Efficacy of ciclesonide in the treatment of patients with asthma exacerbation.

Introduction: Progressing deterioration of the lung function, dyspnoea, cough, wheezing and chest tightness are the main features of asthma exacerbations. The first step in the prevention of severe asthma exacerbations is to intensify the anti-inflammatory treatment with high doses of inhaled corticosteroids (ICS).

Aim: To assess the efficacy of ciclesonide in patients who have been losing control of asthma despite being treated with medium doses of inhaled corticosteroids and long-acting β-agonists (LABA) as the second controller.

Asthma and exercise-induced respiratory disorders in athletes. The position paper of the Polish Society of Allergology and Polish Society of Sports Medicine.

Exercise-induced respiratory symptoms describe acute airway narrowing that occurs as a result of exercise. It includes exercise-induced bronchoconstriction (EIB) and exercise-induced asthma (EIA) issues. To provide clinicians with practical guidelines, a multidisciplinary panel of stakeholders was convened to review the pathogenesis of EIB/EIA and to develop evidence-based guidelines for the diagnosis and treatment.

Changes in blood eosinophilia during omalizumab therapy as a predictor of asthma exacerbation.

Introduction: Omalizumab is a monoclonal anti-immunoglobulin E antibody developed for the treatment of severe allergic asthma. The number of exacerbations used as a parameter of omalizumab therapy efficacy may be insufficient in many cases due to a relatively short time to first evaluation (16 weeks). Therefore, it is advisable to look for parameters of more prognostic value while continuing omalizumab therapy.

Omalizumab treatment in brittle asthma.

Asthma is a heterogeneous disease with variable characteristics such as lung function, symptoms and control, body weight, pattern of inflammation, and response to treatment. Brittle asthma is one of clinical phenotypes of asthma with unclear pathogenic mechanisms and appropriate treatment. Analysis of 2 described cases suggests that omalizumab could be useful in the treatment of brittle allergic asthma.

Inflammatory markers and acid-base equilibrium in exhaled breath condensate of stable and unstable asthma patients.

Background: Nitrosative and acid stress play an important role in the pathogenesis of asthma. The aim of this study was to evaluate whether, in asthmatics, a link exists between the concentrations of nitrite/nitrate, ammonia and pH values in exhaled breath condensate (EBC) and asthma severity, lung function, exhaled nitric oxide (F(ENO)), total IgE, eosinophil cationic protein (ECP) and blood eosinophilia.

Methods: The above-mentioned parameters were measured in 19 healthy volunteers and 91 allergic asthmatics divided into three groups, i.

[Statins and asthma].

Statins are drugs widely used in the treatment of hyperlipidemia and cardiovascular diseases. They decrease cholesterol synthesis by inhibiting 3-hydroxy-methylglutaryl reductase of coenzyme A (HMG-CoA). It was shown that statins are characterized by a wider spectrum of activity, which was attributed as an extralipid (pleiotropic) one.

Eotaxin-1 in exhaled breath condensate of stable and unstable asthma patients.

Background: Airway eosinophilia is considered a central event in the pathogenesis of asthma. Eotaxin plays a key role in selective eosinophil accumulation in the airways and, subsequently, their activation and degranulation. The study was undertaken to evaluate eotaxin-1 levels in the exhaled breath condensate (EBC) of asthmatics with different degrees of asthma severity and to establish the possible correlation of these measurements with other recognized parameters of airway inflammation.

RANTES in exhaled breath condensate of patients with severe persistent allergic asthma during omalizumab therapy.

Background: Omalizumab is a humanized monoclonal anti-IgE antibody developed for the treatment of IgE-mediated diseases, including asthma. The aim of the study was to determine the effect of omalizumab treatment on changes in RANTES in exhaled breath condensate and other inflammatory markers in patients with persistent severe asthma.

Methods: The study was conducted on a group of 19 patients with severe persistent allergic asthma treated with conventional therapy (according to GINA 2006) and with or without omalizumab (9 vs.

Anti-IgE therapy with omalizumab decreases endothelin-1 in exhaled breath condensate of patients with severe persistent allergic asthma.

Background: Omalizumab is a humanized monoclonal anti-IgE antibody, especially useful for the treatment of severe persistent allergic asthma, inadequately controlled despite regular therapy.

Objectives: The aim of the study was to determine the effect of omalizumab treatment on changes in endothelin-1 (ET-1), which plays an important role in the development of airway inflammation and remodeling in exhaled breath condensate (EBC) in patients with severe asthma.

Methods: The study was conducted in a group of 19 patients with severe persistent allergic asthma treated with conventional therapy (according to the Global Initiative for Asthma, 2006) and with or without omalizumab (9 vs.

Changes in high-sensitivity C-reactive protein in serum and exhaled breath condensate after intensive exercise in patients with allergic asthma.

Background: Exercise-induced bronchoconstriction (EIB) in asthmatics depends on the presence of allergic inflammation. This study was performed to assess the possible association of EIB with low-grade systemic inflammation, whose presence was revealed in asthmatic patients.

Methods: The study was conducted in a group of 24 asthmatics (14 with EIB, 10 without EIB) and 8 healthy volunteers.

[The role of interleukin 13 and interleukin 5 in asthma].

Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play roles. Interleukins 5 (IL-5) and 13 (IL-13) are cytokines which play important roles in the pathophysiology of asthma. Selective accumulation and activation of eosinophils in the bronchial mucosa is considered a central event in the pathogenesis of asthma.

[Beta-blockers and statins in the context of asthma].

Asthma is a disease with a complex pathogenesis and differentiated clinical picture with airway inflammation in its background. Many cells and cell-released substances are engaged in the course of the disease. The basic treatment strategy in asthma is based on chronic administration of inhaled glucocorticosteroids (with a strong anti-inflammatory effect) and beta2-adrenoreceptor agonists (bronchodilatory effect).

[Significance of C-reactive protein in asthma].

C-reactive protein (CPR) has been showed to be a specific and sensitive marker in diagnosing and monitoring of many inflammatory diseases. High-sensitive CRP is also a useful diagnostic tool to asses subclinical systemic inflammation in circulatory system diseases and diabetes. There is increasing evidence confirming the presence of systemic inflammation in asthma and the possibility of using hs-CRP in diagnosis and treatment monitoring of this disease.

[Anti-IgE therapy in persistent allergic asthma].

Asthma is a chronic inflammatory disease of airways. Approximately 40% of asthma cases can be attributed to atopy. An increased immunoglobulin E (IgE) production is the strongest predisposing factor for the development of asthma.

High-sensitivity C-reactive protein in the exhaled breath condensate and serum in stable and unstable asthma.

Background: Asthma is a chronic airway inflammatory disease. Measurement of serum high- sensitivity C-reactive protein (hs-CRP) levels has suggested the involvement of low-grade systemic inflammation in several disorders, such as cardiovascular disease and diabetes mellitus. In recent years, there have been some reports concerning hs-CRP assessment as a useful tool for detecting systemic inflammation in asthma.

N-acetyl-beta-hexosaminidase activity in asthma.

Background: N-acetyl-beta-hexosaminidase (beta-hex) is a lysosomal hydrolase, which is selectively secreted into the extracellular space by inflammatory cells. The aim of our study was to assess the activity of beta-hex in the plasma of asthmatic patients, and to establish whether it correlates with asthma severity and airway inflammation.

Methods: The study was conducted in a group of 46 asthmatic patients and 13 healthy volunteers.

Endothelin-1 in exhaled breath condensate of allergic asthma patients with exercise-induced bronchoconstriction.

Background: Exercise-induced bronchoconstriction (EIB) is a highly prevalent condition, whose pathophysiology is not well understood. Endothelins are proinflammatory, profibrotic, broncho- and vasoconstrictive peptides which play an important role in the development of airway inflammation and remodeling in asthma. The aim of the study was to evaluate the changes in endothelin-1 levels in exhaled breath condensate following intensive exercise in asthmatic patients.

[Exhaled breath condensate in the assessment of airway inflammation].

Exhaled breath condensate (EBC) is a novel, non-invasive method for obtaining samples from the lung. Use of exhaled condensate as a source of biomarkers is based on the hypothesis that aerosol particles of exhaled breath reflect the composition of airway lining fluid. The technique is simple to perform, effort-independent, rapid, may be repeated frequently, and can be easily perform even in young children, adults, or patients with severe disease.

[Syndrom Corrao--cough variant asthma].

Asthma is one of the most common aetiologies of chronic cough. In a subgroup of asthmatics, cough may be the predominant or sole symptom. This condition is referred to as cough variant asthma (CVA).

The role of endothelium-derived mediators in exercise-induced bronchoconstriction.

Background: Exercise-induced bronchoconstriction (EIB) is a highly prevalent condition whose pathogenesis and effect on airways remain unclear. The aim of the study was to evaluate the changes in endothelial-derived mediators following intensive exercise in asthmatic patients.

Methods: The study was conducted in a group of 25 asthmatic patients (15 with EIB, 10 without EIB) and 8 healthy volunteers.

[Measurement of airway inflammation in asthma].

Despite of the tremendous progress, which was made within the last few years in the diagnostics and treatment of asthmatic patients, there is a lack in a simple, non-invasive methods, which could be useful in the diagnostics and anti-inflammatory treatment monitoring. Invasive methods, such as bronchofiberoscopy (bronchoalveolar lavage fluid analysis and bronchial biopsy), enabled the better understanding of the pathophysiology of asthma and the elaboration of the grounds of pharmacological treatment of this disease. Unfortunately, these methods are less useful in the clinical practice due to their invasiveness.

Effect of ciclesonide and fluticasone on exhaled nitric oxide in patients with mild allergic asthma.

Ciclesonide is a novel, lung-activated, inhaled corticosteroid with once-daily efficacy and potent anti-inflammatory activity. The aim of the study was to compare the effect of ciclesonide and fluticasone propionate on exhaled nitric oxide (FENO), pulmonary function, and other parameters used in clinical evaluation of patients with mild allergic asthma. The study indicates that ciclesonide (in a daily dose of either 80 or 160 microg) induces both a faster and stronger decrease of FENO in comparison with fluticasone (100 microg twice daily).

[The role of measurement of exhaled nitric oxide in asthma patients].

The aim of the study was to evaluate exhaled nitric oxide levels (F(ENO)) in asthmatics and to establish the possible correlation of these measurements with clinical symptoms, disease severity, anti-inflammatory treatment and spirometric indices. The measurement of exhaled NO was performed using NO analyser model 280i, Sievers Instruments, Inc., USA.

[Exhaled nitric oxide (NO) in patients with respiratory tract diseases].

Nitric oxide (NO) is highly active molecule playing a key role in physiological as well as in pathological processes in the organism. Asthmatic patients show an increased expression of inducible nitric oxide synthase (iNOS) in airway epithelial cells and an increased level of NO in exhaled air. The aim of the study was to evaluate the exhaled NO in different groups of allergic patients and healthy volunteers.