• Clinical and Experimental Pediatrics
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• 제59권10호
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• pp.421-424
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• 2016

Recurrent macrophage activation syndrome (MAS) is very rare. We present the case of an adolescent boy with human leukocyte antigen (HLA) B27-positive ankylosing spondylitis (AS), who experienced episodes of recurrent MAS since he was a toddler. A 16-year-old boy was admitted because of remittent fever with pancytopenia and splenomegaly after surgical intervention for an intractable perianal abscess. He had been diagnosed with hemophagocytic lymphohistiocytosis (HLH) 4 different times, which was well controlled with intravenous immunoglobulin and steroids since the age of 3. We were unable to identify the cause for the HLH. He remained symptom-free until the development of back pain and right ankle joint pain with swelling at 15 years of age. He was diagnosed with HLA B27-positive AS with bilateral active sacroiliitis. He showed symptom aggravation despite taking naproxen and methotrexate, and the symptoms improved with etanercept. On admission, his laboratory data showed leukopenia with high ferritin and triglyceride levels. Bone marrow biopsy examination showed histiocytic hyperplasia with hemophagocytosis. There was no evidence of infection. He received naproxen alone, and his symptoms and laboratory data improved without any other immunomodulatory medications. Genetic study revealed no primary HLH or inflammasome abnormalities. In this case, underlying autoimmune disease should have been considered as the cause of recurrent MAS in the young patient once primary HLH was excluded.

• Clinical and Experimental Pediatrics
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• 제53권4호
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• pp.548-553
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• 2010

목 적: IgA 신병증은 소아들의 만성 사구체 신염 중에서 가장 흔하게 일어나며, HLA유전자는 다양한 염증성 질환과 자가면역질환과 연관이 있어 왔다. 이 연구에서는 한국인에서 건강한 대조군과 IgA 신병증 환자군을 비교하여 IgA 신병증 발생 감수성 및 병리, 임상 양상과 $HLA-G$ 유전자의 SNP와의 연관성에 관해 알아보고자 하였다. 방 법: 소아 IgA 신병증을 앓고 있는 174명의 환자군과 438명의 정상 대조군에서 $HLA-G$ 유전자의 promoter SNP (rs1736936과 rs2735022)를 분석하고 비교하였다. 또한 IgA 신병증 환자들을 단백뇨($4mg/m^2/hour$ 이하군과 이상군)의 유무, 족세포 돌기의 소실 유무, 간질의 섬유화 및 세뇨관 위축이나 미만성 사구체 경화와 같은 병리학적 소견상 진행성 질환의 표지자유무에 따라 하위그룹으로 나누어 비교하였다. 결 과: IgA 신병증 환자군과 정상 대조군 간의 HLA-G에서의 SNP (rs1736936과 rs2735022) 빈도에 대한 유의한 차이는 발견되지 않았다. 또한 단백뇨의 유무, 족세포 돌기의 소실 유무, 질환의 병리학적 진행 정도을 의미하는 표지자의 유무와 SNP사이에서도 유의한 연관성을 보이지는 않았다. 그러나, 일체 배형으로서 rs1736936과 rs2735022는 소아 IgA 신병증을 일으키는 감수성에 대해 통계학적으로 유의한 연관성을 나타내었다(haplotype T/C: dominant model OR 1.71, 95% CI 1.00-2.92, $P$=0.049; haplotype C/T: recessive model OR 0.54, 95% CI 0.31-0.94, $P$=0.030). 결 론: 이번 연구에서 $HLA-G$ 유전자의 SNP 중 rs1736936와 rs2735022로 이루어진 일체배형과 IgA 신병증의 발생간에 유의한 관계를 관찰하였으며, IgA 신병증 환자들의 단백뇨 발생 유무, 족세포 돌기의 소실 유무 및 질병 진행 정도로 구분된 하위그룹과 후보 SNP들간의 유의한 관계는 확인할 수 없었다.

• Tuberculosis and Respiratory Diseases
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• 제59권3호
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• pp.272-278
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• 2005

배 경 : 결핵의 보호면역 반응에서 CD8+T 세포에 의한 여러 기전이 중요한 역할을 한다는 사실이 최근에 보고되고 있다. $IFN-{\gamma}$ 분비 외에도 결핵균으로 감염된 세포에 독성을 나타내어 직접 결핵균으로 감염된 세포를 제거하는 독성능 또한 그 역할이 중요하다고 알려지고 있는데, BCG 예방접종을 받은 개체에서도 이러한 균체항원에 특정한 CD8+T 세포의 독성능이 유도되어 있어서 보호면역 반응에서의 역할을 하는지 연구하였다. 대상 및 방법 : HLA-A*0201 과 A*0206를 표현하며 BCG 예방접종을 한 개체들의 혈액에서 백혈구를 분리하고 균체항원의 항원결정기 ($ThyA_{30-38}$) 에 대한 독성능과 ex vivo $IFN-{\gamma}$ 분비능을 유도하였다. 결 과 : 이들 대상에게서 $IFN-{\gamma}$ 분비능과 독성능이 유도되는 것을 관찰할 수 있었고, 또한 HLA-A*0201에 결합하여 CD8+T 세포의 면역 반응을 일으키는 $ThyA_{30-38}$ 펩티드들은 HLA-A*0206인 개체에서도 면역반응을 일으키는 것을 관찰할 수 있었다. 결 론 : 균체 항원에 특정한 CD8+T 세포들의 $IFN-{\gamma}$ 분비 능과 독성능이 BCG 백신주사를 맞은 개체에서 유도되어 있는 것을 관찰할 수 있었다. 따라서 이러한 균체항원에 특정한 CD8+T 세포들이 보호면역 반응에 관여한다는 것을 제시하며, 또한 HLA-A*0201 개체들과 HLA-A*0206 개체들을 대상으로 하는 백신이나 치료제로써 $ThyA_{30-38}$ 펩티드의 사용 가능성을 제시한다.

• Genomics & Informatics
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• 제21권2호
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• pp.26.1-26.9
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• 2023

Stevens-Johnson syndrome (SJS) produces a severe hypersensitivity reaction caused by Herpes simplex virus or mycoplasma infection, vaccination, systemic disease, or other agents. Several studies have investigated the genetic susceptibility involved in SJS. To provide further genetic insights into the pathogenesis of SJS, this study prioritized high-impact, SJS-associated pathogenic variants through integrating bioinformatic and population genetic data. First, we identified SJS-associated single nucleotide polymorphisms from the genome-wide association studies catalog, followed by genome annotation with HaploReg and variant validation with Ensembl. Subsequently, expression quantitative trait locus (eQTL) from GTEx identified human genetic variants with differential gene expression across human tissues. Our results indicate that two variants, namely rs2074494 and rs5010528, which are encoded by the HLA-C (human leukocyte antigen C) gene, were found to be differentially expressed in skin. The allele frequencies for rs2074494 and rs5010528 also appear to significantly differ across continents. We highlight the utility of these population-specific HLA-C genetic variants for genetic association studies, and aid in early prognosis and disease treatment of SJS.

• IMMUNE NETWORK
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• 제3권2호
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• pp.96-102
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• 2003

Background: Granulocyte-macrophage colony-stimulating factor (GM-CSF) gene-transduced tumor cell vaccines induce very potent systemic anti-tumor immunity in preclinical and clinical models. Our previous phase I clinical trial in patients with metastatic renal cell carcinoma (RCC) has demonstrated both immune cell infiltration at vaccine sites and T cell-mediated delayed-type hypersensitivity (DTH) response to whole tumor cell vaccines. Methods: To investigate the immune responses to autologous genetically- modified tumor cell vaccines, tumor-specific $CD8^+$ T cell lines were generated from peripheral blood lymphocytes (PBL) of a RCC patient 1.24 by repeated in vitro stimulation with either B7.1-transduced autologous RCC tumor cells or B7.1-transduced autologous tumor cells treated with interferon gamma ($IFN{\gamma}$), and cloned by limiting dilution. Results: Among several RCC-specific cytotoxic T lymphocytes (CTLs), a $CD4^+/CD8^+$ double positive T cell clone (17/A2) appeared to recognize $IFN{\gamma}$-treated autologous RCC restricted by HLA-B39. The 17/A2 also recognized other HLA-B39 positive RCC tumor cells after $IFN{\gamma}$ treatment. Conclusion: These results demonstrate that autologous RCC vaccination successfully generates the tumor-specific CTL 17/A2, and suggest that the presentation and recognition of the tumor antigen by the 17/A2 might be upregulated by $IFN{\gamma}$.

• 대한한방내과학회지
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• 제25권1호
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• pp.16-27
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• 2004

목적 : 골쇄보(骨碎補) (Drynariae Rhizoma)는 한의학에서 골격계 질환의 치유력을 강화시키는 것으로 알려져 있는데, 항 virus, 항 박테리아, 항 염증 작용이 있는 것으로 보고되고 있다. 질병을 치료하기 위하여 면역 반응을 조절하는 기전에 관하여 오랫 동안 많은 관심을 기울여왔는데, 식물에서 추출한 약재들이 면역기능을 조절할 수 있는 가능성에 대하여 광범위하게 연구되었다. 이에 저자는 골쇄보(骨碎補)의 ethanol 추출물을 가지고 항 세포성과 변역 조절 기능에 대하여 연구하였다. 방법 : 사람의 혈액단핵구 (PBMC)의 배양은 thymidine 법으로 검정하고 nitric oxide (NO) 생성은 mouse macrophage RAW 264.7 세포주를 이용하였으며 IL-2, IFN 와 TNF-a 생성은 ELISA 기술로 검정하였다. 세포 증식은 FACScan으로 측정하고 세포 표면항원 CD16, CD25 및 HLA-DR 은 FITC/PE 항체로 측정하였다. 결과 : 골쇄보(骨碎補)는 mitogen (phytohaemagglutinin; PHA) 과 antigen (purified protein derivative; PPD) 에 의해 자극받은 human peripheral blood mononuclear cells (PBMCs) 의 증식을 억제하였다. 더욱이, 골쇄보(骨碎補)는 mouse 와 인간에 기원한 여러 세포들의 성장을 억제하였다. 또한, nitric oxide (NO), interleukin-2 (IL-2)와 tumor necrosis $factor-{\alpha}\;(TNF-{\alpha})$ 의 생성을 억제하였다. 한편, human PBMCs 에서 intracytoplasmic $interferon-{\gamma}\;(IFN-{\gamma})$와 cell surface markers 인 CD16, HLA-DR 의 expression은 골쇄보(骨碎補)에 의하여 영향을 받지 않았으나, CD25 expression 은 현저히 통제되었다. 결론 : 골쇄보(骨碎補) ethanol 추출물이 in vitro 에서 항 증식성과 변역 억제작용을 가지고 있다는 가능성을 의미하는 것으로 사료된다.

• IMMUNE NETWORK
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• 제4권2호
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• pp.88-93
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• 2004

Background: Bone marrow mesenchymal stem cells (MSC) inhibit the immune response of lymphocytes to specific antigens and dendritic cells (DC) are professional antigenpresenting cells whose function is to present antigen to naive T-lymphocytes with high efficiency and play a central role in the regulation of immune response. We studied the effects of MSC on DC to evaluate the relationship between MSC and DC in transplantation immunology. Methods: MSC were expanded from the bone marrow and DC were cultured from peripheral blood mononuclear cells (PBMNC) of 6 myelogenous leukemia after achieving complete response. Responder cells isolated from PBMNC and lysates of autologous leukemic cells are used as tumor antigen. The effect of MSC on the DC was analyzed by immunophenotype properties of DC and by proliferative capacity and the amount of cytokine production with activated PBMNC against the allogeneic lymphocytes. Also, cytotoxicity tests against leukemic cells studied to evaluate the immunologic effect of MSC on the DC. Results: MSC inhibit the CD83 and HLA-class II molecules of antigen-loaded DC. The proliferative capacity and the amount of INF-$\gamma$ production of lymphocytes to allogeneic lymphocytes were decreased in DC co-cultured with MSC. Also the cytotoxic activity of lymphocytes against leukemic cells was decreased in DC co-cultured with MSC. Conclusion: MSC inhibit the activation and immune response of DC induced by allogeneic or tumor antigen.

• Journal of Korean Neurosurgical Society
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• 제38권2호
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• pp.126-131
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• 2005

Objective : The choice of tumor antigen for dendritic cell[DC]-loading has still been an unresolved problem in the DC-based vaccine strategies against malignant gliomas that has not been found well-characterized tumor specific antigens. In this study, we compare tumor-specific T cell response induced by glioma apoptotic body[GAB]-pulsed DCs to response induced by glioma cell lysate-pulsed ones quantitatively. Methods : DCs generated in the presence of granulocyte macrophage-colony stimulating factor and interleukin[IL]-4 from peripheral blood mononuclear cells[PBMCs] of HLA-A2 positive healthy donors were cultured. Each GABs and glioma cell lysate generated from HLA-A2 positive T98G glioblastoma cells were co-incubated with DCs. $CD8^+$ T lymphocytes isolated from PBMCs of same donors were cultured in media containing IL-2 and either stimulated by GAB- or lysate-pulsed DCs three times at a weekly interval. The interferon[IFN]-${\gamma}$ concentrations of each cell culture supernate were measured by enzyme immunoassay technique. Cytolytic activity of the generated cytotoxic $CD8^+$ T cells either stimulated with GAB- or lysate-pulsed DCs was determined by a standard 4-h $^{51}Cr$-release assay. Results : IFN-${\gamma}$ production and cytolytic activity of effector T cells stimulated by GAB-pulsed DCs were significantly higher than those of T cells stimulated by lysate-pulsed ones. Conclusion : These results indicate the choice of antigen is a critical determinant in the induction of antitumor immunity against malignant glioma. Antigen preparations from GABs represent a promising alternative to glioma cell lysate in DC-based glioma vaccine strategies.

• Archives of Pharmacal Research
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• 제22권4호
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• pp.354-360
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• 1999

Inflammatory bowel disease (IBD) is a multifactorial disorder with unknown etiology and pathogenesis. DA-6034,$ 7-carboxymethyloxy-3^{l}, 4^{l},$ 5-trimethoxy flavone, is a synthetic flavonoid known to possess anti-inflammatory activity. This study was performed to evaluate the oral therapeutic effect of DA-6034 in three experimental animal models of IBD : two chemical-induced IBD models of rats and the human leukocyte antigen (HLA)-B27 transgenic rat model known to develop spontaneous colitis without the use of exogenous agents. Acute chemical colitis was induced by intracolonic instillation of 1.2 ml of 4% acetic acid solution. Prednisolone (1 mg/kg), sulfasalazine (100 mg/kg) and DA-6034 (0.3~3 mg/kg) were orally administered twice daily for 6 days in these rats. In addition, chronic chemical colitis was induced by intracolonic administration of trinitrobenzene sulfonic acid (TNBS) 30 mg in 50% ethanol and agents were orally administered for 6 or 20 days. In chemical-induced IBD models, all of these agents reduced the severity of colitis and specially, DA-6034 (3 mg/kg) showed more potent effect than other drugs in macroscopic lesion score. In HLA-B27 transgenic rats, DA-6034 (3 mg/kg) and prednisolone (0.5 gm/kg) were treated orally twice daily for 6 weeks. The HLA-B27 transgenic rats showed only mild colitis, compared with the chemical-induced colitis models. DA-6034 ameliorated the loose stool and decreased microscopic damage, which is the important indicator of this model. In conclusion, oral therapy of DA-6034 attenuated the macroscopic and histologic damages of the colon in all three experimental models of IBD, which suggest that DA-6034 could be a promising drug in the treatment of IBD.

• Advances in Traditional Medicine
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• 제5권4호
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• pp.251-261
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• 2005

Rheumatoid arthritis (RA) is an autoimmune/inflammatory disorder with a complex genetic component. RA is characterized by chronic inflammation of the synovial membrane in the joint, which leads to the progressive destruction of articular cartilage, ligament and bone. Several cytokines such as tumor necrosis $factor-{\alpha}\;TNF-{\alpha}\;and\;interleukin-1{\beta}\;(IL-1{\beta})$ and interleukin-6 (IL-6) have been implicated in the pathological mechanisms of synovial tissue proliferation, joint destruction and programmed cell death in rheumatoid joint. Genome wide screening of subjects suffering from autoimmune diseases especially arthritis revealed linkage to inflammatory molecules like $TNF-{\alpha},\;IL-1{\beta}$ and IL-6, inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), nuclear factor-kappaB $(NF-{\kappa}B)$ and human leucocyte antigen/major histocompatibility complex (HLA/MHC) locus. The status of the pharmacological mechanism of herbal drugs in the light of genome wide screening results has been discussed to reinforce the therapeutic potential and the pharmacological basis of the herbal drugs.