• Allergy, Asthma & Immunology Research
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• 제10권6호
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• pp.575-590
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• 2018

The prevalence of allergic disorders has dramatically increased over the past decade, particularly in developed countries. Apart from gastrointestinal disorders, neoplasia, genital and dermatological diseases etc., dysregulation of gut microbiota (dysbiosis) has also been found to be associated with increased risk of allergies. Probiotics are increasingly being employed to correct dysbiosis and, in turn, to modulate allergic diseases. However, several factors like strain variations and effector metabolites or component of them in a bacterial species can affect the efficacy of those as probiotics. On the other hand, host variations like geographical locations, food habits etc. could also affect the expected results from probiotic usage. Thus, there is a glaring deficiency in our approach to establish probiotics as an irrefutable treatment avenue for suitable disorders. In this review, we explicate on the reported probiotics and their effects on certain allergic diseases like atopic dermatitis, food allergy and asthma to establish their utility. We propose possible measures like elucidation of effector molecules and functional mechanisms of probiotics towards establishing probiotics for therapeutic use. Certain probiotics studies have led to very alarming outcomes which could have been precluded, had effective guidelines been in place. Thus, we also propose ways to secure the safety of probiotics. Overall, our efforts tend to propose necessary discovery and quality assurance guidelines for developing probiotics as potential immunomodulatory 'Pharmabiotics.'

• 대한한방내과학회지
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• 제41권4호
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• pp.583-598
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• 2020

Objective: The aims of this study were to analyze deficiency-excess pattern identification and to compare the blood cytokines in patients with asthma. Methods: A total of 112 patients with asthma who met the inclusion and exclusion criteria were divided into deficiency syndrome and excess syndrome groups. Blood was examined for eotaxin, interleukin (IL)-1β, IL-4, IL-5, IL-6, IL-13, and tumor necrosis factor (TNF)-α. The Quality of Life Questionnaire for Adult Korean Asthmatics (QLQAKA), a Visual Analogue Scale (VAS), and heart rate variability (HRV) tests were administered to both groups. Results: Pattern identification divided the 112 patients into two categories: a deficiency syndrome group (N=52) and an excess syndrome group (N=60). Analysis of blood cytokines showed higher levels of IL-4, IL-5, and IL-13 in the deficient pattern than in the excess pattern group, but the difference was not statistically significant. Analysis of the HRV revealed a significantly higher mean value for the very-low-frequency (VLF) and high-frequency (HF) bands in the deficiency than in the excess syndrome group. The morbidity duration was longer in the deficiency than in the excess syndrome group, but the difference was not statistically significant. Analysis of the QLQAKA and VAS scores showed a negative correlation, whereas BMI and VAS showed a positive correlation. Conclusions: Levels of blood cytokines, including eotaxin, IL-1β, IL-4, IL-5, IL-6, IL-13, and TNF-α, did not differ statistically between the deficiency and excess syndrome groups. The development of a more accurate asthma-specific pattern identification tool would be useful in asthma control.

• Tuberculosis and Respiratory Diseases
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• 제83권1호
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• pp.1-13
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• 2020

For the past three decades, more than a thousand of genetic studies have been performed to find out the genetic variants responsible for the risk of asthma. Until now, all of the discovered single nucleotide polymorphisms have explained genetic effects less than initially expected. Thus, clarification of environmental factors has been brought up to overcome the 'missing' heritability. The most exciting solution is epigenesis because it intervenes at the junction between the genome and the environment. Epigenesis is an alteration of genetic expression without changes of DNA sequence caused by environmental factors such as nutrients, allergens, cigarette smoke, air pollutants, use of drugs and infectious agents during pre- and post-natal periods and even in adulthood. Three major forms of epigenesis are composed of DNA methylation, histone modifications, and specific microRNA. Recently, several studies have been published on epigenesis in asthma and allergy as a powerful tool for research of genetic heritability in asthma albeit epigenetic changes are at the starting point to obtain the data on specific phenotypes of asthma. In this presentation, we mainly review the potential role of DNA CpG methylation in the risk of asthma and its sub-phenotypes including nonsteroidal anti-inflammatory exacerbated respiratory diseases.

• Korean Journal of Acupuncture
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• 제25권2호
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• pp.87-94
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• 2008

Objectives : The aim of this study was to find out some rationales for using Hominis placental extract(HPE) pharmaco-acupuncture on asthmatic patients, and to suggest an appropriate clinical research of HPE pharmaco-acupuncture on asthma. Methods : Articles regarding immunologic experiments about HPE and clinical reports about HPE-contained pharmaco-acupuncture on asthmatic patients were reviewed by on-line and off-line searching. Results and Conclusions : HPE is suggested to have several pharmacological effects on allergic diseases including asthma as well as autoimmune diseases. There are some observational studies of HPE-contained pharmaco-acupuncture on asthmatic patients. However, the designs of these studies are not sufficient to investigate the exact effect of HPE pharmaco-acupuncture on asthma. To investigate HPE pharmaco- acupuncture as a novel asthma therapy, it will be needed to perform further experiments about HPE's pharmacological mechanism on asthma and to try further advanced clinical researches such as well-designed randomized controlled trial of HPE pharmaco-acupuncture.

• Allergy, Asthma & Immunology Research
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• 제10권6호
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• pp.648-661
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• 2018

Purpose: Pollen-food allergy syndrome (PFAS) is an immunoglobulin E (IgE)-mediated allergy in pollinosis patients caused by raw fruits and vegetables and is the most common food allergy in adults. However, there has been no nationwide study on PFAS in Korea. In this study, we investigated the prevalence and clinical characteristics of PFAS in Korea. Methods: Twenty-two investigators participated in this study, in which patients with allergic rhinoconjunctivitis and/or bronchial asthma with pollen allergy were enrolled. The questionnaires included demographic characteristics, a list of fruits and vegetables, and clinical manifestations of food allergy. Pollen allergy was diagnosed by skin prick test and/or measurement of the serum level of specific IgE. Results: A total of 648 pollinosis patients were enrolled. The prevalence of PFAS was 41.7% (n = 270). PFAS patients exhibited cutaneous (43.0%), respiratory (20.0%), cardiovascular (3.7%) or neurologic symptoms (4.8%) in addition to oropharyngeal symptoms. Anaphylaxis was noted in 8.9% of the PFAS patients. Seventy types of foods were linked to PFAS; e.g., peach (48.5%), apple (46.7%), kiwi (30.4%), peanut (17.4%), plum (16.3%), chestnut (14.8%), pineapple (13.7%), walnut (14.1%), Korean melon (12.6%), tomato (11.9%), melon (11.5%) and apricot (10.7%). Korean foods such as taro/taro stem (8.9%), ginseong (8.2%), perilla leaf (4.4%), bellflower root (4.4%), crown daisy (3.0%), deodeok (3.3%), kudzu root (3.0%) and lotus root (2.6%) were also linked to PFAS. Conclusions: This was the first nationwide study of PFAS in Korea. The prevalence of PFAS was 41.7%, and 8.9% of the PFAS patients had anaphylaxis. These results will provide clinically useful information to physicians.

• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.289-298
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• 2018

Background: Obstructive airway disease patients with increased variability of airflow and incompletely reversible airflow obstruction are often categorized as having asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). ACOS is heterogeneous with two sub-phenotypes: asthma-ACOS and COPD-ACOS. The objective of this study was to determine the difference in risk of exacerbation between the two sub-phenotypes of ACOS. Methods: A total of 223 patients exhibiting incompletely reversible airflow obstruction with increased variability (spirometrically defined ACOS) were enrolled. These patients were divided into asthma-ACOS and COPD-ACOS according to their physician's diagnosis and smoking history of 10 pack-years. Within-group comparisons were made for asthma-ACOS versus COPD-ACOS and light smokers versus heavy smokers. Results: Compared to patients with COPD-ACOS, patients with asthma-ACOS experienced exacerbation more often despite their younger age, history of light smoking, and better lung function. While the light-smoking group showed better lung function, they made unscheduled outpatient clinic visits more frequently. On multivariate analysis, asthma-ACOS and poor inhaler compliance were significantly associated with more than two unscheduled clinic visits during the previous year. Conclusion: Spirometrically defined ACOS includes heterogeneous subgroups with different clinical features. Phenotyping of ACOS by physician's diagnosis could be significant in predicting future risk of exacerbation.

• 대한한방내과학회지
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• 제29권1호
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• pp.32-41
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• 2008

Background : Monocyte chemoattractant protein-1(MCP-1), one of the CC chemokines, appears to play a significant role in asthma pathogenesis. It was reported that polymorphism in the MCP-1(-2518 A/G promoter) was associated with asthma in Caucasians, but the association of this polymorphism and asthma patients in the Korean population has not yet been clarified. Objective : We investigated the possible association between 2 polymorphisms (-2518 A/G promoter and Cys35Cys) and asthma patients in a Korean population. Materials and Methods : DNA samples were obtained from 86 Korean asthma patients and 270 healthy controls. MCP-1 genomic variants (-2518 A/G promoter and Cys35Cys polymorphism) were detected by PCR-RFLP. Level of MCP-1 was measured by ELISA for each genotype (n=8) (AA, AG, GG) and allele types of -2518 A/G promoter polymorphism for control subjects. Results : The Cys35Cys polymorphism was associated with asthma patients in Korean population [genotype distribution ($X^{2}=16.011$, P<0.001)]. Comparison of the two groups revealed no detectable differences in genotype and allele frequencies of the -2518 A/G polymorphism. Haplotype frequencies analysis revealed significant difference $(X^{2}=51.70$, P<0.001). MCP-1 serum level of subjects with G genotype of -2518 A/G promoter polymorphism was statistically higher than that with AA genotype (P<0.05). Conclusion : Our data indicate that no association exists between the MCP-1 -2518 A/G polymorphism and asthma susceptibility in the Korean population. However, it is noteworthy that the high prevalence of the -2518 G allele in the Korean population suggests a potentially important ethnic variation in the regulation of MCP-1 production. This variation must be considered in gene-association studies in different ethnic populations.

• Molecules and Cells
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• 제27권2호
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• pp.175-181
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• 2009

The myosin light chain kinase (MYLK) gene encodes both smooth muscle and nonmuscle cell isoforms. Recently, polymorphisms in MYLK have been reported to be associated with several diseases. To examine the genetic effects of polymorphisms on the risk of asthma and related phenotypes, we scrutinized MYLK by re-sequencing/genotyping and statistical analysis in Korean population (n = 1,015). Seventeen common polymorphisms located in or near exons, having pairwise $r^2$ values less than 0.25, were genotyped. Our statistical analysis did not replicate the associations with the risk of asthma and log-transformed total IgE levels observed among African descendant populations. However, two SNPs in intron 16 (+89872C> G and +92263T> C), which were in tight LD (|D'| = 0.99), revealed significant association with log-transformed blood eosinophil level even after correction multiple testing ($P=0.002/P^{corr}=0.01$ and $P=0.002/P^{corr}=0.01$, respectively). The log-transformed blood eosinophil levels were higher in individuals bearing the minor alleles for +89872C> G and +92263T> C than in those bearing other allele. In additional subgroup analysis, the genetic effects of both SNPs were much more apparent among asthmatic patients and atopic asthma patients. Among atopic asthma patients, the log-transformed blood eosinophil levels were proportionally increased by gene-dose dependent manner of in both +89872C> G and +92263T> C(P = 0.0002 and P = 0.00007, respectively). These findings suggest that MYLK polymorphisms might be among the genetic factors underlying differential increases of blood eosinophil levels among asthmatic patients. Further biological and/or functional studies are needed to confirm our results.

• Molecules and Cells
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• 제25권1호
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• pp.78-85
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• 2008

In a search for new molecular pathways associated with asthma, we performed an mRNA differential display analysis using total RNA extracted from the tracheal tissues of ovalbumin (OVA)-challenged mice and sham controls. cDNAs corresponding to mRNAs for which expression levels were altered by OVA-challenge were isolate and sequenced. Twenty-eight genes differentially expressed in sham and OVA challenged mice were identified. A GenBank BLAST homology search revealed that they were related to cytoskeleton remodeling, transcription, protein synthesis and modification, energy production, and cell growth and differentiation. Two were selected for further characterization. Up-regulation of both the perinatal skeletal myosin heavy chain (skMHC) and fast skeletal muscle myosin light chain (skMLC) genes was confirmed by RT-PCR of trachea tissue from OVA challenged mice. Overexpression of skMLC protein was observed in the smooth muscle layers of OVA-challenged mice by immunohistochemistry, and the surface areas stained with skMLC antibody increased in the OVA-challenged mice. The overexpression of skMLC in murine asthma may be associated with the changes of bronchial smooth muscle.

• 농촌의학ㆍ지역보건
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• 제34권2호
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• pp.175-187
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• 2009

이 연구는 부모의 알레르기 질환력을 고려해 간접흡연 노출과 소아 천식의 관계를 밝히는 것을 목적으로 이루어졌다. 이를 위해 경기도의 농촌과 도시를 대표하는 두 개 지역 소재 3개 초등학교 학생을 대상으로 이루어진 설문조사 자료를 이용하였다. 이 자료 중 이 연구는 설문에 응답한 대상자 중 평생 천명, 최근 천명, 의사진단 천식을 비롯해 간접흡연, 부모 알레르기 질환 여부에 응답한 2,301명을 최종 분석 대상으로 삼았다. 천식 및 천명을 이 분형 종속 변수로 삼고 로지스틱 회귀 분석을 통해 최근 1년간 간접흡연에의 노출과 부모의 알레르기 질환력이 천식 및 천명 질환에 미치는 독립 적인 효과를 분석하였으며 둘 간의 상호작용 효과를 추정하였다. 분석 결과 아버지와 어머니의 알레르기성 질환 병력은 평생 천명, 최근 천명에 유의한 영향력을 미치는 것으로 나타났으며 어머니의 천식 병력의 경우에는 의사 진단 천식에도 유의한 영향을 미치는 것으로 밝혀졌다. 그러나 어머니나 아버지의 최근 흡연과 소아 천식과의 관계는 통계적 유의성을 확보하지 못했다. 부모의 알레르기 질환력과 간접흡연간의 상호작용효과는 ‘부모알레르기 질환도 없고 간접흡연 노출도 없는 집단’, ‘부모 알레르기 질환력은 없지만 최근 흡연 노출은 있는 집단’, ‘부모 알레르기 질환력은 있지만 최근 흡연 노출은 없는 집단’, 그리고 ‘부모 알레르기 질환도 있으며 간접흡연 노출도 있는 집단’을 비교해 평가하였다. 분석 결과 부모의 알레르기 질환력과 간접흡연의 노출간의 상호작용효과는 어머니의 최근 흡연의 경우에 자녀의 최근 천명에서 유의한 효과를 보였으며 아버지의 최근 흡연의 경우에는 평생 천명과 최근 천명에서 유의한 효과를 타나냈다. 부모의 알레르기 질환과 최근 어머니의 흡연이 모두 없는 집단에 비해서 두 요인 다 있는 집단에서 자녀의 최근 천명이 나타날 교차비는 4.83배(95%CI:189-12.33)로 높았다. 또 아버지가 최근 1년간 흡연을 했으며 부모의 알레르기 질환력이 있는 집단에서는 아버지가 흡연하지도 않고 부모의 알레르기질환도 없는 집단에 비해 자녀의 최근 천명이 나타날 확률이 2.50배(95%CI:1.34-4.70) 높았으며 평생천명이 나타날 확률 역시 2.47배(95%CI:1.64-3.72)높았다. 이러한 연구 결과는 부모의 알레르기 질환력이 있는 경우에는 간접흡연의 노출이 자녀의 천식 및 천명의 유의한 위험 요인이라는 사실을 보여 준다. 따라서 향후에는 간접흡연의 노출과 상호작용하는 특정한 유전자 군에 대한 연구가 필요 할 것이다. 또한 소아 천식의 위험을 낮추기 위해서는 부모의 금연을 중심으로 한 간접흡연 노출을 줄일 수 있는 개입이 필요하며 나아가 부모가 알레르기질환이 있는 집단에 대한 집중적인 금연 교육이 소아 천식을 효과적으로 줄일 수 있을 것으로 여겨진다.