No abstract

The association between venous thromboembolism (VTE) and sarcoidosis has been reported recently, nevertheless the true incidence of co-incident sarcoidosis and VTE is unknown. Sarcoidosis as a chronic disease of immune dysregulation might be associated with an increased risk of VTE. The mechanisms responsible for VTE development are not clear and may be influenced by several factors: activity of inflammation, clinical characteristics of sarcoidosis and comorbidities. Pulmonary embolism (PE) as a potentially fatal condition should be considered in all of the patients with sarcoidosis in whom worsening of the respiratory status is diagnosed. A high plasma D-dimers (DD) level may be suggestive of VTE, nevertheless elevated plasma DD should be interpreted with caution, in the context of the active inflammatory process. If sarcoidosis appears to be one of risk factors for VTE development, further investigations are needed to define the pro-thrombotic phenotype of this disease.

MTX as a single agent in the treatment of sarcoidosis has proved to be a safe and effective steroid alternative. Selected patients with chronic pulmonary sarcoidosis experience definite PFT improvements after MTX treatment. There is need to search for predictors of MTX treatment effectiveness.

Introduction: Sarcoidosis is a disease of unknown aetiology. Little is known of the predictive factors of fibrosis. It has been suggested that PAI-1, uPA, TGF-β1, VEGF, IL-8, TNF-α influence this process. The aim of the study was to assess airway inflammatory and fibrosis markers in EBC in sarcoidosis and the effects of fibreoptic bronchoscopy (FOB), bronchoalveolar lavage fluid (BALF), transbronchial lung biopsy (TBLB) and bronchial mu- cosa membrane biopsy on their production in the airways. Material and methods: The study group consisted of 11 patients (five women, six men, mean age 40 ± 9 yrs, mean ± SD) with sarcoidosis stage I–III. PAI-1 (ng/mL), uPA (ng/mL), TGF-β1 (pg/mL), VEGF (pg/mL), IL-8 (pg/mL), TNF-α (pg/mL) levels were measured in BALF and EBC collected before, and 48 h after, FOB. Results: No significant changes in EBC levels of VEGF, PAI-1, TGF-β1, TNF-α (respectively: 8.02 ± 4.97 pg/mL; 1.1 ± 1.2 ng/mL; 2909.7 ± 206.6 pg/mL; 10.7 ± 19.9 pg/mL) after FOB were observed when compared to baseline. In contrast, IL-8 concentration in EBC (pg/mL) decreased after FOB (0.073 ± 0.13 vs. 0.061 ± 0.1, p = 0.006) and was significantly lower than in BALF (BALF 0.95 ± 0.62, p < 0.05). Also, the mean level of VEGF was higher in BALF than in EBC both pre- and post- FOB (BALF 66.38 ± 36.95, EBC pre-FOB 6.75 ± 3.67 and EBC post-FOB 8.02 ± 4.97). A significant relationship between TNF-a in post-FOB EBC and BALF was also shown (β = 0.63, p = 0.04). Conclusions: FOB does not significantly affect levels of airway inflammation and fibrosis markers present in EBC before and after FOB; they were also comparable to the concentrations marked by BALF. The lack of correlation between marker levels in EBC and BALF indicates that these methods are not equivalent. Due to the possibility of repetition, and the less invasive, simpler method of the EBC test, it would seem reasonable to continue this research on a larger number of patients.

Introduction: Chronic obstructive pulmonary disease (COPD) and bronchiectasis, chronic inflammation disorders of the bronchial tree through the mechanism of 'spill-over' of inflammatory mediators, may lead to systemic manifestations of illness of the respiratory system and comorbidities. The aim of the study was to evaluate the frequency of coexisting COPD and bronchiectasis and influence of bronchiectasis on COPD comorbid diseases. Material and methods: A post-hoc cross-sectional analysis of cohort study of 288 consecutive patients hospitalized due to acute exacerbation of COPD was performed. Results: 177 males (61.5%) and 111 females (38.5%) with mean age = 71.0 8 ± 8.9 years, FEV 1 % pred. = 34.6 ± 16.8 with COPD diagnosis were studied. In this group, 29 (10.1%) patients presented with bronchiectasis confirmed by HRCT scan. COPD patients with and without bronchiectasis had similar Charlson index results (2.5 vs 2.1, p = 0.05). COPD patients with bronchiectasis required longer hospitalization during exacerbation. COPD patients with bronchiectasis significantly more often than patients without this comorbidity revealed the features of colonization with P. aeruginosa (OR = 4.17, p = 0.02). Conclusions: Bronchiectasis is a relatively common comorbidity in COPD patients. COPD patients with bronchiectasis are more frequently colonized with P. aruginosa comparing to non-bronchiectasis COPD patients. We did not confirm the influence of bronchiectasis on COPD comorbidities.