Kim, Changhwan;Kim, Younhee;Yang, Dong-Wook;Rhee, Chin Kook;Kim, Sung Kyoung;Hwang, Yong-Il;Park, Yong Bum;Lee, Young Mok;Jin, Seonglim;Park, Jinkyeong;Hahm, Cho-Rom;Park, Chang-Han;Park, So Yeon;Jung, Cheol Kweon;Kim, Yu-Il;Lee, Sang Haak;Yoon, Hyoung Kyu;Lee, Jin Hwa;Lim, Seong Yong;Yoo, Kwang Ha
Tuberculosis and Respiratory Diseases
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v.82
no.1
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pp.27-34
/
2019
Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.
Liu, Ying;Zheng, Jing;Zhang, Hong Ping;Zhang, Xin;Wang, Lei;Wood, Lisa;Wang, Gang
Allergy, Asthma & Immunology Research
/
v.10
no.6
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pp.628-647
/
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.
Vitamin D is a fat-soluble vitamin helps to retain calcium and phosphorus but also has shown to affect immune regulation and homeostasis. In humans, vitamin D3 and vitamin D2 and their metabolite has intensively studied in both innate and adaptive immune system that they are important to regulate overwhelmed inflammation. The vitamin D receptor is a nuclear hormone receptor which regulate various downstream target gene expressions as a transcription factor related to metabolism, immune regulation, etc. Vitamin D deficiency is a high-risk factor for inflammatory diseases like autoimmune disease and allergy. In addition, reduced vitamin D seem to correlate with susceptibility to the virus infection such as HIV and COVID-19. In this review, we will summarize up-to-date vitamin D's role in various immune cells, immune regulatory functions during autoimmune, allergic, and infectious diseases. We will also discuss about vitamin D supplement effects in human trial studies for COVID-19.
Drug Utilization Review (DUR) is known to play an important role to improve appropriateness of drug prescriptions. This retrospective, observational study was conducted to compare prescription patterns after installation of Computerized DUR Program (Drug Information Framework-$Korea^{TM}$) (Jan-Mar 2008; After) to before DUR program (Jan-Mar 2007: Before). 8 physicians affiliated in the S University Hospital were enrolled in the study and their 3 months' prescription data were analysed for drug prescription trends and DUR conflict events per 7 DUR screening modules (drugdrug interaction, therapeutic duplication, allergy, dosing, disease contra-indication, geriatric contra-indication, pediatric contra-indication). Average rate of DUR modules usage in 2008 (After) were 0.72. Average number of prescription drug per patient were reduced from 5.6 (Before) to 3.8 (After), and DUR program seemed to effect positively on physician's prescription related decision process. Overall DUR conflict events occurred by 8 physicians for 3 months were 17,923 Before and 20,057 After DUR program, and DUR conflict events per prescription were 2.8 Before and 2.9 After, respectively. Therapeutic duplication (37%), geriatric contra-indication (34%) and dosing (18%) were high ranked DUR conflicts. As the study was not sufficient to show a consistent trend to reduce DUR conflicts After, another study to confirm it's effectiveness would be recommended. This study would be of help to develop awareness of DUR program to healthcare providers.
Purpose: The study investigated the effect of adolescent health behavior on the prevalence of current allergic diseases. Methods: The subjects were 57,303 middle and high school youth. Data were analyzed using Rao-Scott χ2 test and complex sample logistic regression analysis. Results: While controlling the affect of the general characteristics of the subjects, health behaviors affecting the current prevalence of allergic diseases were smoking, drinking, physical activity, eating habits, drug abuse, and mental health. Smoking behaviors affecting the current prevalence of allergic diseases were lifetime smoking experience, smoking days, liquid e-cigarette lifetime smoking experience, number of liquid electronic cigarette smoking days, e-cigarette lifetime smoking experience, e-cigarette smoking days, amount of smoking, second-hand smoking and drinking behaviors were lifetime drinking, drinking days, the amount of drinking, and severe drinking. Variables such as physical activity exceeding 60 minutes days, intake of energy and sweet drinks, water intake, habitual drug use and mental health behavior such as stress perception, weekday sleep time, subjective sleep satisfaction, depression, suicidal thoughts/ plan/ attempts affect current allergic diseases (p<.001). Conclusion: The results showed that current allergic disease related health behaviors in Korean adolescents. Therefore, considering these factors, it may be helpful to facilitate a health promotion plan for prevention and management of such diseases and to promote evidence-based health practices at school.
Jo, Suk-Yong;Kang, Min-Seo;Kim, Yong-Min;Kim, Hee-Taek
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.29
no.3
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pp.95-105
/
2016
Objectives : Allergic diseases have a various symptoms of hyperresponsiveness and recently hyperresponsive reaction in the chronic phase is reported as the important mechanisms. Cheonggisan(CGS) is used in oriental clinics for curing various skin diseases due to effect of controlling of pruritus. There have been studies on the anti-allergic effect and anti-inflammatory effect of CGS, but there had no study of anti-allergic effects in allergic late inflammation of CGS, so we aimed to find out the effects of CGS in allergic late inflammation in our study.Methods : To investigate the anti-allergy effect and anti-inflammatory effect of CGS, RAW 264.7 macrophage cells and CSG water-extracts were used. Cytotoxic effect of CSG was examined by MTT assay, an oxidative product of NO was measured in the culture medium by the Griess reagent assay. The level of prostaglandin E2(PGE2) was measured by competitive enzyme-linked immunoassay. Cytokine(PGE2, IL-1β, IL-6, TNF-α) was measured by Bio-Plex suspension assay system and quantitative multiplexed cytokine/chemokine assay.Results : We investigated that there was no cytotoxic effect of CGS water-extract at any levels of concentration on RAW 264.7 macrophage cells by MTT assay. CGS water-extracts significantly suppressed the levels of the inflammatory mediators such as NO and PGE2, cytokine of IL-1β, TNF-α at the level of 400 ㎍/㎖ CGS concentration. But there was no significant effect on IL-6 production suppression.Conclusions : These results suggest that CSG water-extract has and anti-inflammatory effects in allergic reaction. These properties may contribute to the allergic diseases and inflammatory related disease care.
Objective : The objective of this study is to analyze an increasing rate, difference of attack rate in age, relationship between atopic dermatitis and breast-feeding, the relationship between atopic dermatitis and the Sasang constitution, and various treatments of atopic dermatitis. Methods : This clinical study was carried out with 22 theses which are related with diagnosis, treatments, prognosis and control of atopic dermatitis. The 22 theses are carried on J Korean Oriental Pediatrics, J Korean Oriental Ophthalmology, J Korean Oriental Med, J Korean Academy of Pediatric Allergy and Respiratory Disease, J Korean Acad Fam Med and Korean J Food & Nutr. Results : The prevalence rate, attack rate and diagnosis rate of atopic dermatitis are increased in the year of 2000, compared with those of 1995. Comparing age of patient between the year of 1992 and 2002, the attack rate of atopic dermatitis is increased quickly over 7 years old. Specific immunoglobulin E(IgE) antibodies detected in patients under 1 year old was exclusively caused by food. But for the age over 7 years old, food and inhalant allergen are detected in the year of 2002 in compare with that of 1992. Because of breast-feeding, intemperate diet adjustment during the period of maternity of family history of atopic dermatitis, the attack rate of atopic dermatitis is increased in infant. The types of patients are categorized according to Sasang constitution and Soeumin group was largest. The Oriental medicine treatments of atopic dermatitis are bath & skin hydration, avoidance from antigen, dietetic treatment, external treatment, medication and phototherapy. Conclusion : The atopic dermatitis is associated with breast-feeding, Sasang constitution types. More active approach for the treatment and prevention of Atopic dermatitis in children are needed.
Bovine lactoferrin is well known as biological activator in defense mechanism related some cells. In this study, we was investigated about the immune modulator as a role of lactoferrin through the transcriptional regulation of genes associated with hypersensitivity such as allergy, athma and inflammatory disease. Effects of inflammatory reaction of bovine lactoferrin was carried out by RT-PCR analysis from isolated total RNA treated with lactoferrin 0, 10, 50, 100, 500 ${\mu}g/mL$ and PMA 100 ng/mL. The expression of the TYROBP, PITPNA, IL-10, SLP1, DC-stamp and ICAM-1 mRNA were increased by synergy effect of bovine lactoferrin and PMA. The results of RT-PCR showed that bovine lactoferrin and PMA had an effect of immune modulator by enhancement of TYROBP, PITPNA, SLP1, DC-stamp, IL-10 and ICAM-1 gene transcription in U937, Mutz-3 and NK92 cells, respectively. Bovine lactoferrin showed a potential of biological function which could be used for industrial applications as a material of food and pharmaceutical.
The dried unripe fruit of Poncirus trifoliata L. is widely used to treat urticaria, itch and indigestion in folk medicine. And recently it was reported the component of the fruit was found to exhibit an inhibitory effect on histamine release from mast cells. So to evaluate the effect of aqueous extract of Poncirus trifoliata L.(PTFE) on compound 48/80-induced histamine release, the study was carried out in rat peritoneal mast cell. PTFE $(10^{-3}{\sim}1mg/ml)$ inhibits the histamine release induced by compound 48/80 $(5{\mu}g/ml)$ in rat peritoneal mast cells. To clarify the mechanism of these inhibition, we investigated the effect of PTFE on cAMP and intracellular calcium content. The increase in cAMP content, when PTFE was added, was transient. At concentration of 1mg/ml, the cAMP content of mast cells was significantly increased at a rate of 53 times of basal cells at 10sec. PTFE inhibits histamine release by augmenting the cAMP content in mast cells. Moreover, PTFE inhibits intracellular calcium release induced by compound 48/80. This result suggests that PTFE may be useful for the prevention and treatment of allergy-related disease.
Lee, Su Won;Choi, Jin Kwan;Yang, Won Kyung;Kim, Seung Hyung;Lyu, Yee Ran;Park, Yang Chun
The Journal of Korean Medicine
/
v.42
no.3
/
pp.119-138
/
2021
Objectives: This study aimed to review the clinical research of the gut microbiome for respiratory diseases to assist the design of trials for respiratory diseases by regulating the gut microbiome with herbal medicine later. Methods: We searched three international databases (PubMed, CENTRAL and EMBASE) to investigate randomized controlled trials (RCTs) of the gut microbiome for respiratory diseases. The selected trials were analyzed by study design, subject diseases, inclusion/exclusion criteria, sample size, study period, intervention group, control group, outcome measures, and study results. Results: A total of 25 studies were included and published from 1994 to 2021 mostly in Europe and Asia. Subject diseases were many in the order of respiratory tract infection, cystic fibrosis, allergy, and so on. As outcome measures, the gut microbiome in a fecal sample was analyzed by 16S rRNA sequencing analysis method, and symptom assessment tools related each disease were used. Major intervention drugs were probiotics and the results were mostly improved in the composition and diversity of the gut microbiome. Conclusion: Clinical studies of the gut microbiome for respiratory diseases have confirmed various effects and this review provides basic data for a well-designed clinical study for respiratory diseases by regulating the gut microbiome with herbal medicine.
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