• 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.

• Biomolecules & Therapeutics
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• 제29권1호
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• pp.58-63
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• 2021

Asthma is a chronic obstructive lung disease characterized by recurrent episodes of bronchoconstriction and wheezing. Conventional asthma treatment involves the suppression of airway inflammation or improving airway flow. Rosmarinus officialis, also known as rosemary, is a Mediterranean plant that is used for the treatment of inflammatory diseases. Carnosol, a diterpenoid found in rosemary extracts, has been known to exhibit anti-inflammatory, anti-tumor, and anti-oxidant effects. The effect of carnosol on allergic responses has not been tested yet. The effect of carnosol on a murine allergic asthma model were investigated. Carnosol inhibited the degranulation of RBL-2H3 mast cells. Carnosol treatment inhibited the increase in the number of eosinophils in the bronchoalveolar lavage fluids (BALF) of mice treated with ovalbumin. Carnosol treatment also inhibited inflammatory responses and mucin production in histologic studies. Carnosol treatment inhibited the increases of IL-4 and IL-13 cytokines expression in both BALF and the lungs. These results suggest that carnosol may have a potential for allergic asthma therapy.

• 한국환경보건학회지
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• 제34권2호
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• pp.124-130
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• 2008

This study investigated the age dependencies in ambient air pollution-associated asthma hospitalization from 2003 to 2005 in Seoul. For all ages and the age groups of 0-14, 15-64, and 65+years, the Generalized Additive Model (GAM) was used to estimate the relative risks of daily asthma hospitalization associated with changes in particulate matter and ozone. The time-trends, seasonal variances, day effects, temperature, humidity, and pressure at sea level were controlled in the models. Significant associations were observed between asthma hospitalization and the levels of $PM_{10}$ and $O_3$. The relative risks (RRs) of asthma hospitalization for every 10 unit increases in $PM_{10}({\mu}g/m^3)$ and $O_3$(ppb) were 1.008 (95% CI 1.005-1.012), and 1.012 (95% CI 1.003-1.020), respectively. Evaluated over $10\;{\mu}g/m^3$ increase in $PM_{10}$, we found the relative risks of asthma hospitalization to be 1.009 (95% CI 1.004-1.014) in 0-14 age group, and 1.015 (95% CI 1.008-1.022) in 65+ age group. Considering 10 ppb increase in $O_3$, those were 1.014 (95% CI 1.003-1.024) in 0-14 age group, and 1.025 (95% CI 1.009-1.041) in 65+ age group. It was concluded that current levels of ambient air pollution in Seoul make a significant contribution to the variation in daily asthma hospitalization. Further reduction in air pollution is necessary to protect the health of the community, especially that of the higher risky groups including children and elderly population.

• 한국환경보건학회지
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• 제35권1호
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• pp.1-10
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• 2009

This study assessed the relationships between levels of $PM_{10}$ and hospitalization rates for asthma among children from 2003 to 2005 at four major cities in Korea. In addition, we estimated the reduced number of asthma hospitalization associated with an ambient $PM_{10}$ improvement to the acceptable levels as recommended by the World Health Organization (WHO). The Generalized Additive Model (GAM) was used to estimate the relative risks (RR) of asthma hospitalization associated with changes in $PM_{10}$ The RRs of children's asthma hospitalization for every $10{\mu}g/m^3$ increment in $PM_{10}$ were 1.009(95% CI = 1.004-1.014) in Seoul, 1.013(95% CI = 1.006-1.021) in Incheon, 1.009(95% CI = 1.002-1.016) in Busan, and 1.021(95% CI = 1.005-1.037) in Ulsan. We assessed $PM_{10}$ related health benefits from implementing the WHO's guidelines (24-hour average $50{\mu}g/m^3$) using the U.S. Environmental Protection Agency's Environmental Benefits Mapping and Analysis Program. The estimated benefits were 439(95% CI = 216-666) reduced asthma hospitalization in Seoul, 720(95% CI = 304-1,151) in Incheon, 260(95% CI = 66-459) in Busan, and 126(95% CI = 30-228) in Ulsan. It was concluded that improving $PM_{10}$ condition to the WHO guideline would make a significant contribution to the reduction in asthma hospitalization among children. Therefore, public health measures are still needed to improve air quality in Korea.

• 대한한의학회지
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• 제21권3호
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• pp.57-67
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• 2000

Currently asthma is considered to be an inflammatory disease characterized by airway hyperresponsiveness and pulmonary eosinophilia, and mediated by Th lymphocytes expressing a Th 2 cytokine pattern. In many recent studies, molecular biological methods have been used to investigate the role of cytokines in pathogenesis and new therapeutic targets of asthma. Objectives: We aimed to identify the effect of Haepyoijin-tang on the transcriptional activities of cytokines involved in the asthma model. Materials and Methods: RBL-2H3 cell lines were used. Cells were stimulated with DNP-IgE or Calcium inophore+PMA for maximal gene expression. After 24 hours of Haepyoijin-tang-treatment, total cellular RNAs were collected using the Trizol solution method. Then the transcriptional activities of cytokines(IL-1, 4, 5, 10, 13, $TNF-{\alpha}$) were measured by RT-PCR with electrophoresis. Results: DNP-IgE and Calcium inophore+PMA induced IL-4/IL-5 production separately peaked at 3 hours after the stimulation, but the efficacy was better in the Calcium inophore+PMA group. In the IL-4 study, sample groups of 10%, 1 %, 0.01 % Haepyoijin-tang-treatment showed 83%, 98%, 96% of transcriptional activities compared to the control group. In the IL-5 study, sample groups of 10%, 1%, 0.1 %, 0.01 % Haepyoijin-tang showed 97%, 99%, 99%, 99% of transcriptional activities compared to the control group. In other studies any result was not obtained. Conclusions: This study shows that Haepyoijin-tang has an inhibitory effect on the transcription of IL-4 and IL-5 gene expression in RBL-2H3 cell lines. Advanced studies are required to investigate the mechanisms of inhibition by herbal medicine in the asthma model.

• 대한한방내과학회지
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• 제38권6호
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• pp.891-901
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• 2017

Objectives: The aim of the study was to evaluate the anti-asthmatic effect of alismatis rhizoma and alisol acetate B combination therapy in a murine asthma model. Methods: C57BL/6 mice were sensitized to and challenged with a mixture of ragweed, dust mite, and aspergillus to induce an asthma animal model. Alismatis rhizoma extract and alisol acetate B combination therapy was co-administered only in the experimental group. To evaluate the anti-asthmatic effect of the combination therapy, inflammatory cell counts in bronchoalveolar lavage (BAL) fluid were determined, and tissue was examined histologically with hematoxylin and eosin (H & E) and periodic acid-Schiff (PAS) stains, by enzyme-linked immunosorbent assay (ELISA) of IgE, IL-4, and IL-5, and with reverse transcription polymerase chain reaction (RT-PCR) of IL-5, IL-33, MUC5AC. Results: Alismatis rhizoma and alisol acetate B combination therapy reduced the number of inflammatory cells, alleviated histologic features, and down-regulated all the investigated asthma mediators, IgE, IL-4, IL-5, IL-33, and MUC5AC. Conclusions: According to the above results, alismatis rhizoma and alisol acetate B combination therapy may have therapeutic potential for asthma.

• IMMUNE NETWORK
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• 제14권2호
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• pp.107-115
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• 2014

Phellinus linteus has been used as a traditional herbal medicine in Asian countries and is known to have anti-tumor, immunomodulatory, anti-inflammatory, and anti-allergic activities. However, the protective effects of P. linteus against experimental asthma have not been fully investigated. The objective of this study was to determine whether P. linteus ethanol extract (PLE) suppresses inflammatory response in an OVA-induced asthma model. As expected, the oral administration of PLE significantly inhibited eosinophilic airway inflammation and airway hyperresponsiveness in OVA-challenged BALB/c mice. Supporting these data, the augmentation of Th2 cytokines (IL-4, IL-5, and IL-13), eotaxin, and adhesion molecules in lung tissues and bronchoalveolar lavage fluid after OVA inhalation was markedly attenuated by PLE. Furthermore, PLE reduced OVA-induced activation of NF-${\kappa}B$ and p38 MAPK in lung tissues. Therefore, our results suggest the potential of P. linteus as a therapeutic agent for asthma.

• Journal of Microbiology
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• 제43권1호
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• pp.11-16
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• 2005

Matrix metalloproteinase (MMP)-9 plays an important role in the pathogenesis of bronchial asthma. Neovastat, having significant antitumor and antimetastatic properties, is classified as a naturally occurring multifunctional antiangiogenic agent. We evaluated the therapeutic effect of Neovastat on airway inflammation in a mouse model of asthma. BALB/c mice were immunized subcutaneously with ovalbumin (OVA) on days 0, 7, 14, and 21 and challenged with inhaled OVA on days 26, 29, and 31. Neovastat was administrated by gavage (5 mg/kg body weight) three times with 12 h intervals, beginning 30 min before OVA inhalation. On day 32, mice were challenged with inhaled methacholine, and enhanced pause (Penh) was measured as an index of airway hyperresponsiveness. The severity of airway inflammation was determined by differential cell count of bronchoalveolar lavage (BAL) fluid. The MMP-9 concentration in BAL fluid samples was measured by ELISA, and MMP-9 activity was measured by zymography. The untreated asthma group showed an increased inflammatory cell count in BAL fluid and Penh value compared with the normal control group. Mice treated with Neovastat had significantly reduced Penh values and inflammatory cell counts in BAL fluid compared with untreated asthmatic mice. Furthermore, mice treated with Neovastat showed significantly reduced MMP-9 concentrations and activity in BAL fluid. These results demonstrate that Neovastat might have new therapeutic potential for airway asthmatic inflammation.

• Journal of Preventive Medicine and Public Health
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• 제49권5호
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• pp.329-341
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• 2016

Objectives: The goal of this study was to investigate the short-term effect of ambient air pollution on emergency department (ED) visits in Seoul for asthma according to patients' prior history of allergic diseases. Methods: Data on ED visits from 2005 to 2009 were obtained from the Health Insurance Review and Assessment Service. To evaluate the risk of ED visits for asthma related to ambient air pollutants (carbon monoxide [CO], nitrogen dioxide [$NO_2$], ozone [$O_3$], sulfur dioxide [$SO_2$], and particulate matter with an aerodynamic diameter <$10{\mu}m$ [$PM_{10}$]), a generalized additive model with a Poisson distribution was used; a single-lag model and a cumulative-effect model (average concentration over the previous 1-7 days) were also explored. The percent increase and 95% confidence interval (CI) were calculated for each interquartile range (IQR) increment in the concentration of each air pollutant. Subgroup analyses were done by age, gender, the presence of allergic disease, and season. Results: A total of 33 751 asthma attack cases were observed during the study period. The strongest association was a 9.6% increase (95% CI, 6.9% to 12.3%) in the risk of ED visits for asthma per IQR increase in $O_3$ concentration. IQR changes in $NO_2$ and $PM_{10}$ concentrations were also significantly associated with ED visits in the cumulative lag 7 model. Among patients with a prior history of allergic rhinitis or atopic dermatitis, the risk of ED visits for asthma per IQR increase in $PM_{10}$ concentration was higher (3.9%; 95% CI, 1.2% to 6.7%) than in patients with no such history. Conclusions: Ambient air pollutants were positively associated with ED visits for asthma, especially among subjects with a prior history of allergic rhinitis or atopic dermatitis.

• 대한한의학회지
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• 제44권3호
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• pp.163-169
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• 2023

Objectives: This study aimed to review the experimental research trends in asthma caused by particulate matter to conduct further researches, especially in clinical trials. Methods: We searched for the meaningful literature using medicinal herb for asthma through the Pubmed databases. Results: Finally, six studies were finally selected. These studies showed recent trends, from 2018 to 2021 and conducted mostly in South Korea. The type of fine dust and the method of inducing asthma are different for each paper, but the effective mechanism is relatively common. It was commonly confirmed that the ratio and number of eosinophils, th2 cells and related cytokines are decreased in BALF and lung tissue by administration of medicinal herb. Conclusions: Although the method of inducing asthma using fine dust has not yet been standardized, it is thought that more meaningful evaluation results can be derived if a standardized animal model is established in the future. Nevertheless, based on the results that herbal medicine is effective for particular matter induced asthma, it is expected that it will be the basis for expanding into future clinical studies.