Increased expression of selected very late antigen integrin subunits on CD4 and CD8 blood T lymphocytes in patients with clinically stable asymptomatic atopic asthma

Recruitment of the inflammatory cells from blood to the airways in asthma is mediated by adhesive molecules, e.g. selectins and integrins. The most important integrins in cells trafficking are molecules containing $\alpha_{4}$ and $\beta_{2}$ subunits. We hypothesized that also $\alpha_{1}\beta_{1}$ and $\alpha_{2}\beta_{1}$ integrins (both found by us on blood eosinophils. To assess the expression of selected very late antigen (VLA) subunits ($\alpha_{1}$, $\alpha_{2}$, $\alpha_{4}$ and $\beta_{1}$) on blood CD4 and CD8 T lymphocytes from stable atopic asthmatic patients. of asthmatic subjects) are important in asthma pathogenesis. The study was conducted on 25 adult atopic asthmatics (mild to moderate persistent asthma in a stable clinical condition) and 17 matched healthy controls using flow cytometry. Expression of $\alpha_{4}$ and $\beta_{1}$ on CD4 T cells was significantly higher in asthma than in controls. The $\alpha_{1}$ subunit was absent from blood lymphocytes. The $\alpha_{2}$ chain hardly detected on lymphocytes from healthy subjects was distinctively present in asthmatics. Surprisingly, in subjects suffering from asthma for longer than 4 years (n = 15), the overexpression of $\alpha_{2}$, $\alpha_{4}$ and $\beta_{1}$ was observed on both: CD4 and CD8 T cells. Expression of selected VLA subunits on blood T cells may depend on asthma duration. The biological role of $\alpha_{2}\beta_{1}$ integrin in asthma is unknown, but as it was described as a stimulator of collagen accumulation in the airways, $\alpha_{2}\beta_{1}$ integrin could be, at least in part, responsible for asthma airway remodelling

Evaluation of the quality of life in subjects with a history of severe anaphylactic reaction to the Hymenoptera venom

Introduction: Sensitization to the Hymenoptera venom is one of the main causes of anaphylaxis in Poland. Venom immunotherapy is the only effective treatment in such cases. Comprehensive patient care includes also education. The aim of our study was to assess the state of knowledge and to evaluate the quality of life and the anxiety level in patients allergic to the Hymenoptera venom after anaphylactic reaction. Material and methods: The survey was carried out in the period of the insects flight in 61 adult subjects (35 wasp and 26 bee allergic), using a validated Vespid Allergy Quality of Life Questionnaire (VQLQ), Hospital Anxiety and Depression Scale, and subjective assessment of anxiety level. The majority of respondents received venom immunotherapy. Results: Sensitized to the wasp venom had significantly impaired quality of life (VQLQ score) as compared to the bee venom allergic (p = 0.014). The intensity of anxiety decreased with the duration of immunotherapy (p = 0.01). The majority of subjects knew how to recognize and treat anaphylaxis, but only 8% employed an identification card and about 50% implemented rules of the pre-exposition prophylaxis. Conclusions: History of a severe anaphylaxis to the Hymenoptera venom affected the quality of life. Venom immunotherapy reduced anxiety. We hope that presented surveys and their results might be useful in qualifying for immunotherapy in clinically uncertain cases

Przejściowe korowe zaburzenia widzenia po zabiegu koronarografii

Koronarografia jest obecnie złotym standardem w diagnostyce choroby niedokrwiennej serca, w związku z czym częstość wykonywania przezskórnych zabiegów wieńcowych, tj. angiografii oraz angioplastyki, jest duża. Powikłania naczyniowo-mózgowe po koronarografii i koronaroplastyce są rzadkie i zazwyczaj obejmują przejściowe ataki niedokrwienne oraz udary mózgu. Częstość występowania przejściowych korowych zaburzeń widzenia po środkach kontrastowych jest niewielka. Zaburzenia te stwierdza się zazwyczaj w przypadku angiografii naczyń mózgowych. Przemijające korowe zaburzenia widzenia po zabiegu koronarografii opisano dotychczas jedynie u kilkunastu pacjentów. Biorąc pod uwagę szerokie i częste zastosowanie koronarografii na świecie, a także w Polsce, jest to więc wyjątkowo rzadkie powikłanie. Do I Kliniki Kardiologii i Nadciśnienia Tętniczego Szpitala Uniwersyteckiego w Krakowie przyjęto 32-letniego chorego z licznymi pobudzeniami dodatkowymi o morfologii bloku lewej odnogi pęczka Hisa, ze zmianami w spoczynkowym badaniu elektrokardiograficznym sugerującymi podejrzenie zespołu Brugadów, a także z obniżoną frakcją wyrzutową lewej komory serca. W celu wykluczenia podłoża niedokrwiennego obserwowanych nieprawidłowości chorego zakwalifikowano do koronarografii. W wykonanym badaniu nie stwierdzono zmian w tętnicach wieńcowych. Przebieg zabiegu był powikłany przejściowymi korowymi zaburzeniami widzenia, które odniesiono do neurotoksycznego działania kontrastu. W przeprowadzonej wówczas tomografii komputerowej mózgowia nie zaobserwowano patologii, a w badaniu okulistycznym i neurologicznym nie odnotowano przyczyn zgłaszanych dolegliwości. Zaburzenia widzenia ustąpiły samoistnie w ciągu kilkunastu godzin.Coronary angiography is the current gold standard for the diagnosis of ischemic heart disease and therefore the prevalence of percutaneous coronary procedures such as angiography and angioplasty is high. The occurrence of cerebral complications after coronary angiography and coronary angioplasty is low and it mainly includes transient ischemic attack and stroke. The prevalence of transient cortical blindness after X-ray contrast media is low and it is usually seen after cerebral angiography. Until now only a few cases of transient cortical blindness have been described after coronary artery angiography. Regarding the spread of coronary angiography worldwide and in Poland this complication is uniquely rare. A 32-year-old man with multiple extrasystolic ventricular arrhythmia suggesting Brugada syndrome diagnosis according to morphology of the left bundle branch block and with decreased left ventricular ejection fraction was admitted to the First Department of Cardiology and Hypertension, Medical College of the Jagiellonian University in Krakow. Coronary angiography was performed in order to exclude ischemic etiology of the observed abnormalities. No arteriosclerotic lesions were found in coronary arteries. Transient cortical blindness was observed directly after angiography which may have been caused by the neurotoxic effect of the used X-ray contrast medium. In ophthalmologic and neurologic examination as well as in the cerebral computed tomography scan no pathologies were found. Visual impairment disappeared totally within several hours