Ustav Klinicke Imunologie A Alergologie

Brno, Czech Republic

Ustav Klinicke Imunologie A Alergologie

Brno, Czech Republic
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Krcmova I.,Ustav Klinicke Imunologie a Alergologie
Alergie | Year: 2011

Allergen specific immunotherapy is now recognized as an integral part of standardized therapeutical guidelines which efficacy is proved by Evidence Based Medicine standards. The sublingual application of therapeutic allergens is now recognized as safe route of administration in comparison with subcutaneous administration with superior compliance. The principal guidelines of WAO addressing sublingual administration of allergen immunotherapy (SLIT) were launched in 2009 year. The both efficacy, and safety of SLIT comparable with subcutaneous route of immunotherapy were substantiated in this pivotal document. The last variant of SLIT is the form of tablets containing standardized content of allergen. Grazax 75 000 SQ-T tablets were released into large scale clinical application in 2006 year. Grazax 75 000 SQ-T is lyophilized standardized allergen extract of grass pollen Phleum pratense (Phl p5). The SQ-standardized grass allergy immunotherapy Grazax (ALK-AbellóA/S, Hoersholm, Denmark) is indicated in children older than 5 years, adolescents and adults with clinically significant manifestations of allergic rhinoconjunctivitis induced by pollen grass allergens in whom allergic reactivity is substantiated by positive skin prick tests and/or the presence of allergen specific IgE antibodies reacting with pollen grass allergens.

Microbiota represent a complex ecosystem with enormous microbial diversity. The gastrointestinal tract of a new born infant is sterile. Soon after birth it is colonized by numerous types of microorganisms. The gut flora is quantitatively the most important source of microbial stimulations and provides a primary signal for driving the postnatal maturation of the immune system. Over the past years, differences have been documented in the composition of the intestinal microflora between healthy infants in countries with a low and high prevalence of allergy. In developed countries slow colonization of the intestine with enterobacteria may reduce exposure to lipopolysaccharides. Microbial deprivation could be overcome by probiotics which may modify the immune development. Therapeutic or preventive effects of certain probiotics on infectious and inflammatory diseases in children are documented.

Objective: To give an overview about the role of the innate immunity in pathogenesis of intraamniotic inflammation in pregnancies complicated by preterm premature rupture of membranes. Design: Review article. Setting: Department of Clinical Immunology and Allergy, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University in Prague. Method: An overview of recent published data. Conclusion: Immune system has an indisplaceable function throughout the successful pregnancy. Spontaneous labor is the result of many factors in which innate immunity playes a major role. The increased concentrations of proinflammatory markers (interleukin (IL)-1beta, IL-6, tumour necrosis factor alfa a IL-8) were found in amniotic fluid both in term and in preterm spontaneous delivery. These markers could be used for an early diagnosis of intraamnial infection/inflammation, which is the most common cause of preterm delivery (PTD) and preterm premature rupture of membranes (PPROM). The elevation of these markers could also better determine the patients with enhanced probability of PTD and PPROM.

Vojtech T.,Ustav Klinicke Imunologie A Alergologie
Epidemiologie, Mikrobiologie, Imunologie | Year: 2013

Patients with agammaglobulinaemia and hypogammaglobulinaemia require immunoglobulin G (IgG) replacement therapy to prevent serious infections. Since the 1950s, therapy with human immune globulin products has been the standard of treatment. Currently, the most common routes of administration of IgG replacement therapy are intravenous (IVIG) or subcutaneous (SCIG). The home therapy may improve the quality of life in patients who require lifelong IgG replacement. The anti- IgA antibody test identifies the patients with the risk of anaphylactoid reactions in IVIG replacement. The SCIG delivery may be used in patients with anti-IgA antibodies and previous systemic reactions to IVIG.

Early diagnosis of immunodeficiency makes possible early definitive therapy and avoids the complications of pretreatment infections. T-cell immunodeficiency defects become apparent as combined T- and B-cell deficiencies. Therefore, implementation of TRECs and KRECs into the newborn screening from dried blood spot will increase the preventive approach to early immunodeficiency diagnostics. Infants undergoing transplantation in the first 3 months of life have a much higher rate of survival than those undergoing transplantation later.

Krcmova I.,Ustav klinicke imunologie a alergologie
Interni Medicina pro Praxi | Year: 2013

Bronchial asthma is a significant condition of both childhood and adulthood. Chronic bronchial inflammation causes bronchial hyperresponsiveness that results in repeated episodes of wheezing on respiration, dyspnoea, chest tightness, and cough, predominantly at night and very early in the morning. This is accompanied by variable bronchial obstruction that is often reversible, either spontaneously or following treatment. The course of the disease is variable and, in terms of treatment response, it is crucial to determine the asthma phenotype. Phenotype changes caused by epigenetic mechanisms are characterized by high dynamism and reversibility. An increasing group of obese asthmatics and elderly asthmatics is becoming evident in the population; these aspects are dealt with in one part of the paper. The asthma phenotype associated with obesity is manifested by altered respiratory mechanics, a proinflammatory state of the metabolic syndrome, and reduced response to glucocorticoids. Obese asthmatic patients exhibit obstructive sleep apnoea, habitual snoring, hypoventilation, and gastro-oesophageal reflux. Weight reduction as part of tertiary prevention improves lung function and asthma symptoms. Senile characteristics modify the presentation of bronchial asthma in old age, with reduced sensitivity to symptoms and nonspecific presentation of the disease being typical. An originally allergic asthma appears in old age as nonallergic asthma sensitive to nonspecific and infectious stimuli. Reduced respiratory muscle strength, increased chest wall rigidity, and reduced lung elasticity all have a negative impact. The diagnosis is complemented by complicating comorbidities. When diagnosing bronchial asthma, you will find that it is not a definitive text, but a description of a condition that is evolving and subject to review throughout the life of an asthmatic.

Early diagnosis of immunodeficiency makes possible early definitive therapy and avoids the complications of pretreatment infections. B-cell defects constitute the majority of primary immunodeficiencies. All are characterized by the reduction in or absence of immunoglobulins and/or specific antimicrobial antibodies. Consequently, substitution of immunoglobulin G (IgG) is the pillar of treatment. T-cell immunodeficiency defects become apparent as combined T- and B-cell deficiencies.

Lokaj J.,Ustav klinicke imunologie a alergologie
Alergie | Year: 2015

The biological differences between males and females are an important source of variation affecting the immune response. In general, females typically develop higher innate, cell- mediated and humoral immune response than males. These differences are manifested as a more effective defense against infectious diseases but also as a higher readiness for inflammatory, allergic and autoimmune diseases. Sex based differences in vaccine efficacy, adverse events, and humoral immune response after immunization have been reported for many vaccines. Genetic, hormonal and environmental factors contribute to sex differences in immune function and disease pathogenesis.The expression of X- -linked genes. miRNA. epigenetic modulation as well as sex hormones, estrogens and androgens, through hormone receptors in immune cells, can affect responses to immunological stimuli differently in males and females. As evidenced by recent research, the physiological commensal microbiota contributes significantly to defining an immune response. Sex influences multiple aspects of the immunophenotype and must be consider as an integral component of an immune response. Despite data supporting sex based differences in innate and adaptive immune response. sex differences in biomedical and clinical research are yet often overlooked.

Multiple sclerosis (MS) is a chronic autoimmune disorder affecting the central nervous system through demyelination and neurodegeneration. Autoreactive T lymphocytes penetrate the blood-brain barrier to attack the nervous system. Fingolimod was approved as the first oral treatment for relapsing forms of MS. Its active metabolite, formed by in vivo phosphorylation, modulates sphingosine 1-phosphate receptors (S1PRs) and retains autoreactive lymphocytes in lymph nodes. Prompted by two fatal cases of herpes virus infections, fingolimod is the first MS therapy for which assessment of VZV status is advised. In seronegative patients inoculations of VZV vaccine are indicated before fingolimod treatment occurs.

Krcmova I.,Ustav klinicke imunologie a alergologie | Krejsek J.,Ustav klinicke imunologie a alergologie
Alergie | Year: 2015

Diagnostic allergens are classified as medical products and are regulated by the same legislative rules as medical drugs in European Union. The expenses for the registration of diagnostic allergens and cost to maintain these allergens on the market are substantially increased for these reasons. The result of these regulations is that the manufacturers restrict the range of diagnostic allergens. The basic scale of 18 diagnostic allergens which is recommended by the international guidelines (EAACI, GA2LEN study) is not available now. In vivo diagnostics of allergic diseases by prick test is now in largely unavailable. In vivo diagnostic procedures can not been replaced by in vitro diagnostic testing which is in addition more expensive. It is the only solution of this unfavorable condition. It is necessary to initiate the negotiation both on the national and European Union levels. The temporal solution could be exceptional import of diagnostic allergens which are not registered in our country.

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