• Journal of Chest Surgery
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• 제27권7호
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• pp.610-616
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• 1994

Myasthenia gravis is a rare condition, affecting only 1/75000. It is characterized by weakness and fatigue of the voluntary muscles due to impaired neuromuscular transmission at the acetylcholine receptor site. It is probably caused by an autoimmune mechanism leading to reduction of the available nicotinic acetylcholine receptors at the neuromuscular junction. A relationship between the thymus and myasthenia gravis was suggested by Weigert in 1901, and Blalock was the first to report the efficiency of thymectomy in the treatment of myasthnia gravis in 1939. Since that time, thymectomy has become increasingly important in managing patients with myasthenia gravis. Fourteen patients with myasthenia gravis underwent thymectomy between September 1987 and March 1994 and got the following results; 1. The sex distribution was 10 females and 4 males with ages ranging from 15 to 51 years[mean, 34.8 years]. 2. Clinical manifestation of ocular symptoms were seen in all cases, dysphagia in 12[85.7%], extremity weakness in 11 [78.6 %], and dyspnea in 3 [21.4 %]. 3. According to the modified Osserman`s classification, 8 patients were in group IIb, 3 in IIa, 2 in I and 1 in IIc, respectively. 4. Histopathologic examination of the resected thymuses revealed hyperplasia in 8 patients, benign thymoma in 3, and malignant thymoma in 3. 5. There were no perioperative or immediate postoperative deaths but one patient died about two months after the thymectomy due to respiratory failure. 6. During the follow-up period, 11 patients [78.6 %] showed clinical improvement. Among them, 4 cases [28.6 %] showed complete remission, 3 [21.4 %] showed marked improvement, and 4 [28.6 %] showed subjective improvement. 7. Among the 8 patients with thymic hyperplasia, clinical improvement was noticed in 7 patients 5 %]. Among the 6 patients with thymoma, 4 patients [66.7 %] showed improvement.

• IMMUNE NETWORK
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• 제3권3호
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• pp.248-254
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• 2003

Oral administration of antigen has long been used in the induction of immune tolerance in various animal models of autoimmune diseases including rheumatoid arthritis (RA). Alleveation of arthritogenic symptoms has been reported from RA patients who received oral administration of type II collagen (CII) without side effects, however its rather inconsistent therapeutic efficacy and variation among patients calls for more detailed investigation on the mechanism of oral tolerance to be settled as regular treatment for RA. In an attempt to understand the immunogenic processes underpinning tolerance induction by orally administered CII, we analyzed changes in the expression of costimulatory molecules and STAT/SOCS signaling messengers in the mouse model of collagen induced arthritis (CIA). We found thatin the spleen of CIA mice, that has been undergone repeated oral feeding of CII prior to the induction of arthritis, showed increased promortion of CTLA4 expressing lymphocytes than in the spleen of PBS fed control. On the other hand, cells expressing CD28 or ICOS were decreased in the spleen of tolerized mice. Tolerance induction by oral CII administration also enhanced the expression of STAT6 in both RNA and protein level, while not affecting the expression of STAT3. The expression of SOCS3, which hasbeen known to transmit STAT-mediated signals from Th2 type cytokines, remained unchanged in the spleen of tolerized mice. Interestingly transcript of SOCS1, which has been associated with Th1 related pathways, was only visible in the spleen of tolerized but not of control mice, suggesting that as in the case of IL-6 signaling, it may exert a feed back inhibition toward the Th1 type stimulation.

• IMMUNE NETWORK
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• 제10권3호
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• pp.104-108
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• 2010

CD137 (4-1BB/tnfrsf9) has been shown to co-stimulate T cells. However, agonistic anti-CD137 monoclonal antibody (mAb) treatment can suppress $CD4^+$ T cells, ameliorating autoimmune diseases, whereas it induces activation of $CD8^+$ T cells, resulting in diverse therapeutic activity in cancer, viral infection. To investigate the CD137-mediated T cell suppression mechanism, we examined whether anti-CD137 mAb treatment could affect $CD11b^+Gr-1^+$ myeloid-derived suppressor cells (MDSCs). Intriguingly, anti-CD137 mAb injection significantly increased $CD11b^+Gr-1^+$ cells, peaking at days 5 to 10 and continuing for at least 25 days. Furthermore, this cell population could suppress both $CD8^+$ T cells and $CD4^+$ T cells. Thus, this study demonstrated that, for the first time, anti-CD137 mAb treatment could induce $CD11b^+Gr-1^+$ MDSCs under normal conditions, suggesting a possible relationship between myeloid cell induction and CD137-mediated immune suppression.

• 대한간호학회지
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• 제23권4호
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• pp.528-543
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• 1993

Vitamin E, which has its advocates in the treatment of diabetes mellitus. autoimmune disease, cancer and peripheral vascular and thromboembolic disease, has now been alleged to have a powerful antioxident effect and to affect various biological activities such as fertility factor, inhibition of human platelet aggregation and stabilization of biological membranes. The present study was designed to test whether vitamin I(alpha-tocopherol) can : (1) enhance the hemagglutinin response to sheep red blood cells (SRBC), (2) modulate Arthus and delayed type hypersensitivity(DTH) to SRBC and contact hypersensitivity to dinitrofluorobenzene (DNFB). (3) enhance the mitogenic response of murine splenocyte, (4) decrease the recovery of Cryptococcus neoformans from brain, lung, liver, spleen and kidney of infected mice and (5) have an inhibitory or enhancing effect on the induction of active systemic anaphylaxis(ASA) induced by chicken-gamma globulin (CGG) in mice. Mice were given either intramuscular injections of 0.3ml (300mg) of vitamin I before immunization or were infection for 10 consecutive days or were given by vitamin I esophageal intubation, 0.1ml(100mg), for 20 days before sacrifice for the mitogenic response experiments. It was found that vitamin E treated mice showed a significant enhancement in hemagglutinin response, Arthus reaction and DTH to SRBC and contact hypersensitivity to DNFB. There was no significant difference in the mitogenic response to phytohemagglutinin(PHA), but the response to concanavalin A(ConA) or pokeweed mitogem(PWM) was increased in vitamin E-treated mice. Interestingly, the vitamin E administration before C. neoformans infection decreased significantly the recovery of C. neoformans from brain lung, liver, spleen and kidney of the infected mice as compared with that of the control mice, strongly suggesting that vitamin E pretreatment may increase the resistance of mice to the fungal infection. Unexpectedly, vitamin E administration enhanced the production of CGG -induced ASA. Taken together, it can be concluded that vitamin I administration may in-crease the humoral and cellular immune response and resistance. to C. neoformans infection, but enhance the induction of ASA to CGG. Further studies are necessary to clarify the underlying mechanism accounting for these effects.

• 대한한방부인과학회지
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• 제23권2호
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• pp.71-84
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• 2010

Purpose: In the theory of traditional medicine, Glenditsia spina(GS) can resolve carbuncle, relive swelling, dispel wind and destroy parasites. This study was designed to investigate the effects of GS on gene expression of ovarian tissue in polycystic ovary syndrome(PCOS) rats. Methods: In this experiment, female rats injected with a single dose of 2 mg estradiol valerate(EV) and GS was given for 5 weeks. The genetic profile for the effects on ovarian tissue in PCOS rats was measured using microarray technique, and the functional analysis on these genes was conducted. Results: 985 genes were increased in control and restored to normal level in GS group. (B), 733 genes were decreased in control group and restored to normal level in GS group. (F). Metabolic pathways related in B group genes were Graft-versus-host disease, Allograft rejection, Autoimmune thyroid disease, Cytokine-cytokine receptor interaction, Small cell lung cancer, Type I diabetes mellitus. Metabolic pathways related in F group genes were Antigen processing and present, Adipocytokine signalling pathway, Focal adhesion, ECM-receptor interaction, Pancreatic cancer, Notch signalling pathway, Tight junction. The network of total protein interactions was measured using cytoscape program, and some key molecules, such as c-Fos, c-Myc, ABL1 related in B group, MAPK8, RASA1, CALR related in F group that can be used for elucidation of therapeutical mechanism of medicine in future were identified. Conclusion: These results suggest possibility of GS as anti-cancer and anti-hyperplasia drug in PCOS. In addition, the present author also suggests that related mechanisms are involved in suppression of proto-oncogene such as c-Fos, c-Myc and ABL1, and in regulation of cell cycle such as RASA1.

• 대한한방부인과학회지
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• 제23권3호
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• pp.14-25
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• 2010

Purpose: The purpose of this study is to investigate inhibitory effect on the maturation of dendritic cells from aqueous extract from Nardostachys Jatamansi(NJ). Methods: I examined the phenotypic maturation(class II MHC, CD40, CD86), expression of pro-inflammatory cytokine(TNF-$\alpha$, IL-6, IL-12) and endocytosis of FITC-Dextran in the LPS-induced bone marrow-derived dendritic cells(BMDCs) of mice. Furthermore, the Western-blot analysis reveals the mechanism of inhibitory effect. Results: 1. The NJ extract inhibited the phenotypic maturation of BMDCs in a dose-dependent manner. 2. The NJ extract inhibited the LPS induced cytokine production of BMDCs in a dose-dependent manner. 3. The NJ extract enhanced the endocytosis of Dex-FITC in LPS treated DC. 4. The NJ extract inhibited the activation of JNK and p38 phosphorylation, but not ERK phosphorylation of MAPK family and doesn't inhibit Ik-Ba degradation in LPS-stimulated BMDCs. Conclusion: These results suggest that NJ extract is able to attenuate the inflammation and maturation in BMDCs and may inhibit proliferation of T cells. In conclusion, this experiment suggests that NJ extract may be useful in hypersensitivity disease including autoimmune disease.

• 대한한방내과학회지
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• 제27권3호
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• pp.653-663
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• 2006

Objective : Graves' disease, the most common cause of hyperthyroidism, is an autoimmune disorder associated with autoantibodies to the TSH receptor. The clinical features of Graves' disease are goiter and hypermetabolic symptoms induced by excessive hormones. Antithyroid drug therapy is the first-line treatment for Graves' disease in Korea, Japan and European countries. Yet in spite of a long period and high-dose of treatment, it is hard to achieve remission because of adverse effects, frequent recurrence and resistance to antithyroid drugs. Recently, it has been reported that the abnormal thyroid hormone and clinical symptoms of Graves' disease were reduced by Ahnjeonbaekho-tang (AJBHT). Methods : To investigate the effectiveness and action mechanism of AJBHT, we studied the influence of AJBHT on FRTL-5 thyroid cell proliferation, DNA synthesis and expression of T4, TSH, cAMP, Tg and TPO mRNA. Results : AJBHT significantly inhibited the FRTL-5 cell proliferation, DNA synthesis, T4 synthesis, cAMP production and the expression of Tg mRNA in comparison with control and MMI. Conclusions : These results suggest that AJBHT may inhibit the cell proliferation and DNA synthesis by regulating the cAMP, and suppress the T4 synthesis by modulating Tg mRNA expression and cAMP synthesis, and that it may be useful agent for treating the goiter and hormone abnormality of Graves' disease.

• Biomolecules & Therapeutics
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• 제27권1호
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• pp.63-70
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• 2019

Myeloid-derived suppressor cells (MDSCs) that are able to suppress T cell function are a heterogeneous cell population frequently observed in cancer, infection, and autoimmune disease. Immune checkpoint molecules, such as programmed death 1 (PD-1) expressed on T cells and its ligand (PD-L1) expressed on tumor cells or antigen-presenting cells, have received extensive attention in the past decade due to the dramatic effects of their inhibitors in patients with various types of cancer. In the present study, we investigated the expression of PD-1 on MDSCs in bone marrow, spleen, and tumor tissue derived from breast tumor-bearing mice. Our studies demonstrate that PD-1 expression is markedly increased in tumor-infiltrating MDSCs compared to expression in bone marrow and spleens and that it can be induced by LPS that is able to mediate $NF-{\kappa}B$ signaling. Moreover, expression of PD-L1 and CD80 on $PD-1^+$ MDSCs was higher than on $PD-1^-$ MDSCs and proliferation of MDSCs in a tumor microenvironment was more strongly induced in $PD-1^+$ MDSCs than in $PD-1^-$ MDSCs. Although we could not characterize the inducer of PD-1 expression derived from cancer cells, our findings indicate that the study on the mechanism of PD-1 induction in MDSCs is important and necessary for the control of MDSC activity; our results suggest that $PD-1^+$ MDSCs in a tumor microenvironment may induce tumor development and relapse through the modulation of their proliferation and suppressive molecules.

• International Journal of Oral Biology
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• 제45권4호
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• pp.211-217
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• 2020

Molecular mimicry is the most common mechanism that breaches self-tolerance. We previously identified autoantibodies to aquaporin-5 (AQP5) in the sera of patients with Sjögren's syndrome and found that the aquaporin of Prevotella melaninogenica (PmAqp), an oral commensal, is highly homologous to human AQP5. This study aimed to test whether PmAqp can induce anti-AQP5 autoantibodies via molecular mimicry. From the amino acid sequence of PmAqp, an immunizing peptide; i.e., PmE-L, was designed, which contained both the B cell epitope "E" and T cell epitope. C57BL/6 and BALB/c mice were subcutaneously immunized with linear or cyclic forms of PmE-L emulsified in incomplete Freund's adjuvant. The concentrations of the antibodies in sera were measured using enzyme-linked immunosorbent assays. Both linear and cyclic PmE-L induced high levels of antibodies against not only the immunized peptides but also autoantibodies against AQP5E and antibodies against PmE, a Pm homolog of AQP5E. In C57BL/6 mice; however, the cyclic form of PmE-L was more efficient than the linear form in inducing autoantibodies against AQP5E that contained a cyclic epitope. The levels of anti-PmE antibodies and anti-AQP5E autoantibodies showed a strong positive correlation (r = 0.95, p < 0.0005), suggesting molecular mimicry. Collectively, the mice produced anti-AQP5E autoantibodies in response to a PmAqp-derived peptide. This model proved to be useful for studying the mechanisms of autoantibody production by molecular mimicry.

• 동의생리병리학회지
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• 제36권5호
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• pp.155-162
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• 2022

Even after testing negative for COVID-19, some patients continue to struggle with a variety of symptoms such as fatigue, shortness of breath, gastrointestinal problems and neurological problems. The World Health Organization (WHO) defined long COVID (Post COVID-19 conditions) as "A disease occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months, that cannot be explained by an alternative diagnosis." As a possible pathological mechanism of long COVID, three hypotheses are proposed: the persistence of the infectious state due to the residual virus, the persistent inflammatory response, and the autoimmune response. The main symptoms of long COVID are shortness of breath (dyspnea), abdominal pain and dyspepsia, fatigue, cognitive problems (brain fog), anosmia and dysgeusia, and chest pain, palpitations and tachycardia. In the Chinese guidelines, COVID-19 patients were divided into mild, moderate, severe, and recovery, and prescriptions with effective therapeutic effects were summarized to encourage combined treatment of chinese and western medicine. Globally, only symptomatic therapy is recommended for long COVID, but a specific treatment has not yet been proposed. Recently, morbidity code for post COVID-19 conditions was created, and it is planned to announce guidelines for long COVID treatment and management in the first half of 2023. In line with this trend, the Korean medical community needs to make efforts to prepare treatment guidelines for patients with long COVID.