M. Sohn

Basement membrane thickening and clinical features of children with asthma

Background:  Asthma is a chronic inflammatory disease, characterized by airway inflammation, bronchial hyper‐responsiveness, and airway obstruction. Although asthma induces partially reversible airway obstruction, obstruction can sometimes become irreversible. This may be a consequence of airway remodeling, which includes a number of structural changes, such as epithelial detachment, basement membrane (BM) thickening, smooth muscle hypertrophy, and new vessel formation. This study evaluated children with asthma for the presence of BM thickening.

Prediction of buckwheat allergy using specific IgE concentrations in children.

Introduction:  Buckwheat (BW) is considered to be one of the most important food allergens, and positive skin tests are found in about 5% of Koreans. We investigated the positive and negative predictive values of BW‐specific IgE in subjects with a BW allergy in order to reduce the need for buckwheat challenge, which can be more riskier than other causes of food allergies.

Increased serum B cell-activating factor level in children with atopic dermatitis

Background.  B cell‐activating factor (BAFF) is a tumour necrosis factor superfamily member best known for its role in the survival and maturation of B cells. BAFF activity is seen in naïve and effector/memory T cells.

Murine Model of Buckwheat Allergy by Intragastric Sensitization with Fresh Buckwheat Flour Extract

Food allergies affect about 4% of the Korean population, and buckwheat allergy is one of the most severe food allergies in Korea. The purpose of the present study was to develop a murine model of IgE-mediated buckwheat hypersensitivity induced by intragastric sensitization. Young female C3H/HeJ mice were sensitized and challenged intragastricly with fresh buckwheat flour (1, 5, 25 mg/dose of proteins) mixed in cholera toxin, followed by intragastric challenge. Anaphylactic reactions, antigen-specific antibodies, splenocytes proliferation assays and cytokine productions were evaluated. Oral buckwheat challenges of sensitized mice provoked anaphylactic reactions such as severe scratch, perioral/periorbital swellings, or decreased activity. Reactions were associated with elevated levels of buckwheat-specific IgE antibodies. Splenocytes from buckwheat allergic mice exhibited significantly greater proliferative responses to buckwheat than non-allergic mice. Buckwheat-stimulated IL-4, IL-5, and INF-γ productions were associated with elevated levels of buckwheat-specific IgE in sensitized mice. In this model, 1 mg and 5 mg dose of sensitization produced almost the same degree of Th2-directed immune response, however, a 25 mg dose showed blunted antibody responses. In conclusion, we developed IgE-mediated buckwheat allergy by intragastric sensitization and challenge, and this model could provide a good tool for future studies.

The role of interleukin-17 in mouse models of atopic dermatitis and contact dermatitis.

Atopic dermatitis (AD) and contact dermatitis (CD) are both T cell‐mediated eczematous disorders. Interleukin (IL)‐17, expressed by T helper (Th)17 cells, is involved in recruitment of inflammatory cells into AD and CD skin.

Overview and challenges of current genetic research on allergic diseases in Korean children

알레르기질환이 유전적 요인을 가진다는 것은 1916년 Cooke와 Vander Veer에 의해 처음 보고되었으며 1989년 Cookson 등이 염 색체 11q13과 아토피의 연관성을 보고한 후로 알레르기질환에 대 한 유전학적 연구가 활발히 이루어지기 시작했다. 하나의 유전자 변화로 질병의 거의 모든 기전을 설명할 수 있는 낭성섬유증 등의 단일 유전인자질환과 달리 천식이나 알레르기질환은 다양한 유전 자들이 관여된다. 결국 천식과 아토피질환은 개개인에게 다양한 정도의 영향을 미치는 수많은 기여 유전자들을 가지는 복합유전질 환(complex genetic disorder)으로 인식되고 있다. 이 유전자들이 각각 조화를 이루고 환경적인 자극과 상호작용을 이루어 임상적인 질환을 나타내게 된다. 일반적인 질병에 비해 병인과 관련된 상당 한 지식이 축적되었음에도 불구하고 알레르기질환의 발병을 촉발 시키는 세포 수준의 특이 생화학적 결함이나 환경 노출은 명확하 게 밝혀져 있지 않다. 최근 국내에서도 국가의 지원하에 한국인 알 레르기 환자를 대상으로 다양한 유전체 연구가 진행되고 있으며 특히 소아 알레르기질환을 대상으로 한 유전 연구도 많은 발전이 있어 왔다. 따라서 국내 소아에 대한 유전학 연구는 알레르기질환 의 병인기전에서 한국인에 특화된 새로운 요인을 규명하여 보다 근 본적인 기전과 효과적인 치료기회를 제공해줄 수 있을 것으로 기대 된다.

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.

Increased sputum levels of thymus and activation-regulated chemokine in children with asthma not eosinophilic bronchitis☆

BACKGROUND Thymus and activation-regulated chemokine (TARC), a member of the CC chemokine family, plays a crucial role in Th2-specific inflammation. We aimed to determine the concentration of sputum TARC in children with asthma and eosinophilic bronchitis (EB) and its relation with eosinophilic inflammation, pulmonary function, and bronchial hyper-responsiveness. METHODS In total, 90 children with asthma, 38 with EB, and 45 control subjects were enrolled. TARC levels were measured in sputum supernatants using an ELISA. We performed pulmonary function tests and measured exhaled fractional nitric oxide, eosinophil counts in blood, and sputum and serum levels of total IgE in all children. RESULTS Sputum TARC levels were significantly higher in children with asthma than in either children with EB (p=0.004) or the control subjects (p=0.014). Among patients with asthma, sputum TARC concentration was higher in children with sputum eosinophilia than in those without sputum eosinophilia (p=0.035). Sputum TARC levels positively correlated with eosinophil counts in sputum, serum total IgE levels, exhaled fractional nitric, and the bronchodilator response. Negative significant correlations were found between sputum TARC and FEV1/FVC (the ratio of forced expiratory volume in one second and forced expiratory vital capacity) or PC20 (the provocative concentration of methacholine causing a 20% decrease in the FEV1). CONCLUSION Elevated TARC levels in sputum were detected in children with asthma but not in children with EB. Sputum TARC could be a supportive marker for discrimination of asthma from EB in children showing characteristics of eosinophilic airway inflammation.

Rhinitis, sinusitis and ocular disease – 2087. Usefulness of impulse oscilometry and fractional exhaled nitric oxide in children with eosinophilic bronchitis

Background Eosinophilic bronchitis (EB) is a common cause of chronic cough. Although EB shares many immunopathologic features with asthma, it does not show airway hyperresponsiveness or reversible airway obstruction by spirometry. Compared to healthy children without pulmonary disease, we hypothesized that EB patients would demonstrate abnormal pulmonary function and inflammation with impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO), which are more sensitive tests of these parameters than spirometry.

Effect of staphylococcal enterotoxin B on specific antibody production in children with atopic dermatitis

Exotoxins secreted by Staphylococcus aureus have been identified as a possible trigger factor in atopic dermatitis (AD). We investigated the production and role of circulating antibodies, with specificity to staphylococcal enterotoxin B (SEB), in children with AD compared with those of healthy controls. The children with AD had significantly higher levels of serum SEB-specific immunoglobulin G (IgG; p = 0.0193), IgM (p = 0.011), and IgE (p = 0.0001) than the nonatopic children. The proportions of IgG, IgM, and IgE seropositivity in children with AD were 52.5% (21/40), 62.5% (25/40), and 67.5% (27/40), respectively. The levels of SEB-specific IgE and the severity of AD (p = 0.0004) were compared, but no correlation was seen for IgG or IgM. SEB may be involved in exacerbation of AD. SEB-specific IgE may be an important index of the clinical severity of AD. The SEB-specific IgG or IgM was produced during the exposure to the SEB antigen but may not be protective against SEB in AD.