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ABSTRACT: Sarcoidosis is a multiorgan granulomatous disease of unknown etiology. The predominance of Th1‑related cytokines is observed in the bronchoalveolar fluid (BALF) in pulmonary sarcoidosis. Recently, Th17 cells have been postulated to be involved in the pathogenesis of sarcoidosis. Sarcoidosis is more prevalent in nonsmokers than in smokers. The exact effect of smoking on granulomatous inflammation in this disease remains unclear.
The aim of the study was to evaluate the Th1/Th2/Th17‑related cytokine concentration in the BALF of patients with pulmonary sarcoidosis in relation to smoking status.
The study included 74 patients with confirmed pulmonary sarcoidosis. Data on smoking status were available for 61 patients (26 ever‑smokers, 35 never‑smokers; mean 11 ±9.1 pack-years in smokers). The concentrations of interleukin (IL) 17A (IL‑17A), IL‑10, IL‑6, IL‑4, and IL‑2 as well as interferon γ (IFN‑γ) and tumor necrosis factor α (TNF‑α) were measured in BALF supernatants using a flow cytometry method--the Cytometric Bead Array.
The median concentration of IL‑6, IFN‑γ, and IL‑17A (2.19 pg/ml, 1.28 pg/ml, and 6.08 pg/ml, respectively) did not differ significantly between smokers and nonsmokers. TNF‑α, IL‑10, IL‑4 and IL‑2 levels were below the detection limit in most patients. We observed a significant correlation between IFN‑γ concentration and the number of macrophages in BALF (r = 0.66, P <0.05) and between IL‑17A and IL‑6 levels (r = 0.94, P <0.05).
We confirmed a significant role of IL‑6, IFN‑γ, and IL-17A in the local inflammatory response in sarcoidosis. However, the interpretation of the limited number of cytokine measurements should be made with caution. Further studies are needed to explain the effect of smoking on the pathomechanism of inflammation in sarcoidosis.
Polskie archiwum medycyny wewnȩtrznej 07/2012; 122(7-8):320-5. · 1.37 Impact Factor
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ABSTRACT: Sarcoidosis is a multiorgan granulomatous disease of unknown aetiology. Bronchoalveolar lavage (BAL) is approved in diagnostics of sarcoidosis. The aim of the study was to assess epidemiological data, demographic status, clinical picture of sarcoidosis patients and to correlate above-mentioned findings with smoking status.
The study included 101 patients hospitalized due to suspicion of pulmonary sarcoidosis. The results of clinical assessment and smoking status data were obtained by retrospective analysis of 78 confirmed sarcoidosis case records.
Investigated group comprised 54 non-smokers (NS) and 24 smokers (S), including 9 (11.5%) active smokers (AS). Smokers were significantly younger than nonsmokers. Most of the smokers were males. The mean number of pack-years was 8.2. Respiratory symptoms occurred with similar frequency among non-smokers and smokers. The incidence of the Loefgren's syndrome was similar in S and NS . The pulmonary function tests results were comparable in both groups, however, the obstruction was more frequent among smokers. Composition of BAL fluid (BALf) differed significantly between S and NS. The total cell count was significantly higher among active smokers than among nonsmokers (29.3 +/- 19.2 x 10(6) vs 13.7 +/- 6.3 x 10(6)). Compared to non-smokers, smokers had higher number of macrophages and lower percentage of lymphocytes (11.3 +/- 11 x 10(6) vs 6.5 +/- 3.9 x 10(6), 29 +/- 19 vs 41 +/- 17%, respectively).
A significantly lower proportion of smokers is observed among sarcoidosis patients than in general population. The influence of smoking on clinical picture and results of pulmonary function tests is not evident in sarcoidosis. However, tobacco smoking causes significant alteration in the composition of BALf, which should be taken into account in diagnostics of sarcoidosis.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 05/2012; 32(191):298-301.
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ABSTRACT: IL-6 is strongly implicated in the development of chronic obstructive pulmonary disease (COPD). IL-13 is the well-documented central mediator in allergic asthma. IL-6 is attributed to the proinflammatory activities in COPD as well as asthma. In COPD patients exacerbation is increased by serum IL-6. The association of IL-13 as well as IL-6 with the impaired respiratory function of asthma patients remains controversial.
The aim of this study was to compare the concentration of IL-6 and IL-13 in the induced sputum of asthma and COPD patients, and to assess the possible association of these cytokines with the impairment of lung function.
Twenty-six subjects with COPD and 18 subjects with asthma were enrolled in this study. IL-6 and IL-13 levels were measured in induced sputum by ELISA and correlated with the results of respiratory tests.
The induced sputum of COPD patients had a significantly higher IL-6 level than the sputum of asthma subjects while no significant differences were found in the levels of IL-13. There was a statistically significant negative correlation between IL-6 level and FEV(1) or FEV(1)/FVC in asthma patients (r = -0.59 and -0.54, respectively) and a negative correlation that did not reach statistical significance between IL-6 level and FEV(1), FEV(1)% or FVC in COPD subjects (r = -0.30, -0.30 and -0.38, respectively). There was no relationship between concentrations of IL-13 and impaired respiratory function.
Our results confirmed that IL-6, but not of IL-13, is associated with respiratory disorders in both asthma and COPD patients.
Respiration 02/2012; 84(2):101-7. · 2.26 Impact Factor
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ABSTRACT: Asthma treatment requires control and monitoring. According to Global Initiative For Asthma (GINA) asthma severity is described by degree of control. The aim of the present study was to compare self-patients' opinions about asthma control with Asthma Control Test (ACT) scores. Furthermore factors associated with asthma control were analyzed in the examined group of patients. Age, BMI, the length and the degree of asthma treatment, concomitant diseases, physical activity, exposition to the tobacco smoke, needs for education and self-control were assessed.
The study was based on a 36-point questionnaire that evaluated last two years of asthma duration, the reference data were obtained by objective evaluation with ACT. Fifty three patients, 37 women and 16 men, median age 54 years (24-80 years), from outpatients clinic were enrolled into the study. According to ACT score the patients (pts) were divided into 3 groups: 25 points - well controlled asthma (group 1), 20-24 points - partially controlled asthma (group 2) and less than 20 points - lack of asthma control (group 3). Kruskal-Wallis test and Chi-square test were used to compare the characteristics of subjects in different ACT groups. Pearson's test was used for assessment of correlation between different parameters.
Twenty seven of 53 pts (51%) were treated with low dose of inhaled steroids and long acting beta-agonists (third degree of treatment according to GINA). During last two years the treatment was intensified in 37 pts (70%) due to exacerbation, and 19 of them (36%) were hospitalized in the course of exacerbation. Although 36 out of 53 pts (68%) claimed their asthma was fully controlled, ACT showed full control only in 5/53 (9%) of cases, partial control in 18/53 (34%), lack of control - in 30/53 (57%). Older age (p 〈 0.05) and longer duration of the disease (p 〈 0.01) were the factors significantly influencing lack of asthma control. A tendency towards worse asthma control was combined also with overweight and greater number of concomitant diseases (mainly coronary artery disease, diabetes and gastro-esophageal reflux). The presence of influenza vaccinations in medical history was associated with better asthma control (p = 0.05).
A discrepancy between subjective assessment of asthma control and ACT score was observed in the examined group of patients. The frequency of asthma exacerbations (according to questionnaire) was describing the degree of asthma control more precisely than self-assessment. Older age and longer disease duration were combined with significantly worse asthma control. Better asthma control was combined with the presence of influenza vaccinations in medical history.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2012; 80(3):198-208.
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ABSTRACT: 67-year old man in a good physical condition was admitted to the Clinic to diagnose mediastinal tumor which was noticed on chest radiogram. The patient reported chronic cough, sweats and weight loss (5 kg during 4 months). The elevated number of monocytes was the only abnormality in his laboratory tests. Chest computer tomography confirmed well separated solid tumor without calcifications (with focal necrosis) in anterior mediastinal area. No lymphadenopathy was observed. Radiological image suggested teratoma or other germ stem tumor. Considering undiagnostic bronchial forceps biopsy during bronchofibroscopy we performed percutaneous fine needle aspiration biopsy which suggested carcinoid. Patient was referred to Surgery Clinic to be operated. Histological examination of resected tumor showed atypical carcinoid of probably thymic origin.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 11/2011; 31(185):280-3.
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ABSTRACT: Bronchoalveolar lavage (BAL) is a useful technique for differential diagnosis of various interstitial lung diseases (ILDs) and is usually realized by analysis of the differential cell count. This study was conducted to estimate the value of bronchoalveolar lavage fluid (BALF) total cell count (TCC) in the diagnosis of ILD. We analyzed 237 BAL samples from patients with ILD: sarcoidosis (SA), idiopathic pulmonary fibrosis (IPF), cryptogenic organizing pneumonia (COP), hypersensitivity pneumonitis (HP), chronic eosinophilic pneumonia (CEP), and smoking-related ILD (sr-ILD). The control group consisted of 30 healthy volunteers. The statistical analysis revealed significant differences in the BALF TCC between healthy controls and patients with SA, IPF, HP, COP, sr-ILD, and eosinophilic disorders (mean values 6.9 vs. 14.5, 22.5, 22.8, 20.7, 64.5, and 27.3 × 10(6), respectively). Logistic regression revealed a significant relation between the TCC and ILD diagnosis. We conclude that the TCC, as well as the value of total number of inflammatory cells, should be reported in the description of BAL.
Inflammation 09/2011; 35(3):803-9. · 1.75 Impact Factor
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ABSTRACT: A 50-year old patient was admitted to the hospital with hoarseness persisting for two weeks. Chest computed tomography revealed enlargement of lymph nodes in the aortopulmonary window. The bronchoscopy did not show any abnormalities, in transbronchial fine needle aspiration biopsy no diagnostic material was obtained. In the biopsies collected during mediastinoscopy the sarcoid granulomas were recognized. In the follow-up the computed tomography revealed a tumor mass and diagnostic thoracotomy was performed in which pulmonary adenocarcinoma was recognized. After radiotherapy the total regression was achieved. In this case sarcoid-like reaction in the course of lung cancer and the diagnostic difficulties were described.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2010; 78(4):302-5.
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ABSTRACT: Small cell lung carcinoma (SCLC) is a very aggressive neoplasm. Accurate and quick diagnosis is crucial to initiate proper treatment. The aim of this study was to establish the value of initial cytological diagnosis and to present typical cytological features of SCLC.
We reviewed 116 cases of SCLC confirmed by cytology in: bronchial brushings, pleural fluids, and fine needle aspiration biopsies (FNAB).
In 77% of SCLC cases, the diagnosis was established only by cytology; in 23% of cases, both cytological and histological recognition was possible. Cytology of SCLC was initially uncertain in 12%, and histology was uncertain in 30% of the cases. The morphology of SCLC cells was not uniform, and often a mixture of non-small atypical cells and bronchial epithelial cells with signs of metaplasia was observed. There were four cases of combined cell type with large cell carcinoma and two with adenocarcinoma. The main diagnostic problem was to distinguish small cell lung carcinoma from lymphomas, and from cancer consisting of small cells with the cytological features of non-small cell carcinoma.
Diagnosis of SCLC in cytological smears is accurate, and final diagnosis is based on light microscopy. In the differential diagnosis, other tumours of small cells have to be taken into account.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2010; 78(3):203-10.
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ABSTRACT: Cigarette smoking is the most prominent risk factor for chronic obstructive pulmonary disease (COPD) and peripheral arterial disease (PAD). Prevalence of COPD among cigarette smokers is about 23% in Poland. Effort dyspnea which develops in advanced stage of COPD is the leading cause of seeking medical advice. Physical activity among patients with PAD is reduced due to intermittent claudication. It may cause delayed COPD diagnosis in this group of patients.
To estimate the prevalence of COPD among patients suffering from severe PAD who were hospitalized in surgery department due to critical limb ischemia and to evaluate difficulties during COPD diagnosis in this group of patients.
We examined 64 patients suffering from severe PAD (at least IIb stage according to Fontaine's scale). Patients were asked about the typical symptoms of COPD: chronic cough, regular sputum production and dyspnea. To evaluate the intensity of dyspnea we used British Medical Research Council scale. Spirometry was performed to every patient. Patients with airways obstruction underwent spirometry after the administration of inhaled bronchodilator. Every patient who had the post-bronchodilator value of FEV,/FVC ratio below the lower limit of normal values was diagnosed with COPD.
It was not possible to evaluate the dyspnea intensity using MRC scale in 44% of 34 patients who reported dyspnea. During the study we diagnosed 16 patients with COPD (9 pts had 1st stage of COPD according to GOLD classification, 7 pts--2nd). 9 patients had been formerly diagnosed with COPD (2 pts--1st stage, 5 pts--2nd, and 2 pts--3rd). Spirometry-defined COPD was present in 39% of study group. The analysis of data from patients with PAD coexistent COPD revealed that 60% of them were current cigarette smokers and 28% of them declared passive smoking exposure. The other known negative prognostic factors in patients with COPD such as BMI lower than 21 kg/mr2, FEV1% of predicted value below 65% and X-rays photograph visible emphysema were observed in 40%, 32% and 12% of patients with PAD and coexistent COPD respectively. Hypertension was present in 52% of patients with PAD and coexistent COPD, cardiac arterial disease in 52% and chronic heart failure due to cardiac arterial disease in 36%. Further analysis of laboratory tests revealed dyslipidemia and chronic kidney disease in 52% and 60% of these patients respectively.
COPD diagnosis among patients suffering from severe PAD involves several difficulties such as uselessness of MRC dyspnea scale and frequent heart diseases which delay the COPD diagnosis being considered as primary dyspnea reason. Many factors which have been proven to be responsible for worse prognosis due to COPD were observed in patients with PAD and coexistent COPD. High prevalence of COPD among patients suffering from PAD suggests the spirometry as a COPD screening would be justified in that group.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 08/2009; 27(158):92-6.
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ABSTRACT: Dynamic contrast-enhanced computed tomography (CECT) is one of the methods used in the evaluation of lung nodules.
The aim of the study was to evaluate the accuracy of the simplified method (based on only 2 postcontrast measurements) of dynamic CECT in determining the nature of pulmonary nodules.
Forty nodules (solid, 10-40 mm in diameter, spherical, with no visible calcification or fatty tissue) in 40 patients were analyzed. In 30 patients, the nature of the nodule was confirmed by pathological examination. In 10 cases, the nodules were assumed to be benign, as no growth within 2 years was radiologically documented. All patients underwent CECT according to a simplified protocol (based on pre-enhancement and 2 postcontrast measurements at 30 s and 4 min after contrast injection).
Twenty-three (57.5%) nodules were proved to be malignant and 17 (42.5%) benign. The 7 benign and none of the malignant nodules showed an enhancement value of < or = 15 Hounsfield units. Thus, the sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of shortened dynamic CECT were 100, 41, 70, 100 and 75%, respectively.
In CECT, contrast enhancement of a pulmonary nodule < or = 15 Hounsfield units is a reliable predictor of its benignity. Reduction in the number of postcontrast measurements in the simplified method of dynamic CECT does not influence its sensitivity.
Respiration 04/2009; 79(2):91-6. · 2.26 Impact Factor
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ABSTRACT: The detection of solitary pulmonary nodules (SPNs) has increased due to widespread use of computed tomography; nevertheless, chest radiographs still remain the basic routine examination. The aim of the study was to estimate the detection of SPNs in routine chest X-rays in hospitalized patients and to assess the incidence of malignancy in newly diagnosed SPNs.
We analyzed 5,726 routine chest radiographs of patients admitted to the Department of Internal Diseases, Pneumology and Allergology in 2004 and 2005. Most of the patients were admitted to hospital due to emergency reasons. The malignant nature of the nodules was confirmed by pathological examination. The nature of benign nodules was confirmed either by pathological examination or based on radiological criteria: no growth within 2 years of radiological follow up, regression in control radiograms or CT scans, benign pattern of calcification.
Among the 5,726 radiograms we found 116 newly diagnosed SPNs (2.2%). Twenty-four nodules (21%) were malignant: NSCLC in 21 cases and metastases in 3 cases. Fifty-one nodules (44%) were benign. In 19 patients (16%) SPNs proved to be artefacts or erroneously interpreted extrathoracic lesions. In 22 cases (19%) there was no final diagnosis (lack of data, diagnostic procedure renunciation).
The incidence of newly detected SPNs in chest X-rays was 2.2%. Most SPNs were benign. About 21% of SPNs were diagnosed as malignant.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2009; 77(1):37-42.
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ABSTRACT: In spite of intensified antitobacco campaigns and decrease in social acceptance for smoking it is still an important issue. In prevention there is a need to make smokers and non-smoking people aware of a level of exposure to tobacco smoke. One of the objective methods to evaluate this exposition is to measure a concentration of the carbon monoxide in exhaled air. The aim of our study was to evaluate the indication of carbon monoxide in exhaled air. The research was based on examination of 67 patients admitted to admission room in SP CSK, Warsaw. The level of carbon monoxide was measured with Smokerlyzer device in 56 cases (34 women, 22 men). Everyone in this group answered questions concerning a reason of admission to hospital, concomitant diseases, and addiction to smoking and ways of fight against the addiction as far as smokers are concerned. Current smokers answered also questions about their attitude to smoking and filled in Fagerström and Schneider tests. In a group of 67 patients 11 were not able to proceed the test with Smokerlyzer, 5 (45.5%) due to dyspnea, 4 (36.4%) due to lack of a verbal contact. In the group of 56 investigated patients 20 (35.7%) have never smoked, 32 (57.1%) were ex-smokers and 4 (7.1%) were current smokers. 3 (75%) of the smokers have tried to give up smoking 3 times on average. In the Fagerström test their mean came to 3.5 points, what indicates a low level of addiction. The Schneider test averaged out 8 points, what indicates a good motivation to give up smoking. The average of concentration of carbon monoxide in exhaled air came to 8 ppm (1.87% Hb) in this group. In the group of non-smoking patients the level of carbon monoxide came to 1.4 ppm (0.67%Hb). In the group of nonsmoking patients exposed to the tobacco smoke, the level of carbon monoxide came to 3 ppm (1.15%), but the difference was not statistically significant (p > 0.05). The increased CO level in exhaled air is usually caused by smoking cigarettes and exposure to ETS. All the smokers acknowledged the addiction. Routine use of Smokerlyzer in the admission room is limited, mainly by the dyspnea. Despite the practicality of CO level measurement, taking medical history of smoking is still the most important.
Przegla̧d lekarski 01/2009; 66(10):632-5.
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ABSTRACT: Few studies have evaluated exposure to passive smoking among current smokers. The aim of our study was to assess environmental tobacco smoke (ETS) in current smokers, as well as attitudes towards smoking.
We used a questionnaire containing questions about epidemiological information and the history of smoking, including exposure to ETS. The study was conducted in a group of 114 healthy individuals (mean age 29.7 years).
57 of the participants (50%) declared to be daily smokers, 32 (28%) had never smoked, 11 (9.6%) were ex-smokers, and 14 (12%) defined themselves as occasional-smokers. The total exposure to ETS of the entire group was 89.47% (current smokers 87.72%, never-smokers 93%). No significant difference in the range of exposure to ETS according to the place of exposure was found. Symptoms occurring most often during exposure to ETS in the group of smokers were: sputum production 42.1%, cough 31%, lacrymation 24.6%, wheezing 21.0%. Never-smokers suffered mainly from cough 50%, dyspnea 46.9%, lacrymation 46.9%. Wheezes occurred significantly more often in the group of current smokers than in never-smokers (21% v. 3.2%), while dyspnea was significantly more frequent in never-smokers than current smokers (48.4% v. 13.7%). Smokers were less in favor of introducing a smoking ban than never-smokers (public places 77.6% v. 100%, friends' houses 39.6% v. 86.7%, pubs and discos 41.1% v. 84.4%). Over 66% of smokers declared their wish to quit smoking. Seventy percent of subjects who had been exposed to ETS in childhood started smoking significantly earlier than those who had not been exposed.
Our study showed the problem of 'double' exposure to tobacco smoke. Current smokers are in favor of a smoking ban in public places.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 01/2009; 77(5):440-5.
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ABSTRACT: Small cell lung cancer constitutes 15-20% cases of lung cancers, currently the leading cause of death from malignant diseases. It also causes the demise of >90% of affected individuals in 5 years. We have established a new SCLC cell line STP54 derived from fine needle aspirate of metastatic supraclavicular lymph node of 54 -year-old women for model experiments. The primary tumor was diagnosed by histopathological examination as combined type of small cell lung cancer with a non-small cell component. We cultured the cancer cells in the RPMI 1640 medium. In the long-term culture only the small cell component survived. The cell line was established after 30 passages and then characterized by performing cell morphology, cell growth analysis, tumorigenicity in vitro and flow cytometry analysis of selected markers (like NCAM, cytokeratines, HLA-ABC, Fas, Bcl-2, p53, CXCR4, CD210). The cells were growing in floating aggregates and show features suggesting its invasiveness. We suggest that this new cell line may serve as a valuable tool for further studies on lung tumor biology, molecular pathogenesis and metastatic mechanism.
Folia Histochemica et Cytobiologica 01/2009; 47(1):111-5. · 0.81 Impact Factor
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Joanna Domagała-Kulawik
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ABSTRACT: The group of interstitial lung diseases (ILDs) is formed by respiratory tract disorders, whose aetiology is unknown in the majority of cases, the clinical course differs and the prognosis is generally serious. Some of the ILDs have a potential relation to tobacco smoking and are known as smoking-related ILDs (sr-ILD). Bronchoalveolar lavage fluid (BALF) examination is one of the initial procedures in the diagnosis of ILD. Despite the fact that histological confirmation is the gold standard in ILD diagnosis in many studies, the number of reported biopsies was low. In this review we present the results of BALF examinations of patients with sr-ILD and discuss their value in the differential diagnosis with other types of ILD. An extremely high total cell count (about 50 x 10(6) cells) with significant predominance of pigmented alveolar macrophages is a characteristic pattern of BALF in sr-ILD. The greatest challenge in BALF cytology interpretation is to distinguish sr-ILD and idiopathic pulmonary fibrosis (IPF). IPF is characterised by an elevated proportion and absolute count of lymphocytes and neutrophils; in addition, BALF lymphocytosis is higher in non-specific interstitial pneumonia than in usual interstitial pneumonia (UIP). The population of alveolar macrophage of patients with sr-ILD differs markedly from the foamy and vacuolated cells that predominate in IPF/UIP. Thus, the absence of pigmented cells rather excludes sr-ILD and indicates other types of ILD. To summarise, the place of BALF in the diagnosis of sr-ILD seems to be established.
Diagnostic Cytopathology 11/2008; 36(12):909-15. · 1.16 Impact Factor
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ABSTRACT: Chronic obstructive pulmonary disease (COPD) is characterised by chronic inflammation in pulmonary tissue and is also associated with systemic effects. The objective of this study was determination of lymphocyte subpopulation and the expression of Fas receptor on lymphocytes derived from peripheral blood of patients with stable COPD (n=18) and a control group: asymptomatic smokers (n=12) and non-smokers (n=12). Flow cytometry method with monoclonal antibodies was used for evaluation of lymphocyte subsets: CD4+ and CD8+ and the expression of Fas (CD95) on T lymphocytes. We found an elevated proportion of CD8+ cells in the blood of COPD patients. Proportion of Fas+ T lymphocytes was significantly higher in patients with COPD when compared with asymptomatic smokers and non-smokers (mean: 84.4% vs. 71.6% vs. 61.0% for Fas+/ CD4+ and 88.1% vs. 73.8% vs. 58.3% for Fas+/CD8+ lymphocytes). The proportion of Fas positive CD8+ cells significantly correlated with the degree of airway obstruction and hypoxemia. The significant correlations of Fas positive CD4+ and Fas positive CD8+ with smoking history expressed as pack years smoked were observed. Our observation of an elevated proportion of circulating lymphocytes bearing Fas receptor may play a role in induction of these cells' apoptosis and indicate the role of Fas/ FasL pathway in the changes in proportion of lymphocyte subpopulations in patients with COPD.
Respiratory Medicine 07/2007; 101(6):1338-43. · 2.47 Impact Factor
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ABSTRACT: Airway inflammation and remodeling are well recognized features of asthma. Remodeling is usually regarded as a consequence of chronic inflammation, however there are also data suggesting that remodeling is a relatively independent process in asthma. Neither inflammation nor remodeling is a uniform process. Thus the precise relationship between markers of inflammation and different patterns of remodeling are still matter of investigations. The aim of the study was to assess the relationship between total and differential cell count in induced sputum (IS) and BALF, and thickness of the basement membrane (BM) in patients with stable asthma.
18 patients with asthma (M/F 9/9, mean age 36 +/- 15 yrs). Duration of symptoms amounted to 12.7 +/- 11.5 years. Patients who have not been treated with steroids for at least 3 months were enrolled to the study. All patients underwent sputum induction and fiberoptic bronchoscopy with BAL and bronchial biopsies. Total and differential cell counts were measured in induced sputum and BALF. Light-microscopic measurements of BM thickness were performed in hematoxylin-eosin stained slides of bronchial wall specimens with semi-automatic software analysis.
Mean BM thickness was 12.9 +/- 2.8 microm (range: 8.5-20.7 microm). Total sputum cell count was 3.4 +/- 2.7 x 106 cells/ml, whereas in BALF 9.7 +/- 10.2 x 106 cells/ml. There was no correlation between differential cell count in induced sputum and BALF. No significant correlations between BM thickness and total and differential cell count in IS and BALF were observed. There also was no correlation between BM thickness and length of asthma duration or degree of the disease.
There was no relationship between BM thickness and total number of cells nor number of eosinophils in BALF and/or IS.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2007; 75(4):363-9.
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Joanna Domagała-Kulawik
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ABSTRACT: The role of quantitative methods in the cytological diagnosis of pulmonary diseases increases in recent years. Bronchoalveolar lavage (BAL) and induced sputum (IS) belong to these methods. Bronchoalveolar lavage plays an important role in the diagnosis of interstitial lung diseases, IS - in the differential diagnosis of asthma, chronic obstructive lung disease, persistent cough. Both methods are valuable in the evaluation of pathogenesis of lung diseases. The aim of this presentation is to show the main similarities and differences in the morphology of cells in the BAL and IS and difficulties in the interpretation of results of these examinations (on the basis of 1000 BAL and 200 IS smears). The preparation of cell smears according to the obligatory standards plays the most important role in the quality of BAL and IS. If the fluid is bloody or epithelial cells are numerous it can not be qualified as diagnostic. A very good knowledge of the cell morphology is necessary in the quantitative analysis. Epithelial cells, macrophages, lymphocytes, neutrophils and eosinophils are routinely identified. Alveolar macrophages are very numerous heterogeneous cell population in the BAL. IS macrophages are less numerous, are smaller in size, have more condensed cytoplasm, contain less cigarette smoke particles, have higher expression of activation markers than BAL cells. Neutrophils are larger and eosinophils more often degranulated in the IS than in the BALF. Interpretation of squamous epithelial cells needs caution because of the phagocytary function of these cells. This study details differences significant in quantitative and qualitative analysis of BAL and IS in routine and immunocytochemical tests.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2007; 75(3):261-7.
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ABSTRACT: Lung cancer is the most common malignancy in the world and frequency of allergic diseases increases especially in high-developed countries. In the literature there have been published articles about association between lung cancer and allergic diseases, which don't give a simple answer if there is any connection between them. The aim of this study was the assessment of frequency of allergy in patients with lung cancer. The study was based on medical records and questionnaire performed among patients hospitalized in Department of Pneumonology and Allergology Medical University of Warsaw and in Department of Thoracic Surgery Institute of Tuberculosis in Warsaw. The study included 113 patients (30 women and 83 men). Coexistence of allergy with primary lung cancer was observed in 7 cases which makes 6.2% (frequency of: asthma 1.8%, allergy to drugs 3.5%, allergy to animal's dander 0.9%). The result of this examination reveals that there is significant lower frequency of allergic diseases in patients with lung cancer in comparison with frequency of allergic diseases in adult population of Poland estimated at 15.8%.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2006; 74(2):144-8.
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ABSTRACT: The role of fiberoptic bronchoscopy in the diagnosis of peripheral lung nodule is controversial. The aim of the study was to evaluate the results of routine bronchoscopy performed in patients with peripheral lung nodule of 5-40 mm in diameter. From 60 patients with peripheral lung nodule, who underwent routine diagnostic fiberoptic bronchoscopy between 2003 - 2005, we selected 36 patients in whom the final discrimination between malignant and benign tumor was achieved based on either pathological examination or radiological criteria (lack of growth within 2 years of radiological follow up). There were 22 (61%) patients with malignant tumor and 14 (39%) with benign nodule. All malignant tumors were lung carcinomas. In 10 of these patients we found macroscopic abnormalities during bronchoscopy and in 9 of them pathologic examination of specimens collected during the procedure could confirm malignant tissue. In two patients with benign lung nodule a second lung lesion (in different lung lobe) which proved to be lung cancer was identified during fiberoptic bronchoscopy. Sensitivity, specificity and diagnostic accuracy of fiberoptic bronchoscopy in the diagnosis of peripheral lung nodules were 41%, 100%, and 64% respectively. Abandoning fiberoptic bronchoscopy in the diagnostic algorithm in patients with peripheral lung nodules seems unjustified, although its limitations should be taken into account.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/2006; 74(1):16-20.
