• 제목/요약/키워드: chronic inflammatory disease

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Asthma and the Risk of Rheumatoid Arthritis: An Insight into the Heterogeneity and Phenotypes of Asthma

  • Rolfes, Mary Claire;Juhn, Young Jun;Wi, Chung-Il;Sheen, Youn Ho
    • Tuberculosis and Respiratory Diseases
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    • 제80권2호
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    • pp.113-135
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    • 2017
  • Asthma is traditionally regarded as a chronic airway disease, and recent literature proves its heterogeneity, based on distinctive clusters or phenotypes of asthma. In defining such asthma clusters, the nature of comorbidity among patients with asthma is poorly understood, by assuming no causal relationship between asthma and other comorbid conditions, including both communicable and noncommunicable diseases. However, emerging evidence suggests that the status of asthma significantly affects the increased susceptibility of the patient to both communicable and noncommunicable diseases. Specifically, the impact of asthma on susceptibility to noncommunicable diseases such as chronic systemic inflammatory diseases (e.g., rheumatoid arthritis), may provide an important insight into asthma as a disease with systemic inflammatory features, a conceptual understanding between asthma and asthma-related comorbidity, and the potential implications on the therapeutic and preventive interventions for patients with asthma. This review discusses the currently under-recognized clinical and immunological phenotypes of asthma; specifically, a higher risk of developing a systemic inflammatory disease such as rheumatoid arthritis and their implications, on the conceptual understanding and management of asthma. Our discussion is divided into three parts: literature summary on the relationship between asthma and the risk of rheumatoid arthritis; potential mechanisms underlying the association; and implications on asthma management and research.

The Role of Inflammatory Mediators in the Pathogenesis of Nonalcoholic Fatty Liver Disease

  • Kim, Joon Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제15권2호
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    • pp.74-78
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    • 2012
  • With a markedly increased prevalence of obesity, non-alcoholic fatty liver disease (NAFLD) now becomes the most common cause of chronic liver disease in both adults and children. The etiology and pathogenesis of NAFLD are multifactorial and remain incompletely understood. According to the "two-hit" theory, inflammatory cytokines and adipokines are activated by oxidative stress and they are involved in insulin resistance, necroinflammatory steatohepatitis and fibrosis. This review discusses the latest updates on the role of some of important inflammatory adipokines and cytokines in the pathogenesis of NAFLD with an emphasis on their potential therapeutic implications.

Treatment of juvenile rheumatoid arthritis

  • Kim, Kwang-Nam
    • Clinical and Experimental Pediatrics
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    • 제53권11호
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    • pp.936-941
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    • 2010
  • The systematic approach to pharmacologic treatment is typically to begin with the safest, simplest, and most conservative measures. It has been realized that the more rapidly inflammation is under control, the less likely it is that there will be permanent sequelae. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of initial treatment for inflammation. In addition, the slow-acting antirheumatic drugs (SAARDs) and disease-modifying antirheumatic drugs (DMARDs) have efficacy of anti-inflammatory action in children with chronic arthritis. New therapeutic modalities for inflammation, such as etanercept and infliximab, promise even further improvements in the risk/benefit ratio of treatment. It is not typically possible at the onset of the disease to predict which children will recover and which will go on to have unremitting disease with lingering disability or enter adulthood with serious functional impairment. Therefore, the initial therapeutic approach must be vigorous in all children.

만성 질환 노인에서의 면역 성분 양상과 식이예방인자 (Inflammatory Cytokines and Dietary Factors in Korean Elderly with Chronic Disease)

  • 박희정;황유진;김화영
    • Journal of Nutrition and Health
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    • 제39권4호
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    • pp.372-380
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    • 2006
  • The purpose of this study was to investigate the association between inflammatory cytokines and chronic disease status in Korean elderly. The subjects were 248 elderly people aged over 65 years recruited from Health Center in Seoul. The subjects were classified into 3 groups based on their disease (diabetes, hypertension, and hyperlipidemia) status: subjects with one diagnosed disease of diabetes, hypertension, and hyperlipidemia fall into singular group (n=89), subjects with more than 2 disease into multiple group (n=39), and those with free of the diseases into normal (n=122). Anthropometric and biochemical characteristics, and dietary intakes were assessed. Dietary intakes were surveyed by 24-recall method. The means of IL-2, IL-6, MCP-1 and C3 were not differ among 3 groups. However, when subjects classified into tertiles of IL-6, MCP-1, TNF-$\alpha$ and C3 and frequencies of each fertile were compared, the multiple group showed significantly lower frequencies in lowest fertile than normal group (p<0.05), suggesting higher tendency of inflammatory responses. For hematological values, blood pressure, triglycerides, fasting blood glucose levels were highest in multiple group (p<0.05) compared to other 2 groups. BMI, body fat(kg), and triceps skinfold thickness were also significantly higher in multiple group than in 2 other groups(p<0.05). Moreover, the concentrations of IL-2, IL-6 and C3 were significantly correlated with hematologic values of fasting blood glucose, total cholesterol, LDL-cholesterol, and triglycerides or obesity factors such as triceps skinfold thickness, BMI, and body fat(%). Among singular and multiple group, the subjects with higher intakes for vitamins A, C, and E showed the higher level of IL-2 and the lower level of MCP-1, and C3. In conclusion, blood concentrations of triglycerides and proinflammatory cytokines, blood pressure, obesity parameters (BMI, body fat, triceps skinfold thickness) were higher in multiple group than in normal, but this result strongly suggest that the increasement of the vitamin A, C, and E intakes would modify the cytokine levels to reduce the inflammatory response in the elderly people with chronic diseases.

A Case of Cauda Equina Syndrome in Early-Onset Chronic Inflammatory Demyelinating Polyneuropathy Clinically Similar to Charcot-Marie-Tooth Disease Type 1

  • Lee, Seung Eun;Park, Seung Won;Ha, Sam Yeol;Nam, Taek Kyun
    • Journal of Korean Neurosurgical Society
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    • 제55권6호
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    • pp.370-374
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    • 2014
  • To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

자가면역간염과 원발성 경화담관염을 가진 중복증후군 소아 환자에서 발생한 형질세포성 골수염 1예 (A Case of Chronic Lymphoplasmacellular Osteomyelitis with Autoimmune Hepatitis/Primary Sclerosing Cholangitis Overlap Syndrome in a Child)

  • 이지혁;이현영;김진규;이지현;최연호
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제10권1호
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    • pp.91-97
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    • 2007
  • 저자들은 4세에 진단된 자가면역간염과 궤양성 대장염 그리고 6세에 진단된 원발성 경화담관염을 가진 중 복증후군 환아에서 9세에 만성 림프형질세포성 골수염이 발병한 뒤 면역억제 치료에 잘 반응하지 않는 증례를 경험하였기에 보고하는 바이다.

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GPx7 ameliorates non-alcoholic steatohepatitis by regulating oxidative stress

  • Kim, Hyeon Ju;Lee, Yoseob;Fang, Sungsoon;Kim, Won;Kim, Hyo Jung;Kim, Jae-woo
    • BMB Reports
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    • 제53권6호
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    • pp.317-322
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    • 2020
  • Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases. NAFLD can further progress to irreversible liver failure such as non-alcoholic steatohepatitis (NASH) fibrosis and cirrhosis. However, specific regulator of NASH-fibrosis has yet to be established. Here, we found that glutathione peroxidase 7 (GPx7) was markedly expressed in NASH fibrosis. Although GPx7 is an antioxidant enzyme protecting other organs, whether GPx7 plays a role in NASH fibrosis has yet to be studied. We found that knockdown of GPx7 in transforming growth factor-β (TGF-β) and free fatty acids (FFA)-treated LX-2 cells elevated the expression of pro-fibrotic and pro-inflammatory genes and collagen synthesis. Consistently, GPx7 overexpression in LX-2 cells led to the suppression of ROS production and reduced the expression of pro-fibrotic and pro-inflammatory genes. Further, NASH fibrosis induced by choline-deficient amino acid defined, high fat diet (CDAHFD) feeding was significantly accelerated by knockdown of GPx7, as evidenced by up-regulated liver fibrosis and inflammation compared with CDAHFD control mice. Collectively, these results suggest that GPx7 might be a novel therapeutic target to prevent the progression and development of NAFLD.

Effect of nonsurgical periodontal therapy and smoking status on hematological variables related to anemia of chronic disease in chronic periodontitis patient: a case-control study

  • Show, Sangita;Bagchi, Somen;Dey, Arka Kanti;Boyapati, Ramanarayana;Pal, Pritish Chandra;Tejaswi, Kanikanti Siva
    • Journal of Yeungnam Medical Science
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    • 제39권3호
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    • pp.244-249
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    • 2022
  • Background: Chronic infectious, inflammatory, or neoplastic disorders are associated with anemia of chronic disease. Chronic inflammatory diseases such as periodontitis may contribute to masked anemia, especially in smokers. This study was aimed at verifying and comparing the efficacy of nonsurgical periodontal therapy (NSPT) for improving anemia among chronic periodontitis patients with and without the habit of smoking. Methods: Thirty systemically healthy individuals with chronic periodontitis were divided into two groups of 15 each, smokers (group A) and nonsmokers (group B). The groups were compared based on hematological parameters such as serum erythropoietin (SE) and serum ferritin (SF) levels at baseline and 3 months after NSPT for anemia evaluation. Results: The baseline SE levels in groups A and B were 11.84 and 15.19 mIU/mL (p=0.031), respectively; the corresponding levels at 3 months after NSPT were 13.00 and 17.74 mIU/mL (p=0.022). The baseline SF levels in groups A and B were 95.49 and 44.86 ng/mL (p=0.018), respectively; the corresponding levels at 3 months after NSPT were 77.06 and 39.05 ng/mL (p=0.009). Group B showed a significant increase and decrease in the SE and SF levels, respectively, at 3 months after NSPT (p=0.035 and p=0.039, respectively), whereas group A showed insignificant changes (p=0.253 and p=0.618, respectively). Conclusion: NSPT led to an improvement in anemia among chronic periodontitis patients. However, the improvement is less in smokers compared to that in nonsmokers. Furthermore, SF and SE levels might serve as effective biomarkers for assessing anemia in smokers and nonsmokers with chronic periodontitis.

Anti-Tumor Necrosis Factor Therapy in Intestinal Behçet's Disease

  • Park, Jihye;Cheon, Jae Hee
    • Gut and Liver
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    • 제12권6호
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    • pp.623-632
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    • 2018
  • Intestinal Behçet's disease is a rare, immune-mediated chronic intestinal inflammatory disease; therefore, clinical trials to optimize the management and treatment of patients are scarce. Moreover, intestinal Behçet's disease is difficult to treat and often requires surgery because of the failure of conventional medical treatment. Administration of anti-tumor necrosis factor-${\alpha}$, a potential therapeutic strategy, is currently under active clinical investigation, and evidence of its effectiveness for both intestinal Behçet's disease and inflammatory bowel diseases has been accumulating. Here, we review updated data on current experiences and outcomes after the administration of anti-tumor necrosis factor-${\alpha}$ for the treatment of intestinal Behçet's disease. In addition to infliximab and adalimumab, which are the most commonly used agents, we describe agents such as golimumab, etanercept, and certolizumab pegol, which have recently been shown to be effective in refractory intestinal Behçet's disease. This review also discusses safety issues associated with anti-tumor necrosis factor-${\alpha}$, including vulnerability to infections and malignancy.