• Clinical and Experimental Pediatrics
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• 제57권5호
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• pp.205-210
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• 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.

• 대한지역사회영양학회지
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• 제9권1호
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• pp.90-97
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• 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
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• 제46권4호
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• pp.370-375
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• 2003

목 적 : 출생 후 영아기에 알레르겐에 대한 노출 여부가 추후 감작과 알레르기질환의 발생에 중요한 것으로 알려져 왔다. 우리나라에서는 집먼지진드기가 알레르기질환의 주요 흡입 알레르겐으로, 집먼지진드기 항원량은 계절적으로 가을에 가장 높은 것으로 보고되었다. 이에 저자들은 소아 호흡기 알레르기 환자에서 집먼지진드기에 대한 감작 여부에 따라서 출생 월 분포의 차이가 있는지 알아보기 위해 본 연구를 시행하였다. 방 법 : 1995년 1월부터 2002년 5월까지 만성 호흡기 증상으로 서울대학교병원 어린이병원을 방문하여 알레르기 피부단자시험과 메타콜린 유발시험을 시행 받은 환아 1,327명을 대상으로 집먼지진드기에 대한 감작 여부와 출생 월을 조사하여, 집먼지진드기 감작 유무에 따라 출생 월 분포를 비교하였다. 결 과 : 한 가지 이상의 알레르겐에 피부시험 양성을 보인 아토피군은 864명(65.1%)이고 비아토피군은 463명(34.9%)이었다. 아토피군에서 집먼지진드기에 양성을 보인 환아의 수는 787명(91.1%)이고 집먼지진드기를 제외한 나머지 피부시약에 양성반응을 보인 수는 77명(8.9%)이었다. 집먼지진드기 아토피군과 비아토피군의 출생 월별 분포를 기대 환자수와 비교했을 때 집먼지진드기 알레르기를 가진 환아들은 계절적으로 8월에서 11월까지 기대 환자수 보다 유의하게 많이 출생하였고(P=0.03) 비아토피군에서는 상기와 같은 출생 월 분포를 보이지 않았다. 천식으로 진단된 환아는 총 543명(40.9%)이었고 이중 아토피성 천식 환아는 421명(77.5%)이었고 비아토피성 천식 환아가 122명(22.5 %)이었다. 아토피성 천식 환아 중 집먼지진드기 아토피성인 환아는 387명(91.9%)이었다. 집먼지진드기 아토피성 천식과 비아토피성 천식 환아에서 출생 월의 계절별 비교에서 8월에서 11월까지 집먼지진드기 아토피성 천식 환아가 비아토피성 천식 환아보다 유의하게 많이 출생하였다(P=0.002). 결 론 : 출생 월은 알레르겐에 대한 감작 여부에 연관이 있는 것으로 보이며, 우리나라에서는 8월에서 11월까지의 출생이 집먼지진드기에 대한 감작의 위험이 큰 시기로 보인다.

• 대한지역사회영양학회지
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• 제10권3호
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• pp.264-270
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• 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
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• 제57권1호
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• pp.29-34
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• 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
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• 제57권6호
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• pp.271-277
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• 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.

• 한국환경보건학회지
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• 제46권6호
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• pp.735-749
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• 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
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• 제30권6호
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• pp.662-667
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• 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.

• 한방안이비인후피부과학회지
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• 제30권2호
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• pp.86-99
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• 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.

• 한방안이비인후피부과학회지
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• 제27권3호
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• pp.72-83
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• 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.