Papers by Barbara Lisowska
Archives of Medical Science, Jul 23, 2009
I In nt tr ro od du uc ct ti io on n: : This study investigates the course of blood cytokine leve... more I In nt tr ro od du uc ct ti io on n: : This study investigates the course of blood cytokine levels and CRP in patients with rheumatoid arthritis (RA) undergoing total knee replacement (TKR). Additionally, we set out to examine the relationship between cytokines IL-6, TGF-β1 and CRP and parameters such as body temperature, tourniquet time and blood loss. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : The study concerns 40 patients with RA undergoing total knee replacement (TKR). Operative and postoperative details were recorded, including circulation, ventilation, body temperature, tourniquet time under operation and postoperative blood loss. Peripheral vein blood was serially sampled; the first was obtained before anaesthesia and next at 6, 12, 24, 36 h after the end of surgery. IL-6, TGF-β1 and CRP were evaluated in blood and at the same time body temperature (°C) was measured. R Re es su ul lt ts s: : In patients with RA undergoing TKR under regional anaesthesia, the levels of IL-6 and TGF-β1 in the peripheral blood were not significantly changed compared with the levels before operation. The rise of CRP protein concentration was achieved at first 36 h postoperatively. No significant changes in serum IL-6, TGF-β1 and CRP levels with regard to tourniquet time were found. The volume of blood loss was not associated with changes in cytokine and CRP blood concentrations either. A correlation between postoperative CPR levels and temperature was found. The body temperature remained elevated up to 36 h postoperatively. C Co on nc cl lu us si io on ns s: : Our data indicate that high production of cytokines (IL-6, TGF-β1) present in chronic inflammation prevents further enhancement of cytokine synthesis triggered by surgery. The rise of CRP concentrations postoperatively and the significant correlation between CRP and temperature were addressed. The postoperative rise of temperature in the first 3 days following TKR may be a normal physiological response. K Ke ey y w wo or rd ds s: : inflammatory response, orthopaedic surgery, rheumatoid arthritis.
IntroductionImpaired immunogenicity of COVID-19 vaccinations in inflammatory arthritis (IA) patie... more IntroductionImpaired immunogenicity of COVID-19 vaccinations in inflammatory arthritis (IA) patients results in diminished immunity. However, optimal booster vaccination regimens are still unknown, due to not unstudied kinetics of the immune response after booster vaccinations. Therefore, this study aimed to assess the kinetics of humoral and cellular responses in IA patients after the COVID-19 booster.Patients and MethodsIn 29 IA patients and 16 healthy controls (HC) humoral responses (level of IgG antibodies) and cellular responses (IFN-γ production) were assessed before (T0), after 4 weeks (T1), and after more than 6 months (T2) from the booster vaccination with BNT162b2.ResultsIA patients, but not HC, showed lower anti-S-IgG concentration and IGRA fold change at T2 compared to T1 (p=0.026 and p=0.031). Furthermore, in IA patients the level of cellular response at T2 returned to the pre-booster level (T0). All immunomodulatory drugs, except IL-6 and IL-17 inhibitors for the humor...
Frontiers in Immunology
IntroductionPrevious studies have shown a reduction in the effectiveness of primary COVID-19 vacc... more IntroductionPrevious studies have shown a reduction in the effectiveness of primary COVID-19 vaccination in patients with rheumatic diseases. However, limited data is available regarding the effectiveness of the COVID-19 vaccine booster dose, especially on cellular response. The study aimed to assess the humoral and cellular immunogenicity of a booster dose in patients with inflammatory arthritis (IA).Patients and methods49 IA and 47 age and sex-matched healthy controls (HC) were included in a prospective cohort study. Both groups completed primary COVID-19 vaccination and after more than 180 days received a BNT162b2 booster shot. Humoral responses (level of IgG antibodies) and cellular responses (IFN-γ production) were assessed before and after 4 weeks from the booster dose of the vaccine.ResultsAfter the booster dose, all participants showed an increased humoral response, although significantly reduced antibody levels were observed in IA patients compared to HC (p=0.004). The cell...
Reumatologia, 2008
Deformacje stóp w reumatoidalnym zapaleniu stawów-leczenie operacyjne i rehabilitacja Feet deform... more Deformacje stóp w reumatoidalnym zapaleniu stawów-leczenie operacyjne i rehabilitacja Feet deformities in rheumatoid arthritis-surgical treatment and rehabilitation A Ag gn ni ie es sz zk ka a P Pr ru us si in no ow ws sk ka a, , C Ce ez za ar ry y M Mi ic ch ha al la ak k, , B Ba ar rb ba ar ra a L Li is so ow ws sk ka a Klinika i Poliklinika Reumoortopedii Instytutu Reumatologii im. prof. dr hab. med. Eleonory Reicher w Warszawie, kierownik Kliniki dr hab. med. Paweł Małdyk, dyrektor Instytutu prof. dr hab. med. Sławomir Maśliński S Sł ło ow wa a k kl lu uc cz zo ow we e: : rehabilitacja, leczenie operacyjne, postępowanie przeciwbólowe.
Reumatologia, 2006
Ocena przydatności znieczulenia przewodowego do operacji ortopedycznych u chorych z chorobami reu... more Ocena przydatności znieczulenia przewodowego do operacji ortopedycznych u chorych z chorobami reumatycznymi The role of the regional anaesthesia performed for orthopaedic procedures in patients with rheumatic diseases R Re en na at ta a Ć Ćw wi ie ek k, , B Ba ar rb ba ar ra a L Li is so ow ws sk ka a, , P Pa aw we eł ł M Ma ał łd dy yk k Klinika Reumoortopedii Instytutu Reumatologii im. prof. dr hab. med. Eleonory Reicher w Warszawie, kierownik Kliniki doc. dr hab. med. Paweł Małżyk, dyrektor Instytutu prof. dr hab. med. Sławomir Maśliński S Sł ło ow wa a k kl lu uc cz zo ow we e: : znieczulenie przewodowe, chirurgia ortopedyczna, choroby reumatyczne.
Reumatologia, 2009
The aim of our present data was to compare the gastrological side effects of oral versus subcutan... more The aim of our present data was to compare the gastrological side effects of oral versus subcutaneous (SC) administration of methotrexate in patients with long-lasting rheumatoid arthritis (RA). We compared the intensity of gastrological side effects such as nausea, vomiting, loss of appetite, abdominal pain and diarrhea in patients who received methotrexate (MTX) in oral or subcutaneous doses of either 7.5 mg or 15 mg weekly. The survey research was used to evaluate the intensity of the above-mentioned side effects. The questionnaires were completed by a doctor, who conducted a structured interview with patients. Patients receiving oral MTX had more intense gastrological side effects. There was a correlation between dose of oral MTX and intensity of side effects. Patients receiving 15 mg MTX orally had significant severe vomiting and loss of appetite (p < 0.05). Nausea and loss of appetite turned out to be the most frequent side effects in patients receiving SC MTX 15 mg/weekly. In contrast to patients from the oral MTX groups none from the SC MTX groups exhibited vomiting or diarrhea. We found that SC MTX administration demonstrated a significant reduction of gastrological side effects' intensity compared with oral administration of the same MTX dosage among patients with long-lasting RA.
Problemy anestezjologiczne u chorych dializowanych w przebiegu układowych chorób tkanki łącznej p... more Problemy anestezjologiczne u chorych dializowanych w przebiegu układowych chorób tkanki łącznej poddanych operacjom ortopedycznym Anaesthetic considerations in dialised patients with rheumatic disesases undergoing orthopaedic surgery R Re en na at ta a Ć Ćw wi ie ek k 1 1 , , L Li id di ia a R Ru ut tk ko ow ws sk ka aS Sa ak k 2 2 , , B Ba ar rb ba ar ra a L Li is so ow ws sk ka a 1 1 , , P Pa aw we eł ł M Ma ał łd dy yk k 3 3 , , C Ce ez za ar ry y M Mi ic ch ha al la ak k 3 3
Reumatologia, 2011
In this article we would like to present the history of anaesthesiologic activity at the Institut... more In this article we would like to present the history of anaesthesiologic activity at the Institute of Rheumatology, the challenges in our practice and our current achievements. Furthermore, we have presented current world trends in anaesthesia and postoperative analgesia with relation to orthopaedic surgery. We have described our own experiences and the evolution of anaesthesiology in orthopaedic rheumatology.
Journal of Inflammation Research, 2020
The stress of surgery is characterized by an inflammatory response with immune suppression result... more The stress of surgery is characterized by an inflammatory response with immune suppression resulting from many factors, including the type of surgery and the kind of anesthesia, linked with the drugs that are used and the underlying disease of the patient. The trauma of surgery triggers a cascade of reactions involving the immune response and nociception. As strong analgesics, opioids provide the analgesic component of general anesthesia with bi-directional effect on the immune system. Opioids influence almost all aspects of the immune response in regards to leukocytes, macrophages, mast cells, lymphocytes, and NK cells. The suppressive effect of opioids on the immune system is limiting their use, especially in patients with impaired immune response, so the possibility of using multimodal anesthesia without opioids, known as opioid-free anesthesia (OFA), is gaining more and more sympathizers. The idea of OFA is to eliminate opioid analgesia in the treatment of acute pain and to replace it with drugs from other groups that are assumed to have a comparable analgesic effect without affecting the immune system. Here, we present a review on the impact of anesthesia, with and without the use of opioids, on the immune response to surgical stress.
Applied Sciences, 2019
Electroencephalography is a noninvasive method used for the measurement of central nervous system... more Electroencephalography is a noninvasive method used for the measurement of central nervous system bioelectrical activity. Besides its use for neurological disorders diagnostics in humans and animals, it was found to be useful as a part of the anesthetic monitoring. Introducing the electroencephalography (EEG) measurement intraoperatively in humans and in animals, due to its high specificity and sensitivity (limited number of wave patterns and high number of variabilities influencing them), with comparison to cardiovascular parameters might significantly increase the quality of anesthesia. The use of EEG during equine anesthesia may help to maintain a proper depth of anesthesia in this species. Due to the fact that EEG analyzers were designed for humans, there are still limitations of their use in horses, and different methods of analysis are studied. The paper introduces the physiology of EEG, its use in animals during anesthesia, and specification for horses.
Drug Design, Development and Therapy, 2018
In this review, we discuss the current data about the anatomy and function of bone tissue with pa... more In this review, we discuss the current data about the anatomy and function of bone tissue with particular regard to influence of prostaglandins. Bone tissue dynamics are characterized by a constant remodeling process that involves all bone tissue cells. The communication between bone component cells and other organs is necessary for bone remodeling equilibrium and confirms the dynamic character of bone tissue. Remodeling is also a vital element of healing processes and in adapting bone tissue to stress responses. Therefore, in our review we present the role and significance of bone cells and signaling pathways enabling maintenance of bone homeostasis and remodeling process stability. Cyclooxygenase (COX) is a crucial enzyme in the production of prostaglandins and thromboxane. We focus on the role of COX isoenzymes with highlighting their connection with bone formation, resorption and repair. Prostaglandins are known as arachidonic acid metabolites acting through specific membrane receptors and play an important role in the regulation of osteoblast and osteoclast functions. Prostaglandin PGE2 with its four defined receptors (EP1R, EP2R, EP3R and EP4R) is crucial to maintain balanced bone turnover. Their stimulatory or inhibitory effects appear to depend on different structure-activity relations and signaling pathways. We have described the role of these receptors in bone metabolism and healing. We conclude that the activity of prostaglandins in bone tissue is defined by maintaining bone remodeling balance and its reactions to humoral mediators and mechanical stress. Most data confirm that among prostaglandins, PGE2 takes part in all processes of trauma response, including homeostasis, inflammation and healing, and plays a key role in bone physiology.
Drug Design, Development and Therapy, 2018
Tissue damage following injury triggers the processes of coagulation, inflammation and healing. I... more Tissue damage following injury triggers the processes of coagulation, inflammation and healing. In tissues surrounding the bone, the result of the healing process is a scar, while bone tissue has a unique ability to achieve shape, strength and pre-injury function. Bone healing is a process of regeneration rather than classic recovery. The result of this process is the formation of new, healthy bone tissue instead of a scar. Many factors can inhibit or impair the bone healing process, and their influence is critical during the stages of inflammation and angiogenesis and finally on the clinical outcome. Nonsteroidal anti-inflammatory drugs (NSAIDs) play an essential role associated with their analgesic potency and anti-inflammatory effects. NSAIDs are also the most often used drugs in patients who require pain control and inflammation reduction due to musculoskeletal diseases or injures. Although their analgesic effect is well documented, NSAIDs also interfere with bone healing; therefore, the relative benefits and disadvantages connected with their administration should be taken into consideration. Despite the negative effect, NSAIDs have beneficial properties, but their clinical benefits in relation to dose and time of use are still unclear. Therefore, in this review, we focus on bone healing with relation to the impact of NSAIDs.
PLOS ONE, 2016
Objective There is a limited information about the role of Substance P (SP) in acute pain nocicep... more Objective There is a limited information about the role of Substance P (SP) in acute pain nociception following surgical stimulation in patients with a chronic inflammatory state not to mention the link between this neuropeptide level changes and intensity of pain. The goal of the research was to find the correlation between SP level changes and acute pain intensity in patients with rheumatoid arthritis undergoing elective orthopedic surgery. Material and Methods Patients with rheumatoid arthritis (RA) were enrolled in the study. The correlation between acute pain intensity and concentration of SP in serum as well as in drainage fluid from postoperative wound was assessed in patients with RA who underwent Total Knee Replacement (TKA) under spinal anesthesia. Results In patients with RA a correlation between intensity of acute pain and serum SP was found postoperatively, whereas there was no correlation between intensity of acute pain and concentration of SP in drainage fluid. Conclusions 1. The correlation between acute pain intensity and SP serum concentration was found postoperatively in patients with RA. 2. The correlation between acute pain intensity and SP concentration in drainage fluid was not found postoperatively in patients with RA.
PLOS ONE, 2015
Objective Evidence suggests that substance P (SP) is involved in chronic joint inflammation, such... more Objective Evidence suggests that substance P (SP) is involved in chronic joint inflammation, such as the pathogenesis of rheumatoid arthritis and osteoarthritis. The goal of the research was to evaluate the correlation between chronic pain and changes in the SP level in patients with chronic inflammation of the connective tissue. Methods Patients with osteoarthritis and rheumatoid arthritis were enrolled in this study. The relationship between chronic pain intensity and the serum SP concentration was evaluated in these groups of patients with osteoarthritis and rheumatoid arthritis. Results The results showed a positive correlation between the serum SP concentrations and chronic pain intensity. Conclusions 1. The SP serum concentration was significantly different between the groups of patients with OA and RA. 2. There was a positive correlation between the serum SP concentration and chronic pain intensity in OA and RA patients.
Annals of the Rheumatic Diseases, 2013
Background Classical adipokines, leptin and adiponectin, are thought to originate principally fro... more Background Classical adipokines, leptin and adiponectin, are thought to originate principally from white adipose tissue. Although both of them have been suggested to participate in pathogenesis of rheumatoid arthritis (RA), their role is still controversial [1]. Data concerning leptin contribution are inconsistent. Adiponectin was reported to exert mostly proinflammatory and prodestructive effects, but little is known about biological activities of its low (LMW) and high molecular (HMW) complexes. We have recently reported that not only rheumatoid synovial membrane (SM), but also articular adipose tissue (AAT) releases biologically active factors, including leptin and adiponectin [2]. However, it is not known whether periarticular subcutaneous adipose tissue (ScAT) shows similar secretory activity. Objectives (1) To compare the production of leptin and adiponectin by rheumatoid ScAT, AAT, and SM explants. (2) To investigate the effects of leptin and adiponectin on rheumatoid fibroblast-like synoviocytes (FLS) function. Methods Tissue specimens were obtained from the knee joints of 60 patients with established rheumatoid arthritis (RA) who were undergoing total joint replacement surgery. Tissue explants (100 mg/ml/well) were cultured in medium (DMEM) alone or treated for 18 h with recombinant human cytokines relevant to RA pathogenesis: IL-1β, TNF, interferon γ or IL-15, applied at 1, 10 or 40 ng/ml concentrations, respectively. After the treatment leptin and adiponectin concentrations were measured in tissue explants culture supernatants by ELISA. Moreover, RA FLS isolated from SM specimens were stimulated for 18 h with recombinant human leptin, HMW or LMW adiponectin (0.1-10 ng/ml), then the culture supernatants were collected and concentrations of proinflammatory cytokines (IL-6, IL-8) and connective tissue degrading enzyme, matrix metalloproteinase-3 (MMP-3), were measured using specific ELISA. Results Spontaneous leptin secretion by AAT, ScAT and SM explants was similar ($≈ $200 pg/100 mg), while SM secreted twice as much adiponectin as AAT and ScAT (mean ± SEM equal 7966±1016, 4649±340 and 4962±585 pg/100 mg, respectively). The release of both adipokines from SM did not change upon stimulation, while all applied stimuli raised their secretion from AAT and ScAT. In these conditions AAT and ScAT produced twice as much leptin but still less adiponectin than SM. Exogenously added adipokines exerted little (leptin), moderate (HMW adiponectin) or strong (LMW adiponectin) stimulatory effects on IL-6, IL-8 and MMP-3 secretion by RA FLS. Interestingly, the effect of LMW adiponectin (10 ng/ml) was comparable to that exerted by TNF. Conclusions Joint-associated adipose tissues (AAT and ScAT) are highly reactive to proinflammatory cytokines and upon stimulation their contribution to local adipokine pool is substantial. In RA joints adiponectin, especially of LMW, may contribute to synovitis and tissue destruction owing to potent up-regulation of IL-6, IL-8 and MMP-3 secretion by FLS. Acknowledgements This work was sponsored by grant No N N402 369938 from the Polish Ministry of Science and Higher Education. References Neumann E et al., Arthritis Rheum., 2011, 63:1159-69. Kontny E et al., Ann Rheum Dis., 2012, 71:262-267. Disclosure of Interest None Declared
Annals of the Rheumatic Diseases, 2013
with the highest expression of VEGF, Ang2 and Tie2 scored in the VC layer, compared to LL and SL ... more with the highest expression of VEGF, Ang2 and Tie2 scored in the VC layer, compared to LL and SL (all p<0.005). VEGF expression correlated with macroscopic synovitis (r=0.41, p=0.031) and vascularity (r=0.40, p=0.034), Ang2 expression correlated with synovitis (r=0.56, p=0.013) and CD68+ cells (r=0.53, p=0.013) and Tie2 correlated with CD3+ cells (r=0.41, p=0.023) and CD68+ cells (r=0.46, p=0.010). Treatment with TNFi showed a significant reduction in expression of Tie2 (p=0.034) and Ang2 (p=0.021), this was paralleled by an increase in mean tpO2 levels (22.8 mmHg-30.3 mmHg). A significant association between increased ΔVEGF, ΔAng2 and ΔTie2 with high DNA damage (Δ8-oxo-dG) and lipid peroxidation (Δ4-HNE) was demonstrated (all p<0.05), suggesting an interplay between oxidative stress and angiogenesis in a progression of chronic inflammatory arthritis. Colocalisation of angiogenic factors VEGF, Ang2 and Tie2 with oxidative damage markers 4-HNE and 8-oxo-dG in inflamed synovium was demonstrated. Functionally, 4-HNE induced RASFC proliferation (p<0.01), HMVEC tube formation (p<0.001) and the effect was significantly potentiated under hypoxic conditions (p<0.001). Conclusions: Angiogenesis is closely linked to hypoxia and oxidative stress; both of which promote angiogenic inflammatory cell influx and proliferation in inflammatory athritis. References: 1 Hypoxia-a key regulator of angiogenesis and inflammation in rheumatoid arthritis.
Reumatologia/Rheumatology, 2014
Postać układowa młodzieńczego idiopatycznego zapalenia stawów stanowi ok. 10% wszystkich zachorow... more Postać układowa młodzieńczego idiopatycznego zapalenia stawów stanowi ok. 10% wszystkich zachorowań na młodzieńcze idiopatyczne zapalenie stawów i w równej mierze dotyczy chłopców i dziewczynek. Charakteryzuje się bólami i/lub obrzękami stawów, wysoką nawracającą gorączką, polimorficzną wysypką skórną i często objawami ze strony innych narządów. Obserwuje się hepatosplenomegalię, powiększenie węzłów chłonnych, zapalenia błon surowiczych, wysokie wskaźniki ostrego procesu zapalnego. Często występują bóle stawów, rzadko natomiast stwierdza się zapalenie mięśni. Przedstawiono przypadek 22-letniego chorego z postacią układową młodzieńczego idiopatycznego zapalenia stawów, z dominującymi w początkowym okresie choroby stanami gorączkowymi i objawami zapalenia mięśni, głównie międzyżebrowych. Omówiono obraz kliniczny, problemy diagnos tyczne i leczenie.
Postępy Higieny i Medycyny Doświadczalnej, 2013
The immune response is a highly specific reaction carried out by means of specialized cells that ... more The immune response is a highly specific reaction carried out by means of specialized cells that belong to the immune system. There are two types of immune response mechanisms aimed towards pathogens: non-specific, innate reactions, and specific, acquired reactions. Acquired immunity, characterized by its specificity, is comprised of lymphocytes, including both T cell and B cell populations. The role of B lymphocytes is not limited to the humoral response, though the cellular immune response is carried out mainly by various T lymphocyte subpopulations. The reactions of the humoral and cellular responses complement and stimulate one another mutually-cytokines are their common linking element. The attachment of cytokines to their specific receptors activates a sequence of signals-either intracellular or between the cells of various systems. This organization of respective connections and reactions, including the functional relations between cells of the immune response, in its complexity, is best described as a cytokine network. The response of the immune system to surgical trauma can be looked at from both a local and a general perspective. Not only surgical trauma caused by tissue damage, however, influences the functioning of the immune system, but also the drugs and techniques used during anesthesia. Our article is a presentation of the effects of medications used in anesthesia with respect to their influence on the cytokine network.
Clinical Rheumatology, 2008
I In nt tr ro od du uc ct ti io on n: : This study investigates the course of blood cytokine leve... more I In nt tr ro od du uc ct ti io on n: : This study investigates the course of blood cytokine levels and CRP in patients with rheumatoid arthritis (RA) undergoing total knee replacement (TKR). Additionally, we set out to examine the relationship between cytokines IL-6, TGF-β1 and CRP and parameters such as body temperature, tourniquet time and blood loss. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : The study concerns 40 patients with RA undergoing total knee replacement (TKR). Operative and postoperative details were recorded, including circulation, ventilation, body temperature, tourniquet time under operation and postoperative blood loss. Peripheral vein blood was serially sampled; the first was obtained before anaesthesia and next at 6, 12, 24, 36 h after the end of surgery. IL-6, TGF-β1 and CRP were evaluated in blood and at the same time body temperature (°C) was measured. R Re es su ul lt ts s: : In patients with RA undergoing TKR under regional anaesthesia, the levels of IL-6 and TGF-β1 in the peripheral blood were not significantly changed compared with the levels before operation. The rise of CRP protein concentration was achieved at first 36 h postoperatively. No significant changes in serum IL-6, TGF-β1 and CRP levels with regard to tourniquet time were found. The volume of blood loss was not associated with changes in cytokine and CRP blood concentrations either. A correlation between postoperative CPR levels and temperature was found. The body temperature remained elevated up to 36 h postoperatively. C Co on nc cl lu us si io on ns s: : Our data indicate that high production of cytokines (IL-6, TGF-β1) present in chronic inflammation prevents further enhancement of cytokine synthesis triggered by surgery. The rise of CRP concentrations postoperatively and the significant correlation between CRP and temperature were addressed. The postoperative rise of temperature in the first 3 days following TKR may be a normal physiological response. K Ke ey y w wo or rd ds s: : inflammatory response, orthopaedic surgery, rheumatoid arthritis.
Reumatologia, 2010
Obustronna totalna aloplastyka stawów biodrowych u 15-letniej chorej z młodzieńczym idiopatycznym... more Obustronna totalna aloplastyka stawów biodrowych u 15-letniej chorej z młodzieńczym idiopatycznym zapaleniem stawów oraz gruźlicą kości i stawów w wywiadzie-opis przypadku Bilateral hip arthroplasty in 15-year-old girl due to juvenile idiopathic arthritis and tuberculosis osteoarthritis-a case report
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Papers by Barbara Lisowska