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Beta2-adrenoceptor Polymorphisms between Asthmatic and Normal Children in Korea.

Soo Jong HONG ; Bong Seong KIM ; Ja Hung KIM ; Heung Bum OH ; Moo Song LEE ; Soo Ok CHOI ; Mi Young KIM ; Sun Young OH ; Yang PARK ; Young Yull KOH

Pediatric Allergy and Respiratory Disease.2002;12(4):253-262.

BACKGROUND: The role of beta2-agonist is still important to control bronchoconstriction in asthma. Polymorphisms at aminoacid positions 16 and 27 of the beta2-adrenoceptor gene are associated with asthma phenotype. Glu 27 allele is associated with negatively with bronchial hyperresponsiveness(BHR) in asthmatic subjects and Gln 27 allele is associated positively with IgE levels, and Gly16 Gln27 haplotype is suggested to be positively associated with BHR in a population study. And Gly16 Gln27 haplotypes are positively associated with nocturnal cough in atopic subjects. To evaluate the association between beta2-adrenoceptor polymorphisms as asthmatic phenotypes, the frequency of beta2-adrenoceptor polymorphsisms at 2 sites(Arg16->Gly 16 and Gln 27 -> Glu 27) were examined in asthmatic and normal children. METHODS: Ninty nine asthmatic children and seventy three normal children were enrolled. Asthma phenotypes were determined by physician and bronchial responsiveness and genotypes of beta2-adrenoceptor polymorphisms were determined with PCR based methods. RESULTS: The polymorphisms at aminoacid 16 and 27 of beta2-adrenoceptor gene was not different between asthmatic and normal children. The haplotype frequency of aminoacid 16 and 27 polymorphisms of beta2-adrenoceptor gene was not different between asthmatic and normal children. Haplotypes of aminoacid 16 and 27 was not associated with total eosinophil count, eosinophil %, and total IgE in asthmatic children. Haplotypes of aminoacid 16 and 27 was not associated with PC20, and response of FEV1 after beta2-agonist in asthmatic children. CONCLUSION: beta2-adrenoceptor polymorphisms is not associated with the expression of asthma, atopy, bronchial hyperresponsiveness, and response to beta2-agonist in Korean children.
Alleles ; Asthma ; Bronchoconstriction ; Child* ; Cough ; Eosinophils ; Genotype ; Haplotypes ; Humans ; Immunoglobulin E ; Korea* ; Phenotype ; Polymerase Chain Reaction

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Alternative and Complement Therapies for Asthma.

Ha Baik LEE

Pediatric Allergy and Respiratory Disease.2002;12(4):247-252.

No abstract available.
Asthma* ; Complement System Proteins*

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A Case of Milk Allergy with Positive Contact Challenge Test.

Eun A KIM ; Bong Hee SEO ; Myung Hyun SOHN ; Gwang Cheon JANG ; Cheol Hong KIM ; Woo Gyeong KIM ; Kyu Earn KIM ; Ki Young LEE

Pediatric Allergy and Respiratory Disease.2001;11(2):152-156.

Food allergy is a state of immunologic reaction resulting from the exposure to food or food additive. The clinical symptoms and signs varied from localized symptoms at the site of direct contact such as contact urticaria, localized gastrointestinal symptoms with nausea, pain, vomiting and diarrhea to systemic symptoms occurring in remote organs, such as skin, respiratory system, cardiovascular system. We reported a case of 8 month-old girl with milk allergy who presented skin symptoms after cutaneous contact with milk protein. Developed after 15 minutes of milk contact challenge on forearm and followed by erythematous papules and wheals distributed throughout the face and neck area accompanied by edema and itching. The symptoms were continued for 2 hours and disappeared after an injection of pheniramine maleate.
Cardiovascular System ; Diarrhea ; Edema ; Female ; Food Additives ; Food Hypersensitivity ; Forearm ; Humans ; Infant ; Milk Hypersensitivity* ; Milk Proteins ; Milk* ; Nausea ; Neck ; Pheniramine ; Pruritus ; Respiratory System ; Skin ; Urticaria ; Vomiting

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A Case of Persistent Kawasaki Disease Improved with Pulsed Doses of Methylprednisolone.

Kyong Ok AHN ; Shin YOO ; Eun Hye PARK ; Hyun Sang CHO ; Jae Kook CHA ; Hae Ran LEE

Pediatric Allergy and Respiratory Disease.2001;11(2):146-151.

Kawasaki disease is an acute vasculitis of unknown causes that occurs predominantly in infants and young children and produces coronary artery aneurysm. We have recently experienced a case of persistent Kawasaki disease in a 24 month-old-girl improved with pulsed doses of methylprednisolone. Even with an administration of intravenous gamma globulin(IVIG), she repeated the course of recovery and aggravation. After four times repeated doses of IVIG, additional intravenous methylprednisolone pulse therapy was tried and resulted in remarkable improvement. We reported the case with a brief review of the related literature.
Aneurysm ; Child ; Coronary Vessels ; Humans ; Immunoglobulins, Intravenous ; Infant ; Methylprednisolone* ; Mucocutaneous Lymph Node Syndrome* ; Vasculitis

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Factors Associated with Retreatment of Intravenous Gamma-Glubulin in Kawasaki Disease.

Chae Hyeok LEE ; Young Jun KIM ; Woo Sung PARK ; Myeong Ik LEE ; Jun Eun PARK

Pediatric Allergy and Respiratory Disease.2001;11(2):138-145.

PURPOSE: In most patients of Kawasaki disease(KD), fever subsides within 48 hours after infusion of intravenous immunoglobulin(IVIG), but in some cases, retreatment of IVIG is needed because of prolonged fever. This study was performed to findout the factors associated with the retreatment of IVIG in KD. METHODS: Patients with KD, treated with IVIG were classified into two groups : single IVIG treatment group(defeverescence within 48 hours after starting IVIG : group B) and IVIG retreatment group(retreatment with IVIG for fever over 48 hours despite the 1st infusion of IVIG; group A). We compared the clinical symptoms, laboratory findings, clinical signs and echocardiogram findings between group A and B. RESULTS: The mean CRP level of group A was higher than that of group B(P= 0.001), and the mean cholesterol level of group A was lower than that of group B(P=0.002). In CRP level is above 10 mg/dL, odds ratio for retreatment of IVIG is higher than that of level below 10 mg/dL. As cholesterol level decreased, the odds ratio for retreatment with IVIG increased. CONCLUSION: When readministration of IVIG in KD patients for prolonged fever over 48 hours, the consideration of the initial levels of relatively low serum cholesterol and high CRP is recommended.
Cholesterol ; Fever ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome* ; Odds Ratio ; Retreatment*

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Changes of Serum Interleukin-18 Levels in Kawasaki Disease.

Gwang Cheon JANG ; Seung Yeon LEE ; Dong Soo KIM

Pediatric Allergy and Respiratory Disease.2001;11(2):130-137.

PURPOSE: Interleukin 18(IL-18) is a potent proinflammatory cytokine which induces IFN-gamma, GM-CSF, TNF-alpha and IL-1, to activate killing by lymphocytes, and to up-regulate the expression of certain chemokine receptors. Kawasaki disease (KD) is an inflammatory disease which increases serum levels of inflammatory cytokines, such as TNF-alpha and IL-6. This study was performed to examine the serum levels of proinflammatory cytokine IL-18 in KD. METHODS: Twenty patients with KD and 10 healthy children were enrolled in this study. Serum levels of IL-18 and TNF-alpha from the patients with acute and subacute stage of KD and normal controls were measured by using ELISA. Acute phase reactants such as ESR and C-reactive protein were measured during the acute stage of the disease. RESULTS: There was a significant increase in serum levels of IL-18 measured at the acute stage of KD(818.0+/-253.4 pg/mL) compared with those of subacute stage (367.7+/-140.1 pg/mL) (P<0.01) and normal controls(348.6+/-122.9 pg/mL)(P<0.01). However, the increase of IL-18 was not correlated with the increase of TNF-alpha(R=-0.156, P=0.488) or other acute phase reactants. CONCLUSION: The results showed that IL-18 was increased during the acute stage of KD, but the increase of IL-18 was not directly correlated with TNF-alpha. This results suggest that Il-18 is not a useful marker to estimate the severity of inflammation in KD.
Acute-Phase Proteins ; C-Reactive Protein ; Child ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Granulocyte-Macrophage Colony-Stimulating Factor ; Homicide ; Humans ; Inflammation ; Interleukin-1 ; Interleukin-18* ; Interleukin-6 ; Interleukins ; Lymphocytes ; Mucocutaneous Lymph Node Syndrome* ; Receptors, Chemokine ; Tumor Necrosis Factor-alpha

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Specific Antibodies to Staphylococcal Enterotoxin B in Children with Atopic Dermatitis.

Myung Hyun SOHN ; Cheol Hong KIM ; Woo Kyung KIM ; Gwang Cheon JANG ; Kyung Eun LEE ; Kyu Earn KIM ; Ki Young LEE

Pediatric Allergy and Respiratory Disease.2001;11(2):122-129.

PURPOSE: Exotoxin secreted by Staphylococcus aureus has been identified as a possible trigger factor in atopic dermatitis(AD). We investigated the production and the role of circulating antibodies with specificity to staphylococcal enterotoxin B(SEB) in children with AD, and compared with those of healthy controls. METHODS: Forty children with AD and 40 nonatopic healthy children were studied. The severity was determined by the criteria of Rajka. The serum levels of specific antibodies(IgG, IgM, IgE) against SEB were determined by ELISA. The levels and positive rates were compared between the two groups. The correlation between the levels of specific antibodies and the severity of AD or their ages was studied. RESULTS: The children with AD had significantly higher levels of serum SEB specific IgG(P=0.0193), IgM(P=0.011) and IgE(P=0.0001) than the nonatopic children. The proportions of children with AD showing positive to IgG, IgM and IgE were 52.5%(21/40), 62.5%(25/40) and 67.5%(27/40), respectively. The levels of SEB-specific IgE were correlated with the severity of AD(P=0.0004), but no such correlation was seen with IgG or IgM. CONCLUSION: SEB may be involved in exacerbation of AD. The SEB-specific IgE may be an important index of the clinical severity of AD. The SEB-specific IgG or IgM may be produced during the exposure to the SEB antigen, but may not be protective against SEB in AD.
Antibodies* ; Child* ; Dermatitis, Atopic* ; Enterotoxins* ; Enzyme-Linked Immunosorbent Assay ; Exotoxins ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Sensitivity and Specificity ; Staphylococcus aureus

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A Study on Dermatophagoides pteronyssinus Induced Cytokines Gene Expression in Peripheral Blood Mononuclear Cells.

Kyong Og KO ; Dul Le MIN ; Jung Kyu PARK ; Young Hun CHUNG

Pediatric Allergy and Respiratory Disease.2001;11(2):109-121.

PURPOSE: Cytokines are known to play a major role in mediating many of the immunological and pathological findings of allergic disease. Many studies on allergen-specific T cell clones isolated from atopic individuals have shown that these cells produce cytokines of the Th2 phenotype. The purpose of the present study was to investigate cytokine patterns of T lymphocyte induced by Dermatophagoides pteronyssinus in atopic asthma. METHODS: Freshly isolated peripheral blood mononuclear cells of Dp(+) asthmatic children, Dp(-) asthmatic children, nonasthmatic children, and normal adults were stimulated with Dp antigen and examined for the induction of IFN-gamma, IL-2, IL-4, and IL-5 mRNA using RT-PCR. RESULTS: The lymphoproliferative response to crude Dp antigen was maximized at Dp concentration of 2.5 microgram/mL. The lymphoproliferative response was low in children including Dp(+) asthmatics, Dp(-) asthmatics and nonasthmatics, but that of normal adults was high. The expression of IFN-gamma was not so different in each group, but the expression of IL-4 was least in adults, and that of IL-5 was most prominent in Dp(+) asthmatic children. In adult healthy group, IFN-gamma expression without IL-4 and IFN-gamma without IL-5 was significantly higher than those in children. IL-5 expression with or without IFN-gamma was the highest in Dp(+) asthmatic children. IL-4 and IL-5 or IL-5 without IL-4 expression were observed more frequently in Dp(+) asthmatic children than in any other groups. Th2 response was most prominent in Dp(+) asthmatics, and Th1 response was most prominent in normal adult group. CONCLUSION: In conclusion, we observed significantly prominent Th2 response in Dp(+) asthmatic children, especially that of IL-5.
Adult ; Asthma ; Child ; Clone Cells ; Cytokines* ; Dermatophagoides pteronyssinus* ; Gene Expression* ; Humans ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Lymphocytes ; Negotiating ; Phenotype ; Pyroglyphidae* ; RNA, Messenger

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Appraisal of Histamine Concentration on Skin Reactivity in Infancy.

Young Hun CHUNG ; Hoon Young LEE

Pediatric Allergy and Respiratory Disease.2001;11(2):102-108.

PURPOSE: It is well known that the histamine test is essential for positive control in the evaluation of allergy skin test. Estimation of the allergen wheal size without histamine control may be affected by child growth and observer's subjective factos. The skin test reactivity to histamine in infancy is weak and difficult to be used as be positived control. This study is to define the status of skin test reactivity to histamine, and any difference of reactivity between various concentrations of histamine in infancy. METHODS: The 241 babies including normal infants and prematurity in pediatric department of Chungnam National University Hospital from January 2001 to May 2001 were selected and divided into 5 groups by age. Three different Concentrations of histamine of 1, 5, and 10 mg/mL were injected on left forearm by prick procedure respectively. The differences of wheal size by age groups and concentrations of histamine were analyzed. RESULTS: No reaction was predominant in prematurity, weak reaction in birth to 6 months of age, and strong reaction in above 6 months of age. In the skin test reactivity by histamine concentrations, there was no difference of no reaction histamine concentrion of 1 and 5 mg.mL. But rate of no reaction to histamin was significantly lower in the concentration of 10 mg/mL. There was no difference for the rate of week reaction to histamine by histamine concentration. There were significant differences between concentrations of histamine, especially more in 10 mg/mL concentration for strong reaction. CONCLUSION: The skin test reactivity to standard histamine were weak in entire period of infancy, especially in under 6 months of age including prematurity. However, the reactivity to 10 mg/mL conc. of histamine were increased in all infants and different definitely in degree. It was suggested that 10 mg/mL of histamine concentration was more useful for positive control than standard histamine in infancy.
Child ; Chungcheongnam-do ; Forearm ; Histamine* ; Humans ; Hypersensitivity ; Infant ; Parturition ; Skin Tests ; Skin*

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Prediction of Airway Hyperresponsiveness by Asthma Questionaire in Compare with Methacholine Challenge Test.

Wan CHO ; Man Yong HAN

Pediatric Allergy and Respiratory Disease.2001;11(2):93-101.

PURPOSE: It is well-known that the bronchial challenge test is very important to evaluate the bronchial hyperresponsiveness in asthma. This study was done to find the items of clinical symptoms and signs as a predictors for bronchial hyperresponsiveness in compare with methacholine challenge test. METHODS: The methacholine challenge test and allergy questionnaire(total 90 items) were done for 76 children with suspected asthma aged 4 to 11 years old who visited children's allergy clinic from the February to the June in 1999. Methacholine was used in increasing doses from 0.125 mg/mL to 16 mg/mL to a greater-than-20%(PC20) drop in FEV1 was obtained, or to the maximum concentration of 16 mg/mL was reached. The subjects were requested to inhale each preparation for 2 minutes. The bronchial hyperreactivity was considered severe if a PC20 was reached at a concentration of 0.125 mg/mL, moderate if the PC20 was reached at between 0.25 and 0.5 mg/mL(group C), mild if the PC20 was obtained with concentrations between 2 and 8 mg/mL(group B), and negative if the PC20 was obtained with concentrations 16 mg/mL or not obtained with any of the concentrations used(group A). We compared bronchial hyperreactivity with items of the questionnaire. RESULTS: 1) Fifteen children are normal(group A), thirty-nine are mild(group B), nineteen are moderate(group C), and three are severe(group C) among 76 children. 2) Symptom score and bronchial hyperreactivity showed statistical significant correlation. 3) Items which had statistical significance(P<0.05) between the methacholine challenge test and the questionnaire are dyspneic asthma attack, more than twice of asthma attck, asthma history diagnosed by doctor, wheezing regardless of common cold, and wheezing episode for last three months. 4) Family history, residential environment, duration of cough and other allergic disease history didn't have any relation. CONCLUSION Some items of asthma questionaire had a close relationship with the severity of bronchial hyperresponsiveness by methacholine challenge test for the children with suspected asthma. We hope that those items of asthma qyestionaire be helpful to predict the airway hyperresponsiveness for childhood asthma.
Asthma* ; Bronchial Hyperreactivity ; Bronchial Provocation Tests ; Child ; Common Cold ; Cough ; Hope ; Humans ; Hypersensitivity ; Methacholine Chloride* ; Surveys and Questionnaires ; Respiratory Sounds

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