• Tuberculosis and Respiratory Diseases
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• 제80권2호
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• pp.105-112
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• 2017

Spirometry is a physiological test for assessing the functional aspect of the lungs using an objective indicator to measure the maximum amount of air that a patient can inhale and exhale. Acceptable spirometry testing needs to be conducted three times by an acceptable and reproducible method for determining forced vital capacity (FVC). Until the results of three tests meet the criteria of reproducibility, the test should be repeated up to eight times. Interpretation of spirometry should be clear, concise, and informative. Additionally, spirometry should guarantee optimal quality prior to the interpreting spirometry results. Our guideline adopts a fixed normal predictive value instead of the lower limit of normal as the reference value because fixed value is more convenient and also accepts FVC instead of vital capacity (VC) because measurement of VC using a spirometer is impossible. The bronchodilator test is a method for measuring the changes in lung capacity after inhaling a short-acting ${\beta}-agonist$ that dilates the airway. When an obstructive ventilatory defect is observed, this test helps to diagnose and evaluate asthma and chronic obstructive pulmonary disease by measuring reversibility with the use of an inhaled bronchodilator. A positive response to a bronchodilator is generally defined as an increase of ${\geq}12%$ and ${\geq}200mL$ as an absolute value compared with a baseline in either forced expiratory volume at 1 second or FVC.

• Clinical and Experimental Pediatrics
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• 제54권12호
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• pp.501-506
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• 2011

Purpose: A high level of air pollutants can increase the number of patients with allergy-related diseases such as asthma and allergic rhinitis (AR). To analyze the association between air pollution and allergic disease, we investigated 2 areas in Korea: Incheon, an industrial area, and Jeju, a non-industrialized area. Methods: Second grade students at elementary schools (11 schools in Incheon and 45 schools in Jeju) were examined in a cross-sectional study. A questionnaire was used and a skin prick test was performed. The levels of $NO_2$, $CO_2$, $O_3$, particulate matter (PM) $PM_{10/2.5}$, formaldehyde, tVOCs, and dust mites in the classrooms and grounds were determined. Results: The levels of outdoor CO, $PM_{10}$, and $PM_{2.5}$ were significantly higher in Incheon (P<0.01). The levels of indoor CO, $CO_2$, $PM_{10}$, $PM_{2.5}$ were significantly higher in Incheon (P<0.01). The prevalence rates of AR symptoms at any time, AR symptoms during the last 12 months, diagnosis of rhinitis at any time, and AR treatment during the last 12 months were significantly higher in Incheon (P<0.01). The prevalence rate of wheezing or whistling at any time, and wheezing during the last 12 months were significantly higher in Incheon (P<0.01). Conclusion: We found that the children living in Incheon, which was more polluted than Jeju, had a higher rate of AR and asthma symptoms compared to children in Jeju. To determine the effect of air pollution on the development of the AR and asthma, further studies are needed.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.111-120
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• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

• 한국식품과학회지
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• 제34권5호
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• pp.885-888
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• 2002

본 연구의 목적은 우리나라의 식품으로 인한 알레르기 발생 빈도를 파악하며 주 알레르기 원인 식품을 파악하는 것이다. 삼성서울병원에 알레르기 증상으로 1998년 5월부터 2001년 8월까지 방문한 환자의 혈청 특이 IgE 항체를 대상 식품에 대해 CAP 시스템을 이용하여 조사하였다. 총 9054건의 CAP 검사가 난백, 난황, 우유, ${\alpha}-lactalbumin,\;{\beta}-lactoglobulin$, 카세인, 밀, 쌀, 메밀, 대두, 복숭아, 게, 새우, 돼지고기, 쇠고기, 닭고기, 참치, 연어, 고등어 및 혼합식품에 대해 1707명의 방문자를 중심으로 이루어졌다. 조사 결과 CAP 수치가 +2(0.7 U/mL) 이상인 값을 양성으로 판단하였으며 CAP 검사결과 11.3% (1022/9054건)가 양성이었다. 각 알레르기 원인 식품별로는 난백이 336건, 우유가 266건, 난황이 95건, 대두가 76건 ${\alpha}-lactalbumin$ 이 69건, 카세인이 61건, ${\beta}-lactoglobulin$이 58건, 메밀이 39건, 밀이 12건, 쇠고기 3건, 게 2건, 쌀, 새우, 돼지고기, 닭고기, 고등어 가 각각 1건, 복숭아, 참치, 연어 혼합식품이 각각 0건이었다. 우리나라에서 제일 많은 5대 알레르기 원인 식품으로 계란, 우유, 대두, 메밀 및 밀이 확인되었으며 환자 1인당 평균 2가지의 알레르기 원인 식품을 갖고 있는 것으로 확인되었다.

• 혜화의학회지
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• 제18권1호
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• pp.29-41
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• 2009

Wished to examine closely effect that SoPungDoJeokTang-KaMi (SPDJTK) medicines used to atopy dermatitis disease patient get in atopy eruption control experimentally. SPDJTK medicines controlled $CD4^+/IFN-\gamma$, and $CD4^+/CD25^+/foxp3^+$ revelation that an experiment that motive allergy immune reponse because an in vitro experiment stimulates T cells of a NC/Nga mouse same time by anti-CD40/rmIL-4, and interleukin-$1{\beta}$, IL-6, TNF-$\alpha$, and TGF-$\beta$ mRNA outturn that bear in T and B cells decreased remarkably by SPDJTK medicines. Intracellular staining of splenocytes anti-CD40/rmIL-4 plus rmIL-4 stimulated as described in a, assessed after 24 h, SPDJTK exerts a mainly immunosuppressive effect that acts at least partially through suppression of the transcription factor GATA3 expression in $CD4^+$ T cells. Atopic dermatitis (AD) usually develops in patients with an individual or family history of allergic diseases, and is characterized by chronic relapsing inflammation seen specially in childhood, association with IgE hyperproduction and precipitation by environmental factors. However, the exact etiology of AD has been unclear. To further explore the pathogenesis and treatment of AD, a suitable animal model is required. We found that skin lesions, which were clinically and histologically very similar to human AD, mite antigen-induced dermatitis on the face, neck, ears and dorsal skin of inbred NC/Nga mice. Result that Th1 cell and Th2 cell observe to be shifted by cytokine expression with $CD4^+/CD25^+/foxp3^+$ Treg cells induction by SPDJTK medicines could know that SPDJTK medicines can use usefully in allergy autoimmnune diease.

• Allergy, Asthma & Immunology Research
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• 제10권6호
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• pp.628-647
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• 2018

Purpose: Obesity is associated with metabolic dysregulation, but the underlying metabolic signatures involving clinical and inflammatory profiles of obese asthma are largely unexplored. We aimed at identifying the metabolic signatures of obese asthma. Methods: Eligible subjects with obese (n = 11) and lean (n = 22) asthma underwent body composition and clinical assessment, sputum induction, and blood sampling. Sputum supernatant was assessed for interleukin $(IL)-1{\beta}$, -4, -5, -6, -13, and tumor necrosis factor $(TNF)-{\alpha}$, and serum was detected for leptin, adiponectin and C-reactive protein. Untargeted gas chromatography time-of-flight mass spectrometry (GC-TOF-MS)-based metabolic profiles in sputum, serum and peripheral blood monocular cells (PBMCs) were analyzed by orthogonal projections to latent structures-discriminate analysis (OPLS-DA) and pathway topology enrichment analysis. The differential metabolites were further validated by correlation analysis with body composition, and clinical and inflammatory profiles. Results: Body composition, asthma control, and the levels of $IL-1{\beta}$, -4, -13, leptin and adiponectin in obese asthmatics were significantly different from those in lean asthmatics. OPLS-DA analysis revealed 28 differential metabolites that distinguished obese from lean asthmatic subjects. The validation analysis identified 18 potential metabolic signatures (11 in sputum, 4 in serum and 2 in PBMCs) of obese asthmatics. Pathway topology enrichment analysis revealed that cyanoamino acid metabolism, caffeine metabolism, alanine, aspartate and glutamate metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, pentose phosphate pathway in sputum, and glyoxylate and dicarboxylate metabolism, glycerolipid metabolism and pentose phosphate pathway in serum are suggested to be significant pathways related to obese asthma. Conclusions: GC-TOF-MS-based metabolomics indicates obese asthma is characterized by a metabolic profile different from lean asthma. The potential metabolic signatures indicated novel immune-metabolic mechanisms in obese asthma with providing more phenotypic and therapeutic implications, which needs further replication and validation.

• 대한임상검사과학회지
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• 제51권2호
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• pp.134-144
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• 2019

대사증후군과 알레르기 비염은 중요한 만성질환이다. 본 연구에서는 대사증후군의 각 항목에 따른 알레르기 비염 유병률의 관계를 분석하였다. 제4, 5, 6기 및 제7기 1차년도 국민건강 영양조사 자료를 이용한 것으로(KNHANES IV, V, VI, VII-1) (2007~2016년) 이 자료를 통합하여. 51,854명의 연구대상자를 선정하였다. 연령대는 청장년(19~39세), 중년(40~64세), 노년(65세 이상)으로 분류하였다. 또 대사증후군에 영향을 미치는 일반적인 특성인 근력운동, 걷기운동, 흡연, 음주가 미치는 영향이 있다는 사실에 근거하여 조사하였다. 따라서 본 연구는 연령대 및 근력운동, 걷기운동, 흡연, 음주에 따라서 대사증후군 및 알레르기 비염의 유병률에 미치는 영향을 조사했다. 연구 결과 전 연령대에서 대사증후군이 없는 대상자가 대사증후군이 있는 대상자보다 알레르기 유병률이 높았고, 이는 연령대가 낮을 수록 알레르기 유병률이 높은 것으로 나타났다. 종합해 보면, 이 연구의 결과는 연령별, 일반적 특성별(근력운동, 걷기운동, 흡연, 음주), 대사증후군 또는 대사증후군 각각의 항목별로 알레르기 비염 유병률에 유의한 영향을 미친다는 것을 확인하였다. 본 연구에서 발견된 근거를 바탕으로 대사증후군과 알레르기 비염 유병률의 상관관계를 더 잘 이해하는데 도움이 될 것이다.

• 식품과학과 산업
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• 제55권3호
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• pp.276-283
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• 2022

비타민D3는 칼슘 대사를 조절하며 뼈의 건강을 담당하는 중요한 호르몬이지만 다양한 면역세포에 작용하여 면역반응을 조절할 수 있다는 것이 알려지면서 자가면역질환, 알레르기질환, 감염 등 여러 질병과의 상관관계에 대한 관심이 증가되었다. 비타민D3의 활성 형태인 1,25(OH)2D3는 면역세포에 의해 전환될 수 있으며 핵-호르몬 수용체인 VDR과 결합하여 세포 내 다양한 유전자 발현을 조절함으로써, 세포의 형질과 기능을 바꿀 수 있다. 특히, 최근 다양한 연구를 통해 과도한 면역 반응을 조절하는 Treg 세포의 분화를 증가시키고 그 기능을 향상시키는 기전을 통해 염증성 사이토카인을 감소시키며, 외부 병원균을 제거할 수 있는 AMP의 생산을 유도함으로써 자가면역질환, 알레르기, 감염성 질환 등 다양한 질환에 긍정적 역할을 할 수 있음이 확인되었다. 특히, 최근 COVID-19 에 의한 글로벌 팬데믹을 경험하면서, 중증 질환 및 사망에 이르는 환자들과 비타민D의 상관관계 연구, 다양한 나라들에서 시행된 비타민D 치료의 임상결과들을 통해, 비타민D 보충 기반의 면역조절의 전략이 유리할 수 있음을 알 수 있었다. 전세계 현대인들의 비타민D 결핍은 최근 50년 간 지속적으로 증가하고 있으며, 자외선 노출로 합성할 수 있는 비타민D의 양이 충분하지 않은 부분을 식품 또는 보충제의 형태로 섭취하는 것이 여러 자가면역질환과 알레르기, 감염성 질병을 예방하는데 도움이 될 것이다.

• IMMUNE NETWORK
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• 제21권4호
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• pp.25.1-25.16
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• 2021

Asthma is a heterogeneous disease whose development is shaped by a variety of environmental and genetic factors. While several recent studies suggest that microbial dysbiosis in the gut may promote asthma, little is known about the relationship between the recently discovered lung microbiome and asthma. Innate lymphoid cells (ILCs) have also been shown recently to participate in asthma. To investigate the relationship between the lung microbiome, ILCs, and asthma, we recruited 23 healthy controls (HC), 42 patients with non-severe asthma, and 32 patients with severe asthma. Flow cytometry analysis showed severe asthma associated with fewer natural cytotoxicity receptor (NCR)⁺ILC3s in the lung. Similar changes in other ILC subsets, macrophages, and monocytes were not observed. The asthma patients did not differ from the HC in terms of the alpha and beta-diversity of the lung and gut microbiomes. However, lung function correlated positively with both NCR⁺ILC3 frequencies and microbial diversity in the lung. Sputum NCR⁺ILC3 frequencies correlated positively with lung microbiome diversity in the HC, but this relationship was inversed in severe asthma. Together, these data suggest that airway NCR⁺ILC3s may contribute to a healthy commensal diversity and normal lung function.

• Tuberculosis and Respiratory Diseases
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• 제57권4호
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• pp.320-328
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• 2004

연구배경 : 만성폐쇄성폐질환의 경과 중 조기에 나타나는 폐혈관의 변화는 이후 만성폐쇄성폐질환의 불량한 예후 인자인 폐고혈압증의 원인이 된다. Beraprost sodium (BPS)은 경구투여가 가능한 prostacyclin 유사 약제이며, 원발성폐고혈압 환자에서 생존율을 향상시킨다고 알려져 있다. 본 연구는 만성폐쇄성폐질환 환자에 대한 BPS의 효과에 대해 알아보고자 하였다. 연구방법 : 본 연구는 이중맹검, 무작위, 무효약대조, 2기관 임상시험이다. 2003년 6월부터 2004년 6월까지 만성폐쇄성폐질환 환자 21명이 선정되었다(이중 BPS를 3개월간 복용한 BPS군은 11명, 무효약을 복용한 무효약군은 10명). 기초평가, 폐기능검사, 혈역학적 지표에서 두 군간 통계적 차이는 없었다. 연구결과 : 심장초음파검사에서 Trans Tricuspid valve Pressure Gradient(TTPG) 측정값이 BPS군에서 BPS 복용 전보다 복용 3개월 후 현저한 감소를 보였다[17.7(${\pm}11.4$)에서 8.2(${\pm}8.9$) mm Hg, p-value<0.05]. 한편 무효약군 에서는 통계학적 차이가 없었다. 6분 도보거리는 무효약군에서는 감소를 보였고 BPS군에서는 증가된 결과를 보였으나 통계적 유의성은 없었다. 결 론 : 만성폐쇄성폐질환 환자에서 BPS의 경구복용은 폐동맥압을 감소하게 하였다. 이런 결과의 임상적 중요 성인 증상 및 질병의 자연경과의 개선을 조사하기 위한 추가연구가 필요할 것으로 사료된다.