Pnemonologia i Alergologia Polska 2013, tom 81, numer 4

U 30–40% chorych na raka płuca stwierdza się przewlekłą obturacyjną chorobę płuc (POChP).Jednocześnie chorzy na POChP są narażeni na kilkakrotnie większe ryzyko zachorowania na raka płuca

The antiphospholipid syndrome is characterized by the presence of antiphospholipid antibodies and the association of proteanclinical manifestations as a result of both venous and arterial thrombosis. While pulmonary embolism (secondary to deepvein thrombosis) is common and well-known disturbance in antiphospholipid syndrome, recently there are growing numberof case reports describing nonthrombotic lung pathologies in APS. We present here a young male with antiphospholipidsyndrome, whose the only manifestation was diffuse alveolar hemorrhage.

Legionella pneumophila is an agent also well known to be frequently responsible for severe community acquired pneumonia.Recent studies regarding severe community-acquired pneumonia have shown that Legionella pneumophila is the secondmost common cause of admission to ICU, not far behind pneumococcal pneumonia. The mortality of severe Legionellapneumonia is high (30%).

Pulmonary hypertension (PH) is a common complication of advanced chronic obstructive pulmonary disease (COPD) and is definedby a mean pulmonary artery pressure (PAP) ≥ 25 mm Hg at rest in the supine position. Owing to its frequency, COPD is a commoncause of PH; in fact, it is the second most frequent cause of PH, just after left heart diseases. PH is due to the elevation of pulmonaryvascular resistance, which is caused by functional and morphological factors, chronic alveolar hypoxia being the most important.In COPD PH is generally mild to moderate, PAP usually ranging between 25 and 35 mm Hg in a stable state of the disease.A small proportion of COPD patients may present a severe or “disproportionate” PH with a resting PAP > 35–40 mm Hg. Theprognosis is particularly poor in these patients. In COPD PH worsens during exercise, sleep and severe exacerbations of thedisease, and these acute increases in afterload may favour the development of right heart failure.

Non-invasive mechanical ventilation (NIV) is a modern method of chronic respiratory failure (CRF) treatment. With thedevelopment of medicine and society known as “western”, the number of elderly people, in whom there is overlapping ofchronic diseases such as COPD, is growing. In adult population NIV is used in the treatment of neuromuscular diseases suchas amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy. The other main indications include restrictive diseasessuch as kyphoscoliosis, pulmonary diseases with COPD which is the primary indication, and various forms of central apneasyndrome with epidemiologically essential role of obesity hypoventilation syndrome (OHS). In each of those indications, andin different patients, the mode and ventilation intensity may significantly differ.

Inherited alpha-1 antitrypsin (AAT) deficiency is one of the three most common genetic disorders in Caucasians.It considerably increases the risk of progressive obstructive lung diseases, mostly chronic obstructive pulmonarydisease. It has also been suggested that AAT deficiency might be instrumental vasculitis associated with the anti-neutrophilcytoplasm antibodies (cANCA) and subsequent lung tissue injury.

Recent studies have shown an increased risk of lung cancer in patients with bronchial obstructivechanges, including patients with COPD. It seems that there are common factors of pathogenesisof both diseases associated with oxidative stress. In the present paper the genes linked to the repair of oxidativedamage of DNA, associated with cancer, of iron metabolism and coding proteolytic enzymes were assessed.

A major role in the development of resistance of Mycobacterium tuberculosis to isoniazid (INH) is attributed tomutations in the katG gene coding for the catalase/peroxidase, an enzyme required for obtaining a pharmacologically active formof the drug. Analysis of mutations in the katG gene in M. tuberculosis strains may contribute to the development of reliable andrapid tests for detection of INH resistance.

HER2 (ErbB2/neu) is a member of the ErbB family of four structurally related receptors of tyrosine kinase activity.Overexpression of ErbB-1 (EGFR) and HER2 is found in many human cancers, but the presence of these genes mutations determinesthe effectiveness of EGFR and HER2 tyrosine kinase inhibitors in the therapy of non-small cell lung cancer (NSCLC).

Chronic obstructive pulmonary disease (COPD) is characterized by an airflow limitation that is usually progressive.The progression of COPD expressed as the rate of an annual decline in FEV1 is very heterogeneous. Exercise capacityin COPD patients is often diminished and becomes worsened over the time.The purpose of the study was to examine how the change in FEV1 and exercise capacity would deteriorate over long-termobservation.