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The gut microbiota serves a crucial role in the development of host immunity. Immunocompromised patients are particularly vulnerable to dysbiosis not only by virtue of a defect in the immune system but also due to increased susceptibility to infection and multiple courses of antibiotic therapy. Fecal microbiota transplantation is by far the most effective option for restoring gastrointestinal homeostasis. However, it is contraindicated in patients with significant primary and secondary immunodeficiencies. This article presents the case of a 59-year-old patient with common variable immunodeficiency, after splenectomy at age 39 for primary immune thrombocytopenia, who manifested diarrhea of up to 10 stools per day accompanied by secondary malnutrition and cachexia. The patient was admitted to the hospital on multiple occasions due to this condition, with stool PCR tests confirming a HHV-5 (Cytomegalovirus, CMV) infection. Following the administration of valganciclovir, the patient's complaints diminished, although, upon cessation of the drug, the symptoms recurred. In addition, the patient had an intestinal infection with C. difficile etiology. Given that the patient's therapeutic options had been exhausted, after obtaining informed consent from the patient and approval from the bioethics committee to conduct a medical experiment, treatment of diarrhea was undertaken by fecal microbiota transplantation with the certified preparation Mbiotix HBI from the Human Biome Institute. The patient underwent two transplants, with a one-week interval between them. The initial procedure was performed using the endoscopic method, while the subsequent was conducted using the capsule method. Following the administration of the applied treatment, the patient's symptoms were successfully alleviated, and no adverse effects were observed. A microbiological analysis of the intestinal microbiota was conducted prior to and following transplantation via next-generation sequencing (NGS). No recurrence of symptoms was observed during the two-year follow-up period. To the best of our knowledge, this is the first fecal microbiota transplantation in an adult patient with primary and secondary immunodeficiency. [ABSTRACT FROM AUTHOR]

Allergy to fur animals is becoming an increasingly common clinical problem in everyday medical practice. Depending on the route of exposure to the allergen, patients present with many, often non-specific symptoms. The most common illnesses among people with allergies to the above-mentioned allergens are as follows: allergic rhinitis, allergic conjunctivitis, atopic bronchial asthma, food allergy, allergic contact dermatitis, and sometimes anaphylactic shock. In recent years, there has been a change in the holistic approach to the treatment of allergy patients. The method of treatment should be tailored to a specific patient, taking into account his or her predispositions, economic possibilities, and therapeutic goals. The article describes the main methods of treating allergies, focusing primarily on allergies to fur animals. Allergy treatment always requires great care, and qualification for specific types of therapy should be preceded by a thorough and accurate diagnosis. [ABSTRACT FROM AUTHOR]

Diagnosing allergies is not always easy. Sometimes the symptoms reported by the patient do not match the results of diagnostic tests. Diagnostics of IgE-dependent allergy, including allergy to furry animals, can be based on two basic strategies, "BOTTOM-UP" and "TOP-DOWN", and almost all available allergy tests can be used ranging from skin tests, through specific IgE, to molecular panels and challenge tests. Currently, most information regarding the diagnosis and incidence of allergies to furry animals focuses almost exclusively on the two most common pets—dogs and cats. This is certainly due to the fact that allergy to cats and/or dogs is a common phenomenon, has a huge impact on quality of life, and is a challenge for doctors of many specialties. However, the growing number of owners of other pet species means that diagnostic methods must keep up with the changing needs of patients. Further research in these groups will certainly provide new facts and facilitate clinical decision-making when working with allergic patients. [ABSTRACT FROM AUTHOR]

An improved recognition of inborn errors of immunity (IEI) is associated with an increase in life expectancy and a higher incidence of complications and related conditions. The aim of the study was to analyze factors enabling the primary prevention: BMI, smoking and selected laboratory tests (morphology with smear, creatinine, eGFR, total protein, albumin, ferritin, folic acid, vitamin B12, vitamin D3) included in the protocols of standard of care for adult patients with primary antibody deficiencies (PADs). The study included 94 participants ≥ 18 years old, diagnosed with PADs. Overweight was found in 17%, obesity in 14% and underweight in 15% of patients; 11.5% of patients smoked. Leukopenia was diagnosed in 16%, neutropenia in 8.5%, lymphopenia in 22.5% and thrombocytopenia in 14% of patients. A decreased concentration of hemoglobin was found in 32%, total protein in 19%, albumin in 17%, vitamin D3 in 52%, vitamin B12 in 6.5%, folic acid in 34% and ferritin in 26% of patients. Creatinine concentrations were elevated in 16% of patients, while in 20%, eGFR was reduced. Only a holistic assessment of comorbidities and complications of deficiency, as well as regular follow-up and lifestyle changes, can yield the best results in the long-term care of patients. [ABSTRACT FROM AUTHOR]

Treatment of eosinophilic gastroenteritis (EGE) is mainly empirical and is based on the assessment of symptom severity and the experience of clinicians. Patients with mild disease can be treated symptomatically, while patients with more severe symptoms or malabsorption symptoms require more aggressive therapy. So far, several therapeutic options have been proposed, including the following: dietary treatment, glucocorticosteroids, inhibitors of leukotriene receptors, mast cell stabilizers, immunomodulating drugs, and biological drugs. Unfortunately, there is still a lack of well-designed, prospective. and randomized clinical trials involving large groups of patients with EGE and assessing the effectiveness of individual treatments. More research is needed to compare the efficacy and safety profiles of the various treatments available, and to select the prognostic factors of relapse, which in turn will be extremely important in making decisions about the initial treatment phase and maintenance therapy. [ABSTRACT FROM AUTHOR]

Eosinophilic gastroenteritis (EGE) is a relatively rare disease, but it should be considered whenever a patient presents with unexplained gastrointestinal symptoms that cannot be explained by parasitic infection or other gastrointestinal diseases characterized by eosinophilic infiltration. A high coexistence of EGE and allergic diseases has been documented. Diagnosis of EGE is based primarily on clinical, endoscopic, and histopathological findings. Glucocorticosteroids and other immunomodulatory drugs are the mainstay of treatment, but currently the greatest hope lies in biological drugs, which are undergoing intensive research. This disease is troublesome for the patient and significantly reduces the quality of life. [ABSTRACT FROM AUTHOR]

Introduction: SARS-CoV-2 is responsible for causing the COVID-19 disease, which affected 174 million people worldwide. After vaccines were launched, the focus was on their effectiveness and the degree of their safety. Aim: The authors try to find factors that may affect the response to vaccination. Material and methods: The study was conducted in 47 adults (39 women and 8 men; age: 47.3 ±11.2). Participants were vaccinated with two doses of the Comirnaty mRNA vaccine. Each patient had a medical history taken and the concentration of specific sIgG antibodies against S1 protein and SARS-CoV-2 N protein, as well as of selected cytokines (IL-8, TGF-β, IFN-g) was determined before and 3 weeks after the first and second dose of the vaccine. Results: There were 18 convalescents among the respondents. A statistically significant increase in the concentration of specific sIgG S1 in subsequent determinations was observed. Higher levels of sIgG S1 were found after the first dose of the vaccine in COVID-19 convalescents. There was no statistically significant influence of age, body mass index and sex on the increase in the concentration of antibodies and the concentration of the determined cytokines. It was shown that the higher the initial TGF-β concentration, the greater the increase in sIgG S1 after administration of the vaccine. Conclusions: Vaccination did not increase the levels of IL-8, IFN-g and TGF-β. A higher concentration of serum TGF-β before vaccination correlated with the higher concentration of sIgG S1 antibodies after the first dose of the vaccine. [ABSTRACT FROM AUTHOR]

The majority of primary immunodeficiencies (PIDs) are antibody deficiencies (PADs), and not all of them are rare diseases; As an example, Caucasian individuals suffer from selective IgA deficiency at a frequency of 1:500. In addition to infections, symptomatic patients with PAD are more likely to develop neoplastic, autoimmune, and allergic diseases. In the event that PAD is neglected or delayed for more than ten years, complications develop, eventually resulting in death. No studies have been conducted to devise and report detailed ready-to-use protocols for managing PAD to date. This study aimed to propose protocols and guidelines for the adult PAD patients' standard care. Preparing the protocol, we considered the frequency and type of laboratory tests, imaging, endoscopic examinations, specialist consultations, and standardized recommendations for further care in the place of residence.  As a result of the proposed monitoring scheme, patients can be provided with complete care in terms of their underlying conditions and comorbidities, as well as early detection of complications. This protocol will serve as a guide for physicians dealing with these patients and enable comparisons of patient groups across a variety of treatment centers, even far away from each other. A national consultant in the field of clinical immunology verified the protocol mainly developed by Polish experts from reference immunology centres for adults. [ABSTRACT FROM AUTHOR]