1.Eosionophils in Induced Sputum and Peak Experatory Flow Rate Variability in Children with Allergic Rhinitis.
Kyoung Ae PARK ; Sung Eun KIM ; Sung Suk DO ; Seung Hee JUNG ; Do Young SONG ; Im Ju KANG
Pediatric Allergy and Respiratory Disease 2000;10(2):131-140
PURPOSE: A large number of studies have demonstrated that rhinitis and asthma commonly occur together, and that a temporary relationship between the onset of rhinitis and asthma with rhinitis frequently preceding the development of asthma. We studied to know whether there were asthmatic airway inflammations in subjects with allergic rhinitis with bronchial hyperresponsiveness to methacholine who had no asthma symptoms. METHODS: Thirty seven children with an allergic rhinitis who visited the pediatric allergy clinic from January 1998 through June 1999 were enrolled. They were grouped into two groups according to the degree of airway responsiveness to methacholine, and 19 bronchial asthma patients with had no asthma attacks for 2 months were compared as control group.; AR-Mch (+) group (n=19) had a PC20-Methacholine lower than 10 mg/mL: AR-Mch (-) group (n=18) had a PC20-Metacholine greater than 10 mg/mL. The relationship of PEFR variability, sputum eosinophils, and nasal eosinophils with bronchial hyperresponsiveness to methacholine in each groups was compared. RESULTS: 1) The PC20-Methacholine was 5.7+/-3.5 mg/mL in the AR-Mch (+) Group, 1.9+/-2.7 mg/mL in the BA Group. 2) Sputum eosinophil was 14+/-6.9% in the AR-Mch (+) Group, 8.1+/-5.2% in the AR-Mch (-) Group, 29.6+/-16.9% in the BA Group, and sputum eosinophils of the AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 3) PEFR dinural variation was 7.0+/-2.6% in the AR-Mch (+) Group, 5.0+/-2.9% in the AR-Mch (-) Group, 14.0+/-6.0% in the BA Group, and PEFR dinural variation in AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 4) The PC20-Methacholine was not correlated with PEFR dinural variation in both the AR-Mch (+) Group and the BA Group. 5) The PC20-Methacholine was correlated with sputum eosinophils only in the BA Group. 6) Nasal eosinophils were not correlated with sputum eosinophils in the AR-Mch (+) and the BA Group. CONCLUSIONS: This study demonstrated that patients with allergic rhinitis who had bronchial hyperresponsiveness to methacholine might have eosinophilic inflammation in the lower airway and increased dinural PEFR. Further studies are necessary to evaluate whether asthma symptoms will be developed in these allergic rhinitis children.
Asthma
;
Child*
;
Eosinophils
;
Humans
;
Hypersensitivity
;
Inflammation
;
Methacholine Chloride
;
Peak Expiratory Flow Rate
;
Rhinitis*
;
Sputum*
2.Aerobiological Study for Airborne Pollen and Mold in Pusan.
Ming Jung KIM ; Kyoung Whoon CHEON ; Sung Won KIM
Pediatric Allergy and Respiratory Disease 2000;10(2):119-130
PURPOSE: Airborne pollen and mold spores are common causative agents of allergic disease. Atmospheric pollen and spores in one area of Pusan were collected to investigate species, particle amount, seasonal distribution, and of its association with reactivity to skin prick test in children. METHODS: Rotorod sampler was installed on the rooftop of St. Benedict Hospital in Pusan. 24 hour sampling of airborne allergens over a two year period was conducted 6 days/week from July 1, 1997 to June 30, 1999. Those samples were stained with Calberla's fuchsin and were identified, counted under the light microscope (400xfor pollen, 1000xfor mold). The data were compared with the daily weather report and allergy skin test. RESULTS: Major pollens collected were Pinus, Alnus, Juniperus, Betula, Quercus, Artemisia, Ambrosia, and Chenospodium-Amaranthus. The pollen season is relatively short and the pollen dispersed mainly during the period from March to May in case of tree pollen and from August to October in case of grass pollen. Total pollen count ranged from 0 to 1000 grains/m3/day (May 14, 99). The peak pollen season was seen during Spring and Autumn, especially in March and September. Major mold spores counted were Cladosporium, Leptospheria and Alternaria. Mold spore count ranged from 0 to 2,360 spores/m3/day (Oct. 8, 98). Cladosporium was dispersed year-round, but mainly in the October and November, while Leptospheria was dispersed mainly in the period from July to September and Alternaria counts tended to be higher around July. The concentration of mold is roughly correlated with the amount of rainfall, having high spore count in July and August, especially in case of Leptospheria. In terms of positive reaction to skin prick test in children, Alnus and Artemisia were found to be allergen source in early spring and late summer season, respectively. CONCLUSION: Analysis of pollens and mold spores sampled in the atmosphere of Pusan, Korea, for a 2 year period identified 19 species of pollens and 22 species of mold spores with seasonal variation of some clinically important pollen/mold load. Cladosporium, Leptospheria and Alternaria are found to be three major molds, especially from June to October.
Allergens
;
Alnus
;
Alternaria
;
Ambrosia
;
Artemisia
;
Atmosphere
;
Betula
;
Busan*
;
Child
;
Cladosporium
;
Colony Count, Microbial
;
Fungi*
;
Humans
;
Hypersensitivity
;
Juniperus
;
Korea
;
Pinus
;
Poaceae
;
Pollen*
;
Quercus
;
Rosaniline Dyes
;
Seasons
;
Skin
;
Skin Tests
;
Spores
;
Weather
3.Anti-Inflammatory Effect of Theophylline in Asthma Management.
Pediatric Allergy and Respiratory Disease 2000;10(2):112-118
No abstract available.
Asthma*
;
Theophylline*
4.Allergic Inflammation.
Pediatric Allergy and Respiratory Disease 2000;10(2):104-111
No abstract available.
Inflammation*
5.Bronchial Hyperresponsiveness.
Pediatric Allergy and Respiratory Disease 2000;10(2):89-103
No abstract available.
7.A Study of the Dietary Intakes and Causative Foods in Allergic Children.
Hong Seok AHN ; Sun Min LEE ; Min Yung LEE ; Ji Tae CHOUNG
Pediatric Allergy and Respiratory Disease 1999;9(1):79-92
PURPOSE: Recently, allergic disorders in children have increased. The cause of allergic disorders made not clear. Therefore study in aspect of food and nutrition was required to prevent allergic disorders in children, show guide of dietary management. METHODS: This study was done in 78 children with allergy from July, 1997 to September, 1997, investigated family history of allergy and general environment with questionnaire, besides growth levels of children with allergic symptoms, nutrient intakes, eating behavior, and allergy-inducing foods. RESULTS: The results of this study are summarized as follows. 1) Allergic symptoms with a age 2-3 years old were asthma (46%), dermatitis (39%), hypersensitivity skin (7%), urticaria (5%) and rhinitis (5%). At age 4-6 years, asthma was 54%, dermatitis 44%, rhinitis 28%, hypersensitivity skin 10%, and urticaria 3%. Most of the dermatits was caused by unknown etiology, temperature change and house dust mite. Asthma was caused by house dust mite and temperature change. Urticaria was caused by foods and rhinitis was caused by house dust mite. 2) Tomato was the most common food as a cause of allergic disease and peach, mackerel, yoghurt, cheese, and egg were included. Urticaria was provoked mainly by tomato and peach, diarrhea was induced by milk, yoghurt and cheese, vomiting by quail eggs, and swelling lip was induced by tomato. 3) The average daily calory intake was 80% of the RDA at the age of 2-3 years old, 66% at the age of 4-6 year old. Protein and fat intake were similar as RDA. The other nutrients intake at the age of 2-3 and 4-6 years old were 106% and 71% for calcuim, 49% and 52% for iron, 30% and 31% for zinc, respectively. The amount of vitamin intake also lower than RDA for both age groups. CONCLUSION: The average calory intake and other nutrients intake for the children with allergic symptoms were lower than RDA. But they showed relatively normal growth pattern compared with the Korean growth standard. It is necessary to findout the food that provoke the allergic symptoms and make guideline for diet therapy for the children with a various allergic symptoms.
Asthma
;
Cheese
;
Child*
;
Dermatitis
;
Diarrhea
;
Diet Therapy
;
Eggs
;
Feeding Behavior
;
Humans
;
Hypersensitivity
;
Iron
;
Lip
;
Lycopersicon esculentum
;
Milk
;
Ovum
;
Perciformes
;
Prunus persica
;
Pyroglyphidae
;
Quail
;
Surveys and Questionnaires
;
Rhinitis
;
Skin
;
Urticaria
;
Vitamins
;
Vomiting
;
Yogurt
;
Zinc
8.A Study on Provocation Test by Cat Contacts.
Chang Woo LEE ; Jeong Woo RYU ; Hye Yung YUM ; Byeung Ju JEOUNG ; Kyu Earn KIM ; Ki Young LEE
Pediatric Allergy and Respiratory Disease 1999;9(1):65-71
PURPOSE: Cat is the pet which many of us quite frequently contact without any specific precautions. According to the allergy skin tests conducted in children, cat antigen shows a comparatively high positive reaction, and past history also shows that there are many patients who suffer allergies from cat contacts. Therefore, once it is diagnosed as an allergy caused by cat, it is important that patients be isolated in order to restrict their contact with cat. In this context, this study was conducted for the purpose of finding out how serious and how frequent the allergies by cat contacts are. METHODS: Forty five children patients who visited to the Allergy Clinic for Children, Severance Hospital annexed to the Medical College, Yonsei University were enrolled in this study. Some of patients had shown a positive reaction against cat antigen in the allergy skin test, and others had a past history of developing symtoms when contacted by cat. The patients were isolated from cat for seven days, and then contacted with cats for 30 minutes and observed the provocated symptoms. RESULTS: 1) Among the tested patients, the number of cases who were provocated by the symptoms after cat contact were 18 (40%). 2) Among those patients who were shown to be positive only in allergy skin test, only 24.2% proved to be provocated by the symptoms, while 90.0% of those who had a past history in addition to allergy skin test proved to be provocated by the symptoms. 3) Symptoms provocated after cat contact showed allergic rhinitis patients 88.2% which was the highest ratio, bronchical asthma, 35.3%, urticaria, 29.4%, and allergic conjunctivitis, 23.5%, respectively. 4) The onset and duration of symptoms provcated were under 10 minutes and from 30 to 60 minutes, which included most cases in the test. 5) Total IgE and eosinophil count of patients did not show any meaningful differences between the group which was provocated and that which was not provocated. CONCLUSION: It was shown that 40% patients who were suspected of cat allergy had a positive reaction to the cat contact provocation test. Ninety percents of patients who showed both positive allergy skin test and past history were provocated after cat contact.
Animals
;
Asthma
;
Cats*
;
Child
;
Conjunctivitis, Allergic
;
Eosinophils
;
Humans
;
Hypersensitivity
;
Immunoglobulin E
;
Rhinitis
;
Skin Tests
;
Urticaria
9.Effect of Bronchodilator and Corticosteroid Inhalation Therapy in Cough Variant Childhood Asthma.
Bok Yang PYUN ; Sung Hwan BAN ; Sang Hyun KIM
Pediatric Allergy and Respiratory Disease 1999;9(1):56-64
PURPOSE: Cough variant asthma may be defined as a presentation of asthma that fulfills all the criteria of asthma, inflammatory process of the airways and airway hyperresponsiveness. Because of the cough is only the manifestation in cough variant asthma especially in children, it may be very difficult to assess by the physical examination and routine spirometry. Airway function may be further evaluated by bronchial provocation, usually with methacholine or exercise, to supprot or exclude the diagnosis of asthma. In children too young to perform pulmonary function tests, a therapeutic trial can serve as a diagnostic tool. In this study we evaluate the effectiveness of inhaled bronchodilator and corticosteroid treatment to the children with cough variant asthma. METHODS: Forth-eight children who visited to our pediatric allergy clinic having a chronic cough more than 3 weeks were enrolled to our study. We defined a children who showed bronchial hyperresponsiveness after exercise challenge as a cough variant asthma. We analyzed the changes of PEFR before and after exercise and treatment for 4 weeks. RESULTS: 1) All the patients with cough variant asthma or sinobronchitis have a night aggravating cough as a sole manifestation. 2) The baseline % predicted PEFR showed within normal range in the study subjects. But there was significant decrease of % perdicted PEFR after execise challenge in the patients with cough variant asthma. 3) There was significant increase of % predicted PEFR after treatment with inhaled bronchodilator and corticosteroid in the patients with cough vatiant asthma. Also it is noted in the patients with sinobronchitis treated with antibiotics. CONCLUSION: We can find significant improvement of clinical manifestation and pulmonary function in the patients with cough variant asthma who treated with inhaled bronchodilator and corticosteoid. Because of many children suffering from chronic cough may have a cough variant asthma, we emphasized that inhaled bron-chodilator and corticosteroid treatment is effective for long-term control of cough variant asthma.
Anti-Bacterial Agents
;
Asthma*
;
Child
;
Cough*
;
Diagnosis
;
Humans
;
Hypersensitivity
;
Inhalation*
;
Methacholine Chloride
;
Peak Expiratory Flow Rate
;
Physical Examination
;
Reference Values
;
Respiratory Function Tests
;
Respiratory Therapy*
;
Spirometry
10.The Effect of Allergen-Specific Immunotherapy on IL-10 and IL-13 mRNA Expression in Peripheral Blood Mononuclear Cells from Patients with Atopic Asthma.
Soo Jung LEE ; Joon Sung LEE ; Kyong Su LEE
Pediatric Allergy and Respiratory Disease 1999;9(1):41-55
PURPOSE: Allergen-specific immunotherapy (IT) has been shown to be effective in the treatment for allergic diseases. But the immunologic mechanism of IT effect has not been fully elucidated. We studied house dust mite (HDM)-specific cytokine mRNA expression in peripheral blood mononuclear cells (PBMC) from patient with HDM- sensitive asthma and determined whether alterations in cytokine mRNA expression correlated with the clinical outcome of IT. METHODS: PBMC were obtained from 64 children with mite-sensitive asthma : 25 had never received HDM-IT (NIT), 39 had been receiving HDM-IT for more than 12 months. The 39 patients were divided into two groups according to the clinical response based on the asthma scores (symptom and medication scores) before and after IT. Good responders were those patients who showed an improvement greater than 50%, whereas poor responders were those who showed an improvement less than 50%. After a 18 hr culture with HDM, cytokine mRNA expression was analysed by RT-PCR and densitometry. RESULTS: 1) IL-10 mRNA expression in NIT was significantly lower than that in the normal controls and was significantly increased by IT. IL-10 mRNA expression in the good responders was significantly higher than that in the poor responders and NIT. 2) Little or no IL-13 mRNA were detected in the good responders and the normal controls. IL-13 mRNA expression in the good responders was significantly lower than that in the poor responders and NIT. 3) IFN-gamma mRNA expression in NIT was significantly lower than that in the normal controls and was significantly increased with IT. IFN-gamma mRNA expression in the good responders was significantly higher than that in the poor responders and NIT. 4) Little IL-4 mRNA were detected in the good responders and the normal controls. IL-4 mRNA expression in the good responders was significantly lower than that in the poor responders and NIT. CONCLUSION: These results show that IT not only induces a shift in cytokine expression from TH2 (IL-4 and IL-13) to TH1 cytokines (IFN-gamma), but also leads to induction of the antiinflammatory cytokine IL-10. These changes in cytokine expression may be responsible for clinical effects by immunotherapy.
Asthma*
;
Child
;
Cytokines
;
Densitometry
;
Humans
;
Immunotherapy*
;
Interleukin-10*
;
Interleukin-13*
;
Interleukin-4
;
Pyroglyphidae
;
RNA, Messenger*