Cross talk between NKT and regulatory T cells (Tregs) in prostatic tissue of patients with benign prostatic hyperplasia and prostate cancer

Background and Purpose: Regulatory T cells (Tregs) and NKT cells are two subpopulations of T lymphocytes that independently regulate innate and adaptive immunity, but there is some evidence for cross-talk between Tregs and NKT cells, which allow a new immunoregulatory networks. Activated NKT cells may modulate quantitatively and qualitatively the function of Tregs through IL-2-dependent mechanisms, while Tregs can suppress the proliferation, cytokine release and cytotoxic activity of NKT cells by cell-contact-dependent mechanisms. Tregs may control tumor expansion at the priming, as well as the effector’s phase of T immune responses. Tumor cells provide antigenic stimulation of T cells and interact with the tumor-infiltrated innate immune cells secreting cytokines that are crucial for T-cell differentiation. Patients and Methods: In this study we examined the prostate tissue infiltrating lymphocytes of patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) by flow cytometric technique (FACSCalibur) for determine the number of T, B, NK, NKT and Tregs and investigate the local regulatory immunosurveillance which allows the tumor’s immuneescape. Results: Our results have shown the statistically significantly elevated number of Tregs in prostatic tissue and slightly diminished percentage of NKT cells in prostate cancer patients in comparison to patients with benign prostatic hyperplasia. Conclusion: Although the exact mechanism is still unknown, increased infiltration of prostate tissue with T regulatory cells seems that stimulate the tumor to secrete factors (chemokines) that attract these cells in the tissue of the prostate where they achieve their anti-tumor effect and thus may contribute the tumor progressio

Učinak „Ruka-ruci“ fizioterapijskog pristupa na stabilnost ramena

Uvod: Nestabilnost ramena pojavljuje se kao prirođena ili traumatska, češće vezana za sport. Svaka peta osoba s problematikom ramena ima jedan od oblika nestabilnosti ramena. Cilj: Istražiti učinak „Ruka-ruci“ fizioterapijskog pristupa na stabilnost ramena. Materijali i metode: U istraživanje je uključeno 30 ispitanika (N=30). Provedeno je mjerenje propriocepcijskog indeksa straha i aktivnog opsega pokreta u ramenom zglobu prije početka i na kraju fizioterapije. Ispitanici su provodili „Ruka-ruci“ fizioterapijski postupak u trajanju od 18 dana. Rezultati: Dobiveni rezultati upućuju na statističku značajnost u smanjenju propriocepcijskog indeksa straha i povećanju opsega pokreta u ramenom zglobu (P<0,05). Zaključak: Istraživanje upućuje na učinkovitost „Ruka- ruci“ fizioterapijskog pristupa na stabilnost ramena

Učinak „Ruka-ruci“ fizioterapijskog pristupa na stabilnost ramena

Uvod: Nestabilnost ramena pojavljuje se kao prirođena ili traumatska, češće vezana za sport. Svaka peta osoba s problematikom ramena ima jedan od oblika nestabilnosti ramena. Cilj: Istražiti učinak „Ruka-ruci“ fizioterapijskog pristupa na stabilnost ramena. Materijali i metode: U istraživanje je uključeno 30 ispitanika (N=30). Provedeno je mjerenje propriocepcijskog indeksa straha i aktivnog opsega pokreta u ramenom zglobu prije početka i na kraju fizioterapije. Ispitanici su provodili „Ruka-ruci“ fizioterapijski postupak u trajanju od 18 dana. Rezultati: Dobiveni rezultati upućuju na statističku značajnost u smanjenju propriocepcijskog indeksa straha i povećanju opsega pokreta u ramenom zglobu (P<0,05). Zaključak: Istraživanje upućuje na učinkovitost „Ruka- ruci“ fizioterapijskog pristupa na stabilnost ramena

Determination of Enzyme Matrix Metalloproteinases-9 and Immune Status as Indicators of Development of the Environmental Diseases

The majority of environmental diseases are multifactorial airway illnesses, including genetic background and exposure to different kind of airborne irritants and allergens. Altered lifestyle and changes in environmental exposures contribute to the occurring of these diseases. The term of environmental illnesses includes the disease primarily caused by pollution of air and water, chemical and physical agents, radiation, contaminated food and direct contact with the toxins we are exposed to natural and/or working environment. The members of the matrix metalloproteinase (MMP) family are involved in the pathogenesis of COPD. MMPs comprise a large family of structurally related zinc metalloendopeptidases with different substrate specificities and possibilities to degrade protein constituents of the extracellular matrix. We investigated immunological status and level of MMP-9 in workers occupationally exposed to volatile aromatic hydrocarbons compared to urban residents and rural areas. The phenotypic profiles of peripheral blood lymphocytes were done by flow cytometry. The method of enzyme immunoassay (ELISA) was used to determine enzyme expression of matrix metalloproteinase-9 (MMP-9). The occupationally exposed group had a significantly elevated level of enzyme MMP-9 in the urine, accompanied with augmentation of cells of innate immunity in peripheral blood, which could contribute to the monitoring, early detection of environmental diseases and consequent earlier and more effective treatment

Early immunological events in postoperative epidural/intravenous analgesia after colorectal cancer resection

Background and purpose: Postoperative pain is a common consequence of extensive surgery with activation of the nervous system for the implementation of pain (nociceptive system), tissue injury or inflammation. As a result of tissue injury, many different mediators are released from damaged tissues, immunocompetent cells, sympathetic and sensory fibers which directly or indirectly activate nociceptors. Postoperative pain leads to suppression of the immune system, including reduced activity of NK cells, cytotoxic T lymphocytes and macrophages. Patients and Methods: We examined the effects of epidural and intravenous analgesia in patients after colorectal cancer surgery on the immune system. We analyzed the phenotype of isolated peripheral blood mononuclear cells of patients during first six postoperative days by flow cytometry and compared them with healthy volunteers. Results: Application of intravenous analgesia leads to statistically significant decreasing in the percentage of cells of innate immunity in comparison with them after epidural analgesia. Intravenous analgesia has led to a statistically significant reduction of subpopulation of T lymphocytes (CD3+) and B lymphocytes (CD19+) on the 6th postoperative day compared to epidural analgesia. Conclusion: Intravenous analgesia after colorectal cancer surgery has led to a statistically significant greater depression of innate and acquired immunity in comparison to epidural analgesia

Perforin Expression in Peripheral Blood Lymphatic Cells of Patients Subjected to Laparoscopic or Open Cholecystectomy

Perforin-(P-) related characteristics of cytotoxic T lymphocytes and natural killer cells were investigated in peripheral blood of patients subjected to open (OC; n = 23) or laparoscopic cholecystectomy (LC; n = 21) and healthy controls (n = 20). Blood samples were obtained preoperatively and 24 hours after the surgeries, and the data were correlated with the intensity of cholestasis and concomitant inflammation, determined by functional hepatic tests. Postoperative differences were found to be minimal: OC decreased only the percentage of CD56+ cells, while LC decreased the fraction of CD8+P+ cells and augmented the mean fluorescence intensity of P in CD56 cells. Patients elected for OC had, however, higher preoperative numbers of total P+, CD3+P+, and CD4+P+ cells than patients elected for LC and healthy controls, while both groups of patients, preoperatively, had lower fraction of CD16+P+ and CD56+P+ cells. These changes were in high correlation with blood concentrations of CRP, AP, and ALT, emphasizing the link between the preoperative cholestasis and inflammation and P-dependent cytotoxic mechanisms

Determination of Enzyme Matrix Metalloproteinases-9 and Immune Status as Indicators of Development of the Environmental Diseases

The majority of environmental diseases are multifactorial airway illnesses, including genetic background and exposure to different kind of airborne irritants and allergens. Altered lifestyle and changes in environmental exposures contribute to the occurring of these diseases. The term of environmental illnesses includes the disease primarily caused by pollution of air and water, chemical and physical agents, radiation, contaminated food and direct contact with the toxins we are exposed to natural and/or working environment. The members of the matrix metalloproteinase (MMP) family are involved in the pathogenesis of COPD. MMPs comprise a large family of structurally related zinc metalloendopeptidases with different substrate specificities and possibilities to degrade protein constituents of the extracellular matrix. We investigated immunological status and level of MMP-9 in workers occupationally exposed to volatile aromatic hydrocarbons compared to urban residents and rural areas. The phenotypic profiles of peripheral blood lymphocytes were done by flow cytometry. The method of enzyme immunoassay (ELISA) was used to determine enzyme expression of matrix metalloproteinase-9 (MMP-9). The occupationally exposed group had a significantly elevated level of enzyme MMP-9 in the urine, accompanied with augmentation of cells of innate immunity in peripheral blood, which could contribute to the monitoring, early detection of environmental diseases and consequent earlier and more effective treatment

Prognostic Value of Venoarterial Carbon Dioxide Gradient in Patients with Severe Sepsis and Septic Shock

Aim To investigate the changes in the venoarterial carbondioxide gradient (V-a Pco2) and its prognostic value for survival of patients with severe sepsis and septic shock. Methods The study was conducted in General Hospital Holy Spirit from January 2004 to December 2007 and included 71 conveniently sampled adult patients (25 women and 46 men), who fulfilled the severe sepsis and septic shock criteria and were followed for a median of 8 days (interquartile range, 12 days). The patients were divided in two groups depending on whether or not they had been mechanically ventilated. Both groups of patients underwent interventions with an aim to achieve hemodynamic stability. Mechanical ventilation was applied in respiratory failure. Venoarterial carbon dioxide gradient was calculated from the difference between the partial pressure of arterial CO2 and the partial pressure of mixed venous CO2, which was measured with a pulmonary arterial Swan-Ganz catheter. The data were analyzed using Kaplan-Meier survival analysis, along with a calculation of the hazard ratios. Results There was a significant difference between nonventilated and ventilated patients, with almost 4-fold greater hazard ratio for lethal outcome in ventilated patients (3.85; 95% confidence interval, 1.64-9.03). Furthermore, the pattern of changes of many other variables was also different in these two groups (carbon dioxide-related variables, variables related to acid-base status, mean arterial pressure, systemic vascular resistance, lactate, body mass index, Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology II Score, and Sepsis-related Organ Failure Assessment score). Pco2 values (with a cut-off of 0.8 kPa) were a significant predictor of lethal outcome in non-ventilated patients (P = 0.015) but not in ventilated ones (P = 0.270). Conclusion V-a Pco2 was a significant predictor of fatal outcome only in the non-ventilated group of patients. Ventilated patients are more likely to be admitted with a less favorable clinical status, and other variables seem to have a more important role in their outcome

Immune response in patients with cancer pain

The role of perioperative pain management techniques on immune functions in patients with malignancies is still poorly understood. Although the suppression of cellular and humoral immune response in carcinoma patients is a subject of great scientific interest, we know very little about the changes in innate immunity (natural killer T cells-NKT cells, regulatory T cells-Tregs) following tumor growth, as well as in acquired immunity and cytotoxic functions of NK cells in these patients undergoing surgery and the involvement of different perioperative analgesia techniques. Immune compromise could affect the healing processes, postoperative infections and rate and size of tumor metastases disseminated during operation and may be associated with increased risk of mortality immunosuppression is also a result of perioperative psychological and physiological stress induced by the mechanisms closely related to hypothalamus-pituitary-adrenocortical axis, sympathetic nervous system, cytokines, opioids and T cell signal molecule. Furthermore, peripheral and central immune reaction play a key role in hyperalgesia and allodynia, as a consequence of releasing proinflammatory cytokines (PIC) from activated microglia and astrocytes.Release of PIC causes the augmented secretion of excitatory neurotransmitters from synaptic nerves of primary afferent neuron, representing PIC as very important mediators of enhanced pain in the periphery and in the central nervous system. These findings emphasise that perioperative pain management in patients with malignancies is significant to attenuate developed serious immune suppression mediated by the complicated network of neuro-immuno-endocrine interactions caused by the primary disease accompanied with exogenous and endogenous stimuli