In Suk Sol

Vitamin D levels in allergic rhinitis: a systematic review and meta-analysis

We aimed to systematically review observational studies investigating the relationship between vitamin D levels and allergic rhinitis (AR).

Sputum pentraxin 3 as a candidate to assess airway inflammation and remodeling in childhood asthma

AbstractPentraxin 3 (PTX3) is a soluble pattern recognition receptor and an acute-phase protein. It has gained attention as a new biomarker reflecting tissue inflammation and damage in a variety of diseases. Aim of this study is to investigate the role of PTX3 in childhood asthma.In total, 260 children (140 patients with asthma and 120 controls) were enrolled. PTX3 levels were measured in sputum supernatants using enzyme-linked immunosorbent assay test. We performed spirometry and methacholine challenge tests and measured the total eosinophil count and the serum levels of total IgE and eosinophil cationic protein (ECP) in all subjects.Sputum PTX3 concentration was significantly higher in children with asthma than in control subjects (P < 0.001). Furthermore, sputum PTX3 levels correlated with atopic status and disease severity among patients with asthma. A positive significant correlation was found between sputum PTX3 and the bronchodilator response (r = 0.25, P = 0.013). Sputum PTX3 levels were negatively correlated with forced expiratory volume in 1 second (FEV1) (r = -0.30, P = 0.001), FEV1/forced vital capacity (FVC) (r = -0.27, P = 0.002), and FEF25–75 (r = -0.392, P < 0.001), which are indicators of airway obstruction and inflammation. In addition, the PTX3 concentration in sputum showed negative correlations with post-bronchodilator (BD) FEV1 (r = -0.25, P < 0.001) and post-BD FEV1/FVC (r = -0.25, P < 0.001), which are parameters of persistent airflow limitation reflecting airway remodeling.Sputum PTX3 levels increased in children with asthma, suggesting that PTX3 in sputum could be a candidate molecule to evaluate airway inflammation and remodeling in childhood asthma.

Relationship between Sputum Clusterin Levels and Childhood Asthma

Clusterin is a sensitive cellular biosensor of oxidative stress and has been studied as a biomarker for inflammation‐associated diseases. Clusterin levels in childhood asthma have not been evaluated.

High-Sensitivity C-Reactive Protein Can Reflect Small Airway Obstruction in Childhood Asthma

Purpose High-sensitivity assays enabled the identification of C-reactive protein (hs-CRP) at levels that were previously undetectable. We aimed to determine if hs-CRP could reflect airway inflammation in children, by comparing hs-CRP with spirometry and impulse oscillometry (IOS) parameters and symptomatic severities. Materials and Methods A total of 276 asthmatic children who visited Severance Childrens Hospital from 2012–2014 were enrolled. Serum hs-CRP and pulmonary function tests were performed on the same day. Patients were divided into hs-CRP positive and negative groups (cut-off value, 3.0 mg/L). Results Of the 276 asthmatic children [median age 7.5 (5.9/10.1) years, 171 boys (62%)], 39 were hs-CRP positive and 237 were negative. Regarding spirometry parameters, we observed significant differences in maximum mid-expiratory flow, % predicted (FEF25–75) (p=0.010) between hs-CRP positive and negative groups, and a negative correlation between FEF25–75 and hs-CRP. There were significant differences in the reactance area (AX) (p=0.046), difference between resistance at 5 Hz and 20 Hz (R5–R20) (p=0.027), resistance at 5 Hz, % predicted (R5) (p=0.027), and reactance at 5 Hz, % predicted (X5) (p=0.041) between hs-CRP positive and negative groups. There were significant positive correlations between hs-CRP and R5 (r=0.163, p=0.008), and X5 (r=0.164, p=0.007). Spirometry and IOS parameters had more relevance in patients with higher blood neutrophil levels in comparison to hs-CRP. Conclusion Hs-CRP showed significant correlation with FEF25–75, R5, and X5. It can reflect small airway obstruction in childhood asthma, and it is more prominent in neutrophil dominant inflammation.

Serum clusterin level in children with atopic dermatitis.

BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease. Clusterin is a sensitive cellular biosensor of oxidative stress and has been studied as a marker to assess inflammatory diseases. The clusterin levels in AD have not been evaluated thus far. OBJECTIVE We evaluated serum clusterin levels in children with AD and assessed the relationship between serum clusterin levels and the severity of AD. METHOD The study enrolled a total 140 children, of whom 100 had AD (n = 100) and 40 were healthy (n = 40). The severity of AD was scored by using the SCORing Atopic Dermatitis (SCORAD). Total serum immunoglobulin E and specific immunoglobulin E levels against egg whites, cows milk, peanuts, soybeans, wheat, and Dermatophagoides farinae were measured. Clusterin levels in serum were measured by enzyme-linked immunosorbent assay. RESULTS The mean (interquartile range) age of the children was 5.1 years (1.3-8.4 years), and 92 (69.3%) of the children were boys. The mean (standard deviation) SCORAD index was 50.4 ± 17. The mean (standard deviation) clusterin level of children with AD was higher than that in the healthy control group children (148.13 ± 4.3 pg/mL versus 144.85 ± 5.1 pg/mL; p = 0.001). Serum clusterin levels were correlated with the SCORAD index (r = 0.327, p = 0.002). CONCLUSIONS The serum clusterin level was higher in children with AD than in the healthy control group and increased with the severity of AD. Serum clusterin may be a candidate molecule that reflects AD and its severity.

Clinical implication of exhaled breath temperature measurement in pediatric asthma

Correspondence to: Yoon Hee Kim https://orcid.org/0000-0002-2149-8501 Department of Pediatrics, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea Tel: +82-2-2019-3350, Fax: +82-2-3461-9473, E-mail: YHKIM@yuhs.ac • This research was supported by Kuhnil academic research fund. Received: September 6, 2016 Revised: October 13, 2016 Accepted: October 15, 2016

Sputum TWEAK Expression Correlates with Severity and Degree of Control in Noneosinophilic Childhood Asthma

Tumor necrosis factor‐like weak inducer of apoptosis (TWEAK) is known to play a role in the pathogenesis of various inflammatory diseases. However, no study has been performed on childhood asthma.

Activated Leukocyte Cell Adhesion Molecule Stimulates the T-Cell Response in Allergic Asthma

Rationale: The activated leukocyte cell adhesion molecule (ALCAM) is a cluster of differentiation 6 ligand that is important for stabilizing the immunological synapse and inducing T‐cell activation and proliferation. Objectives: In this study, we investigated the role of ALCAM in the development of inflammation in allergic asthma. Methods: An ovalbumin (OVA)‐induced allergic asthma model was established in wild‐type (WT) and ALCAM‐deficient (ALCAM−/−) mice. T‐cell proliferation was evaluated in cocultures with dendritic cells (DCs). Bone marrow‐derived dendritic cells (BMDCs) from WT and ALCAM−/− mice were cultured and adoptively transferred to OT‐II mice for either OVA sensitization or challenge. An anti‐ALCAM antibody was administered to assess its therapeutic potential. ALCAM concentrations in the sputum and serum of children with asthma were quantified by ELISA. Measurements and Main Results: Inflammatory responses were lower in ALCAM−/− mice than in WT mice, and T cells cocultured with DCs from ALCAM−/− mice showed reduced proliferation relative to those cocultured with DCs from WT mice. A decreased inflammatory response was observed upon adoptive transfer of BMDCs from ALCAM−/− mice as compared with that observed after transfer of BMDCs from WT mice. In addition, anti‐ALCAM antibody‐treated mice showed a reduced inflammatory response, and sputum and serum ALCAM concentrations were higher in children with asthma than in control subjects. Conclusions: ALCAM contributes to OVA‐induced allergic asthma by stimulating T‐cell activation and proliferation, suggesting it as a potential therapeutic target for allergic asthma.

Chitotriosidase inhibits allergic asthmatic airways via regulation of TGF-β expression and Foxp3+ Treg cells

Chitotriosidase (chitinase 1, Chit1), a major true chitinase in humans, is induced in childhood asthma and has been implicated in the pathogenesis of a variety of inflammatory and tissue remodeling responses. However, the role and the mechanisms that underlie these contributions to the diseases have not been defined. We hypothesized that Chit1 plays a significant role in the pathogenesis of allergic asthma.

Validation of Pediatric Index of Mortality 3 for Predicting Mortality among Patients Admitted to a Pediatric Intensive Care Unit

Background The objective of this study was to evaluate the usefulness of the newest version of the pediatric index of mortality (PIM) 3 for predicting mortality and validating PIM 3 in Korean children admitted to a single intensive care unit (ICU). Methods We enrolled children at least 1 month old but less than 18 years of age who were admitted to the medical ICU between March 2009 and February 2015. Performances of the pediatric risk of mortality (PRISM) III, PIM 2, and PIM 3 were evaluated by assessing the area under the receiver operating characteristic (ROC) curve, conducting the Hosmer-Lemeshow test, and calculating the standardized mortality ratio (SMR). Results In total, 503 children were enrolled; the areas under the ROC curve for PRISM III, PIM 2, and PIM 3 were 0.775, 0.796, and 0.826, respectively. The area under the ROC curve was significantly greater for PIM 3 than for PIM 2 (P<0.001) and PRISM III (P=0.016). There were no significant differences in the Hosmer-Lemeshow test results for PRISM III (P=0.498), PIM 2 (P=0.249), and PIM 3 (P=0.337). The SMR calculated using PIM 3 (1.11) was closer to 1 than PIM 2 (0.84). Conclusions PIM 3 showed better prediction of the risk of mortality than PIM 2 for the Korean pediatric population admitted in the ICU.