• Clinical and Experimental Pediatrics
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• v.56 no.8
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• pp.338-342
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• 2013

Purpose: Allergic disease and its comorbidities significantly influence the quality of life. Although the comorbidities of allergic diseases are well described in adult populations, little is known about them in preschool children. In the present study, we aimed to assess the prevalence and comorbidity of allergic diseases in Korean preschool children. Methods: We conducted a cross-sectional study comprising 615 Korean children (age, 3 to 6 years). Symptoms of allergic diseases were assessed using the Korean version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire that was modified for preschool children. Comorbidities of allergic diseases were assessed by 'In the last 12 months, has your child had symptoms?'. Results: The prevalence of symptoms of asthma, allergic rhinitis, and atopic dermatitis as recorded using the ISAAC questionnaire, within the last 12 months was 13.8%, 40.7%, and 20.8%, respectively. The symptom rates of allergic conjunctivitis, food allergy, and drug allergy were 14.8%, 10.4%, and 0.8%, respectively. The prevalence of allergic rhinitis in children with asthma was 64.3% and that of asthma in children with allergic rhinitis was 21.6%. The prevalence of rhinitis in children with conjunctivitis was 64.8% and that of conjunctivitis in children with rhinitis was 23.6%. Conclusion: The prevalence of current rhinitis in our preschool children is shown to be higher than that previously reported. Allergic conjunctivitis is closely associated with asthma and allergic rhinitis. However, further studies are warranted to determine the prevalence and effects of these comorbidities on health outcomes in preschool children.

• Clinical and Experimental Pediatrics
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• v.59 no.8
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• pp.319-327
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• 2016

Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and food allergy, are most common chronic, noncommunicable diseases in childhood. In the past few decades, the prevalence has increased abruptly worldwide. There are 2 possible explanations for the rising prevalence of allergic diseases worldwide, that an increased disease-awareness of physician, patient, or caregivers, and an abrupt exposure to unknown hazards. Unfortunately, the underlying mechanisms remain largely unknown. Despite the continuing efforts worldwide, the etiologies and rising prevalence remain unclear. Thus, it is important to identify and control risk factors in the susceptible individual for the best prevention and management. Genetic susceptibility or environments may be a potential background for the development of allergic disease, however they alone cannot explain the rising prevalence worldwide. There is growing evidence that epigenetic change depends on the gene, environment, and their interactions, may induce a long-lasting altered gene expression and the consequent development of allergic diseases. In epigenetic mechanisms, environmental tobacco smoke (ETS) exposure during critical period (i.e., during pregnancy and early life) are considered as a potential cause of the development of childhood allergic diseases. However, the causal relationship is still unclear. This review aimed to highlight the impact of ETS exposure during the perinatal period on the development of childhood allergic diseases and to propose a future research direction.

• IMMUNE NETWORK
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• v.7 no.2
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• pp.87-94
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• 2007

Background: Chronic rhino-sinusitis and persistent allergic rhinitis is often cited as risk factor for developing adenoid hypertrophy or adenoiditis, but this relationship has not been studied extensively. In this study, we evaluated the mucosal barrier, squamous changes of ciliated epithelium, IgA secretion and BCL-6 expression in adenoids, and adenoid size. Methods: Six children with allergic rhinitis and sinusitis, nine children with only allergic rhinitis, nine children with only sinusitis and six children without any history of allergic rhinitis and sinusitis were enrolled. H-E stain of adenoid for squamous metaplasia, immunohistochemical study of adenoid for IgA and BCL-6, cytokeratin stain for evaluation of mucosal barrier and lateral view X-ray for adenoid size were performed. ANOVA test was used in the analysis and data showing p value of less than 0.05 were considered significant. Results: The number of ciliated cells had tendency to be decreased and squamous metaplasia had tendency to be increased in three experimental groups (p>0.05). Deterioration of mucosal barrier had tendency to be detected in three experimental groups than control group (p>0.05). BCL-6 had tendency to be increased and IgA secretion had tendency to be decreased in three experimental groups (p>0.05). There is no difference in adenoid size between three experimental groups and control group. Conclusion: Despite the expectation that adenoid would be affectecd by allergic rhinitis and rhino-sinusitis, we found no evidence for influence of adenoid immunity.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.1
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• pp.32-42
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• 2014

Objectives The purpose of this study is to establish relationship between allergic diseases and functional gastrointestinal disorders in children and adolescents using objective criteria and questionnaires. Methods This study surveyed 237 children and adolescents who visited the department of Pediatrics of ${\bigcirc}{\bigcirc}$ Korean Medicine Hospital from September 23rd, 2013 to December 26th, 2013. The Korean version of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the Korean-translated Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-Rome III) were used. We analyzed the data by using PASW Statistics 18.0 with Chi-square test, Fisher's exact test and Linear by linear association. Results There was no significant difference between prevalence of allergic diseases and functional gastrointestinal disorders. Also, there was no strong relationship between the number of allergic diseases and the functional gastrointestinal disorders. However, some parts showed significant relationships - such as asthma symptoms ever and belch; asthma symptoms last 12 months and belch; allergic rhinitis diagnosis ever and belly aches and abdominal pain around and below the belly button; allergic rhinitis treatment last 12 months and belly aches and abdominal pain around and below the belly button; and atopic dermatitis diagnosis ever and irritable bowel syndrome (respectively; p=0.046, p=0.008, p=0.004, p=0.029, p=0.035). And as the number of allergic diseases increases, the prevalence of functional gastrointestinal disorders are 19.4%, 31.3%, 41.7%, 31.0% respectively. Conclusions Although there was no significant relationship between allergic diseases and functional gastrointestinal disorders, some gastrointestinal symptoms were related to allergic diseases.

• Clinical and Experimental Pediatrics
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• v.63 no.7
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• pp.278-283
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• 2020

Background: Major questions remain regarding the agestratified trends of allergic diseases and asthma in Korea. Purpose: To identify the estimated recent prevalence and 10-year trends in asthma, allergic rhinitis, and atopic dermatitis among the Korean population from 2008 to 2017. Methods: This nationwide cross-sectional survey (Korean National Health and Nutrition Examination Survey) over 10 years (2008-2017) examined representative samples of the Korean population (n=85,006) including 2,131 infants, 4,352 preschool children, 12,919 school-age children, 44,200 adults, and 21,404 elderly adults. Results: In the 2016 to 2017 population, the estimated prevalence of asthma was 0.9% in infants, 2.3% in preschool children, 4.1% in school-age children, 2.3% in adults, and 4.1% in the elderly. The estimated prevalence of allergic rhinitis was 9.0%, 20.2%, 27.6%, 17.1%, and 6.9%, respectively. The estimated prevalence of atopic dermatitis was 5.9%, 11.3%, 14.6%, 3.9%, and 1.6%, respectively. Ten-year trends revealed a significant decrease in asthma prevalence in infants, preschool children, and the elderly. and in atopic dermatitis prevalence in infants and preschool children (P<0.05 for all trends). Furthermore, 10-year trends demonstrated a significant increase in allergic rhinitis prevalence in school-age children, adults, and the elderly, and in atopic dermatitis prevalence in school-age children and the elderly (P<0.05 for all trends). Conclusion: These results improve our understanding of the age-stratified epidemiology of allergic diseases in Korea and suggest the need for the development of tailored and precise strategies to prevent allergic diseases in different age groups.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.939-947
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• 2002

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.640-645
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• 2008

Purpose : It is widely known that allergic diseases progress through an allergic march. However, there have not been any recent reports in Korea on how the diseases progress. Methods : Parents who visited one of the Pediatric Allergy Clinics of four university hospitals in Seoul with a child under the age of 6 years during the period from May 1-30, 2006 were asked to complete a questionnaire. Results : A total of 229 parents answered the questionnaire about their children, of which 122 were male and 107 were female. The most common allergic disease before 2 years of age was atopic dermatitis (79%). Meanwhile, in 2- to 4-year age group, allergic rhinitis (38%) and asthma (37%) were predominant. The most common allergic disease in the 4- to 6-year age group was asthma (72%), followed by allergic rhinitis (64%). Seventy-three percent of the children had a family history of allergic disease, most often in the fathers (39%). Among patients with allergic rhinitis, 50% had experienced asthma in their earlier days and 30% had experienced atopic dermatitis. In addition, 57% of the children with asthma had suffered from atopic dermatitis. Parents believed that asthma was the most serious allergic disease. Conclusion : In the present study, allergic disease showed a tendency to march from atopic dermatitis to asthma and then to allergic rhinitis. Early diagnosis and treatment of atopic dermatitis is, therefore, considered important for prevention of the allergic march.

• Clinical and Experimental Pediatrics
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• v.62 no.9
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• pp.325-333
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• 2019

Allergic diseases, including allergic rhinitis, asthma, and atopic dermatitis, are common heterogeneous diseases that encompass diverse phenotypes and different pathogeneses. Phenotype studies of allergic diseases can facilitate the identification of risk factors and their underlying pathophysiology, resulting in the application of more effective treatment, selection of better treatment responses, and prediction of prognosis for each phenotype. In the early phase of phenotype studies in allergic diseases, artificial classifications were usually performed based on clinical features, such as triggering factors or the presence of atopy, which can result in the biased classification of phenotypes and limit the characterization of heterogeneous allergic diseases. Subsequent phenotype studies have suggested more diverse phenotypes for each allergic disease using relatively unbiased statistical methods, such as cluster analysis or latent class analysis. The classifications of phenotypes in allergic diseases may overlap or be unstable over time due to their complex interactions with genetic and encountered environmental factors during the illness, which may affect the disease course and pathophysiology. In this review, diverse phenotype classifications of allergic diseases, including atopic dermatitis, asthma, and wheezing in children, allergic rhinitis, and atopy, are described. The review also discusses the applications of the results obtained from phenotype studies performed in other countries to Korean children. Consideration of changes in the characteristics of each phenotype over time in an individual's lifespan is needed in future studies.

• Clinical and Experimental Pediatrics
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• v.58 no.9
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• pp.325-329
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• 2015

Purpose: In addition to regulating calcium and phosphorus homeostasis and bone metabolism, vitamin D is known as an immune modulator. Recently, there has been increased worldwide interest in the association between low levels of vitamin D and allergic diseases. The purpose of this study was to assess the relationship between serum vitamin D levels and allergic/vasomotor rhinitis (AR/VR) in children. Methods: This study included 164 patients. The sample included 59 patients with AR, 42 patients with VR, and 63 controls. Their ages ranged from 0 to 16 years. We examined the levels of 25-hydroxyvitamin D, Immunoglobulin E, specific IgE, and eosinophil cationic protein; peripheral blood eosinophil count; and the results of a skin prick test. Results: Serum 25-hydroxyvitamin D levels were $19.0{\pm}8.5ng/mL$ in the AR group, $25.5{\pm}10.9ng/mL$ in the VR group, and $26.9{\pm}10.7ng/mL$ in the control group. After adjustment for body mass index and season at the time of blood sampling, vitamin D levels in the AR group were lower than those of the VR group (P=0.003) and control group (P<0.001). Vitamin D levels were inversely correlated with Immunoglobulin E levels (r=-0.317, P<0.001). AR patients with food allergy or atopic dermatitis did not have lower levels of 25-hydroxyvitamin D than AR patients without these diseases. Conclusion: This study demonstrates a possible relationship between vitamin D levels and allergic rhinitis in Korean children.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.30 no.4
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• pp.75-96
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• 2017

Objectives : The purpose of this study was to investigate the treatment trend for allergic rhinitis in Korean Medicine. Methods : We conducted an online survey for Korean Medicine Doctors who were registered in the association of Korean Medicine. The questionnaire was consisted of patient characteristics, diagnosis status, treatment status, and future research needs. Results : Data from total of 396 respondents were analyzed. More than 70% of the patient came to the Korean Medicine Clinic after visiting the Western Medicine Clinic in 43.9% of the respondents. 55.6% of the respondents performed combination therapy. History taking, nasal examination, x-ray, and Korean Medicine diagnostic test were used for diagnosis. The mean duration of treatment ranged from $4.9{\pm}2.91$ to $15.2{\pm}8.45$ for pediatric and early childhood patients and from $17.5{\pm}16.15$ to $5.3{\pm}3.85$ weeks for adolescents and adult patients. The mean number of treatment times was from $9.8{\pm}7.00$ to $33.5{\pm}24.45$ for pediatric and early childhood patients and from $10.8{\pm}11.55$ to $40.4{\pm}48.18$ times for adolescents and adult patients. 64.5%, 48.0%, and 91.2% of the respondents used herbal medication in national health insurance coverage, herbal medication uninsured in health insurance and herbal prescription filled at each medical institution, respectively for pediatric and early childhood patients and 67.6%, 42.8% and 86.1% for adolescents and adult patients. 36.9% and 36.4% of respondents answered that the study of acupuncture and herbal medicine are needed preferentially. Conclusions : The results of this survey will be used to develop clinical practice guideline that reflect actual clinical practice.