Hlavní téma – Novinky v léčbě alergie, astmatu a poruch imunity

doc. MUDr. Tomáš Milota, Ph.D.

Vnitr Lek 2026, 72(3):139  

Recent advances in biologic therapy of allergic diseases

Mojmír Račanský

Vnitr Lek 2026, 72(3):144-147 | DOI: 10.36290/vnl.2026.031  

Allergic diseases are showing a continuously rising prevalence worldwide. It is estimated that 20-40 % of the global population suffer from some form of allergic condition. According to data from the World Allergy Organization affiliated with the World Health Organization, roughly one in five people are affected. The severity of allergic diseases varies. However, all forms impact the daily lives of those affected - from seasonal allergic rhinitis, through various manifestations of atopic dermatitis and food allergies, to severe bronchial asthma. Severe forms of allergic diseases considerably diminish patients' quality of life. Their management is challenging...

Advances in asthma treatment

Tomáš Slisz

Vnitr Lek 2026, 72(3):148-150 | DOI: 10.36290/vnl.2026.032  

This review summarizes the latest GINA 2025 recommendations, focusing on updated diagnostic criteria, particularly in pediatric patients, the role of biomarkers such as FeNO and blood eosinophils, and modern therapeutic strategies. Special emphasis is placed on the anti-inflammatory reliever concept, which promotes the use of low-dose ICS-formoterol as needed across all severity steps. The article also reviews recent developments in biologic therapy, including expanded indications for dupilumab, the use of tezepelumab across asthma phenotypes, and the emerging role of long-acting agents such as depemokimab. Environmental factors influencing disease...

Recent advances in primary immunodeficiencies

Ondřej Vladyka, Katarína Simonová, Martin Orlický, Adam Klocperk

Vnitr Lek 2026, 72(3):151-157 | DOI: 10.36290/vnl.2026.033  

The article summarises key recent developments in the field of primary immunodeficiencies, now preferentially referred to as inborn errors of immunity (IEI). It is based on the current International Union of Immunological Societies (IUIS) classification, which reflects the rapidly increasing number of described entities, and highlights the shift from an "infection-centred" perspective to a broad spectrum of manifestations including autoimmunity, allergy, autoinflammation, and malignancies. Using selected examples of newly described conditions, it illustrates phenotypic diversity and diagnostic challenges, including incomplete penetrance, mosaicism,...

Secondary antibody deficiency - novel diagnostic and therapeutic approaches

Tomáš Milota

Vnitr Lek 2026, 72(3):158-164 | DOI: 10.36290/vnl.2026.034  

Secondary antibody immunodeficiencies (SAD) are a heterogeneous group of diseases of acquired immune disorders that arise under broad spectrum of internal and external factors. Unlike primary antibody immunodeficiencies, they are often accompanied by multiple components of the immune system being affected, either within the disease itself or as a result of its treatment. The picture is often accompanied by neutropenia, lymphopenia, hypocomplementemia, etc. According to etiology, SAD can be divided into loss hypogammaglobulinemia and SAD associated with impaired antibody production. We assess the total levels of immunoglobulins and specific antibodies...

Advances in immuno-oncology

Zuzana Ozaniak Střížová

Vnitr Lek 2026, 72(3):165-170 | DOI: 10.36290/vnl.2026.035  

Immunotherapy has emerged over the past decade as a central modality in the treatment of many malignancies, representing a fundamental shift from conventional therapeutic approaches toward strategies that harness the patient's immune system. It is no longer considered merely an adjunctive option used after the failure of other therapeutic modalities; rather, in selected indications, it constitutes a first-line treatment. A thorough understanding of the tumor microenvironment and tumor immunogenicity is a key factor influencing treatment efficacy. The following sections provide a detailed overview of the main types of immunotherapy, including nonspecific...

Hypolipidemic therapy in pregnancy

Pavla Jadrníčková, Jan Václavík, Filip Dubský

Vnitr Lek 2026, 72(3):171-175 | DOI: 10.36290/vnl.2026.036  

Pregnancy is accompanied by significant metabolic adaptations, including a physiological increase in lipid levels, particularly low-density lipoprotein cholesterol (LDL-C), a causal risk factor for cardiovascular disease. Elevated LDL-C exposure during gestation, especially in women with familial hypercholesterolemia (FH), contributes to lifelong cardiovascular risk. Although atherosclerotic coronary artery disease is rare in women of reproductive age, pregnancy in the fourth and fifth decades of life is becoming increasingly common and is associated with a higher prevalence of acute myocardial infarction during pregnancy. This review summarizes current...

Primary aldosteronism: diagnosis and treatment in clinical practice

Ondřej Petrák

Vnitr Lek 2026, 72(3):176-182 | DOI: 10.36290/vnl.2026.037  

Primary aldosteronism is the most common cause of secondary endocrine hypertension, with a prevalence of 5-14% among hypertensive patients. It is caused by autonomous aldosterone overproduction from the adrenal cortex, leading to sodium retention and the development of hypertension, often accompanied by significant hypokalemia. Compared with essential hypertension, primary aldosteronism is associated with an increased cardiovascular and renal risk, independent of blood pressure levels. This article provides a concise overview of the pathophysiology, clinical manifestations, and complications of primary aldosteronism and focuses on a practical diagnostic...

The relationship between atrial fibrillation and dementia

Petra Kratochvílová

Vnitr Lek 2026, 72(3):183-186 | DOI: 10.36290/vnl.2026.038  

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide and currently affecting approximately 2-4 % of the population. Its prevalence continues to rise, and by around 2050, the number of patients with AF is expected to approach 100 million (1). Dementia currently affects 5-7 % of individuals over the age of 60, and its prevalence is projected to triple by 2050 (2). This disease leads to loss of independence, increased need for long-term care, and higher overall mortality. In recent years, accumulating evidence has suggested an association between AF and an increased risk of cognitive decline and dementia. The aim of this...

Diabetic ketoacidosis and hypophosphatemia

Ondřej Lukáč, Ondřej Hloch, Nikola Stieranková, Juraj Michalec, Martin Wasserbauer, Jan Brož

Vnitr Lek 2026, 72(3):E1-E4 | DOI: 10.36290/vnl.2026.041  

Hypophosphatemia is a common but generally underestimated electrolyte abnormality associated with diabetic ketoacidosis (DKA) that can cause serious clinical complications. Monitoring and, if necessary, supplementation of phosphate levels should be an integral part of the care of patients with diabetic ketoacidosis, although routine supplementation is not currently recommended.

Immunosuppression with tacrolimus in kidney transplant recipients aged 65+

Silvie Rajnochová Bloudíčková, Roman Šafránek, Zdeněk Lys, Karel Krejčí, Milan Kuman, Vladimír Hanzal, Ondřej Viklický

Vnitr Lek 2026, 72(3):E5-E7 | DOI: 10.36290/vnl.2026.042  

Although the number of kidney transplant recipients aged 65+ is increasing, clear recommendations regarding immunosuppressive regimens have not yet been clearly defined. Immunosenescence increases the risk of post-transplant complications and adverse drug effects, contributing to a decline in quality of life, non-adherence, increased morbidity and mortality. The optimal strategy to minimize these complications is to take age and sensitization into account when accepting and allocating donors in order to limit the use of depletion induction therapy and utilize maintenance immunosuppression with lower toxicity.

Pancreatic panniculitis - a cutaneous manifestation of pancreatic disease

David Solil, Petr Dítě, Radek Kroupa, Michal Šenkyřík, Martin Harazim, Petr Litzman, Klára Bochníčková, Jan Šlapák, Milan Dastych, Jiří Dolina

Vnitr Lek 2026, 72(3):189-192 | DOI: 10.36290/vnl.2026.039  

Pancreatic panniculitis is a rare cutaneous manifestation of pancreatic disease, characterized by painful erythematous nodules predominantly affecting the lower extremities, resulting from the release of pancreatic enzymes into subcutaneous tissue and subsequent fat necrosis. It is most commonly associated with acute pancreatitis but may also occur in the setting of pancreatic malignancy. In some cases, it represents the first clinical manifestation of previously asymptomatic pancreatic disease. This article provides an overview of pancreatic panniculitis, inspired by a case report from our institution.

Musculoskeletal pain - osteoporosis, or non-specific back pain?

Vlasta Tošnerová

Vnitr Lek 2026, 72(3):193-196 | DOI: 10.36290/vnl.2026.040  

Introduction: The question often arises as to how spinal pain is related to osteoporosis, or whether it is mainly non-specific back pain, vertebrogenic algic syndrome. Distinguishing the origin of pain is related to basic clinical specializatiin and the extension field of Rehabilitation and Physical Medicine. Interdisciplinary, it is appropriate, in addition to laboratory and imaging methods, which are related to basic fields, to supplement the examination with active range of motion, passive range of motion and range of motion to the segment in addition to a structured history. Palpation of muscles, fascia, skin, subcutaneous tissue and periosteal...

Při jaké klidové srdeční frekvenci se zvyšuje riziko kardiovaskulárních příhod u pacientů s diabetem 2. typu? Komentář ke studii Sobieraj et al.: Heart rate and cardiovascular risk in diabetes

Sabina Kvasnicová, Jan Brož

Vnitr Lek 2026, 72(3):E8-E9 | DOI: 10.36290/vnl.2026.043