• Clinical and Experimental Pediatrics
• /
• v.57 no.5
• /
• pp.205-210
• /
• 2014

Atopic sensitization is a complex phenomenon that changes dynamically with age throughout childhood; its prevalence increases with age in young children. Additionally, with increasing age, the prevalence of sensitization to inhalant allergens and the prevalence of polysensitization to allergens increase. It is also well established that the development of atopic sensitization is the result of a complex interplay of genetic and environmental factors. However, there is considerable heterogeneity in the literature in terms of the effect of different environmental exposures in young children on the subsequent risk of atopic sensitization and allergic diseases. Previous studies on the relationship, in early life, between pet ownership, sex, exposure to secondhand smoke, exposure to traffic-related air pollution components, and atopic sensitization have yielded different results. Recent studies have highlighted the importance of gene-environment interactions, especially during early childhood, on the risk of subsequent atopic sensitization and allergic diseases. Therefore, pediatricians should consider the genetic and environmental determinants of atopic sensitization in infants and young children when diagnosing and treating patients with allergic diseases. Determining ways in which early exposure to these risk factors in young children may be reduced could be beneficial in preventing the likelihood of developing atopic sensitization.

• Korean Journal of Community Nutrition
• /
• v.9 no.1
• /
• pp.90-97
• /
• 2004

The purpose of this study was to determined the rate of sensitization to food allergen in children with Atopic Dermatitis (AD) in Korea. A total of 3,783 patients (male = 1983, female = 1800) with AD (age under 18 years) who had visited Samsung Medical Center from 1998 to 2003 were enrolled in the study. Food hypersensitivity was measured by specific IgE to egg, cow's milk, soy, peanut, wheat, buckwheat, beef, pork, chicken, shrimp, crab, salmon, mackerel, etc. Specific IgE levels > 0.7 kU/L. by Captured Allergen Product (CAP) assay were considered positive. Chi-square test at p value < 0.05 was used to examine the difference of the prevalence by sex and age. The rate of sensitization to multiple food allergens was 31.2% and decreased with age. Hypersensitivity to egg showed highest prevalence, which was 24.3%, compared to the prevalence of other foods. High prevalence of hypersensitivity to milk. wheat, soy, peanut, crab or shrimp was observed (11.6- 17.7%). Low prevalence of hypersensitivity to beef, pork, tuna or chicken was observed (1.9-3.5%). Children aged under 3 years had significantly higher prevalence of hypersensitivity to egg, milk, soy and beef than children aged at least 3 years. Our results stress the need for examination of food hypersensitivity aimed at identified and limited each food allergen among children with AD caused by food to help patients outgrow their food allergy.

• Clinical and Experimental Pediatrics
• /
• v.46 no.4
• /
• pp.370-375
• /
• 2003

Purpose : It has been suggested that the exposure to aeroallergens during early infancy after birth is important in the subsequent development of sensitization and allergic diseases. In Korea, the level of house dust mites as one of the important aeroallergens is known to be the highest in autumn. The aim of this study was to test whether the distribution of month of birth bears a relationship to the presence of mite sensitization in children with respiratory allergy. Methods : Skin prick tests and methacholine provocation tests were performed on 1,327 patients with chronic respiratory symptoms who visited Seoul National University Children's Hospital from January 1995 to May 2002. An analysis of patients' month of birth distribution according to the presence of mite sensitization was performed. Results : Atopic subjects who had at least one positive skin test numbered 864(65.1%); and non-atopic subjects numbered 463(34.9%). Among atopic subjects, 787(59.3%) had positive skin tests to mites and 77(5.8%) had positive skin test only to minor allergens. A significantly greater than expected number of mite atopic subjects were born in the months between August and November(P=0.03), however, the birth month of non-atopic subjects didn't show a consistent seasonal preference. Asthma patients numbered 543(40.9%). Among these, atopic asthmatics numbered 421(77.5%) and non-atopic asthmatics, 122(22.5%). Dust-mite atopic asthmatics numbered 387(91.9%) out of 421 atopic asthmatics. Dust-mite atopic asthmatics were born significantly higher in the season lasting from August to November in comparison to non-atopic asthmatics(P=0.002). Conclusion : Month of birth seems to be related with sensitization to allergens. Our results show that August to November is the risk period for the development of mite sensitization in Korea.

• Korean Journal of Community Nutrition
• /
• v.10 no.3
• /
• pp.264-270
• /
• 2005

Breastfeeding has been known as the best feeding practice to prevent allergies including atopic dermatitis (AD) However, the benefit on the prevention of allergic disease is still controversial. The objectives of this study were to examine the rate of sensitization to the protein of eggs, cow's milk and soy in exclusively breastfed infants and to evaluate antigen-antibody reaction between breast milk and serum of AD infant. Data on feeding and food hypersensitivity were obtained for 62 AD infants (32 male, 30 female) aged < 6 month who had visited Samsung Medical Center from September 2001 to May 2003. Food hypersensitivity was determined by measuring specific IgE to egg, cow's milk and soy. Specific IgE levels > 0.7 kU/L by CAP assay (Pharmacia, Uppsala, Sweden) were considered positive. The rates of sensitization in breastfed infants were $41.9\%$ (26/62) to egg, $30.6\%$ (19/62) to milk and $18.0\%$ (11/62) to soy. Immunoblotting analyses were performed using breast milk with the matched serum of seven AD infants (4 male/3 female). Binding patterns of AD infant's IgE to breast milk extract showed visible specific band for immunoglobulin, especially in case of a lactating mother who did not completely restricted ingestion of egg, milk and soy. These results indicate that sensitization to food allergen develops via breast milk feeding. Breast milk feeding should be recommended in infants at risk of developing allergic disease, but maternal intake of highly allergenic food might be restricted for prevention and treatment of food allergy among the babies with AD.

• Clinical and Experimental Pediatrics
• /
• v.57 no.1
• /
• pp.29-34
• /
• 2014

Purpose: In this study, we aimed to investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection (LRTI) and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. Methods: We investigated the sources for acute LRTIs in children admitted to our hospital from May 2010 to April 2011. The 6 most common respiratory viruses were isolated from nasopharyngeal aspirate using multiplex reverse transcription-polymerase chain reaction in 309 children; respiratory syncytial virus (RSV), adenovirus (AV), parainfluenza virus (PIV), influenza virus (IFV), human metapneumovirus (hMPV), rhinovirus (RV). Atopic sensitization was defined if more than 1 serum specific Immunoglobulin E level measured using UniCAP (Pharmacia) was over 0.35 IU/mL. Results: RSV was the most common pathogen of bronchiolitis in hospitalized children through the year. RV or IFV infection was more prevalent in asthma exacerbations compared to other LRTIs. AV and hMPV were more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. Conclusion: RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.

• Clinical and Experimental Pediatrics
• /
• v.57 no.6
• /
• pp.271-277
• /
• 2014

Purpose: A nationwide outbreak of Mycoplasma pneumoniae pneumonia (MP) refractory to macrolide antibiotics occurred in Korea during 2011. Steroid therapy has been reported to be both efficacious and well tolerated in pediatric patients with refractory MP. We compared clinical features and laboratory characteristics between children with refractory MP requiring steroid treatment and those with macrolide-responsive MP and evaluated the risk factors associated with refractory MP. Methods: We investigated 203 children who were admitted to our institution with MP from June to November 2011. Refractory MP was defined by persistent fever over $38.3^{\circ}C$ with progressive pulmonary consolidation or pleural effusion despite administration of appropriate macrolide antibiotics for 5 days or longer after admission. Steroid therapy was initiated on the fifth day after admission for refractory cases. Results: There were 26 patients with refractory MP requiring steroid therapy. The mean duration of steroid therapy was 5.4 days and most of the patients were afebrile within 24 hours after initiation of steroid therapy. The prevalence of refractory MP was higher in patients with pleural effusion, lobar pneumonia affecting more than 2 lobes, higher levels of serum lactate dehydrogenase, increased oxygen requirements, and longer duration of hospitalization. Atopic sensitization and history of asthma were also associated with refractory MP after adjusting for age and gender. Conclusion: Children with refractory MP had more severe pneumonia. Atopic sensitization and history of asthma may be risk factors for refractory MP requiring steroid therapy in Korean children.

• Journal of Environmental Health Sciences
• /
• v.46 no.6
• /
• pp.735-749
• /
• 2020

Objectives: The aim of this study was to investigate airborne pollen counts, inhalant allergen sensitization rate, and allergic disease prevalence among elementary school children in Ulsan, South Korea during 2012-2018. Methods: Burkard samplers for pollen were installed on rooftops in suburban and urban areas in Ulsan. A 24-hour sampling of airborne allergens was conducted six days/week from January 1, 2013 to November 31, 2018. Skin prick tests were done with a total of 4,246 primary school students residing in urban and suburban areas in 2012, 2014, 2016, and 2018. This study examined sensitization to 20 major inhalant allergens. Results: The highest monthly counts of airborne pollen were observed in April and September each year. Among the pollen identified over the six years, pine showed the highest pollen counts (44.3%), followed by oak (22.3%), alder (6.3%) and Japanese hops (4.3%). Tree pollen predominated from March to June, and weed pollen predominated from August to October. Higher sensitization rates for inhalant allergens were observed in Dermatophagoides farinae (42.4%), Dermatophagoides pteronyssinus (43.6%), cat fur (12.1%), birch (9.9%), oak (9.6%), and alder (8.7%). The inhalant allergen sensitization rate was highest in the group with comorbidity (asthma and/or rhinitis and atopic dermatitis), and respiratory allergic disease (asthma and/or rhinitis) was higher than that of atopic dermatitis. Conclusion: Both the counts of tree pollen in the air and the sensitization rate for tree pollen were high in Ulsan. The temporal change in respiratory allergic diseases was similar to that for the sensitization rate of tree pollen, such as oak. In the future, it is considered that additional continuous research on various inhalant allergens and pollen should be conducted.

• Annals of dermatology
• /
• v.30 no.6
• /
• pp.662-667
• /
• 2018

Background: Recently, the number of domestic pets has increased. As a consequence, sensitization to animal allergens, such as cat or dog allergens, has become a problem. Objective: We studied the annual trends of sensitization to cats or dogs, and the characteristics of the patients. Methods: We retrospectively analyzed the medical records of 7,469 patients who visited a dermatology clinic and underwent an allergic profile test, from January 2011 to December 2015. Specific immunoglobulin E (IgE) levels to cat or dog antibody greater than 3.50 IU/ml were regarded as positive results. Results: In all, 274 patients showed significant increase in levels of specific IgE antibody to dog, and 307 revealed increase in levels of of specific IgE antibody to cat. The prevalence of these specific IgEs increased from 2011 to 2015. Independent risks for sensitization to cat allergens were sensitization to dog, but not to house dust, Dermatophagoides pteronyssinus, and D. farinae. Independent risks for sensitization to dog allergens were sensitization to cat, but not to house dust, D. pteronyssinus, and D. farinae. Total IgE level was not related to specific IgE level against either cats or dogs. Conclusion: In conclusion, the prevalence of sensitization to cat or dog has increased. Sensitization to cat or dog is related to each other, but is irrelevant to the total IgE level.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.30 no.2
• /
• pp.86-99
• /
• 2017

Objectives : The purpose of this study is to compare atopic dermatitis and food allergy of Korean Medicine with those of western medicine. Methods : We examined the relationship between atopic dermatitis and food allergy mainly in digestive system abnormalities through literature review. Results : Food allergy is classified into categories such as diarrhea, abdominal pain and cough caused by retention of undigested food(食積) and pimples(癮疹) in Korean medicine. The side effects caused by specific immune reactions occur repeatedly due to exposure to specific food allergen or retention of undigested food. Atopic dermatitis and food allergy are often coexisting and deeply related. Digestive system abnormalities can result not only in indigestion but also in immune function abnormalities. Food allergies are known to cause atopic dermatitis and the influx of food antigens exacerbates atopic dermatitis. This corresponds to atopic dermatitis due to abnormal digestive system(脾胃) accompanied by fever(熱), wind(風), and weakness(虛) with focusing on dampness(濕). A typical example of the relationship between atopic dermatitis and food allergy in Korean medicine is Tae-yeul (胎熱). Tae-yeul refers to atopic dermatitis caused by a sensitization to reaction to the dietary antigens of the mother through the placenta during the fetal life with a unusual genetic disposition. Conclusions : We compared korean medicine with western medicine for atopic dermatitis and food allergy. Atopic dermatitis caused by abnormal immune function due to ingestion of food antigen corresponds to dermatitis due to retention of undigested food(食積), digestive system(脾胃臟) problems in korean medicine.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.27 no.3
• /
• pp.72-83
• /
• 2014

Objective: This study was to evaluate whether herbal mixture (HM-A : Houttuynia cordata Thunberg, Rubus coreanus, Rehmannia glutinosa, Prunus yedoensis, HM-B : Houttuynia cordata Thunberg, Rubus coreanus, Rehmannia glutinosa, Angelica gigas nakai) supresses the development of atopic dermatitis in Balb/c mice sensitized by ovalbumin. Methods: Mice were sensitized by intraperitoneal injection of ovalbumin plus aluminum hydroxide hydrate, followed by epicutaneous sensitization for 6 weeks. After induced atopic dermatitis, HM-A and HM-B were orally administrated for two weeks(once a two days) as a 50 mg/kg concentration. After all mice were sacrificed at the end of the experiment, skin and blood were harvested. Results: Oral administration group was reduced the infiltration of eosinophils, mast cells and total T cells on the skin areas as well as blood analysis. Also, cutaneous expression of IL-4,13,17 decreased. Blood IgE level was decreased. Conclusion: These drugs could be potential candidates for the atopic dermatitis.