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Fenotype - Based Treatment of Severe Asthma Bronchiale in the Czech Republic
Vaník, Petr ; Teřl, Milan (advisor) ; Rozborilová, Eva (referee) ; Pauk, Norbert (referee)
INTRODUCTION In recent years there has been a lot of evidence that asthma is etiopathogenetically widely heterogeneous inflammatory disease. Simultaneously with this knowledge, there are new therapeutic possibilities of severe asthma, ie. targeted biological therapy, which reflects their inflammatory heterogeneity. A prerequisite of rational indications of this treatment requires closer asthma phenotyping using available biomarkers. AIM The aim of submitted work is as follows: A) Overview of diagnostics and treatment of asthma in the world and in the Czech Republic with focus on monitoring the effect of targeted therapy of severe asthma selected on the basis of phenotyping using biomarkers. B) The work is divided into three parts. 1. In the first part it is about evaluating the effect of treatment with anti IgE antibody omalizumab in the Czech Republic since 2007. 2. In the second part, the relationship between the specific allergic profile of patients to the results of treatment with omalizumab in the Czech Republic is examined in detail. 3. The third part deals with the benefit of the periostin investigation in the selection of targeted therapy. METHODS In the first part of our work we performed a retrospective post-hoc analysis of patient data with severe refractory asthma from 10 centers in the...
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Risk factors for lung cancer-Modulation of the level of antidotes to polycyclic hydrocarbons (PAH) in relation to smoking, tumorous and non-tumorous lung disease and research of a possible strengthening of the immune system against PAH by immunization.
Klimešová, Šárka ; Pauk, Norbert (advisor) ; Marel, Miloslav (referee) ; Pešek, Miloš (referee)
The thesis is divided in two parts; the first of which, following the initial statistics regarding occurrence of the lung cancer and outline of its history, is devoted to the issue of risk factors of development of this disease. Due to the fact that the main focus of the research work is the genotoxic effect of polycyclic aromatic hydrocarbons, a closer attention is paid to them. The beginning of the second part deals briefly with certain lung diseases, i.e. the chronic obstructive pulmonary disease and the lung cancer and the role of inflammation in pathophysiology of both diseases. The rest of the thesis is focused on the research project Modulation of the level of antidotes to polycyclic hydrocarbons (PAH) in relation to smoking, tumorous and non-tumorous lung disease, and research of a possible strengthening of the immune system against the PAH effects by immunization. The main objective of the project was to verify the presence, change of levels and protective effect of the antibodies against the PAH and PAH-DNA adducts in the serum after impact of the pure PAH and cigarette smoke and the application of an epidemiologic study to discover the influence of the level of the anti-PAH antibodies and other tested parameters on the risk of developing a lung disease. In addition to the results proper,...
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Breath condensate in the diagnosis of lung diseases
Řihák, Vladimír ; Pauk, Norbert (advisor) ; Salajka, František (referee) ; Musil, Jaromír (referee)
Univerzita Karlova v Praze, 3. lékařská fakulta Disertační práce MUDr. Vladimír Řihák Kondenzát vydechovaného vzduchu v diagnostice plicních nemocí Breath condensate in the diagnostics of lung diseases Školitel: doc. MUDr. Norbert Pauk, Ph.D. SUMMARY Introduction: Examination of exhaled breath condensate is offered as a new, noninvasive diagnostic method in lung diseases. It has been described about 200 markers, which were verified in the condensate, some more, some less developed. The gold standard of examination is exhaled nitric oxide and its metabolites. Other markers are studied in the diagnosis of COPD or pulmonary fibrotic processes. The aim is to use them not only for diagnosis, but also for monitoring dinase, or preventive measures. Methods: 124 patients were examined during 3 years at The University Clinics of Pneumology and Thoracic Surgery in Prague Bulovka and the Pulmonary Department of the Regional Hospital of Tomas Bata in Zlín. Among them were assembled subgroups: a) the health of nonsmokers, b) smokers without any symptoms of respiratory illness with normal lung function tests, c) asthmatics with evidence of uncontrolled disease treatment, d) in asthmatics who had controlled disease, e) patients with exacerbated COPD, f) COPD patients without evidence of exacerbation, g) patients with...
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Breath condensate in the diagnosis of lung diseases
Řihák, Vladimír ; Pauk, Norbert (advisor) ; Salajka, František (referee) ; Musil, Jaromír (referee)
Univerzita Karlova v Praze, 3. lékařská fakulta Disertační práce MUDr. Vladimír Řihák Kondenzát vydechovaného vzduchu v diagnostice plicních nemocí Breath condensate in the diagnostics of lung diseases Školitel: doc. MUDr. Norbert Pauk, Ph.D. SUMMARY Introduction: Examination of exhaled breath condensate is offered as a new, noninvasive diagnostic method in lung diseases. It has been described about 200 markers, which were verified in the condensate, some more, some less developed. The gold standard of examination is exhaled nitric oxide and its metabolites. Other markers are studied in the diagnosis of COPD or pulmonary fibrotic processes. The aim is to use them not only for diagnosis, but also for monitoring dinase, or preventive measures. Methods: 124 patients were examined during 3 years at The University Clinics of Pneumology and Thoracic Surgery in Prague Bulovka and the Pulmonary Department of the Regional Hospital of Tomas Bata in Zlín. Among them were assembled subgroups: a) the health of nonsmokers, b) smokers without any symptoms of respiratory illness with normal lung function tests, c) asthmatics with evidence of uncontrolled disease treatment, d) in asthmatics who had controlled disease, e) patients with exacerbated COPD, f) COPD patients without evidence of exacerbation, g) patients with...
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Risk factors for lung cancer-Modulation of the level of antidotes to polycyclic hydrocarbons (PAH) in relation to smoking, tumorous and non-tumorous lung disease and research of a possible strengthening of the immune system against PAH by immunization.
Klimešová, Šárka ; Pauk, Norbert (advisor) ; Marel, Miloslav (referee) ; Pešek, Miloš (referee)
The thesis is divided in two parts; the first of which, following the initial statistics regarding occurrence of the lung cancer and outline of its history, is devoted to the issue of risk factors of development of this disease. Due to the fact that the main focus of the research work is the genotoxic effect of polycyclic aromatic hydrocarbons, a closer attention is paid to them. The beginning of the second part deals briefly with certain lung diseases, i.e. the chronic obstructive pulmonary disease and the lung cancer and the role of inflammation in pathophysiology of both diseases. The rest of the thesis is focused on the research project Modulation of the level of antidotes to polycyclic hydrocarbons (PAH) in relation to smoking, tumorous and non-tumorous lung disease, and research of a possible strengthening of the immune system against the PAH effects by immunization. The main objective of the project was to verify the presence, change of levels and protective effect of the antibodies against the PAH and PAH-DNA adducts in the serum after impact of the pure PAH and cigarette smoke and the application of an epidemiologic study to discover the influence of the level of the anti-PAH antibodies and other tested parameters on the risk of developing a lung disease. In addition to the results proper,...
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Risk factors for lung cancer
Pauk, Norbert ; Zatloukal, Petr (advisor) ; Králíková, Eva (referee) ; Malý, Marek (referee) ; Molnár, Vladimír (referee)
The objective of the fi rst part of the thesis was to estimate risk and protective factors on lung cancer risk in females, especially to study the differences in the impact of diet and physical exercise on lung cancer risk in female nonsmokers vs. smokers, and reveal interactions, if any. In a hospital based case-control study, data collected by in-person interviews from 569 female lung cancer cases and 2120 controls were analyzed using unconditional logistic regression stratifying by appropriate factors. To investigate the role of tobacco and some other known or suspected factors responsible for the risk of developing adenocarcinoma of the lung, and to compare with other cell types (squamous-, small- and large-cell cancers) in Czech women, we conducted a case-control study, this is described as a second part of the thesis. Data collected by personal interviews from 145 cases of adenocarcinoma of the lung, 221 lung cancer cases of other cell types, and 1624 controls were analyzed using unconditional logistic regression.
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