Search

Matrix metalloproteinases (MMPs) are capable of degrading components of the basal lamina of cerebral vessels, thereby disrupting the blood-brain barrier and inducing leukocyte recruitment. This study provides comprehensive information regarding the cell specificity of matrix metalloproteinases (MMP-2, MMP-9) and their binding tissue inhibitors (TIMP-1, TIMP-2) in the central nervous system during viral and bacterial meningitis. Specifically, we evaluated the immunoreactivity of MMPs and TIMPs in various cell types in brain parenchyma and meninges obtained from autopsy tissues. We found that a higher proportion of endothelial cells were positive for MMP-9 during meningitis when compared to controls. In addition, the immunoreactivity of MMP-9 decreased and the immunoreactivity of TIMP-1 increased in astrocytes upon infection. Furthermore, the results of this study revealed that mononuclear cells were highly immunoreactive for TIMP-1, TIMP-2 and MMP-9 during viral meningitis and that the expression of TIMPs in polymorphonuclear cells was even higher during bacterial meningitis. Taken together the results of this study indicated that the central nervous system resident cells and inflammatory infiltrates contribute to MMPs activity and that the expression patterns vary between cell types and in response to viral and bacterial meningitis. [ABSTRACT FROM AUTHOR]

BACKGROUND COVID-19 manifests with varying degrees of severity across different age groups; adults typically experience more severe symptoms than children. Matrix metalloproteinases (MMPs), known for their role in tissue remodeling and immune responses, may contribute to the pathophysiological disparities observed between these groups. We sought to delineate differences in serum MMP profiles between adult and pediatric COVID-19 patients, assess the influence of anti-inflammatory treatment on MMP levels, and examine potential implications for long-term consequences. MATERIAL AND METHODS Serum samples from adult and pediatric COVID-19 patients, alongside controls, were analyzed for MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-10, MMP-12, MMP-13, EMMPRIN, TNF-alpha, TIMP-1, TIMP-2, TIMP-3, and TIMP-4. A subset of adult patients received treatment with glucocorticoids, tocilizumab, and convalescent plasma, and MMP levels were compared with those of untreated patients. RESULTS Elevated levels of MMP-1, MMP-7, TIMP-1, and TIMP-2 were observed in adult and pediatric patients. Adult patients displayed higher concentrations of MMP-3, MMP-8, MMP-9, TNF-alpha, and TIMP-4 than children. Post-treatment reduction in MMP-1, MMP-8, MMP-9 levels was observed, with median decreases from 21% to 70%. MMP-3 and MMP-7 remained largely unchanged, and MMP-2 concentrations increased after treatment. Notably, anti-inflammatory treatment correlated with reduced post-treatment MMP levels, suggesting potential therapeutic benefit. CONCLUSIONS Distinctive inflammatory responses in COVID-19 were evident between adults and children. While certain MMPs exhibited post-treatment reduction, the persistence of elevated levels raises concerns about potential long-term consequences, including lung fibrosis. Our findings emphasize the need for personalized treatment strategies and further investigation into the dynamics of MMP regulation in COVID-19.

Despite the constant development of biotechnology, laboratory diagnostics of Lyme disease in children still poses a significant challenge. The aim of this article is to present the current methods of Lyme disease diagnosis and its future perspectives. A serological test is often the first step in supporting clinical diagnosis of Lyme disease in children. Recently, a new generation of enzyme-linked immunosorbent assays has been created. These assays use recombinant proteins or synthetic peptides in their antigenic spectrum. It is postulated that these tests may replace the classic immunoblot as the second step in the Lyme disease diagnostic protocol. Direct detection methods based on bacterial culture techniques or using the polymerase chain reaction (PCR) have inadequate sensitivity, which prevents their widespread use in clinical practice. Recently, a number of other tools have been developed that are of supportive importance. Among them, measuring of the CXCL13 chemokine concentration in the cerebrospinal fluid has the potential to become a routine procedure in the diagnosis of Lyme disease in children. Future diagnostic strategies of Lyme disease might include: innovative immunological tests using new antigens, combining serology with direct methods in order to increase sensitivity, standardization of selected unconventional tests, identification of host response biochemical metabolic markers or linking clinical symptoms reported by patients with appropriate test panels. In the absence a vaccine which protects against the disease, the preventive recommendations given to parents to prevent tick bites in children remain valid., (© National Institute of Public Health – National Institute of Hygiene.)

Matrix metalloproteinases (MMPs) were originally described as proteases capable of degrading extracellular matrix components. Increasing evidence indicates a much more complex role of MMPs. Diverse functions of MMPs include cellular differentiation, migration, survival or death, angiogenesis and signalling. Metalloproteinases are crucially involved in a number of inflammatory conditions in the central nervous system facilitating blood-brain barrier breakdown, leukocyte recruitment and shedding of cytokines and growth factors. These enzymes contribute to pathogenesis of meningitis, multiple sclerosis and neurodegenerative disorders. While most studied in the context of disease, beneficial role of metalloproteinases during nervous system development and following injury is now being appreciated. The present study aimed at reviewing clinical relevance of these enzymes and potential therapeutic prospects for the coming future.

Objective: Verification of Lyme disease serodiagnosis in children by use of Western blot (WB) testing., Material and Methods: 24 children (8 males, 16 females) at the average age of 15,5y have been diagnosed from January 1st till December 31, 2007. All Lyme patients with positive or equivocal ELISA IgM and or ELISA IgG test results were included in the study. The ELISA (Bellco Biomedica, Austria)-Western blot (DRG, Diagnostics, Germany) two test protocol using sera of Lyme borreliosis patients was evaluated., Results: Positive ELISA IgM results were confirmed in 20 out of 24 children (83,3%). In WB confirmation test, the positive results were obtained in 10 children (41,7%), equivocal results--in 22 (8.3%) and negative in 12 (50%) children. The quantitative accordance of both ELISA IgM-WB IgM tests was 50%. The higher quantitative accordance (96%) of both tests was obtained studying IgG serologic response., Conclusion: A positive ELISA IgM result very likely represents a false-positive result and should always be confirmed by WB assay and objective clinical signs of borreliosis before implementing the appropriate antimicrobial therapy.

Background: In the afforested area of North-Eastern Poland the risk of Borrelia burgdorferi infection seems to be higher compared to the other regions. Because of unspecific clinical manifestation of Lyme borreliosis in children the positive ELISA IgM results should be confirmed with Western blot IgM tests., Objective: Retrospective analysis of clinical signs and symptoms of Lyme borreliosis in children with positive ELISA IgM and positive Western blot IgM results and in children with positive ELISA IgM and negative Western blot IgM results., Material and Methods: The study included 20 children reactive with ELISA IgM (Bellco Biomedica, Austria), hospitalized in Pediatric Infectious Diseases Clinic in 2007 due to probable diagnosis of Lyme disease. All children were tested with B. burgdorferi Western blot IgM and/or IgG assay (DRG, Diagnostics, Germany) as a second-step diagnosis. In 10 (50% females, 50% males) out of 20 children the results were positive (borreliosis) and in other 10 (80% females, 20% males) the results were negative (controls). In both groups of patients the retrospective analysis of signs and symptoms was done., Results: The most often clinical manifestation of Lyme borreliosis in children was neuroborreliosis. Children presented Lyme meningitis (30%), facial nerve palsy (10%) and chronic or recurrent headaches (40%), associated with vertigo (20%), weakness (30%), fever (40%), and fatigue syndrome (30%). One patient presented Lyme arthritis. Children of control group presented with unspecific symptoms like isolated headaches (40%), arthralgias (70%), myalgias (10%) and abdomen pain (20%), Conclusions: (1) The most frequent clinical presentation of Lyme borreliosis in analyzed children was neuroborreliosis; (2) Isolated arthralgias in children reactive with B. burgdorferi ELISA IgM need to be confirmed with Western blot assay before implementing the antibiotic therapy.

Unusual clinical manifestation of Lyme borreliosis in two children has been presented. We discuss patient from Borrelia-endemic area who presented with persistent headache, weakness and fever. The second patient experienced acute flu-like signs with associated neck pain and stiffness (probable diagnosis). After two weeks lasting antibiotic therapy (ceftriaxone, ampicillin) nonspecific symptoms and signs decreased.

Noroviruses belonging to the family of Caliciviridae are a major cause of acute gastroenteritis in both children and adults. In the current study incidence of norovirus gastroenteritis was estimated in children hospitalized for acute gastroenteritis using commercially available ELISA tests. Epidemiological data were correlated with basic demographic findings. A hundred and forty nine children with acute gastroenteritis were enrolled in the study. Screening for common viruses causing gastroenteritis: rotavirus and adenovirus was performed and than stool samples were frozen and stored in <20 degrees C for future simultaneous testing with IDEIA Norovirus (Dakocytomation). Group I noroviruses were found in one child when 16 children were tested positive for Norowirus group two. In total noroviruses were found in 11.4% of children included in the study. Children with norovirus infection were 3 weeks to 15 years old (mean age 5.9 years). Seasonal peak of norovirus infection was seen in September through December. The infectious agent has not been identified in 43% of investigated children. Our results support important role of noroviruses as a causing agent of gastroenteritis in children in Northeastern Poland. The importance of noroviruses may grow as rotavirus infections are likely to be eliminated due to wide introduction of vaccine in the nearest future. Routine testing for noroviruses should be considered in clinical practice.

Aim of the Study: Our study aimed to investigate the ambulatory antibiotics use for acute gastroenteritis in children admitted to the hospital in 1998-2000., Material and Methods: The retrospective analysis of medical records was performed in 369 children up to two-years of age; including 87 admitted in 1998, 136 - in 1999 and 146 in 2000 year. Results. Antimicrobials use decreased year after year. In 1998 the antibiotics therapy was included in 44.9% of children, in 1999--in 35.3% and in 2000 year in 32.2% (p = 0.02). In 1998 year, the antibiotics were ordered mainly for children diagnosed as bacterial diarrhea (76.9%) compared to viral etiology (18%). In 2000 year the antibiotics were prescribed for viral gastroenteritis twice more often (61.7%) than for bacterial etiology (29.8). Children with acute gastroenteritis and coexistent signs and symptoms were given antibiotics for treatment diarrhea in the similar percentage as those without any: in 1998--54.2 and 45.8%, in 1999--50.8 and 49.2%, in 2000--40.3 and 59.7%, respectively. Microbiologic examination was not performed in any case before treatment., Conclusions: This study demonstrates the discrepancies between recommendations and ambulatory practice in the antibiotic treatment of acute diarrhea in children both before and after implementation the healthcare system reform. Education programs are needed for optimal management of acute gastroenteritis in children including training in necessity of coproculture before prescribing antimicrobials.

The article presents common etiologic agents of viral gastroenteritis in children. The actual knowledge on molecular characteristics of rotaviruses, noroviruses, sapoviruses, astroviruses, and adenoviruses as well as their epidemiology in the world and Poland is reviewed. The authors emphasize the need of greater use of molecular procedures (RT-PCR) for detection the common serotypes of rotavirus and other viral agents of gastroenteritis in Polish children. Familiarity with molecular epidemiology of viruses and with their antigenic diversity allows to elaborate and apply the adequate vaccines as well as to initiate the prophylactic procedures.

Objective: This study examined the burden of hospitalization of children with viral meningitis in Department of Pediatric Infectious Diseases, Medical University of Bialystok from 2003 to 2005., Methods: Data were extracted from Children Teaching Hospital database. A hospitalization with viral meningitis was defined as any discharge with diagnoses of mumps meningitis (B26.1), enteroviral meningitis (A85.0), tick-born encephalitis (A84.1) and viral undifferentiated meningitis (A87.9) due to ICD-10. Outcome measures included number of hospitalizations in total and due to different etiology as well as their impact in the budget of the unit., Results: 316 hospitalizations with viral meningitis were identified. Of these 246 (77.6%) were diagnosed with mumps etiology, 10 (3.2%) with enteroviral, 1 (0.3%) with tick-born virus and 59 (18.7%) with unknown viral etiology. Most cases of viral meningitis were hospitalized in 2003--132 (41.8%). Of these 93.9% were diagnosed with mumps meningitis. In 2005, of 78 hospitalizations associated with viral meningitis 10 (12.8%) were confirmed and further 38 (48.7%) were suspected enteroviral meningitis. The percentages of costs associated with viral meningitis in 2004 and 2005 (26% and 18.8%) were high in comparison to percentage of hospitalizations with viral meningitis (10.7% and 7.3%, respectively).

A total of 74 fresh stool specimens obtained from children with acute diarrhoea (43) and without diarrhoea (31) were examined simultaneously for bacteria pathogens (culture methods) and for Clostridium difficile toxin A (Oxoid Toxin A Kits) and enteric viruses (only diarrhoeal samples) (Slidex Rota-Adeno Kits; bioMçrieux). One (49%) or dual with C. difficile (23%) enteric pathogens associated with community-acquired diarrhoea (58% bacteria and 14% viruses) in 31 (72%) children were recognized. Clostridium difficile associated diarrhoea (CDAD) (18,6%) and Salmonella enterica subsp. enterica serovar Enteritidis (16,3%) the most commonly were observed. Children were considered to have CDAD if they met special criteria such as the positive test for C. difficile toxin A, the presence of diarrhoea for at least 2 days and no other documented enteric pathogens. It was be found that antibiotic usage in the previous 3 weeks as a main risk factor for CDAD not be frequent (only 2/8 CDAD). The frequency of C. difficile toxin A detection in the diarrhoeal stool specimens from children treated or not treated with antibiotics was comparable (p>0,05); this same observed when stool specimens from children without diarrhoea were tested. The frequency of toxin A detection in stool specimens from children with acute diarrhoea (41,9%) and without diarrhoea (54,8%) was comparable (p>0,05) also. In conclusion, we recommended detection of toxin A by C. difficile toxin A Test as the rapid screening in diarrhoeal stool specimens only because the high predictive value of a negative test and the high sensitivity for CDAD with special criteria were found.

Nowadays in Poland, Salmonella typhi (S. typhi) infections are diagnosed rare. Despite the low incidence of typhoid fever, this disorder should be still in our mind. The clinical profiles of typhoid fever are various and atypical manifestation often makes the serious diagnostic problem, in childhood especially. We report herewith a case of typhoid fever in 5 years old boy, manifested as a respiratory tract infection. We present also some basic information on this rare but still serious disorder and on Gram-negative bacilli identified as S. typhi causing the typhoid fever.

Mumps is a viral infection primarily affecting the salivary glands. Although disease is usually mild about 10-15% of patients can develop aseptic meningitis. Rare but more serious complication is encephalitis, which can result in death. Orchitis, pancreatitis, deafness are other complications of mumps. In the countries where there is no vaccination for mumps, its incidence remains high, usually >100 per 100,000 population with epidemic peaks every 2-5 years. Peak incidence is found among children 5-9 years of age. The mumps morbidity in Poland is in the range 50-560 per 100,000 population. Up to 2003, 107 countries reported using mumps vaccine in their national immunization programmes. Countries that have achieved high coverage have shown rapid decline in mumps morbidity (for a one-dose schedule > or = 80%, for two-dose schedule > or = 97%). This review analyses the clinical manifestation, epidemiology of mumps as well as immunogenicity, effectiveness and safety of different types of mumps vaccines. It also provides information about epidemiological situation for mumps in Poland in the context of national mumps immunization programmme. There is low seroprevalence among the children population in Poland--up to 2003, about 75% children population in the 1 to 4 age group was seronegative for mumps. The childhood mumps vaccination should aim at an 80% coverage rate, or more. An insufficient childhood vaccination coverage may result in an epidemiological shift in the incidence of mumps to older age groups. If a large proportion of the population remains seronegative for mumps, vaccination of adults should be also considered.

Rotavirus is the most common gastrointestinal pathogen in infants and young children. The aim of this study was to determine the role of rotavirus in acute diarrhea in children hospitalized in Pediatric Infectious Diseases Clinic in Bialystok. 658 children aged 0-7 years admitted to the ward: 466 children with gastroenteritis and another 192 without any diarrheic symptoms were tested for rotavirus infection by latex agglutination. Rotavirus was detected in 16.1% stool specimens collected from children with acute diarrhea. None of patients without diarrhea was positive for rotavirus on admission--2% of this patients acquired symptomatic rotavirus infection during hospitalization. This study delivers epidemiological data on rotavirus infection and shows the need of further study on etiology of viral gastroenteritis in children in our district.

The paper presents the findings of histological studies on the effect of sodium salt of 2,4-D acid on the changes within kidneys in newborn rats exposed to this herbicide in the prenatal and postnatal period. The experiment was performed on 60 Wistar rats of both sexes, up to 10 weeks of age. The animals were divided into two groups: I group (control)--18 rats fed on a standard diet and given tap water ad libitum, and group II (experimental)--42 rats, whose mothers received sodium salt of 2.4 dichlorophenoxyacetic acid in drinking water at a daily dose of c. 250 mg/kg for 2 months before fertilization and during pregnancy and lactation. The animals were killed after 24 hours, 4, 6 and 10 weeks of the experiment. The sections were taken from the kidneys, fixed in 4% formaldehyde and stained with hematoxylin and eosin. For acid and alkaline phosphatase examination, the kidney section were fixed in Backer's liquid and Gomori histoenzymatic reaction was performed. Histological examination of the first four experimental groups revealed changes in kidney tubules. Histologic changes were nonspecific and a variety of conditions. The presence vacuoles in cytoplasm and necrosis of tubular epithelial cells. Varying degrees of isometric vacuolization of proximal tubular epithelium, tubular microfocal calcification, tubular epithelial inclusion bodies and peritubular capillary congestion were observed. The observations suggest that chronic intoxication with 2,4-D acid leads to renal cell damage in kidneys more intensified in the fetal than in the postnatal period. Following herbicide withdrawal, the most pronounced changes observed in the fetus were found to regress.