-TNF-alpha therapy in many other inflammatory diseases such as for instance Crohn's Disease and Rheumatoid Arthritis, there appeared several trials discussing the usage of anti-TNF agents in asthma. The first wave of enthusiasm over positive results in treating asthma patients was blunted by other researches which challenged the benefit of anti-TNF-alpha in asthma. What is more, they warned about serious problems and adverse events related to that kind of treatment. These results hindered further investigation, especially in case of children's population, because of the ambiguity as far as the risks and benefits of the treatment were concerned. Nevertheless, the research on anti-TNF-alpha and asthma underlined a significant polymorphism in asthma phenotypes. It seems likely that a therapy with anti-TNF-alpha should be limited to a small subgroup of patients with a specific phenotype manifested by an increased TNF axis. The purpose of this review article is to discuss some recent patents in anti-TNF-alpha therapy.

Respiratory tract inflammations are among the most frequent diseases in children. In natural conditions, respiratory tract is constantly prone to environmental pathogens. In fighting the respiratory tract infections both non-specific and specific: humoral and cellular immune mechanisms, related to mucosa-associated lymphoid tissue (MALT), take part. In healthy subjects, the upper respiratory tract is affluent in physiological bacterial flora comprising aerobic and anaerobic bacteria, some of them potentially pathogenic. In periods of reduced immunity they can cause endogenous infections. Contrary to the upper, the lower respiratory ways are physiologically sterile. The imbalance between defense mechanisms and pathogenity of microorganisms can lead to the development of infection. Recurrent respiratory tract inflammations, due to complexity of their causes, are a problem of great importance. Early estimation of the etiology of recurrent inflammations is particularly crucial, as it allows introduction of aimed therapy and prophylactics, thus preventing the child from the development of irreversible pulmonary lesions and impairment of physical development.

Unlabelled: Recent studies have emphasied the role of eosinophils and it's metabolites in the pathogenesis of lung disease in cystic fibrosis. This study was designed to assess the relationship between serum and sputum ECP levels and clinical status of cystic fibrosis patients., Material and Methods: 30 patients, aged 6-30 with moderate cystic fibrosis were recruited. Spirometry, weight and high, and Shwachman-Kulczycki score were measured, and serum and sputum samples were obtained for measurements of the eosinophil cationic protein (ECP)., Results: We observed significant inverse correlation between sputum ECP levels and BMI (p<0.001) and FEV1 (p<0.001), and not significant inverse correlation between sputum ECP levels Shwachman-Kulczycki score (p=0.057). There was no signifi cant correlation between sputum ECP levels and FEF25/75% and between serum ECP levels and measured clinical parameters., Conclusions: Results of this study suggest influence of eosinophil inflammation in respiratory tract on clinical status of CF patients.