Background: While the importance of vascular endothelial growth factor (VEGF) in the pathogenesis of several diseases (eg, neoplasms) has been proven, its role in asthma, especially in terms of the potential associations between genetic variants of VEGF and airway remodeling, has received relatively little attention. Objectives: This study aimed to evaluate the possible connection between a genetic factor, ie, the polymorphism del/ins in the VEGF promoter region, and airway remodeling potential in asthmatics with and without irreversible bronchoconstriction. Materials and Methods: The study population comprised 82 patients with asthma (of whom 42 had irreversible bronchoconstriction) and a group of 40 controls. DNA was isolated from peripheral blood leukocytes. Polymerase chain reaction was used to type the VEGF (18-bp deletion/insertion) gene polymorphism at loci -2549 -2567. Other factors (ie, smoking, disease duration) were also taken into consideration. Results: The del/del genotype was found in 74.39% of patients with asthma (P=.031; OR=2.38), 80.95% of patients with irreversible bronchoconstriction (P=.012; OR=3.48), and 67.5% patients with reversible bronchoconstriction (P=.251; OR=1.70). The proportion of smokers to nonsmokers was higher (P=.032) and disease duration was longer (P=.041) in patients with irreversible bronchoconstriction than in those with reversible bronchoconstriction. Conclusions: Our results showed that the risk of irreversible bronchoconstriction in asthmatics was associated with the presence of the del18 genotype at the -2549 -2567 position in the promoter region of the VEGF gene, as were disease duration and other factors such as smoking. ResumenAntecedentes: Aunque se ha demostrado la importancia del factor de crecimiento endotelial vascular (VEGF) en la patogénesis de varias enfermedades (p. ej. neoplasias), los datos relativos al asma son escasos, especialmente los relacionados con las posibles asociaciones entre las variantes genéticas de VEGF y la remodelación de las vías respiratorias. Objetivos: En este estudio se propuso evaluar la posible relación entre un factor genético como el polimorfismo del/ins en la región promotora de VEGF y el potencial de remodelación de las vías aéreas en los asmáticos con y sin broncoconstricción irreversible. Materiales y métodos: en el estudio participaron 82 pacientes con asma (42 pacientes con broncoconstricción irreversible) y un grupo de 40 controles. El ADN fue extraído de leucocitos de sangre periférica. Para la tipificación del polimorfismo del gen VEGF (delección / inserción de 18 pb) en loci -2549 -2567 se utilizó el método de reacción en cadena de la polimerasa (PCR). Se consideraron también otros factores (fumar, duración de la enfermedad). Resultados: El genotipo del/del se encontró en el 74,39% de pacientes con asma (p = 0,031; OR = 2,38), el 80,95% de los pacientes con broncoconstricción irreversible (p = 0,012; OR = 3,48) y el 67,5% de los pacientes con broncoconstricción reversible (p = 0,251; OR = 1,70). La proporción de fumado...
There have been reports of food hypersensitivity reactions to food additives (HFA) for many years. The mechanisms of HFA and their frequency are difficult to precisely define, as most of the data come from outdated studies with poor methodology. In 2020, the European Food Safety Authority completed a review of additives, examining their influence on the occurrence of HFA, but did not include all of them. The aim of this review is to systematise knowledge about selected groups of food additives (FAs) and the HFA induced by them. We also briefly discuss the issues of diagnosis and therapy in this disease. FAs are commonly used in prosscessed foods, but HFA appears to be a rare phenomenon. Identification of the FA responsible for hypersensitivity and its treatment is difficult. Diagnosis is a challenge for the clinician and for the patient. A food diary is a helpful diagnostic tool. It allows diet therapy to be monitored based on the partial or complete elimination of products containing a harmful additive. An elimination diet must not be deficient, and symptomatic pharmacotherapy may be necessary if its application is ineffective. Taking all this into account, we conclude that it is necessary to conduct randomised multicentre studies based on the double-blind placebo control protocol in this field.
Background. Vascular endothelial growth factor (VEGF) is an angiogenic, heparin-binding glycoprotein playing an important role in the pathogenesis of many diseases and disorders, including asthma. It has been reported that increased VEGF serum concentration is a biomarker of neovascularization, which could suggest that higher VEGF expression may be relevant to asthmatics with airway remodeling and irreversible bronchoconstriction. Objectives. The aim of this study was to assess the possible association between VEGF serum concentration and irreversible bronchoconstriction in adult patients with a diagnosis of asthma. Material and methods. This study involved 82 adult patients with asthma (42 persons with and 40 persons without irreversible bronchoconstriction) and 40 healthy adult controls. Vascular endothelial growth factor serum concentration was analyzed using enzyme-linked immunosorbent assay (ELISA). Results. Vascular endothelial growth factor serum concentration in patients with asthma was higher than in healthy controls (p = 0.0131), particularly in those from the subgroup of irreversible bronchoconstriction (p = 0.0133). The rising tendency was confirmed using the Kruskal-Wallis rank sum test that showed a significant difference (p = 0.0374) in VEGF values among the 3 groups examined: healthy controls (Me = 246.6 pg/mL), asthmatics with reversible bronchoconstriction (Me = 288.6 pg/mL) and asthmatics with irreversible bronchoconstriction (Me = 340.6 pg/mL). However, the direct comparison between the 2 asthmatics groups (reversible vs irreversible bronchoconstriction) did not show a statistically significant difference (p = 0.5521). Conclusions. Increased VEGF serum concentration is characteristic of patients with asthma, especially those with irreversible bronchoconstriction.
In the group of urticaria, contact urticaria syndrome is a particular variety. In these patients, appearance of typical skin lesions is preceded by contact of the skin and mucous membranes with various inhaled allergens, nutrients or contact details. Furthermore, symptoms connected with contact urticaria syndrome are characterized by gradual, stepwise waveform, which can be easily generalized – patients may develop systemic symptoms similar to those found in the angioedema, asthma or anaphylactic shock. It is an attribute of contact urticaria syndrome in the course of which potentially life-threatening symptoms may develop after contact of the skin with the allergen. The underlying mechanisms are poorly understood; both immunological and non-immunological mechanisms are taken into account, therefore contact urticaria syndrome can be classified into two categories – allergic and non-allergic. An intriguing phenomenon seems to be the immediate reaction after exposure to low molecular weight allergens – haptens, such as metals, which are usually the cause of delayed allergic reactions. Diagnosis is based on clinical presentation indicating a coincidence of the onset of allergy with contract with allergen, and helpful exposure tests. Treatment consists of supportive antihistamines and corticosteroids – locally and systemically. In the case of anaphylaxis, appropriate treatment intensification of the integration of pressor amines and hydration is necessary. It is also regarded that prevention is advisable, which consists of relevant information to avoid situations connected with contact with well-known factors. In this paper we describe a case of a 57-year-old female admitted to the Department of Internal Medicine, Geriatrics and Allergology, Medical University in Wroclaw to undergo diagnostic tests of chronic urticaria and angioedema. According to information obtained from the clinical presentation and after the diagnostic procedures, contact urticaria syndrome due to exposure to metals was diagnosed.
Introduction: Vascular endothelial growth factor (VEGF) is an angiogenic cytokine and a potential stimulator of permeability and lung neovascularization in asthmatics. It also plays an important role in the development of airway remodelling and in activation of many cells, including basophils. Aim: To reveal the possible role of VEGF in the activation of basophils in asthmatics-subgroups with and without irreversible bronchoconstriction. Protein CD203c on the basophils surface was used as the activation marker. To define the possible pathway of basophils VEGF-activation, the influence of a genetic factor (polymorphism del18/ ins-2549-2567 in the VEGF-promoter region) was also considered. Material and methods: Our study involved 82 patients with asthma (40 patients without and 42 patients with irreversible bronchoconstriction) and a group of 40 controls. The flow cytometric methods with anti-CD203c in the samples of basophils with increasing concentrations of VEGF was used for analysis of their activity. Genotyping for VEGF-promoter region was performed by PCR-based methods. Results: Patients with asthma and del/del genotype showed more significant differences in the basophils activation after stimulation with increasing concentrations of VEGF than asthmatics with ins/ins and ins/del genotype (p = 0.023) and controls with del/del genotype (p = 0.0006). Conclusions: Raised basophils VEGF-activation is characteristic for examined patients with asthma and might be associated with presence of polymorphism del18/ins-2549-2567 in the VEGF-promoter region. Furthermore, it may contribute to the development of airways remodelling-this pathway has not been considered yet.
Diabetic retinopathy (DR) as a microangiopathy is the most common complication in patients with diabetes mellitus (DM) and remains the leading cause of blindness among adult population. DM in its complicated pathomechanism relates to chronic hyperglycemia, hypoinsulinemia, dyslipidemia and hypertension—all these components in molecular pathways maintain oxidative stress, formation of advanced glycation end-products, microvascular changes, inflammation, and retinal neurodegeneration as one of the key players in diabetes-associated retinal perturbations. In this current review, we discuss the natural history of DR with special emphasis on ongoing inflammation and the key role of vascular endothelial growth factor (VEGF). Additionally, we provide an overview of the principles of diabetic retinopathy treatments, i.e., in laser therapy, anti-VEGF and steroid options.
Chronic spontaneous urticaria (CSU) is a skin disease characterized by the presence of wheals, angioedema, or both for at least 6 weeks. Although, CSU is often regarded as autoimmune in nature, its etiology is not fully explained and interactions between various small molecules are still taken under account. The aim of this research was to investigate the mean serum concentration of vascular endothelial growth factor (VEGF), platelet activating factor (PAF), and eosinophil-derived neurotoxin (EDN) in relation to the disease activity and pruritus intensity in adult patients with CSU. Fifteen patients with CSU and 15 healthy subjects participated in this pilot study. Blood samples were taken to examine the mean serum levels of VEGF, PAF, and EDN by the enzyme-linked immunosorbent assay test (ELISA). The Urticaria Activity Score (UAS7) and The Visual Analogue Scale (VAS) were used to assess the disease activity and the pruritus intensity, respectively. Obtained results revealed that VEGF, PAF, and EDN concentrations were higher in patients with CSU compared with those of the control group, but only for VEGF it was statistically significant (p = 0.008). However, levels of all investigated cytokines were not significantly correlated neither with the disease activity nor with the pruritus intensity. Our results showed higher serum levels of VEGF, PAF, and EDN among CSU patients which may highlight a functional role of these cytokines in the disease’s pathogenesis. In contrast, VEGF, PAF, or EDN might not be useful to reflect the severity of symptoms.
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