Naturally occurring compounds have widely been applied to treat diverse pharmacological effects, including asthma, allergic diseases, antioxidants, inflammation, antibiotics, and cancer. Recent research has revealed the essential role of the thymic stromal lymphopoietin (TSLP) in regulating inflammatory responses at mucosal barriers and maintaining immune homeostasis. Asthma, inflammation, and chronic obstructive pulmonary disease are allergic disorders in which TSLP plays a significant role. Although TSLP’s role in type 2 immune responses has undergone comprehensive investigation, its involvement in inflammatory diseases and cancer has also been found to be expanding. However, investigating how to block the TSLP pathway using natural products has been limited. This paper summarizes the roles of various medicinal plants and their chemical components that effectively inhibit the TSLP pathway. In addition, we also highlight the contributions of several plant-derived compounds to treat allergic diseases via targeting TSLP. This review intends to offer innovative concepts to scientists investigating the use of naturally produced compounds and extracts for the treatment of allergic illnesses.

Naturally occurring compounds have widely been applied to treat diverse pharmacological effects, including asthma, allergic diseases, antioxidants, inflammation, antibiotics, and cancer. Recent research has revealed the essential role of the thymic stromal lymphopoietin (TSLP) in regulating inflammatory responses at mucosal barriers and maintaining immune homeostasis. Asthma, inflammation, and chronic obstructive pulmonary disease are allergic disorders in which TSLP plays a significant role. Although TSLP’s role in type 2 immune responses has undergone comprehensive investigation, its involvement in inflammatory diseases and cancer has also been found to be expanding. However, investigating how to block the TSLP pathway using natural products has been limited. This paper summarizes the roles of various medicinal plants and their chemical components that effectively inhibit the TSLP pathway. In addition, we also highlight the contributions of several plant-derived compounds to treat allergic diseases via targeting TSLP. This review intends to offer innovative concepts to scientists investigating the use of naturally produced compounds and extracts for the treatment of allergic illnesses.

Naturally occurring compounds have widely been applied to treat diverse pharmacological effects, including asthma, allergic diseases, antioxidants, inflammation, antibiotics, and cancer. Recent research has revealed the essential role of the thymic stromal lymphopoietin (TSLP) in regulating inflammatory responses at mucosal barriers and maintaining immune homeostasis. Asthma, inflammation, and chronic obstructive pulmonary disease are allergic disorders in which TSLP plays a significant role. Although TSLP’s role in type 2 immune responses has undergone comprehensive investigation, its involvement in inflammatory diseases and cancer has also been found to be expanding. However, investigating how to block the TSLP pathway using natural products has been limited. This paper summarizes the roles of various medicinal plants and their chemical components that effectively inhibit the TSLP pathway. In addition, we also highlight the contributions of several plant-derived compounds to treat allergic diseases via targeting TSLP. This review intends to offer innovative concepts to scientists investigating the use of naturally produced compounds and extracts for the treatment of allergic illnesses.

Objective: This was a retrospective investigation conducted to evaluate the impact of the coronavirus disease-2019 (COVID-19) pandemic on the treatment and outcomes of patients with ischemic stroke. Methods: Data were collected over one year for the COVID-19 and pre-COVID-19 (control) groups, from May 1, 2020, to April 30, 2021, when COVID-19 was prevalent in Korea, and from May 1, 2018 to April 30, 2019, before the COVID-19 outbreak, respectively. Adult patients diagnosed with acute cerebral infarction at three emergency medical centers during the study period were included. COVID-19-positive patients (i.e., those with COVID-19 symptoms but those who tested positive) were excluded from this study to ensure only the evaluation of delays in stroke treatment due to the pandemic. Results: During the COVID-19 pandemic, of the total of 82,558 patients who visited the emergency centers, 710 were diagnosed with ischemic stroke. The study observed that the pandemic caused process delays for these patients, resulting in longer wait times for brain CT scans (P=0.010, P<0.001) and emergency room stays (P=0.0055, P<0.001) during the COVID-19 period. However, the length of time for administration of tissue plasminogen activator remained relatively constant. Notably, the 28-day mortality rate was considerably higher for patients with COVID-19-related symptoms during the pandemic (13.6% vs 3.1%; P=0.006). A cumulative risk analysis revealed an increased mortality risk for patients with COVID-19 related symptoms (P=0.005). Conclusion This study showed the need to improve emergency care procedures during pandemics to ensure prompt treatment of ischemic stroke. Preparation and resource allocation for ischemic stroke patients with COVID-19 symptoms are crucial.

Objective: This was a retrospective investigation conducted to evaluate the impact of the coronavirus disease-2019 (COVID-19) pandemic on the treatment and outcomes of patients with ischemic stroke. Methods: Data were collected over one year for the COVID-19 and pre-COVID-19 (control) groups, from May 1, 2020, to April 30, 2021, when COVID-19 was prevalent in Korea, and from May 1, 2018 to April 30, 2019, before the COVID-19 outbreak, respectively. Adult patients diagnosed with acute cerebral infarction at three emergency medical centers during the study period were included. COVID-19-positive patients (i.e., those with COVID-19 symptoms but those who tested positive) were excluded from this study to ensure only the evaluation of delays in stroke treatment due to the pandemic. Results: During the COVID-19 pandemic, of the total of 82,558 patients who visited the emergency centers, 710 were diagnosed with ischemic stroke. The study observed that the pandemic caused process delays for these patients, resulting in longer wait times for brain CT scans (P=0.010, P<0.001) and emergency room stays (P=0.0055, P<0.001) during the COVID-19 period. However, the length of time for administration of tissue plasminogen activator remained relatively constant. Notably, the 28-day mortality rate was considerably higher for patients with COVID-19-related symptoms during the pandemic (13.6% vs 3.1%; P=0.006). A cumulative risk analysis revealed an increased mortality risk for patients with COVID-19 related symptoms (P=0.005). Conclusion This study showed the need to improve emergency care procedures during pandemics to ensure prompt treatment of ischemic stroke. Preparation and resource allocation for ischemic stroke patients with COVID-19 symptoms are crucial.

Objective: This was a retrospective investigation conducted to evaluate the impact of the coronavirus disease-2019 (COVID-19) pandemic on the treatment and outcomes of patients with ischemic stroke. Methods: Data were collected over one year for the COVID-19 and pre-COVID-19 (control) groups, from May 1, 2020, to April 30, 2021, when COVID-19 was prevalent in Korea, and from May 1, 2018 to April 30, 2019, before the COVID-19 outbreak, respectively. Adult patients diagnosed with acute cerebral infarction at three emergency medical centers during the study period were included. COVID-19-positive patients (i.e., those with COVID-19 symptoms but those who tested positive) were excluded from this study to ensure only the evaluation of delays in stroke treatment due to the pandemic. Results: During the COVID-19 pandemic, of the total of 82,558 patients who visited the emergency centers, 710 were diagnosed with ischemic stroke. The study observed that the pandemic caused process delays for these patients, resulting in longer wait times for brain CT scans (P=0.010, P<0.001) and emergency room stays (P=0.0055, P<0.001) during the COVID-19 period. However, the length of time for administration of tissue plasminogen activator remained relatively constant. Notably, the 28-day mortality rate was considerably higher for patients with COVID-19-related symptoms during the pandemic (13.6% vs 3.1%; P=0.006). A cumulative risk analysis revealed an increased mortality risk for patients with COVID-19 related symptoms (P=0.005). Conclusion This study showed the need to improve emergency care procedures during pandemics to ensure prompt treatment of ischemic stroke. Preparation and resource allocation for ischemic stroke patients with COVID-19 symptoms are crucial.

Purpose: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors have greatly improved survival in EGFR-mutant (EGFRm) non–small cell lung cancer (NSCLC); however, their effects on the tumor microenvironment (TME) are unknown. We assessed the changes induced by neoadjuvant erlotinib therapy (NE) in the TME of operable EGFRm NSCLC. Materials and Methods: This was a single-arm phase II trial for neoadjuvant/adjuvant erlotinib therapy in patients with stage II/IIIA EGFRm NSCLC (EGFR exon 19 deletion or L858R mutations). Patients received up to 2 cycles of NE (150 mg/day) for 4 weeks, followed by surgery and adjuvant erlotinib or vinorelbine plus cisplatin therapy depending on observed NE response. TME changes were assessed based on gene expression analysis and mutation profiling. Results: A total of 26 patients were enrolled; the median age was 61, 69% were female, 88% were stage IIIA, and 62% had L858R mutation. Among 25 patients who received NE, the objective response rate was 72% (95% confidence interval [CI], 52.4 to 85.7). The median disease-free and overall survival (OS) were 17.9 (95% CI, 10.5 to 25.4) and 84.7 months (95% CI, 49.7 to 119.8), respectively. Gene set enrichment analysis in resected tissues revealed upregulation of interleukin, complement, cytokine, transforming growth factor β, and hedgehog pathways. Patients with upregulated pathogen defense, interleukins, and T-cell function pathways at baseline exhibited partial response to NE and longer OS. Patients with upregulated cell cycle pathways at baseline exhibited stable/progressive disease after NE and shorter OS. Conclusion NE modulated the TME in EGFRm NSCLC. Upregulation of immune-related pathways was associated with better outcomes.

Purpose: This subgroup analysis of the Korean subset of patients in the phase 3 LASER301 trial evaluated the efficacy and safety of lazertinib versus gefitinib as first-line therapy for epidermal growth factor receptor mutated (EGFRm) non–small cell lung cancer (NSCLC). Materials and Methods: Patients with locally advanced or metastatic EGFRm NSCLC were randomized 1:1 to lazertinib (240 mg/day) or gefitinib (250 mg/day). The primary endpoint was investigator-assessed progression-free survival (PFS). Results: In total, 172 Korean patients were enrolled (lazertinib, n=87; gefitinib, n=85). Baseline characteristics were balanced between the treatment groups. One-third of patients had brain metastases (BM) at baseline. Median PFS was 20.8 months (95% confidence interval [CI], 16.7 to 26.1) for lazertinib and 9.6 months (95% CI, 8.2 to 12.3) for gefitinib (hazard ratio [HR], 0.41; 95% CI, 0.28 to 0.60). This was supported by PFS analysis based on blinded independent central review. Significant PFS benefit with lazertinib was consistently observed across predefined subgroups, including patients with BM (HR, 0.28; 95% CI, 0.15 to 0.53) and those with L858R mutations (HR, 0.36; 95% CI, 0.20 to 0.63). Lazertinib safety data were consistent with its previously reported safety profile. Common adverse events (AEs) in both groups included rash, pruritus, and diarrhoea. Numerically fewer severe AEs and severe treatment–related AEs occurred with lazertinib than gefitinib. Conclusion Consistent with results for the overall LASER301 population, this analysis showed significant PFS benefit with lazertinib versus gefitinib with comparable safety in Korean patients with untreated EGFRm NSCLC, supporting lazertinib as a new potential treatment option for this patient population.

Purpose: This study evaluated whether an addition of simvastatin to chemotherapy improves survival in ever-smokers with extensive disease (ED)–small cell lung cancer (SCLC). Materials and Methods: This is an open-label randomized phase II study conducted in National Cancer Center (Goyang, Korea). Chemonaive patients with ED-SCLC, smoking history (≥ 100 cigarettes lifetime), and Eastern Cooperative Oncology Group performance status of ≤ 2 were eligible. Patients were randomized to receive irinotecan plus cisplatin alone or with simvastatin (40 mg once daily orally) for a maximum of six cycles. Primary endpoint was the the 1-year survival rate. Results: Between September 16, 2011, and September 9, 2021, 125 patients were randomly assigned to the simvastatin (n=62) or control (n=63) groups. The median smoking pack year was 40 years. There was no significant difference in the 1-year survival rate between the simvastatin and control groups (53.2% vs. 58.7%, p=0.535). The median progression-free survival and overall survival between the simvastatin arm vs. the control groups were 6.3 months vs. 6.4 months (p=0.686), and 14.4 months vs. 15.2 months, respectively (p=0.749). The incidence of grade 3-4 adverse events was 62.9% in the simvastatin group and 61.9% in the control group. In the exploratory analysis of lipid profiles, patients with hypertriglyceridemia had significantly higher 1-year survival rates than those with normal triglyceride levels (80.0% vs. 52.7%, p=0.046). Conclusion Addition of simvastatin to chemotherapy provided no survival benefit in ever-smokers with ED-SCLC. Hypertriglyceridemia may be associated with better prognosis in these patient population.

Objective: The Korean Triage and Acuity Scale (KTAS) is a triage tool for patients in the emergency department (ED). This study aimed to evaluate the ability of the KTAS to predict poor outcomes in South Korean ED patients with a suspected infection. We also compared the effectiveness of KTAS with that of the National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) in predicting poor outcomes. Methods: We conducted a single-center retrospective study that included adult patients with a suspected infection who were admitted to the ED between January 2019 and December 2019. Patients who received a prescription for antibiotics and associated culture tests in the ED were considered to have an infection. Poor outcomes were evaluated by in-hospital mortality, general ward admission, and intensive care unit (ICU) admission. A receiver operating characteristics (ROC) curve analysis was performed to evaluate and compare KTAS, NEWS, and MEWS. Results: Of the 4,127 patients in the study, in-hospital mortality was reported in 154 (3.7%) patients. The median KTAS was lower in the non-survivors than in the survivors (2.51 vs. 3.35). Multivariate logistic regression analysis showed that the KTAS was associated with in-hospital mortality, ward admission, and ICU admission. The area under the ROC curve (AUROC) values for predicting in-hospital mortality associated with the KTAS, NEWS, and MEWS were 0.776 (95% confidence interval, 0.747-0.803), 0.829 (0.759-0.811) and 0.739 (0.694-0.786), respectively. Conclusion Our results showed that the KTAS was associated with in-hospital mortality, ward admissions, and ICU admissions among ED patients with a suspected infection. Thus, KTAS may be reliable in predicting a poor outcome in ED patients with a suspected infection.