• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.2
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• pp.118-126
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• 2018

Purpose: Classical criteria for diagnosis of autoimmune hepatitis (AIH) are intended as research tool and are difficult to apply at patient's bedside. We aimed to study the accuracy of simplified criteria and the concordance with the expert diagnosis based on the original criteria. Methods: A cohort of children under study for liver disorder was selected through consecutive sampling to obtain the prevalence of AIH within the group of differential diagnoses. AIH was defined, based on classical criteria, through committee review of medical reports. Validity indicators of the simplified criteria were obtained in an intention to diagnose approach. Optimal cut-off and the area under the receiver operating characteristic (ROC) curve were calculated. Results: Out of 212 cases reviewed, 47.2% were AIH. For the optimal cut-off (6 points), the simplified criteria showed a sensitivity of 72.0% and a specificity of 96.4%, with a 94.7% positive and a 79.4% negative predictive value. The area under the ROC curve was 94.3%. There was a good agreement in the pre-treatment concordance between the classical and the simplified criteria (kappa index, 0.775). Conclusion: Simplified criteria provide a moderate sensitivity for the diagnosis of AIH, but may help in indicating treatment in cases under suspicion with 6 or more points.

• Korean Journal of Veterinary Research
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• v.43 no.4
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• pp.525-529
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• 2003

The phosphorylation of extracellular signal-regulated kinases (p-ERK) in the spinal cord of rats with acute monophasic experimental autoimmune encephalomyelitis (EAE) was studied using immunohistochemistry and treatment with inhibitor. P-ERK is constitutively expressed in glial cells in the normal spinal cord. In EAE, some inflammatory cells in the subarachnoid space were positive for p-ERK at the early stage, and its immunoreactivity declined when those cells infiltrated the parenchyma at the peak stage. In a blocking experiment using its inhibitor, the intravenous administration of PD98059 from day 7 to 13 post-immunization did not modulate EAE paralysis. Considering the results, we postulate that intravenous administration of PD98059 is not effective in ameliorating EAE paralysis, although many inflammatory cells express ERK in the subarachnoid space.

• IMMUNE NETWORK
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• v.4 no.2
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• pp.108-115
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• 2004

Background: Production of nitric oxide (NO) by inducible NO synthase (iNOS) has been implicated in the pathology of autoimmune disease. It is unknown whether iNOS expression is increased within testes and whether iNOS and NO have essential roles in the pathogenesis of EAO. Methods: EAO was induced in guinea pig testes at 17 days after secondary immunization by administration of crude extract (CE) and purified glycoprotein 1 (GP1) from normal guinea pig testes. iNOS gene expression was assessed by RT-PCR and Northern blot analysis in testes. Localization of iNOS and Mac-1 and the indicator of NO-mediated tissue injury, nitrotyrosine, were detected in the testicular lesion by immunohistochemistry. Results: In control testes, inflammation and iNOS gene expression were not detected, whereas, in CE- and GP1-injected testes, inflammation and marked iNOS gene expression were evident at day 17 after secondary immunization. Immunohistochemistry of Mac-1 showed the colocalization with iNOS protein and nitrotyrosyl proteins in intertubules, suggesting that NO produced by infiltrated macrophages may be involved in inflammatory lesions of intertubules. Intraperitoneal administration of aminoguanidine significantly prevented EAO with reduction of inflammation, iNOS expression and nitrotyrosine formation. Conclusion: These results suggest that NO production by macrophages may be important in the pathogenesis of CE- and GP1-induced EAO. Furthermore, this study demonstrated the therapeutic potential of iNOS inhibitor in the treatment of inflammatory and autoimmune mediated-diseases.

• Journal of Haehwa Medicine
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• v.20 no.1
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• pp.11-23
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• 2011

Systemic Lupus Erythematosus(SLE) is an autoimmune disease invading the skin, joint, kidney, intestinal membrane, neurosystem and other organs. SLE is an autoimmune disease characterized by immune dysregulation resulting in the production of antinuclear antibodies(ANA), generation of circulating immune complexes, and activation of the complement system. In Korean medicine, lupus can be classified as acute arthritis, reddish butterfly erythema, asthenic disease, edema and so on. The cause and procedure of the diseases are flourishing noxious heat, excessive fire due to deficiency of yin, blood stasis due to stagnation of qi, internal movement of the liver-wind, congenital deficiency, exhausted vital-qi, which are treated by clearing away heat and cooling the blood, nourshing yin and extinguishing fire, treating flatulence and activating blood circulation, nourishing the blood to expel wind, invigorating the liver and kidney, invigorating qi and replenishing the blood. To experimentally examine the influence of Insam-Buja-Tang (Ginseng & Aconiti Extract, IBT) on the outbreak and development of lupus, lupus induce MRL/MpJ-Faslpr lupus-prone mice model was used. As IBT was orally administrated to a lupus model mouse, various tests such as the weight, urine protein, renal function, Lymph cell test of the spleen, Cytokine expression, histopathological analysis of kideny were performed to see the influence on the kidney and whether it work effectively on the immune function. The main purpose of this study is to evaluate the effect of IBT on MRL/MpJ-Faslpr lupus-prone mice model. The effect of IBT on MRL/MpJ-Faslpr lupus-prone mice that can have autoimmune disease similar to SLE in human was evaluated after IBT per oral in the present study.

• Korean Journal of Clinical Pharmacy
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• v.25 no.3
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• pp.166-170
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• 2015

Background: Primary warm autoimmune hemolytic anemia (AIHA) is a relatively rare hematologic disorder resulting from autoantibody production against red blood cells. There has been very few studies about primary warm AIHA in South Korea because of its low incidence. We retrospectively analyzed the treatment outcome of primary warm AIHA. Method: We reviewed retrospectively the medical records of 9 primary warm AIHA patients from December 2002 to January 2015. We analyzed the causes and clinical characteristics of primary warm AIHA patients. We retrospectively analyzed the clinical data in electronic medical records for 9 Korean patients with AIHA patients who were diagnosed during the period from December 2002 to January 2015 at the Regional University Hospital in Korea. The study protocol was approved by the Institutional Review Board (IRB #2015-08-007, Chosun University Hospital IRB). Results: The mean age was 52 years (range 27~78), the mean hemoglobin level was 5.0 g/dL (range 2.5~6.4 g/dL). All patients received steroids at therapeutic dosages (corticosteroid 1 mg/Kg) as first line treatment. Eight of them showed complete response (5/8, 62.5%) and partial response (3/8, 37.5%), one patient required second-line treatment with rituximab. Two patients who responded first line treatment were relapsed at 86 weeks and 24 weeks after response, respectively. Only one patient of them was retreated with corticosteroid because of anemic symptoms. Conclusion: This study indicates that oral corticosteroid is an effective therapy for primary warm AIHA.

• The Journal of Internal Korean Medicine
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• v.37 no.3
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• pp.560-567
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• 2016

Objectives: The medical records, including laboratory test results, of a patient with autoimmune hepatitis (AIH)-primary biliary cirrhosis (PBC) overlap syndrome were reviewed to observe changes in steroid-induced adverse reactions before and after herbal medicine treatment.Methods: We investigated the records of a 44-year-old female patient with AIH-PBC overlap syndrome treated at the Kyung Hee University Korean Medicine Hospital. Injinchunggan-tang and its modified decoctions were administered, and any changes inclinical manifestations as well as laboratory test results were monitored.Results and Conclusions: Significant decreases in ALP, GGT, ALT, and AST levels were observed after oral administration of the herbal medicines. Improvements in steroid-induced symptoms (hyperglycemia, fatigue, and moon face) were also observed. Injinchunggan-tang and its modified prescriptions are promising candidates for proper management of AIH-PBC overlap syndrome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.1
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• pp.63-71
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• 2020

Purpose: Autoimmune hepatitis (AIH) is a chronic disease that may lead to cirrhosis. The immunopathogenesis of AIH is not fully understood and it mainly involves T-cell mediated mechanism. Macrophage migration inhibitory factor (MIF) is a pro-inflammatory cytokine that promotes T cell response and its polymorphism may serve as a severity marker of AIH. No previous study has considered investigating MIF polymorphism in children with AIH. Methods: Forty-two children with definite diagnosis of AIH were enrolled along with 100 age and sex matched controls. All participants were tested for polymorphism at -173GC (rs755622) of MIF gene. All patients received the standard protocol of steroid plus azathioprine to achieve remission. Liver biopsy was performed at time of diagnosis for all patients and only 18 of them underwent a second biopsy after treatment. Results: No statistically significant differences in the frequency of the genotypes GG and GC or in allele distribution were found in both patient and control groups (p=0.590, 0.640 respectively). Initial alanine aminotransferase (ALT) levels at the time of presentation was significantly higher in the GC group than GG group (p=0.020). GC genotype significantly correlated with disease relapse (r=0.41, p=0.007). Regression of necroinflammation and the fibrosis score in the second liver biopsy was statistically significant in the GG group (p<0.0001, p=0.010 respectively). Conclusion: MIF -173GC polymorphism is associated with clinically significant markers of pediatric AIH, including increased initial serum ALT levels, may help predict necroinflammatory/fibrosis regression effectively, following immunosuppressive treatment.

• Journal of Veterinary Clinics
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• v.23 no.2
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• pp.149-152
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• 2006

The canine thyroglobulin autoantibody assay is to be used for the diagnosis of autoimmune thyroid disease in dogs. Antithyroglobulin antibodies are present in about 50 percent of hypothyroid dogs. In this report, the sera of the five canine patients ($P1{\sim}P5$) referred to the Veterinary Medical Teaching Hospital in Seoul National University were assessed by T4, TSH and thyroglobulin autoantibody (TgAA). P1 was diagnosed as severe hypothyroidism since he showed very high TSH levels with low T4 values. P2 and P3 born with a genetic predisposition were assessed as normal in thyroid function. P4 was normal, but needed follow-up examination for TgAA assay. P5 showed the positive result in TgAA assay, so it was diagnosed as autoimmune thyroiditis. As the cases above show, not only T4 and TSH, but also TgAA assay to be considered for more accurate assessment of the status of the thyroid.

• Korean Journal of Pharmacognosy
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• v.36 no.2 s.141
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• pp.88-92
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• 2005

Apoptosis plays an important role in autoimmune chronic (Hashimoto's) thyroiditis, a disorder that often results in hypothyroidism. The goal of this study was to induce apoptosis by the combination of inflammatory cytokines, interferon $(IFN)-{\gamma}$ and tumor necrosis factor $(TNF)-{\alpha}$, and to investigate a potential role of medicinal plants in the thyroid follicular cells (FRTL) in vitro. The apoptosis was evaluated by cellular viability, DNA fragmentation, and terminal deoxynucleotidyl transferase-mediated deoxy-UTP nick end labeling (TUNEL) assay. Extract of Gamgung-tang (GGT, Glycyrrhizae Radix, black beans, Angelicae Radix, and Cnidii Rhizoma) $(0.3{\sim}9.0mg/ml)$ was shown to maintain the viability of cells treated with $IFN-{\gamma}(100U/ml)$ and $TNF-{\alpha}$ (0.5 ng/ml). FRTL cells were found to undergo DNA fragmentation with the inflammatory cytokines. The extract of GGT inhibited DNA fragmentation in dose-dependent manner. The cells with TUNEL-positive nuclei were detected with $IFN-{\gamma}$ and $TNF-{\alpha}$ treatment. The number of TUNEL-positive cells decreased with the treatment of extract of GGT. These results indicate that medicinal plants inhibit the occurrence of apoptosis in thyroid follicular cells, therefore, may have therapeutic potential in the treatment of autoimmune chronic thyroiditis.

• Korean Journal of Veterinary Research
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• v.44 no.3
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• pp.349-355
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• 2004

The aim of this study was to evaluate the expression of galectin-3, one of beta-galactoside-binding proteins, in the experimental autoimmune encephalomyelitis(EAE) model of Lewis rats or non-obese diabetic (NOD) mice. Western blot analysis showed that galectin-3 was weakly expressed in the spinal cords of complete Freund's adjuvant(CFA) immunized control rats. In EAE, however, galectin-3 expression was significantly increased at the peak stage(days 14 post-immunization), while it was decreased slightly at the recovery stage(day 21 post-immunization). Immunohistochemical analysis showed that galectin-3 was detected in some macrophages in demyelinating lesions of NOD mice, while galectin-3 was immunoreacted in some inflammatory cells in the perivascular cuffing in rat EAE lesions. Collectively, it is postulated that the expression of galectin-3 is significantly increased in response to neuroimmunological stimulation in the central nervous system, whereas it is weak in normal rats and mice.