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1

Immunotherapy in the management of sepsis

100%
Sikora J. P.
Archivum Immunologiae et Therapiae Experimentalis
|
2002
|
vol. 50
|
issue 5
317-324
EN
The work presents the role of Gram-negative bacteria endotoxins, pro- and anti-inflammatory cytokines and reactive oxygen species (ROS) in the complex and not fully explained pathogenesis of sepsis. The so called ?respiratory burst? of neutrophils and antioxidant mechanisms of the host are also discussed. The work has focused on possible approaches to the management of sepsis connected with immunotherapy. Neutralisation of endotoxin lypopolysaccharide (LPS), anti-TNF-alpha therapy with monoclonal antibodies or pentoxifylline (PTXF) as well as soluble recombinant cytokine agonists and antagonists used in clinical trials were taken into consideration. Besides, cytokine manipulation therapy, anti-adhesion techniques or glicocorticoides and antioxidant barrier interference were also described. So far there has been no immunotherapy of sepsis in children of proven clinical efficacy, which prompts aggressive examination of the immune system, aimed at affecting its function.
2

Proinflammatory cytokines (IL-6, IL-8), cytokine inhibitors (IL-6 sR, sTNFR II) and anti-inflammatory cytokines (IL-10, IL-13) in the pathogenesis of sepsis in newborns and infants

51%
Sikora J. P., Chlebna-Sokol D., Krzyzanska-Oberbek A.
Archivum Immunologiae et Therapiae Experimentalis
|
2001
|
vol. 49
|
issue 5
399-405
EN
The levels of the proinflammatory cytokines interleukin 6 (IL-6) and IL-8, and the anti-inflammatory cytokines IL-10 and IL-13 were studied in child patients with sepsis. The changes of the cytokines inhibitors soluble IL-6 receptor and soluble p75 TNF alpha receptor were also investigated in the patients' sera. An increase of pro- and anti-inflammatory cytokine levels was demonstrated at the time of diagnosis. Pharmacotherpy was accompanied by a decrease of the elevated concentrations of both cytokines and their inhibitors. The time pattern of changes in cytokine and cytokine inhibitor serum concentrations along with the time course of acute phase indices, including procalcitonin and C-reactive protein, allows for an evaluation of system inflammatory response and may support diagnostic and prognosis methods.
3

Haemophilus influenzae type b and pertussis vaccinations in preterm infants

51%
Sikora J. P., Chlebna-Sokol D., Ligenza I., Sikora A.
Archivum Immunologiae et Therapiae Experimentalis
|
2006
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vol. 54
|
issue 3
193-199
EN
Introduction: The aim of the study was to evaluate the serological efficacy of Hiberix and Infanrix-DTPa vaccines in preterm infants. Materials and Methods: The results of the investigation of 61 preterm infants immunized three times (primary vaccination) with Hiberix and Infanrix-DTPa at 6-week intervals are presented. Of the 61 children, 17 were additionally immunized with a booster dose of these vaccines. Postvaccinal response to these immunizations was evaluated by an immunoenzymatic method. Results: We observed a significant increase in protective postvaccinal antibody titers against Haemophilus influenzae type b (Hib) and Bordetella pertussis after the primary vaccination compared with the initial antibody levels (p<0.05). A significant increase (p<0.0002) in protective antibody titers after the booster dose of Hiberix compared with the primary vaccination was also noted. No correlations between birth weight, gestational age, and the achieved levels of postvaccinal anti-polyribosylribitol phosphate of Hib and of anti-pertussis toxin and anti-filamentous hemagglutinin of B. pertussis antibodies after the primary vaccination or booster dose were found. After the booster dose, all the preterm infants responded with the production of protective postvaccinal antibody titers against Hib and B. pertussis. Conclusions: Due to the very good immunogenicity of the vaccines against Hib studied, inclusion of this immunization should be proposed in the obligatory vaccination schedule in Poland, especially in preterm infants. An additional immunization (i.e. a second booster dose) of Polish children with acellular pertussis (DTPa) vaccine is necessary to protect them from decreasing protective anti-pertussis antibody titers in early childhood.
4

Proinflammatory cytokine inhibitors, TNF- and oxidative burst of polymorphonuclear leukocytes in the pathogenesis of sepsis in newborns

45%
Sikora J. P., Chlebna-Sokol D., Dabrowska I., Lipczynski D., Chrul S.
Archivum Immunologiae et Therapiae Experimentalis
|
2001
|
vol. 49
|
issue 2
155-162
EN
This study was to evaluate the levels of the proinflammatory cytokine tumor necrosis factor alpha (TNF-) and the cytokine inhibitors soluble TNF- receptor (sTNFR) and IL-1 receptor antagonist (IL-1 ra) as well as the intensity of oxidative metabolism of peripheral blood polymorphonuclear leukocytes in the course of sepsis in newborns. An increase of TNF-, sTNFR and IL-1 ra concentrations was found in the blood serum of the patients at the time of diagnosis. This was further accompanied by polymorphonuclear leukocyte stimulation and, as a consequence of prolonged bacterial antigen stimulation, functional exhaustion of these cells and their diminished oxidative metabolism was observed. Within the same time period, an enhanced expression of p55 and p75 TNF- receptors on polymorphonuclear leukocyte cell surfaces was found. It was indicated that the applied pharmacotherapy caused a decrease of the initially elevated concentrations of TNF- and proinflammatory cytokine inhibitors (sTNFR, IL-1 ra). The intensive therapy of sepsis was associated with the increased oxidative burst of polymorphonuclear leukocytes along with the decrease of p55 and p75 expression on their cell surfaces.
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