Absolute Number Of Eosinophils Research Articles

Опыт применения генно-инженерных биологических препаратов при тяжелой бронхиальной астме в Республике Саха (Якутия)

In the Republic of Sakha (Yakutia), from 2001 to 2020, the incidence of asthma is increasing from 4.1 per 1000 population to 12.5 per 1000 population. Considering that currently one of the most effective modern methods of treating severe asthma is genetic engineering biological therapy, research on biologically active medications, as well as the lack of research on this problem in the Yakut population, our work seems relevant. The purpose of this study was to evaluate the effectiveness of treatment with genetic engineering biological drugs (GEBD) in patients with severe asthma in the Yakut population. The study included 17 patients suffering from severe asthma. In 5 patients with severe asthma, the effectiveness of the following GEBD was assessed: anti IL-4, IL-13 drug, in 6 patients – anti IL-5 drug, in 6 patients – anti IgE drug. The effectiveness of treatment was assessed using the ACQ-5 symptom control test, the number of exacerbations over the previous 12 months of asthma therapy, IgE levels, the absolute number of eosinophils, indicators of external respiratory function, and the need of patients for additional asthma therapy. Before initiation, 8 (47.10%) patients had exacerbations and sought medical help; 2 patients were hospitalized in the pulmonology department; after 6 and 12 months, no exacerbations or hospitalizations in specialized hospitals were registered. When using a GEBD for 12 months, the need for inhaled corticosteroids decreased in micrograms/day. Thus, treatment of severe asthma in the Yakut population with GEBD makes it possible to achieve control over its symptoms, reduce the risk of severe exacerbations and the number of hospitalizations, and prevent side effects from high doses of standard therapy.

Features of local and systemic indicators in chronic rhinitis

Aim. The study of the features of local and systemic indicators in chronic rhinitis.
 Material and methods. The study groups included 21 patients with chronic allergic rhinitis, 20 patients with chronic vasomotor rhinitis, 9 patients with chronic atrophic rhinitis, 15 patients with chronic infectious rhinitis and 50 people from the control group. Diagnosis of chronic rhinitis, depending on the phenotype, taking into account the clinical recommendations of the Ministry of Health of Russia, was carried out by a doctor when the patient applied for treatment, followed by analysis of the data from a full range of instrumental examinations, clinical manifestations, anamnesis, and rhinoendoscopy results. 65 subjects with chronic rhinitis, as well as the control group, underwent a cytological examination of the nasal mucosa and an assessment of hematological parameters. Statistical analysis was carried out using the Statistica 10 package. Differences in groups were assessed using the nonparametric KruskalWallis test (for three or more comparison groups) and MannWhitney test (for pairwise comparison). The critical level of statistical significance in testing scientific hypotheses was p ˂0.05.
 Results. In chronic allergic rhinitis, three syndromes were locally identified: allergic syndrome (with a statistically significant increase in the absolute number of eosinophils up to 14 per field of view), non-specific inflammation syndrome (with a statistically significant increase in the number of leukocytes up to 9 per field of view) and a syndrome of protective changes in the nasal mucosa. At the same time, changes associated with allergic syndrome were recorded in the blood (with a statistically significant increase in the absolute number of eosinophils up to 0.84109/l). In chronic vasomotor rhinitis, changes in the nasal mucosa did not cause significant changes in the activity of blood cells. In chronic atrophic rhinitis, degenerative changes in the nasal mucosa (with a statistically significant decrease in the number of epithelial cells up to 2 per field of view; p14 0.001, p24 0.001) with local hemorrhagic syndrome were accompanied by the presence of statistically significant anemic (hemoglobin up to 109 g/l; p14 0.001, p24 0.001, p34 0.001, p45 0.001) and inflammatory syndromes in terms of blood parameters (with statistically significant leukocytosis up to 10109/l; p14 0.001, p24 0.001, p34 0.001). In chronic infectious rhinitis, local inflammatory syndrome with a statistically significant increase in the number of leukocytes up to 75 per field of view (p15 0.001, p25 0.001, p35 0.001, p45 0.001) with protective changes in the nasal mucosa confirmed by systemic inflammatory syndrome with statistically significant leukocytosis up to 12109/l (p15 0.001, p25 0.001, p35 0.001, p45=0.04), neutrophilic granulocytosis up to 9109/l (p15 0.001, p25 0.001, p35 0.001, p45=0.03) and an increase in the erythrocyte sedimentation rate up to 22 mm/h (p15 0.001, p25 0.001 , p35 0.001, p45 0.001) according to blood tests.
 Conclusion. The greatest number of local and systemic changes was found in chronic allergic and chronic infectious rhinitis, which requires increased attention to these diseases.

Cerebral sparganosis in a child with corpus callosum invasion: a case report

BackgroundInvasion of the corpus callosum by sparganosis is rare in children. After invading the corpus callosum, sparganosis has various migration modes, which can break through the ependyma and enter the ventricles, thus causing secondary migratory brain injury.Case presentationA girl aged 4 years and 7 months presented with left lower limb paralysis for more than 50 days. Blood examination showed that the proportion and absolute number of eosinophils in the peripheral blood were increased. Furthermore, enzyme-linked immunosorbent assay of serum and cerebrospinal fluid samples revealed positivity for IgG and IgM antibodies for sparganosis. Initial magnetic resonance imaging (MRI) revealed ring-like enhancements in the right frontoparietal cortex, subcortical white matter, and splenium of the corpus callosum. Within 2 months, a fourth follow-up MRI showed that the lesion had spread to the left parietal cortex, subcortical white matter, and deep white matter in the right occipital lobe and right ventricular choroid plexus, with left parietal leptomeningeal enhancement.ConclusionMigratory movement is one of the characteristics of cerebral sparganosis. When sparganosis invades the corpus callosum, clinicians should be aware that it may then break through the ependyma and enter the lateral ventricles, leading to secondary migratory brain injury. Short-term follow-up MRI is necessary to evaluate the migration mode of sparganosis and dynamically guide treatment strategies.

Comparison of Oxidative Stress Levels in Healthy Children and Children with Allergic Rhinitis.

Background/aim: Allergic rhinitis (AR) is characterized by chronic inflammation of the nasal mucosa. Under the influence of exogenous factors - allergens, reactive oxygen species (ROS) are released during cellular metabolism. They induce a series of pathological changes in the mucosa. Oxidative stress is а result of an imbalance between the production of ROS and the ability to neutralize them. The aim of this study is to compare the levels of oxidative stress between healthy children and children with allergic rhinitis. Material and methods: A total number of 60 children were included (30 healthy children and 30 children with AR). The oxidative stress index was determined by using the FRAS 5 (Free Radical Analytical System) Bravo system. Demographic characteristics, medical history, children's living conditions and eating habits were obtained from the questionnaire. Anthropometric measurements and the absolute number of eosinophils in the peripheral smear were performed on each child. Results: This study showed high oxidative stress index and a significantly higher value of the absolute number of eosinophils in the peripheral smear in children with AR in comparison to healthy children (p<0.05). The group of children with AR had more atopic characteristics and was more exposed to passive smoking than healthy children. Conclusion: Compared to healthy children, children with AR have a high index of oxidative stress, despite of the very high mean value of the concentration of water-soluble antioxidants in serum (PAT test) in the group of children with AR.

Risk factors for adverse outcomes in elderly patients with asthma and severe COVID-19 at the hospital and early post-hospital stages

Mortality and COVID-19 related factors are thoroughly analyzed. Given the large number of hospitalized patients, the potential short- and long-term COVID-19 related complications, further research is needed on the possible consequences of hospitalization, especially in higher-risk patients, after prolonged hospitalization and intensive care admission. To study the clinical course and outcomes of severe COVID-19 in elderly patients with asthma at the hospital and early post-hospital stages. The study included 131 elderly patients (WHO, 2020) >60 years old, n=131 with asthma, hospitalized for severe COVID-19. Of these, 86 (65.6%) patients survived, 30 (22.9%) died in the hospital, and 15 (14.9%) patients died after discharge from the hospital (in the 90-day post-hospital period). COVID-19 was confirmed by laboratory tests (SARS-CoV-2 PCR RNA test) and/or clinically and radiologically. All patients had a documented history of asthma. Patients were followed up during the hospital stay and for 90 days after discharge. Comparison of outcomes showed that in the groups of patients with a fatal outcome (regardless of the stage), the Charlson comorbidity index, respiratory rate, extent of lung damage assessed by computed tomography, the absolute leukocyte and neutrophil number and the ratio of neutrophils to lymphocytes were statistically significantly higher. The absolute number of eosinophils was lower in these groups. In the group of patients who died during hospitalization, severe (IV-V) asthma (p=0.03), steroid use during the previous year (p=0.02), chronic heart failure with a reduced ejection fraction (p=0.009) were more common, and atopic asthma phenotype was less common (p=0.02). In those who died after discharge, more common were non-invasive ventilation and diabetes mellitus (p<0.001). The multivariate regression analysis model revealed the most significant predictors of mortality at the hospital and early post-hospital stages. Adverse outcomes of severe COVID-19 in elderly patients with asthma include hospital and post-hospital mortality. The most significant predictors of mortality are the comorbidity index and low eosinophil count. Hospital mortality is associated with a higher ratio of neutrophils to lymphocytes and lower total protein levels; early (90-day) post-hospital mortality is associated with extensive lung damage shown by computed tomography and diabetes mellitus.

EFFECT OF NASAL CORTICOSTEROIDS ON OXIDATIVE STRESS PARAMETERS IN CHILDREN WITH ALLERGIC RHINITS

Oxidative stress (OS) is a result of an imbalance between the production of free radicals and the antioxidant defense mechanisms in the organism. Allergic rhinitis (AR) is characterized by chronic inflammation and increased presence of eosinophils, basophils and mast cells in nasal secretions and mucosa. Stimulation of these cells results in production of free radicals (reactive oxygen metabolites). The aim of this study was to determine the level of OS and antioxidant capacity in children with AR after 8 weeks treatment with nasal corticosteroid (NCS). Thirty children with AR (mean age 8.3 ± 2.9 years) were included. The FRAS 5 Bravo system was used to determine the OS parameters. Demographic characteristics, medical history, children's living conditions and eating habits were obtained from the questionarrie. Anthropometric measurements, absolute number of eosinophils in the peripheral smear and eosinophils in nasal smear were performed in each child. The mean value of blood concentration of serum peroxides (d-ROMs) was 403.4 ± 91.3 U. Carr, while the mean value of OS index was 95.1 ± 45.9. After 8 weeks of treatment with NCS, the mean values were 337.6 ± 71.9 U. Carr, and 53.6 ± 28.3, respectively. Both parameters had significantly lower values (p&lt;0.05) compared to those before the initiation of NCS therapy. After treatment, a significant improvement in the symptoms score of AR was detected (p&lt;0.05). NCS therapy makes asignificant improvement of the symptoms and a considerable reduction in the OS in children with AR. Keywords: allergic rhinitis, children, oxidative stress, d-ROMs, PAT, OSI

Hematological and immune disorders in colorectal cancer patients with liver metastases after radiofrequency ablation

Background. Colorectal cancer (CRC) is one of the most common malignant neoplasms in the world. It ranks third in the structure of oncological morbidity and second in the structure of mortality. The liver is the most common site of metastatic spread of CR and 14 to 18% of patients have liver metastases at diagnosis. Radiofrequency ablation is currently the most promising method of treating metastatic lesions.&#x0D; Рurpose – to study quantitative changes in hematoimmunological indicators and their influence on antitumor reactivity in patients with colorectal cancer after RFA of liver metastases.&#x0D; Materials and Methods. Clinical and laboratory examination was carried out in 12 patients with colorectal cancer with metastases in the liver, the majority of patients were over 60 years old. Adenocarcinoma was histologically determined in all patients, and most of them had a moderate degree of malignancy (G2). The study was carried out in three stages: I – one day before radiofrequency ablation (RFA), II – 3 days after RFA, III – 14 days after RFA of liver metastases.&#x0D; Results. Immune and hematological indicators of the development of the inflammatory response after RFA in patients with colorectal cancer with liver metastases were established. On the 3rd day (II stage) after RFA, a significant increase in the total number of leukocytes, the ratio of neutrophils to lymphocytes, the number of eosinophils, a violation of the balance of CD4+ and CD8+ lymphocytes, a decrease in the number of NK- and NKT-cells, an increase in the percentage of CD3+ HLA-Dr -, CD4 +PD1+, CD8+PD1+ lymphocytes. On the 14th day (stage III), most of the parameters were close to those determined before the treatment, except for the reduced number of NK and NKT cells and the increase in the level of platelets.&#x0D; Conclusions. A number of hematological changes on the 3rd day after RFA related to the inflammatory reaction were identified: an increase in the total number of leukocytes, an increase in the ratio of neutrophils/lymphocytes from 1.72 to 4.12, a significant decrease in the relative and absolute number of eosinophils. But on the 14th day, after the inflammatory reaction subsided, the normalization of most of the studied indicators was observed. A violation of the subpopulation composition of lymphocytes was established in patients with CR metastases in the liver, on the 3rd day after RFA. Those that had taken place even before the intervention (low number of CD8+ lymphocytes and NK cells) and additional ones appeared (increased CD4+/CD8+ ratio, increased percentage of CD3+ cells HLA-Dr+, CD4+ and CD8+ lymphocytes PD1+ (CD279+), decrease in the number of NKT cells). On the 14th day, the picture approached the initial one, with the exception of the number of NK and NKT cells. We believe that timely correction of inflammatory immunosuppression in the early days after RFA can shorten the period of vulnerability to recurrence of CR, and in the long term potentiate the positive effect of RFA on antitumor reactivity.

Changes in peripheral blood eosinophils may predict colorectal cancer – A retrospective study

BackgroundColorectal cancer (CRC) is a leading cause of morbidity and mortality worldwide. Eosinophils are traditionally associated and studied in context of allergic diseases. However, recent data implicate their involvement in mucosal tumors, especially in CRC where they may have an anti-tumorigenic function.Our objective was to evaluate whether trends in peripheral blood eosinophil numbers are associated with future diagnosis of CRC. MethodsThis retrospective cohort study included adult patients diagnosed with CRC compared to matched controls. We evaluated the linear change in the absolute number of eosinophils (ANE) in peripheral blood over time, described as a correlation coefficient (r). The timeline started 7 years and ended 3 months before diagnosis of CRC. ResultsWe included 8334 CRC patient/control pairs. Over the study period, no linear correlation was found between levels of eosinophils and time in either group. In a subset of patients (1350, 8.1%), a positive linear correlation was found between levels of eosinophils and time. CRC was significantly more common in these patients (59% vs. 41%, p < 0.01). In a logistic regression, positive r was found to be an independent predictor for CRC (OR 1.31, 95%CI: 1.22–1.41, p < 0.001) with high specificity (0.93) but low sensitivity (0.1). ConclusionWe found higher risk for CRC in patients with a positive linear increase in peripheral eosinophils over time. This may be an indirect clue that eosinophils play a role in the pathogenesis of CRC. Linear changes in ANE may be used in the future to improve screening measures for CRC. Trial registrationNot relevant.

Haematological profiles of pigs of different age in relation to the presence or absence of porcine reproductive and respiratory virus, porcine circovirus type 2 and hepatitis E virus

This study was aimed to assessing haematological parameters in pigs of different age categories from six farms differing in the presence or absence of selected pathogens. The following categories were included: 5 age groups of growers, fatteners and breeding sows. Individual blood samples for determining complete blood count and white blood cell differential count were taken. Group samples of oral fluid and faeces were collected from each farm and tested for detection of Porcine Reproductive and Respiratory Virus (PRRSV), Porcine Circovirus Type 2 (PCV2), and Hepatitis E Virus (HEV) using PCR, RT-PCR, and qRT-PCR protocols. On farms free of PRRSV, PCV2 and HEV, the age of pigs had significant effect on: white blood cell count (WBC), haemoglobin concentration (Hb), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration, platelet count (PLT), percentage of neutrophils, lymphocytes and eosinophils and absolute numbers of neutrophils, lymphocytes, monocytes, basophils and ‘large unstained cells’ (LUCs). On positive farms all observed blood parameters except the percentage of LUCs were significantly affected by the age. The percentages of lymphocytes, mean corpuscular volume (MCV) and haematocrit were significantly lowered by PRRSV, while WBC, PLT, percentage and absolute numbers of neutrophils, basophils and LUCs were increased. Nine-week-old pigs with PCV2 had significantly lower red blood cell count, PLT, percentage and absolute numbers of monocytes and LUCs, and significantly higher MCV, MCH, percentage of neutrophils and percentage and absolute number of eosinophils than 9-week-old pigs with PCV2 and HEV. Age-related changes in haematological parameters occurred in PCR negative and positive farms. HIGHLIGHTS Age-related changes in haematological parameters were present in PCR negative farms and in PCR positive farms in relation to selected pathogens. Values for several haematological parameters in 9-week-old pigs with a monoinfection differed significantly from those in pigs of the same age with two viral infections. To interpret results of haematological analyses correctly, it is important to consider the haematological analyser used, the pig age and, health history, and clinical data.

#74 PROGNOSTIC ROLE OF EOSINOPENIA IN CHILDHOOD SEPSIS

Abstract Background Sepsis constitutes one of the most common causes of morbidity and mortality in children. To improve the survival of childhood sepsis, while reducing the risk of antimicrobial resistance, it is obligatory to perform disease risk stratification and risk-adapted antimicrobial treatment. Recently, procalcitonin and C-reactive protein (CRP) are widely used as markers in tertiary health facilities. Due to financial constraints, however, it is not possible to determine procalcitonin and CRP levels in the majority of health facilities in developing countries. A number of studies described that the absolute number of eosinophils decreases in the acute phase of bacterial infection. Method This medical record-based cross-sectional study involved children 1 – 18 years of age with the clinical suspicion of sepsis, who were admitted to Dr. Sardjito General Hospital during the period of 2017 – 2021. Children, who received immunosuppressive agents and had no complete medical record data, were excluded from this study. Results A total of 149 children were included in which 7.4% (11) cases with eosinopenia and 52.3% (78) cases with sepsis. Septic patients with eosinopenia had a mortality rate 33.3% less than patients without eosinopenia at 43.2%. There was no significant difference, p= 0.731. This means that there was no effect of eosinopenia on mortality. Out of 78 proven sepsis cases with microbial culture 7.69% (6) with eosinopenia and 94.73% without eosinopenia. There was not a significant difference (p = 0.880) between eosinopenia and sepsis. Conclusion Eosinopenia cannot be used to prognostic mortality childhood sepsis.

Asthma and COVID-19 in the elderly: course, survival, predictors of mortality

Bronchial asthma occurs in 0.9 – 17% of patients hospitalized with COVID-19. However, it is not clear whether asthma is a risk factor for the development and severity of COVID-19. Studies have shown that patients with asthma appear to be more susceptible to COVID-19 infection, but severe disease progression is not related to medication use, including asthma biologics, but rather to older age and comorbidities.Aim.To evaluate the clinical course of SARS-CoV-2 infection in elderly patients with asthma, to examine the effect of asthma and comorbidities on COVID-19related outcomes, and to determine predictors of mortality.Methods.Elderly patients [WHO, 2020] (&gt; 60 years,n= 131, median age 74 (67; 80) years; 59 men, 72 women) with asthma hospitalized for COVID-19 were included in the study. COVID-19 was confirmed by laboratory tests (PCR smear) and/or clinical and radiological examinations. All patients had a history of a documented diagnosis of asthma (GINA, 2020).Results.Out of 131 patients, 30 (22.9%) died in the hospital, and 15 (14.9%) died after discharge from the hospital (within 90 days). The group of patients with lethal outcome showed the following differences from those who recovered: values of Charlson index, respiration rate, degree of lung damage on CT scan, absolute number of leukocytes, neutrophils and neutrophils-to-lymphocytes ratio, C-reactive protein on the 5th day of hospitalization, and LDH were statistically significantly higher, while absolute number of eosinophils, total protein content, SpO2and SpO2/FiO2levels were lower; steroid intake during the year and non-atopic asthma were more common. Multivariate and ROC analysis revealed the most significant predictors of hospital mortality and their thresholds: Charlson comorbidity index ≥ 6 points, neutrophil/lymphocyte ratio ≥ 4.5, total protein ≤ 60 g/l, eosinophil level ≤ 100 cells/μL.Conclusion.The most significant predictors of hospital mortality in elderly patients with severe COVID-19 against asthma are Charlson comorbidity, neutrophil/lymphocyte ratio; lower eosinophil and total protein levels. Survival time of patients has an inverse correlation with the number of mortality risk factors present.

Principles of modern diagnosis and treatment of atopic dermatitis and bronchial asthma: Clinical case

This article presents the experience of successful use of the drug dupilumab in a patient with severe atopic dermatitis and bronchial asthma. The effectiveness of biological therapy with dupilumab 300 mg subcutaneously for 52 weeks of T-2 associated diseases, including a combination of severe atopic dermatitis and bronchial asthma, uncontrolled course based on the case history of patient Ts., born in 2006 with the diagnosis "Main: atopic dermatitis, common form, severe course. Concomitant diagnosis: bronchial asthma, persistent course, uncontrolled, moderate severity". Dynamic monitoring of the total blood count with the calculation of the absolute number of eosinophils in peripheral blood was performed. The study showed high efficacy and safety of biological therapy with dupilumab 300 mg subcutaneously every 2 weeks for 52 weeks with a combination of severe atopic dermatitis and bronchial asthma, uncontrolled course in patient Ts (Born in 2006). The examination of the ALEX2 allergochip made it possible to establish the molecular components of the primary causal allergens, predict the course of an allergic disease, and carry out successful elimination measures against food allergens, preserving the maximum set of nutrients in the patient's diet. Dupilumab therapy in severe atopic dermatitis and uncontrolled bronchial asthma leads to clinically significant improvement in the course of diseases, control of disease symptoms. Atopic dermatitis shows a decrease in itching of the skin, normalization of sleep, improvement of quality of life. With bronchial asthma, a reduction in exacerbations, normalization of respiratory function indicators, complete control of the disease has been achieved. The targeted biological drug dupilumab has a targeted effect on the key links in the pathogenesis of atopic dermatitis and bronchial asthma and reduces the burden of severe diseases. Therefore, the use of dupilumab in atopic dermatitis and bronchial asthma contributes to achieving disease control and improving the patient's quality of life.

Severe asthma in Kuwait population: Phenotype-based approach

BackgroundThere is increasing recognition of marked phenotypic heterogeneity within severe asthma patients. MethodsSevere asthma patients on GINA step 4 or 5 treatment, followed up at Al-Rashed Allergy center Kuwait, were evaluated for: demographics (gender, age, age of asthma onset), comorbidities (allergic rhinitis (AR), chronic rhinosinusitis (CRS), chronic rhinosinusitis with nasal polyposis (CRSwNP), obesity), blood biomarkers (total serum Immunoglobulin E (IgE), peripheral eosinophils), and sensitization to inhalants allergens. ResultsA total of 169 patients were candidates for biological treatment. Patients were divided in two groups based on level of total IgE as a “low” group with IgE<160 IU/ml (n = 55) and “high” group with IgE≥ 160 IU/ml (n = 114). Both groups were further divided in subgroups, “low” and “high”, based on absolute number of eosinophils (Eos) in peripheral blood with <300 cells/μl or ≥ 300 cells/μl. Only 10% of patients were in low IgE/low Eos while majority (46%) were in the high IgE/high Eos group. Mean age of patients was 44.1 year with domination of females (n = 123). Majority of patients were obese. AR, CRS and CRSwNP were more common in group with IgE ≥160 IU/ml, while CRS and CRSwNP in group with Eos ≥300 cells/μl. ConclusionThe majority of severe asthma patients in Kuwait are obese females with adult-onset asthma (>18 years of age) who were allergic with comorbid conditions including AR, CRS and CRSwNP, which correlates well with the level of Eos.

Some Immunological Impacts of Face Mask Usage During the COVID-19 Pandemic.

&lt;b&gt;Background and Objective:&lt;/b&gt; COVID-19 is a fast-spreading worldwide pandemic caused by SARS-CoV-2. The World Health Organization recommended wearing face masks. Masks have become an urgent necessity throughout the pandemic, the study's goal was to track the impact of wearing masks on immunological responses. &lt;b&gt;Materials and Methods:&lt;/b&gt; This study was conducted on 40 healthy people who were working in health care at Nineveh Governorate Hospitals from September-December, 2020. They wore face masks at work for more than 8 months for an average of 6 hrs a day. The control sample included 40 healthy individuals, who wore masks for very short periods. All samples underwent immunological and physiological tests to research the effects of wearing masks for extended periods within these parameters. &lt;b&gt;Results:&lt;/b&gt; The results showed a significant decrease in total White Blood Count and the absolute number of neutrophils, lymphocytes, monocytes and phagocytic activity. However, there was a significant increase in the absolute number of eosinophils in participants compared with the control. The results also suggested there were no significant differences in IgE, haemoglobin concentration and blood O&lt;sub&gt;2 &lt;/sub&gt;saturation in participants who wore masks for more than 6 hrs compared to the control group. The results showed a significant increase in pulse rate in participants who wore masks for more than 6 hrs compared to the control group. The results also showed a strong correlation coefficient between the time of wearing masks and some immunological, haematological parameters. &lt;b&gt;Conclusion:&lt;/b&gt; Wearing masks for long periods alters immunological parameters that initiate the immune response, making the body weaker in its resistance to infectious agents.

New possibilities of therapy of T2-associated diseases

New opportunities for the treatment of T2-associated diseases in recent years, the number of patients with atopic dermatitis (ATD), having a moderate and severe form of course, has been increasing. According to research, 30% of the world's population suffer from allergic diseases, such as bronchial asthma (BA), ATD, food allergies, anaphylaxis, chronic polypous rhinosinusitis. The development of these diseases is based on the pathophysiological mechanism of T2-mediated immune inflammation, where cytokines IL-4 and IL-13 play a key role. Diseases based on this type of inflammation belong to the group of T2-associated diseases. Thanks to targeted therapy with dupilumab, which affects the main links of pathogenesis, it is possible to effectively cope with the main manifestations of severe and moderate ATD and BA.&#x0D; Aim. To evaluate the effectiveness of biological therapy with dupilumab 300 mg subcutaneously for 52 weeks of T2-associated diseases, including a combination of severe ATD and BA, uncontrolled course in a teenager C. (born 2006).&#x0D; Materials and methods. The analysis of the medical history of the patient C., born in 2006, who received therapy with dupilumab 300 mg subcutaneously every 2 weeks for 52 weeks with the diagnosis Main: ATD, common form, severe course. Secondary diagnosis: BA, persistent course, uncontrolled, moderate severity. Dynamic monitoring of the total blood count with the calculation of the absolute number of eosinophils in peripheral blood was performed. The allergological examination included the determination of specific IgE-AT to 300 allergens using ALEX2 technology. Criteria for the effectiveness of ATD therapy were evaluated on the SCORAD scale in dynamics, an AST test was used for BA, as well as a study of the function of external respiration before treatment and during therapy.&#x0D; Results. The study showed high efficacy and safety of biological therapy with dupilumab 300 mg subcutaneously every 2 weeks for 52 weeks of T2-associated diseases, including a combination of severe ATD and BA, uncontrolled course in patient C. (born in 2006). The conducted allergological examination with the help of the ALEX2 Allergochip made it possible to establish the molecular components of the primary causal allergens, predict the course of an allergic disease, and carry out successful elimination measures against food allergens, preserving the maximum set of nutrients in the patient's diet.&#x0D; Conclusion. Therapy with dupilumab 300 mg subcutaneously every 2 weeks for 52 weeks of T2-associated diseases, with manifestations of severe ATD and BA, uncontrolled course leads to clinically significant improvement in the course of diseases, control of symptoms of diseases. ATD shows a decrease in itching of the skin, normalization of sleep, improvement of quality of life. With BA, a significant reduction in exacerbations, normalization of respiratory function indicators, complete control of the disease has been achieved. The targeted biological drug dupilumab has a targeted effect on the key links in the pathogenesis of ATD and BA and reduces the burden of severe diseases. Therefore, the use of dupilumab in ATD and BA contributes to achieving disease control and improving the patient's quality of life.

Prognostic role of systemic inflammation in oral cavity squamous cell carcinoma

Background . The inflammatory is an integral part of the formation and development of malignant neoplasms, including oral cavity squamous cell carcinoma (OCSCC). The aim. Identification of the prognostic role of the factors of systemic inflammation in the peripheral blood of patients with OCSCC, as well as the relative indicators: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR), with an assessment of their effect on overall survival (OS) and progression-free survival (PFS). Materials and methods . A prospective study was included 165 patients with OCSCC. At the initial assessment, all patients underwent counting of peripheral blood parameters: leukocytes, lymphocytes, monocytes, eosinophils, platelets, as well as calculation of NLR, PLR and LMR. Results. Due to univariate analysis a negative effect on OS is exerted by: the relative number of neutrophils &gt; 61.18 % (HR = 0.66; p = 0.0280), the absolute number of lymphocytes ≤ 2.12 × 10 9 /L (HR = 0.65; p = 0.0025), relative number of monocytes &gt; 9.1 % (HR = 0.67; p = 0.0313), NLR &gt; 2.30 (HR = 0.63; p = 0.0130) and LMR ≤ 3.47 (HR = 0.64; p = 0.0157). The PFS in univariate analysis was significantly negatively influenced by: the level of peripheral blood leukocytes ≤ 5.23 × 10 9 /L (HR = 0.58; p = 0.0492), the absolute number of neutrophils &gt; 2.86 × 10 9 /L (HR = 0.62; p = 0.0386), the relative number of neutrophils &gt; 61.18 % (HR = 0.53; p = 0.0028), the absolute number of lymphocytes ≤ 2.88 × 10 9 /L (HR = 0.55; p = 0.0097), relative lymphocyte number 29.71 % (HR = 0.52; p = 0.0006), absolute number of eosinophils ≤ 0.09 × 10 9 /L (HR = 0.55; p = 0.0244), relative number of monocytes &gt; 6.96 % (HR = 0.58; p = 0.0087), NLR &gt; 1.74 (HR = 0.52; p = 0.0006), PLR &gt; 111.39 (HR = 0.63; p = 0.0196) and LMR ≤ 3.71 (HR = 0.55; p = 0.0019). According to the results of multivariate analysis, a significant negative effect on PFS was exerted by the relative number of monocytes &gt; 6.96 %, and the absolute number of eosinophils in the peripheral blood ≤ 0.09 × 10 9 /L. Conclusion. The analysis allows us to consider the factors of systemic inflammation recorded in the peripheral blood, as well as the NLR, PLR and LMR can serve as reliable additional factors in predicting the course of OCSCC.

Polypous rhinosinusitis in combination with bronchial asthma: clinical features and cellular characteristics of local and systemic inflammation

Background. The combination of chronic rhinosinusitis with nasal polyps (CRSwNP) and bronchial asthma (BA) is currently considered as a separate phenotype characterized by similar features of inflammatory changes leading to an increase in the clinical course of both CRSwNP and BA. The aim of the study was to investigate the clinical features and characteristics of the local and systemic inflammatory process in patients having a combination of CRSwNP and BA. Materials and methods. The study included 96 volunteers, who were divided into 4 groups: group 1 consisted of healthy volunteers (Normal); group 2 consisted of volunteers with CRSwNP in combination with allergic BA (CRSwNP + aBA); group 3 - volunteers with PRS in combination with non-allergic BA (CRSwNP + nBA); and group 4 - CRSwNP without BA. Clinical, laboratory, instrumental and allergology examination methods were applied for all participants of the study. BA control status was determined using the asthma control questionnaire (ACQ-7), and CRSwNP control status was determined using the nasal and paranasal sinus clinical outcome control questionnaire (SNOT-22). At the same time, the quality of life of the patients was also evaluated using AQLQ (Asthma Quality of Life Questionnaire). Results. The results confirmed the interaction of BA and CRSwNP, where the combination of these diseases led to a more severe and uncontrolled clinical course of BA and CRSwNP based on the assessment using SNOT-22, ACQ-7 and AQLQ questionnaires. These results correlated with an increase in the absolute number of eosinophils in peripheral blood and pronounced eosinophilic cell infiltration of nasal polyp stroma. Data processing demonstrated that the combination of CRSwNP and nBA showed signs of more pronounced eosinophilic inflammation, which is an unfavorable prognostic factor. Conclusions. The comparison of the cellular characteristics of the local and systemic inflammatory process in patients with CRSwNP in combination with BA allowed us to conclude that polyp development follows a local inflammatory process. Further study of the pathogenesis of CRSwNP and BA will help to understand the mechanisms that connect these diseases and consider possible target molecules for biological therapy.

The role of hematological parameters as predictors of mortality in elderly patients in the hospital period

The development of algorithms for predicting adverse outcomes, including death in elderly and senile patients, is an urgent issue. Potential predictors include hematologic parameters. A clinical blood test is one of the most affordable diagnostic methods in practical medicine, reflecting systemic pathological processes in the human body based on a quantitative assessment of the cellular composition and blood morphology. The aim of this study was to evaluate hematological parameters as predictors of in-hospital mortality in patients of the elderly and senile age with acute coronary syndrome. Material and methods . The study included 277 patients with acute coronary syndrome. The study of hematological parameters was carried out on a CELL-DYN Sapphire hematology analyzer (Abbott Laboratories, USA). The values of neutrophil-lymphocytes ratio and platelet-lymphocytes ratio were also evaluated as predictors of in-hospital mortality. Results . High content of leukocytes (above 10.45 x 10 9 /l) during hospitalization in patients with ACS aged 60-74 years are associated with a higher risk of death at the hospital stage. Among patients with ACS aged 75-89 years, the risk of death is associated with the following changes in peripheral blood upon admission: a decrease in the absolute number of eosinophils below 0.086 x 10 9 /l, an increase in the absolute number of basophils above 0.079 x 10 9 /l and a decrease in platelet-lymphocytes ratio below 31.06.

Use of the routine complete blood count to predict steroid resistance in patients with chronic obstructive pulmonary disease

The aimof the present study was to investigate the significance of complete blood count, lymphocyte subpopulations, and cytokines in the peripheral blood in order to evaluate steroid resistance in patients with chronic obstructive pulmonary disease (COPD).Methods.Forty five patients with acute exacerbation of COPD (AECOPD) who underwent bronchoscopy the next day after hospital admission were included in the study. The patients were considered as steroid-sensitive or steroid-resistant according to the ability of dexamethasone to inhibit 50% of interleukin-8 production by alveolar macrophages. Complete blood count, lymphocyte subpopulations, cytokines, immunoglobulin E, and hormone level were measured in the peripheral blood of all patients with COPD.Results.Macrophage migration inhibitory factor (MIF) level, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were higher, and absolute and relative eosinophil numbers were lower in steroid-resistant patients with COPD compared to steroid-sensitive COPD patients. Absolute eosinophil number below the cut-off value of 0.126 × 109/L was predictive for steroid resistance with the sensitivity of 83.3%, the specificity of 55.6% and the area under ROC curve (AUC) of 0.677. Relative eosinophil number below 1.2% predicted steroid resistance with sensitivity, specificity and AUC of 83.3%, 63.0%, and 0.751, respectively. NLR, PLR, and MIF higher than 2.75, 116, and 2.24 ng/mL, respectively, predicted steroid resistance with the sensitivities of 66.7%, 61.1%, and 72.2%, respectively; the specificities of 74.1%, 77.8%, and 70.4%, respectively; and the AUCs of 0.731, 0.678, and 0.740, respectively. The combination of relative eosinophil number, NLR and PLR increased the sensitivity to 83.3%, specificity to 77.8%, and AUC to 0.805. The combination of relative eosinophil number, PLR and MIF increased the sensitivity to 83.3%, specificity to 88.9%, and AUC to 0.889.Conclusion.Steroid-resistant and steroid-sensitive COPD patients differ in absolute and relative eosinophil numbers, LNR, PLR, and MIF level. These parameters could be used to predict steroid resistance in COPD.

Elevated levels of periostin and TGF-β1 in the bronchoalveolar lavage fluid of patients with idiopathic eosinophilic pneumonia.

Periostin is induced in bronchial epithelial cells and fibroblasts by various stimuli including interleukin (IL)13 and transforming growth factor (TGF)-β1, and is involved in allergic diseases such as asthma and atopic dermatitis, playing an important role in tissue remodeling and fibrosis. The role of periostin in the pathogenesis of eosinophilic lung diseases, however, is unclear. To examine the contribution of periostin to eosinophilic inflammation of the lung in humans, we evaluated periostin, IL-13, and TGF-β1 levels in the bronchoalveolar lavage fluid (BALF) of patients with eosinophilic pneumonia (EP). Periostin, IL-13, and TGF-β1 concentrations in the BALF were measured by enzyme-linked immunosorbent assay in patients with acute EP, chronic EP, idiopathic pulmonary fibrosis (IPF), and sarcoidosis. Further, we analyzed the relationship between periostin, IL-13, and TGFβ-1, levels and the number of inflammatory cells in the BALF. The absolute number of eosinophils, and the periostin, IL-13, and TGF-β1 levels in the BALF were significantly higher in patients with EP than in patients with IPF and sarcoidosis. Concentrations of periostin significantly correlated with the concentrations of TGF-β1, but not those of IL-13, in the BALF of patients with EP. Periostin levels also significantly correlated with the absolute number of eosinophils in the BALF of patients with IPF, but not EP. Our findings suggest that TGF-β1 might increase the production of periostin in the lungs of patients with EP. Periostin might contribute the pathogenesis of not only EP, but also IPF.