2.Exosomes from Human Embryonic Stem Cell-Derived Mesenchymal Stem Cells Protect Lung Epithelium and Attenuate Fibrosis
Sangryul CHA ; Jooyeon LEE ; Jimin JANG ; Yeongcheol KIM ; Dahee HAN ; Seok-Ho HONG ; Seung-Jin KIM ; Dae-Hee LEE ; Chung Hyeun MA ; Han Pil LEE ; Se-Ran YANG
International Journal of Stem Cells 2026;19(1):66-82
Idiopathic pulmonary fibrosis (IPF) is characterized by maladaptive epithelial–mesenchymal crosstalk and progressive extracellular matrix accumulation, whereas currently available antifibrotic agents merely decelerate functional decline.This study investigated whether exosomes derived from human mesenchymal stem cells derived from embryonic stem cells (ESC-MSCs) restore epithelial stress responses and attenuate fibrotic remodeling. Human IPF lung transcriptomes were integrated with a bleomycin-induced murine model analyzed by RNA sequencing and protein signaling, together with cigarette smoke extract-induced injury in A549 epithelial cells. ESC-MSCs-derived exosomes exhibited typical morphology and size distribution, enrichment of tetraspanins, and absence of endoplasmic reticulum contamination, consistent with high-purity preparations. Across human IPF and bleomycin-injured lungs, transcriptomic profiling revealed prominent enrichment of extracellular matrix and cytoskeletal gene programs, whereas mitogen-activated protein kinase (MAPK) and Smad families displayed only modest alterations at the mRNA level. In vivo administration of exosomes during the fibrotic remodeling phase, via either intravenous or intratracheal delivery, resulted in improved body weight, reduced lung weight-to-body weight ratios, and decreased collagen deposition and Ashcroft scores. These structural and functional improvements were accompanied by suppression of profibrotic and mesenchymal markers and selective attenuation of activator protein-1 (AP-1) activity. In epithelial injury models, ESC-MSCs-derived exosomes enhanced cell viability, restored redox homeostasis, and constrained stress-induced mesenchymal gene expression and MAPK phosphorylation in both co-treatment and post-treatment settings. Collectively, these data support an epithelial-centered mechanism in which ESC-MSCs-derived exosomes re-establish oxidative balance and selectively restrict AP-1-driven stress signaling, thereby secondarily limiting extracellular matrix accumulation and fibrotic remodeling.
3.Efficacy and Safety of Dupilumab for Chronic Rhinosinusitis With Nasal Polyps: A Retrospective Study of Every Month Injection
Pooreum KANG ; Donggyu CHOI ; Jaehwan KWON ; Jooyeon KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2025;68(4):159-167
Background and Objectives:
Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable.
Results:
A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant.
Conclusion
Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.
4.Efficacy and Safety of Dupilumab for Chronic Rhinosinusitis With Nasal Polyps: A Retrospective Study of Every Month Injection
Pooreum KANG ; Donggyu CHOI ; Jaehwan KWON ; Jooyeon KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2025;68(4):159-167
Background and Objectives:
Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable.
Results:
A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant.
Conclusion
Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.
5.Efficacy and Safety of Dupilumab for Chronic Rhinosinusitis With Nasal Polyps: A Retrospective Study of Every Month Injection
Pooreum KANG ; Donggyu CHOI ; Jaehwan KWON ; Jooyeon KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2025;68(4):159-167
Background and Objectives:
Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable.
Results:
A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant.
Conclusion
Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.
6.Efficacy and Safety of Dupilumab for Chronic Rhinosinusitis With Nasal Polyps: A Retrospective Study of Every Month Injection
Pooreum KANG ; Donggyu CHOI ; Jaehwan KWON ; Jooyeon KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2025;68(4):159-167
Background and Objectives:
Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable.
Results:
A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant.
Conclusion
Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.
7.Efficacy and Safety of Dupilumab for Chronic Rhinosinusitis With Nasal Polyps: A Retrospective Study of Every Month Injection
Pooreum KANG ; Donggyu CHOI ; Jaehwan KWON ; Jooyeon KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2025;68(4):159-167
Background and Objectives:
Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable.
Results:
A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant.
Conclusion
Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.
8.A Statistical Analysis of Forensic Autopsies Performed in the Jungbu Province of Korea in 2022
JeongHwan KIM ; Donghyun KIM ; Minjung KIM ; Min Jee PARK ; Yujin WON ; Nak-won LEE ; Soo Kyung LEE ; Jooyeon LEE ; Hyelim YI ; Inseok CHOI ; Ji Hye PARK
Korean Journal of Legal Medicine 2024;48(4):153-164
We analyzed the manner and cause of death in 1,193 forensic autopsies from the Jungbu province (central part of South Korea) conducted by the National Forensic Service Daejeon Institute in 2022. Analysis of the manner of deaths revealed that 43.1% (514/1,193 cases) were natural deaths; 42.8% (511/1,193 cases) were unnatural deaths; and 14.1% (168/1,193 cases) were unknown. Among the unnatural deaths, the major manner of death was 44.6% (228/511 cases) by accidents, 34.1% (174/511 cases) by suicide, 13.5% (69/511 cases) undetermined, and 7.8% (40/511 cases) by homicide. Among the unnatural deaths, the major causes of death was 38.4% (196/511 cases) by trauma, 20.4% (104/511 cases) by poisoning, and 17.6% (90/511 cases) by asphyxia. Falling was the major cause of death by trauma (58.7%, 115/196 cases), and strangulation was the major cause of death by asphyxia (75.6%, 68/90 cases). Among the natural deaths, heart disease was the major cause (46.7%, 240/514 cases), followed by endocrine, nutritional and metabolic diseases (14.0%, 72/514 cases). A time-series statistical analysis and comparison of the manner and cause of deaths in this province may facilitate more advanced interpretations relating to both public safety and healthcare in the future.
9.Changes in Sensitization Rate to Inhalation Allergy in Busan Area Over Past 40 Years
Jooyeon KIM ; Gilsoon CHOI ; Hyunjeong HWANG ; Jae Hwan KWON ; Joong Hwan CHO
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(4):214-221
Background and Objectives:
This study analyzed skin prick tests conducted on respiratory allergy patients in the Busan area for a 40-year period and estimated future changes in inhaled allergens.Subjects and Method This study conducted a retrospective analysis of patients who underwent skin prick tests for respiratory allergies at two hospitals. We analyzed 5942 test results out of the total tests of 6174 recorded from 1982 to 2021.
Results:
For over 40 years, the main inhalant allergens in the Busan area, including house dust mites (HDM), pollen, have been found to be similar to those in other regions. The sensitization rate of HDM was very high, around 50%-60%, in the early 1990s and the early 2010s, and it showed a gradual increase over time. The sensitization rate of pollen were high at 10- year cycles. The sensitization rate of tree pollens showed a decreasing trend after reaching its peak in the late 1980s, but has been steadily increasing since the 2010s, with a sharp rise (over 25%) observed in 2019-2020. The sensitivity to weed and grass pollens was relatively high in the late 1990s and late 2000s, and exhibited a declining trend since. Among the animal allergens, the sensitization rate of cat allergen was the highest (45%).
Conclusion
We identified high rates of sensitization to house dust mites and tree pollens, and age-related changes over time. With the increasing prevalence of pet ownership, further research is necessary to monitor sensitization changes. Additionally, due to climate change, continuous monitoring of allergen sensitization rates to pollens and molds is called for.
10.Adverse Events of Dupilumab Injection in Patients With Chronic Rhinosinusitis With Nasal Polyposis
Pooreum KANG ; Donggyu CHOI ; Jaehwan KWON ; Changhoi KIM ; Jooyeon KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(7):388-393
Background and Objectives:
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is one phenotype of the diffuse type. In spite of surgical and medical treatment, the polyp recurrence rate is high. Recently biologics are concerned as a therapeutic option of it. To figure out adverse events associated with the dupilumab injection in adult patients with CRSwNP.Subjects and Method Retrospective chart review of patients that were treated with dupilumab from January 2022 to December 2022 for CRSwNP was performed.
Results:
Of 40 patients (23 of male and 17 of female), 8 patients (20.0%) experienced 9 patients (22.5%) adverse events. The most common adverse event was skin reaction (3 patients, 7.5%), followed by 2 of pruritis, 2 of epistaxis. Three patients quit dupilumab after the adverse events, 4 patients continued, and 1 patient hold the next injection.
Conclusion
Dupilumab is reported to be relatively safe medication. However, physician should notice that adverse events including skin rash can occur after dupilumab injection.

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