National Institute for Tuberculosis and Lung Diseases

Rabka-Zdrój, Poland

National Institute for Tuberculosis and Lung Diseases

Rabka-Zdrój, Poland
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Nowak J.K.,Poznan University of Medical Sciences | Wojsyk-Banaszak I.,Poznan University of Medical Sciences | Madry E.,Poznan University of Medical Sciences | Wykretowicz A.,Poznan University of Medical Sciences | And 9 more authors.
Lung | Year: 2017

Purpose: As life expectancy in cystic fibrosis (CF) increases, questions regarding its potential impact on cardiovascular health arise. Soluble vascular cell adhesion molecule 1 (sVCAM-1), P-selectin (sP-selectin) are proposed as biomarkers of cardiovascular disease. We aimed to: compare their concentrations in clinically stable CF patients and healthy subjects (HS) and verify whether they independently correlate with CF characteristics. Methods: Serum sVCAM-1 and sP-selectin levels were measured using ELISA. CF was characterized using: forced expiratory volume in 1 s, exocrine pancreatic and CF-related liver disease status, Pseudomonas aeruginosa colonization, serum high-sensitivity C-reactive protein, and body mass index (BMI). CFTR genotypes were classified as severe (classes I and II) or other. Results: 108 CF patients and 51 healthy subjects volunteered for the study. In the CF group BMI was lower (median [IQR]: 20.5 kg/m2 [18.4–22.2] vs. 21.6 kg/m2 [19.9–23.4], p = 0.02) and hsCRP levels were higher (3.6 mg/L [1.1–7.1] vs. 0.5 mg/dL [0.3–1.0], p < 10−10). While sVCAM-1 concentrations were greater in CF patients (1018 ng/mL [851–1279] vs. 861 ng/mL [806–979], p < 10−4), sP-selectin levels did not differ (155 ng/mL [129–188] vs. 156 ng/mL [144–177], p = 0.48). None of the multivariable regression models was valid for the prediction of sVCAM-1 and sP-selectin in CF. Conclusions: We found higher sVCAM-1 concentrations in CF patients than in healthy subjects, which were not explained by CF characteristics. Further research is required to check whether sVCAM-1 is a marker of microangiopathy in CF. © 2017 The Author(s)


Lisowska A.,Poznan University of Medical Sciences | Pogorzelski A.,National Institute for Tuberculosis and Lung Diseases | Oracz G.,Child Memorial Health Institute | Siuda K.,Poznan University of Medical Sciences | And 6 more authors.
Journal of Cystic Fibrosis | Year: 2011

Background: The aim of the present study was to assess the influence of antibiotic therapy on fat assimilation in cystic fibrosis (CF) patients with small intestine bacterial overgrowth (SIBO). Materials and methods: Twenty six pancreatic insufficient CF patients with bronchopulmonary exacerbation and diagnosed SIBO (positive hydrogen-methane breath test) entered the study. 13C mixed triglyceride breath test was performed before and after antibiotic therapy. Sixteen subjects were treated intravenously (ceftazidime and amikacin), ten patients orally (ciprofloxacin). Results: Cumulative percentage dose recovery changed significantly in the subgroup receiving antibiotics orally [median (mean ± SEM): 3.6% (4.5 ± 1.3%) vs. 7.2 (6.9 ± 1.6%); p = 0.019]. In the subgroup with intravenous drug administration, the tendency towards improvement was noted [2.7 (4.3 ± 1.5%) vs. 5.2 (5.7 ± 0.8%); p = 0.109]. Conclusions: Antibiotic therapy applied in CF patients with SIBO in the course of pulmonary exacerbation results in a significant improvement of fat digestion and absorption. © 2011 European Cystic Fibrosis Society.


Drzymala-Czyz S.,Poznan University of Medical Sciences | Kwiecien J.,Medical University of Silesia, Katowice | Pogorzelski A.,National Institute for Tuberculosis and Lung Diseases | Rachel M.,Provincial Hospital No 2 | And 6 more authors.
Journal of Cystic Fibrosis | Year: 2013

Introduction: Helicobacter pylori (H. pylori) is one of the most common bacterial infections worldwide. The prevalence of Hp infection in cystic fibrosis (CF) is unclear. Thus, the aim of our study was to determine the prevalence of H. pylori infection in CF patients and to correlate H. pylori presence with CF expression. Material and methods: The presence of H. pylori infection was assessed using a breath test with isotope-labeled urea in CF 79 patients compared to 302 healthy control subjects (HS). Results: Fifteen (19.0%) CF patients were H. pylori positive. No statistical differences in the basic clinical parameters or in their distribution were documented. No clinical factor was an independent risk factor of H. pylori infection. The corrected prevalence of H. pylori infection in pediatric CF patients and HS was 14.4% and 9.8%, respectively. Conclusion: The prevalence of H. pylori infection in CF patients is not different from that in healthy subjects. © 2013 European Cystic Fibrosis Society.


Lisowska A.,Poznan University of Medical Sciences | Mdry E.,Poznan University of Medical Sciences | Pogorzelski A.,National Institute for Tuberculosis and Lung Diseases | Szydlowski J.,Poznan University of Medical Sciences | And 3 more authors.
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2010

Introduction. Small intestine bacterial overgrowth (SIBO) has been reported in cystic fibrosis (CF) patients. However, the potential link to intestinal inflammation has not been studied so far. Therefore, we aimed to assess whether SIBO correlates with intestinal inflammation in CF patients. Material and methods. As a preliminary study, we assessed whether calprotectin is detectable in sputum expectorated by 10 CF patients. Since significant immunoreactivity was documented, in the major study we have included exclusively CF subjects not expectorating sputum for at least two weeks. Fecal calprotectin was measured in 25 CF patients and 30 healthy subjects (HS). All CF subjects were tested for the presence of SIBO using the hydrogen-methane breath test (BT). According to obtained results CF patients were divided into SIBO positive and negative subgroups. Subsequently, the intensity of intestinal inflammation in both subgroups was compared. Results. Fecal calprotectin concentrations in CF patients (range: 1.8-302.5; median 80.0 mg/L) were significantly higher (p < 0.00001) than in HS (not detectable - 15.5; 2.5 mg/L). Calprotectin levels were abnormal in 21 (84%) studied CF subjects and none of HS. Abnormal BT results were found in 10 (40.0%) of CF patients. Calprotectin concentrations in SIBO positive and negative patients did not differ. Conclusions. Gastrointestinal inflammation is a frequent finding in cystic fibrosis patients. However, small intestine bacterial overgrowth does not seem to be the major or at least not the only determinant of intestinal inflammation. Indirect measures of intestinal inflammation in CF patients may give false positive results. © 2010 Informa Healthcare.


Madry E.,Poznan University of Medical Sciences | Fidler E.,Poznan University of Medical Sciences | Sobczyska-Tomaszewska A.,Genomed Inc. | Lisowska A.,Poznan University of Medical Sciences | And 12 more authors.
European Journal of Human Genetics | Year: 2011

Taking into account the reported incidence of hypolactasia in cystic fibrosis (CF) and the possible impact of milk products on nutritional status we aimed to assess the genetic predisposition to adult-type hypolactasia (ATH) and its incidence in CF. Single nucleotide polymorphism upstream of the lactase gene (LCT) was assessed in 289 CF patients. In subject with 13910C/C genotype (C/C) predisposing to ATH, hydrogen-methane breath test (BT) with lactose loading was conducted and clinical symptoms typical for lactose malabsorption were assessed. The percentage of CF patients with C/C was similar to that observed in healthy subjects (HS) (31.5 vs 32.5%). Eleven out of 52 (24.5%) CF C/C patients had abnormal BT results. The recalculated frequency of lactose malabsorption was similar for the entire CF and HS populations (6.9 vs 7.2%). Similarly as in the control group, few CF patients have identified and linked to lactose consumption clinical symptoms. The frequency of LCT polymorphic variants in CF patients having and not having severe mutations of CFTR gene showed significant differences. The C allele was more frequent in homozygotes of the severe mutations than in patients carrying at least one mild/unknown mutation (P0.0028) and in patients with at least one mild mutation (P0.0377). In conclusion, CF patients carrying mild CFTR mutations seem to have lower genetic predisposition to ATH. Lactose malabsorption due to ATH in CF is not more frequent than in the general population. Symptomatic assessment of lactose malabsorption in CF is not reliable. © 2011 Macmillan Publishers Limited All rights reserved.


Walkowiak J.,University of Life Sciences in Poznań | Blask-Osipa A.,Poznan University of Medical Sciences | Lisowska A.,Poznan University of Medical Sciences | Oralewska B.,Child Memorial Health Institute | And 6 more authors.
Acta Biochimica Polonica | Year: 2010

Background: The coexistence of cystic fibrosis (CF) and celiac disease (CD) has been reported. To our knowledge there is no study directly comparing the incidence of CD in CF patients to that in the general population at the same time. There is no published data on genetic predisposition to CD in CF patients either. Therefore, in the present study we aimed to assess the genetic predisposition to CD and its incidence in CF patients comparing it to data from the general population. Patients and methods: Two hundred eighty-two CF patients were enrolled in the study. In 230 CF patients the genetic predisposition to CD (the presence of HLA-DQ2/DQ8) was assessed. In all CF patients, serological screening for CD was conducted. In patients with positive antiendomysial antibodies (EMA) gastroduenoscopy was offered. Intestinal histology was classified according to modified Marsh criteria. The results of serological CD screening in 3235 Polish schoolchildren and HLA-DQ typing in 200 healthy subjects (HS) were used for comparison. Results: Positive EMA was found in 2.84 % of the studied CF patients. The incidence of proven CD was 2.13 %. The incidence of CD as well as positive serological screening were significantly more frequent in the CF group than in the general population. The frequency of CD-related HLA-DQ alleles in CF and HS did not differ. Conclusions: Genetic predisposition to celiac disease in cystic fibrosis patients is similar to that of the general population. However, our results suggest that cystic fibrosis is a risk factor for celiac disease development.


Lisowska A.,Poznan University of Medical Sciences | Pogorzelski A.,National Institute for Tuberculosis and Lung Diseases | Oracz G.,Child Memorial Health Institute | Skorupa W.,National Tuberculosis and Lung Diseases Research Institute | And 4 more authors.
Acta Scientiarum Polonorum, Technologia Alimentaria | Year: 2010

Background. Available data suggests that small intestine bacterial overgrowth (SIBO) may frequently occur in cystic fibrosis (CF) subjects. SIBO may result in synthesis of enterotoxic and unabsorbable metabolites which may cause mucosal damage and - additionally - interfere with digestion and absorption. Such a relationship was documented in CF mouse model. Therefore, in the present study we aimed to assess the influence of bacterial overgrowth in small intestine in CF patients on lipid digestion and absorption. Material and methods. The study comprised 60 pancreatic insufficient CF patients, 30 children and 30 adults. All enrolled CF subjects were tested for the presence of SIBO using hydrogen/methane breath test with glucose loading. According to the obtained results CF patients were divided into SIBO positive and negative subgroups. Subsequently, 13C-labelled mixed triglyceride breath test was performed to assess lipid digestion and absorption. Cumulative percentage dose recovery (cPDR) was considered to reflect digestion and absorption of lipids. Results. SIBO was detected in 12 (40.0%) children and 11 (36.7%) adults with CF. The cPDR did not differ between SIBO positive and negative subgroups, neither when assessed separately for children (mean ±SEM: 5.5 ±0.8 vs. 7.4 ±1.0%) and adults (4.9 ±0.8 vs. 7.1 ±0.7%) nor for the entire studied population. Conclusions. Small intestine bacterial overgrowth does not seem to play a key role in lipid digestion and absorption in cystic fibrosis patients. © Copyright by Wydawnictwo Uniwersytetu Przyrodniczego w Poznaniu.


Opoka-Winiarska V.,Medical University of Lublin | Cofta S.,Poznan University of Medical Sciences | Mazurek H.,National Institute for Tuberculosis and Lung Diseases | Kozielski J.,Medical University of Silesia, Katowice
Pneumonologia i Alergologia Polska | Year: 2015

The proper care of cystic fibrosis patients extends over their lifetime. More than half of the children with the disease die before adulthood. An important element in the patient’s care is a time of transition from a paediatric to the care of an internist and the patient’s acceptance of this necessity. Transition from paediatric care to an internist should be adequately prepared. It is not only a question of transfer of medical records, but also careful preparation of patients for such transition. The patients expect not only continuity of care but also the introduction to the management with the disease. The creation of a base for specialist hospital treatment for exacerbation of the disease at the adulthood is an important element in the care of these patients. The problem has been solved in the children group, but is still waiting for solution in adults with cystic fibrosis. It has been proven that care in the centres carried out by a specialized team ensures longer life and better quality of life of these patients. The paper is an overview of these two important elements of care of adults with cystic fibrosis. © 2015 PTChP.


Stefanska J.,Medical University of Lódz | Sarniak A.,Medical University of Lódz | Wlodarczyk A.,Medical University of Lódz | Sokolowska M.,Medical University of Lódz | And 4 more authors.
Experimental Lung Research | Year: 2012

Asthma is an inflammatory airway disease, and oxidative stress was proven to be involved in its pathogenesis. Apocynin effectively inhibits the main source of reactive oxygen species (ROS)nicotinamide adenine dinucleotide phosphate (NADPH) oxidaseby blocking its activation. The aim of this study was to investigate the effect of inhaled apocynin on ROS and RNS (reactive nitrogen species) concentration in 14 nonsmoking mild asthmatics. Effects of nebulized apocynin (0.5 mg/mL) were assessed in exhaled breath condensate (EBC) after 30, 60, and 120 minutes, and safety parameters have been analyzed. Apocynin significantly decreased H 2O 2 concentration in EBC in comparison with placebo after 60 and 120 minutes. Moreover, apocynin significantly reduced NO - 2 concentration 30 and 60 minutes after nebulization and caused a significant decrease of NO - 3 concentration in EBC 60 and 120 minutes after administration, comparing with placebo. No adverse events have been observed throughout the study. This research confirmed anti-inflammatory properties of nebulized apocynin, which might be an effective and safe drug in bronchial asthma. © 2012 Informa Healthcare USA, Inc.


PubMed | National Institute for Tuberculosis and Lung Diseases
Type: Journal Article | Journal: Revista espanola de cardiologia | Year: 2010

Pulmonary thromboembolism falls between the areas of pulmonology and cardiology, internal medicine and intensive care, radiology and nuclear medicine, and hematology and cardiothoracic surgery. Depending on their clinical background, physicians faced with a patient with a pulmonary thromboembolism may speak different languages and adopt different treatment approaches. Now, however, there is an opportunity to end the Tower of Babel surrounding pulmonary thromboembolism. There is a growing acknowledgement that the key clinical problems in both acute pulmonary embolism and chronic thromboembolic pulmonary hypertension are linked to right ventricular pressure overload and right ventricular failure. As a result, cardiologists and cardiac intensive care specialists are taking an increasing interest in understanding and combating these conditions. The European Society of Cardiology was the first to elaborate comprehensive clinical practice guidelines for pulmonary thromboembolism and chronic thromboembolic pulmonary hypertension. The task forces involved in producing these guidelines included radiologists, pulmonologists, hematologists, intensive care physicians and surgeons, which ensured that the final document was universally acceptable. The aim of this article was to provide an overview of the epidemiology, risk factors, diagnosis, treatment, prognosis and prevention of acute pulmonary thromboembolism and chronic thromboembolic pulmonary hypertension, while taking into account European Society of Cardiology guidelines and incorporating new evidence where necessary.

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