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Biologicals in the treatment of chronic rhinosinusitis with nasal polyps – position of the Polish Society of Otorhinolaryngologists – Head and Neck Surgeons and the Polish Society of Allergology experts

100%

Jurkiewicz D. , Kupczyk M. , Brożek-Mądry E. , Rapiejko P.

nr 2

1-11

Przewlekłe zapalenie błony śluzowej nosa i zatok przynosowych z polipami nosa (PZZPzPN) wywiera duży wpływ na samopoczucie i funkcje społeczne chorego. Uogólniony proces zapalny przebiegający z powstawaniem polipów nosa i nadmiarem eozynofilów w obrębie błony śluzowej zatok przynosowych to zapalenie typu 2., w którym pośredniczą limfocyty Th2 – komórki układu immunologicznego, odpowiadające za przewlekłe procesy zapalne. Dziś znamy też kluczowe mediatory prozapalne, przeciwko którym powstały nowe leki, tzw. leki biologiczne, wytwarzane w liniach komórkowych. W dokumencie przedstawiamy dostępne, w obecnej chwili, leczenie biologiczne zatwierdzone do leczenia pacjentów z T2 – zależnym przewlekłym zapaleniem zatok przynosowych.

Chronic rhinosinusitis with nasal polyps (CRSwNP) has a significant impact on the well-being and social functions of the patient. The generalized inflammatory process with the formation of nasal polyps and excess eosinophils in the mucosa of the paranasal sinuses is called type 2 inflammation, which is mediated by Th2 lymphocytes – cells of the immune system responsible for chronic inflammatory processes. Today, we also know the key pro-inflammatory mediators against which new drugs have been developed, the so-called biological drugs, are produced in cell lines. In this document, we present currently available biologicals approved for the treatment of patients with T2-related chronic rhinosinusitis.

The prevalence of asthma work relatedness: Preliminary data

63%

Dudek W. , Kupryś-Lipińska I. , Wittczak T. , Świerczyńska-Machura D. , Kupczyk M. , Walusiak-Skorupa J. , Kuna P. , Pałczyński C.

International Journal of Occupational Medicine and Environmental Health

2015

tom 28

nr 6

1025-1029

Objectives About 5–10% of asthmatics do not respond well to standard treatment plan. Occupational exposure may be one of the factors that can be linked with treatment failure. The aim of the study was to assess the prevalence of work-related asthma (WRA) among adult asthmatics under follow up in an outpatient allergy clinic and to create a useful tool for detecting individuals with possible WRA. Material and Methods Preliminary 5-question questionnaire designed to recognize WRA was presented to 300 asthmatics. All patients with positive preliminary verification along with 50 subjects from control group were asked to fill up a detailed questionnaire. The WRA was diagnosed by positive match for asthma symptoms in combination with workplace exposure indicated in the detailed WRA questionnaire followed by confirmation of each WRA case by detailed exposure analysis. Results Work-related asthma was recognized in 63 subjects (21% of study group). The preliminary questionnaire has 76.9% sensitivity and 94% specificity in recognition of WRA. Occupational exposure to irritants is a risk factor of WRA recognition (relative risk (RR) = 2.09 (1.44:3.03)). Working in exposure-free environment is a factor against WRA recognition (RR = 0.38 (0.24:0.61)). Among subjects with work-related asthma, the uncontrolled course of the disease is significantly more frequent (p = 0.012). Subjects with WRA more often report sickness absenteeism due to asthma than those without WRA (9.6% vs. 3.2%, respectively), but the observed differences did not reach the statistical significance. Conclusions Short 5-question questionnaire seems to be a promising tool to detect individuals with possible work-related asthma in the outpatient setting for further evaluation and additional attention.