Imunitní systém ve fyziologickém řádu organizmu

Jindřich Lokaj

Vnitr Lek 2019, 65(2):71-74 | DOI: 10.36290/vnl.2019.018  

Defensive and damaging inflammation: basic characteristics

Jan Krejsek

Vnitr Lek 2019, 65(2):76-80 | DOI: 10.36290/vnl.2019.019  

Immune system is the integral part of the complex body response, inflammation, which is raised either by the exposure to external signals, predominantly pathogens or by damage of own structures. Predominantly innate immunity is equiped by the receptors recognizing pathogenic PAMPs or signals of own damage DAMPs. The inflammatory response is reflecting the actual demand of our body. The potential of the inflammatory response is so powerful that its intensity and extent have to be carefully regulated on many levels.

IL-1 family cytokines in chronic inflammatory disorders

Ilja Stříž

Vnitr Lek 2019, 65(2):81-85 | DOI: 10.36290/vnl.2019.020  

IL-1 family represent a group of structurally related cytokines with prevailing pro-inflammatory (IL-1α, IL-1β, IL-18, IL-33, IL-36α, IL-36β a IL-37γ) or anti-inflammatory (IL-1Ra, IL-36Ra, IL-38, IL-37) effects. They are involved not only in defense mechanisms and physiological modulation of homeostatic processes, but also in the imunopathogenesis of many diseases including rheumatoid arthritis, inflammatory bowel disease, autoimmune and auto-inflammatory diseases. Recently, advances in biologic therapy enabled blocking of IL-1α, IL-1β, IL-18, and IL-33 with new monoclonal antibodies, soluble receptors, or recombinant...

Heterogeneity of lymphocytes as central operating units of the immune system

Milan Buc

Vnitr Lek 2019, 65(2):86-97 | DOI: 10.36290/vnl.2019.021  

Immune response is divided into natural and adaptive although such strict division is rather contentious as one type of immunity influences another one and vice-versa; moreover, there are cells and immune mechanisms, which stay somewhere in an interface. B and T lymphocytes represent principal cells of adaptive immunity. Not one of them form a uniform population. B cells comprise of three subpopulations (follicular, B1, marginal zone). Concerning T cells, the situation is more complicated. There are two basic populations, that expressing T cell receptors α, β and that expressing γ, δ receptors. T cells αβ are very...

Microbiota, immunity and immunologically-mediated diseases

Helena Tlaskalová Hogenová, Zuzana Jirásková Zákostelská, Jitka Petanová, Miloslav Kverka

Vnitr Lek 2019, 65(2):98-107 | DOI: 10.36290/vnl.2019.022  

Each individual is colonized by broad spectrum of microbes. Recent surge of interest in microbiota across all fields of medicine was motivated by an increasing body of knowledge on how commensals influence human health. This is most notable in the gut, where most microbes reside, but microbes colonizing other niches, such as oral cavity or skin, may influence health as well. Microbiota fundamentally influences the immune system development and its perturbation, i.e. dysbiosis, is associated with many inflammatory, autoimmune and neoplastic diseases. Microbiota forms a symbiotic relationship with the host - maintaining balanced and efficient immune...

Primary immunodeficiencies in adults

Jiří Litzman

Vnitr Lek 2019, 65(2):109-116 | DOI: 10.36290/vnl.2019.023  

In contrast to general opinion, the issue of primary immunodeficiency is far from just a pediatric medicine; a large number of patients with primary immunodefciencies are not only treated, but also diagnosed in adulthood. The most important manifestation of these diseases are serious, unusual or ill-treatable infections. Some primary immune deficiency diseases manifest themselves in adulthood - mainly common variable immunodeficiency (CVID) and Good's syndrome (hypogammaglobulinemia with thymoma). Due to successful treatment, adults also suffer from illnesses manifestation of which begin in early infancy. Among these, the most common are patients with...

Secondary immunodeficiency as a consequence of chronic diseases

Zita Chovancová

Vnitr Lek 2019, 65(2):117-124 | DOI: 10.36290/vnl.2019.024  

Secondary immunodeficiencies (SID) represents heterogeneous group of acquired impairment of immune system function with diverse etiology. It is mostly a combined disorder of both humoral and cellular component of the innate and adaptive immune response. SID occurs mainly in adulthood. Among the most important causes of SID development belong diabetes mellitus, impairment of liver and kidney functions, protein-energy malnutrition, splenic defects and immunosenescence. These deficiencies of immunity are clinically manifested by an increased frequency or unusual complications of common infections and occasionally by the occurrence of opportunistic infections....

Treatment of antibody immunodeficiency

Jiří Litzman

Vnitr Lek 2019, 65(2):126-130 | DOI: 10.36290/vnl.2019.025  

The basis of treatment of patients with hypogammaglobulinemia, primary or secondary, is immunoglobulin replacement. Current immunoglobulin derivates contain highly purified IgG from healthy human donors. Intravenous or subcutaneous route are almost exclusively used at present. The treatment must be individualized. Adequate doses of immunoglobulin derivates must be administered to avoid frequent and severe infections of the respiratory tract. Antibiotic prophylaxis may be alternative and complementary treatment to immunoglobulin substitution.

Adverse effects of immunoglobulin therapy

Iva Šutová, Zita Chovancová, Jiří Litzman

Vnitr Lek 2019, 65(2):131-135  

Immunoglobulin products contain specific antibodies in IgG class which are directed against wide range of pathogens. These products are obtained from plasma of healthy donors. Immunoglobulin derivates can be administrated by intravenous or subcutaneous route in substitution or immunomodulation indications. The administration can be accompanied by a risk of adverse events. The most common are pyretic reactions, chills, headache, nausea, malaise and muscle pain, nevertheless also severe systemic reactions can occur. Almost one third of the reactions appear during the first administration. The number and severity of reactions depends on administered dose,...

Current trends in immunosuppressive treatment

Marta Sobotková, Jiřina Bartůňková

Vnitr Lek 2019, 65(2):136-142 | DOI: 10.36290/vnl.2019.027  

Immunosuppressive agents represent a class of drugs that inhibits activity of the immune system. They are mostly used in autoimmune diseases and other inflammatory conditions treatment and in prevention of recipient's immune response to donors antigens in transplantations. There is a broad spectrum of different immunosuppressive drugs with various mechanisms of action. This article provides an overview of drugs currently registered as immunosuppressive agents in the Czech Republic and provides some insights what we might expect regarding this group of drugs in the future.

The role of allergology in internal medicine today and vice versa

Petr Čáp

Vnitr Lek 2019, 65(2):143-147 | DOI: 10.36290/vnl.2019.028  

Author underlines recent growing importance of allergology as a medical discipline and offers a brief overview focused on the overlap between allergy and internal medicine. The important diagnostic and therapeutic methods are described to give an information useful for a postgraduate medical education in internal medicine. The analysis of individual case history especially in allergy is emphasized. Allergen immunotherapy is described as a very modern therapeutic method with a special respect to disease modifying effect under the definite conditions. The availability of new quick dissolving tablets as a vaccine are mentioned and finally some very important...

Anaphylactic symptoms and anaphylactic shock

Irena Krčmová, Jakub Novosad

Vnitr Lek 2019, 65(2):149-156 | DOI: 10.36290/vnl.2019.029  

Anaphylactic symptoms and anaphylactic shock are serious, rapidly developing and potentially fatal systemic reactions occurring after contact with the trigger, followed by release of a number of substances that affect vascular permeability, smooth muscle tone of blood vessels and bronchi with activation of the systemic inflammatory cascade. From a pathophysiological point of view, it can be an IgE-mediated immune response followed by massive release of biologically active mediators from mast cells and basophils (IgE dependent). If the mastocyt/basophil is degranulated via a direct IgE-free pathway, it is non-allergic (non-IgE dependent, anaphylactoid...

Helen Chapel et al. Základy klinické imunologie

Vojtěch Thon

Vnitr Lek 2019, 65(2):157