The study was designed to prove the hypothesis that lipopolysaccharide (LPS)-induced fever elicits the changes in surfactant specific proteins, potentially related to thermal tachypnea. In adult rats fever was induced by intraperitoneal administration of LPS at a dose 100 μg/kg of body weight; control group received saline. Respiratory parameters, arterial blood gases and pH and colonic body temperature (BT) were recorded. Five hours later, surfactant proteins (SP) A, B, C and D were evaluated in bronchoalveolar lavage fluid (BALF) and lung tissue (LT). LPS evoked monophasic thermic response (at 300 min 38.7±0.2 vs. 36.4±0.3 °C, P<0.05) and an increase in minute ventilation due to changes in breathing rate and tidal volume. LPS-instilled animals had higher levels of SP-A and SP-D in LT (P<0.05 and 0.01), and higher SP-D in BALF (P<0.01) than controls. SP-B increased in LT and SP-C in BALF of animals with LPS (both P0.05 vs. controls). The changes in all surfactant specific proteins are present in LPS-induced fever. Alterations of proteins related to local immune mechanisms (SP-A, SP-D) are probably a part of general inflammatory response to pyrogen. Changes in proteins related to surface activity (SP-B and SP-C) might reflect the effort of the body to stabilize the lungs in thermal challenge., M. Kolomaznik, I. Zila, J. Kopincova, D. Mokra, A. Calkovska., and Obsahuje bibliografii
To specify the role of individual cytokines in the immune response to pyrogens, isolated and cultivated human peripheral blood mononuclear cells (PBMC) were used for the experiments. Different pyrogens (lipopolysaccharide from Escherichia coli - LPS and live Borrelia afzelii) were applied and the time course of changes in concentrations of different cytokines in the medium was followed using the ELISA method. It was found that nonstimulated human PBMC proliferate under in vitro conditions and produce IL-6, TNF-a, IL-10 and finally also IL-1b. Productions of IL-12 and INF-g are not changed. Proliferation of PBMC is potentiated after incubation with LPS or live Borrelia. PBMC stimulated by LPS increase the net production (stimulated minus unstimulated) of IL-1b and TNF-a significantly, while production of IL-6 was smaller. A delayed increase in the production of IL-10 was also observed. Productions of IL-12 and INF-g were not influenced. In contrast to LPS, stimulation of PBMC with live Borrelia, increases also the production of IL-12 and IFN-g, besides IL-1b, TNF-a, IL-6 and IL-10. Productions of IL-1b, IL-6 and TNFa increased immediately after incubation with both LPS and Borrelia, while productions of IL-12 and INF-g begin to increase 8 hours and production of IL-10 12 hours after stimulation. Data indicate that stimulation with different pyrogens may activate the cells of the immune cascade in a different way. Stimulation of BPMC by LPS seems to activate the initial steps of the immune response (macrophages and granulocytes) only, while infection with live Borrelia also stimulates the later phase of the immune response, probably due to effect of initially produced cytokines., L. Janský, P. Reymanová, J. Kopecký., and Obsahuje bibliografii
To specify the role of individual cytokines in the immune response to pyrogens, isolated and cultivated human peripheral blood mononuclear cells (PBMC) were used for the experiments. Different pyrogens (lipopolysaccharide from Escherichia coli - LPS and live Borrelia afzelii) were applied and the time course of changes in concentrations of different cytokines in the medium was followed using the ELISA method. It was found that nonstimulated human PBMC proliferate under in vitro conditions and produce IL-6, TNF-a, IL-10 and finally also IL-1b. Productions of IL-12 and INF-g are not changed. Proliferation of PBMC is potentiated after incubation with LPS or live Borrelia. PBMC stimulated by LPS increase the net production (stimulated minus unstimulated) of IL-1b and TNF-a significantly, while production of IL-6 was smaller. A delayed increase in the production of IL-10 was also observed. Productions of IL-12 and INF-g were not influenced. In contrast to LPS, stimulation of PBMC with live Borrelia, increases also the production of IL-12 and IFN-g, besides IL-1b, TNF-a, IL-6 and IL-10. Productions of IL-1b, IL-6 and TNFa increased immediately after incubation with both LPS and Borrelia, while productions of IL-12 and INF-g begin to increase 8 hours and production of IL-10 12 hours after stimulation. Data indicate that stimulation with different pyrogens may activate the cells of the immune cascade in a different way. Stimulation of BPMC by LPS seems to activate the initial steps of the immune response (macrophages and granulocytes) only, while infection with live Borrelia also stimulates the later phase of the immune response, probably due to effect of initially produced cytokines., L. Janský, P. Reymanová, J. Kopecký., and Obsahuje bibliografii
Lyellův syndrom (syndrom toxické epidermální nekrolýzy) je raritně se vyskytující onemocnění, které poprvé popsal skotský lékař Alan Lyell v roce 1956. Je charakterizováno rozsáhlou kožní a slizniční nekrolýzou postihující minimálně 30 % tělesného povrchu a systémovými projevy. Podle četnosti výskytu se jedná o extrémně vzácnou nozologickou jednotku s incidencí 0,5–1,5/1 milion obyvatel a rok. Leyllův syndrom je považován za toxoalergickou reakci, spouštěčem je nejčastěji některé léčivo. Syndrom je spojen s vysokou letalitou (knižně udávanou v rozmezí 30–90 %). Neodkladná lokální i celková léčba na jednotkách intenzivní péče nebo na specializovaném pracovišti může zlepšit celkově špatnou prognózu pacientů. V naší kazuistice popisujeme vzácný případ pacienta s rozvojem Lyellova syndromu po práci s běžným fungicidním prostředkem, který je častou součástí vybavení zahrádkářů a zemědělců. Klíčová slova: bis-dithiokarbamidany – Leyllův syndrom – toxická epidermální nekrolýza, Leyll’s syndrome (syndrome of toxic epidermal necrolysis) is a rare disease, firstly described by Scottish doctor of medicine Allan Lyell in 1956. It is characterized by huge skin and mucosa necrolysis, which affects at least 30 % of body surface, and systemic symptoms. According to the frequency of the occurrence it is an extremely rare condition, with an incidence of 0.5–2 cases per million residents per year. Leyll’s syndrome is considered as a toxoallergic reaction, triggered mostly by some medication and it is associated with a very high mortality rate (in the literature reported between 30 to 90 %). Adequate and timely local and systemic treatment at the Intensive Care Unit or at the specialized clinic can improve the overall poor prognosis of the patients. In our case report we describe a very rare case of the Lyell’s syndrome after exposure to the antifungal organosulfur compound, which is widely used by the homegardners and farmers. Key words: bis-dithiocarbamates – Leyll’s syndrome – toxic epidermal necrolysis, and Ján Csomor, Bohuš Bunganič, Sergey Zakharov, Igor Pafčuga, Pavel Sedloň, Petr Urbánek
Autoři probírají kazuistiku 12leté pacientky s alergickou dispozicí, u níž v průběhu akutního horečnatého stavu s řadou komplikací byl v séru zachycen paraprotein IgM lambda. Při kontrolní elektroforéze, provedené za 4 měsíce, již nebyl prokazatelný. V článku je uvedena literatura zabývající se problematikou transientních paraproteinemií, diskutovány možné vztahy a příčiny. Transientní paraproteinemie jsou zřejmě častější, než se předpokládá., The case study of a 12 - year-old girl with allergic disposition is discussed. During an acute feverish condition accompanied with a number of complications, the IgM lambda paraprotein was found in the serum sample. In the subsequent control electrophoresis which was carried four months later, this paraprotein was not found any more. Literature dealing with the problems of transient paraproteinemias is included in this work and possible causal relations are discussed. Transient paraproteinemias seem to be more frequent than originally assumed., Jan Buryška, B. Mlejnková, M. Nieslaniková, and Lit. 13