House Dust Mite Induces Expression of Intercellular Adhesion Molecule-1 in EoL-1 Human Eosinophilic Leukemic Cells

The house dust mite (HDM) is considered to be the most common indoor allergen associated with bronchial asthma. In this study, we investigated whether crude extract of the HDM Dermatophagoides farinae could activate human eosinophilic leukemic cells (EoL-1) to induce upregulation of cell-surface adhesion molecules. When EoL-1 cells were incubated with D. farinae extract, expression of intercellular adhesion molecule-1 (ICAM-1) significantly increased on the cell surfaces compared to cells incubated with medium alone. In contrast, surface expression of CD11b and CD49d in EoL-1 cells was not affected by D. farinae extract. In addition, pretreatment of cells with NF- kappaB inhibitor (MG-132) or JNK inhibitor (SP600125) significantly inhibited ICAM-1 expression promoted by HDM extract. However, neither p38 MAP kinase inhibitor nor MEK inhibitor prevented HDM-induced ICAM-1 expression in EoL-1 cells. These results suggest that crude extract of D. farinae induces ICAM-1 expression in EoL-1 cells through signaling pathways involving both NF- kappaB and JNK.

Peritonsillar Abscess in a 40-Day-Old Infant

A peritonsillar abscess is one of the most commonly occurring deep space infections of the head and neck in adults and children. A peritonsillar abscess that appears in newborns, however, is extremely rare. The treatment of a peritonsillar abscess requires both the selection of appropriate antibiotics and the best procedure to remove the abscessed material. We report a case of a peritonsillar abscess in a 40-day-old infant who was treated with antibiotic therapy alone.

Comparison of Allergic Indices in Monosensitized and Polysensitized Patients with Childhood Asthma

Monosensitization differs both immunologically and clinically from polysensitization, and specific immunotherapy is more effective in patients sensitized only to a single pollen than in multiple-pollen sensitized patients. To further examine the differences between monosensitized and polysensitized allergies, allergic indices were examined in 68 monosensitized and 62 polysensitized patients with childhood asthma. Measurements included symptom scores, eosinophil counts, skin prick tests, serum total and specific IgE levels, and IL-10 levels, and were used to compare allergic indices between the two groups. Patients were followed for 18 months following immunotherapy to examine the effectiveness of the treatment. Symptom scores and total IgE levels were significantly higher in the polysensitized group than those in the monosensitized group (p<0.05). The levels of skin test response decreased significantly in both groups following immunotherapy. In the monosensitized group, symptom scores and specific IgE levels were significantly reduced after immunotherapy (p<0.05). In the polysensitized group, symptom scores were reduced after immunotherapy (p<0.05), but the degree of reduction was less than that of the monosensitized group (p<0.05). Moreover, in the polysensitized group, specific IgE levels after immunotherapy did not differ from that before immunotherapy. Serum IL-10 levels were not significantly increased after immunotherapy in either group. In conclusion, polysensitized patients tend to show higher allergic indices and immunotherapy might be less effective for these patients.

Comparison of Allergic Indices in Monosensitized and Polysensitized Patients with Childhood Asthma

Monosensitization differs both immunologically and clinically from polysensitization, and specific immunotherapy is more effective in patients sensitized only to a single pollen than in multiple-pollen sensitized patients. To further examine the differences between monosensitized and polysensitized allergies, allergic indices were examined in 68 monosensitized and 62 polysensitized patients with childhood asthma. Measurements included symptom scores, eosinophil counts, skin prick tests, serum total and specific IgE levels, and IL-10 levels, and were used to compare allergic indices between the two groups. Patients were followed for 18 months following immunotherapy to examine the effectiveness of the treatment. Symptom scores and total IgE levels were significantly higher in the polysensitized group than those in the monosensitized group (p<0.05). The levels of skin test response decreased significantly in both groups following immunotherapy. In the monosensitized group, symptom scores and specific IgE levels were significantly reduced after immunotherapy (p<0.05). In the polysensitized group, symptom scores were reduced after immunotherapy (p<0.05), but the degree of reduction was less than that of the monosensitized group (p<0.05). Moreover, in the polysensitized group, specific IgE levels after immunotherapy did not differ from that before immunotherapy. Serum IL-10 levels were not significantly increased after immunotherapy in either group. In conclusion, polysensitized patients tend to show higher allergic indices and immunotherapy might be less effective for these patients.

House Dust Endotoxin Exposure and Allergic Sensitization in Korean Home Living Conditions / 소아알레르기및호흡기학회지

PURPOSE: Household endotoxin exposure in allergy and asthma has been gaining attention for its dual potential to exacerbate these conditions in individuals with established disease and to abrogate atopy before disease onset. The aim of this work was to analyze associations between current exposure to bacterial endotoxin in house dust and allergic sensitization in adults with asthma. METHODS: From the homes of 52 adults with asthma and 28 normal controls, house dust endotoxin (detected with a Limulus Amebocyte Lysate QCL-1000) and house dust mite allergens (Der f 1 and Der p 1) were quantified. Allergen sensitization was measured by skin prick test. RESULTS: The endotoxin levels from mattresses were lower in the home of adults with asthma than in that of normal controls. The endotoxin levels from mattresses detected in the home of adults with asthma were positively correlated with Der p 1 levels and wheal size to housedust mite allergens on skin prick tests. Furthermore, the endotoxin levels in living room floor dust were positively correlated with Der f 1 levels, but didn't relate with wheal size to house dust mite allergens. CONCLUSION: Our results indicate that current exposure to house dust endotoxin might be positively associated with allergic sensitization in adults with asthma.

Effects of Hyperosmolar Stimuli on Activation of Human Eosinophilic Leukaemia EoL-1 Cells / 소아과

PURPOSE: Airway dehydration and subsequent hyperosmolarity of periciliary fluid are considered critical events in exercise-induced bronchoconstriction. The aim of this study was to establish if a hyperosmolar challenge could induce activation of eosinophils. METHODS: Human eosinophilic leukaemic cell lines, EoL-1 cells were incubated with hyperosmolar solutions for 15 minutes. Activation of EoL-1 cells was monitored by degranulation and superoxide anion production. In addition, we examined surface expression of CD69 and ICAM-1. RESULTS: Hyperosmolar stimuli didn't induce superoxide anion production and degranulation. In addition, EoL-1 cells cultured with hyperosmolar medium at 930 mOsm/kg H2O resulted in no significant increment in fluorescent intensity of CD69 and ICAM-1 expression compared with results for cells incubated with isomolar medium. CONCLUSION: We found that hyperosmolar stimuli don't cause activation of EoL-1 cells, but further studies are required to determine the role of eosinophil in the mechanism of exercise-induced asthma.

Food Sensitization in Infants and Young Children with Atopic Dermatitis

Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disease. Children with AD tend to have a higher prevalence of food allergies. This study investigated the clinical significance of food sensitization in AD patients. A total of 266 AD patients participated in this study. The prevalence of food sensitization and clinically relevant sensitization were compared in the subjects according to their age and AD severity. Sera from all patients were analyzed for food-specific IgE levels using the Pharmacia CAP System FEIA. The serum specific IgE levels for egg, milk, peanut and soybean were measured. Patients were regarded as sensitized to the food if their food-specific IgE levels were above 0.35 kUA/L. Also the food-specific IgE levels, the so-called diagnostic decision point, which is recommended as the clinically relevant level, for clinical food allergy, as suggested by Sampson et al, was used as an alternative method. From the measurement of food-specific IgE antibodies of the four foods, egg was the most highly sensitized and the main causative allergenic food in children with AD. The positive rates of specific IgE to the four major food allergens, and the prevalences of clinically relevant food sensitization, were higher for all foods tested in the group less than 1 year of age, and were significantly higher in moderate to severe AD compared to mild AD in infants and young children. In summary, presence of food specific IgE is prevalent in infants and young children with AD, and clinically relevant food sensitization is important in Korean infants and children with moderate to severe AD.

The Relationship between Fungal Sensitization and Month of Birth in Children with Allergies / 소아알레르기및호흡기학회지

PURPOSE: Fungus allergy is one of the major causes of atopic diseases. It has been suggested that the exposure to aeroallergens during early infancy is important in subsequent development of sensitization, and the prevalence of allergic diseases. In this study, we analyzed the characteristics of molds through skin prick test results and tested whether the month of birth bears any relationship to the presence of fungal sensitization in children with allergies. METHODS: We performed skin prick test with 63 allergens in 3, 044 patients with allergies who visited Yonsei University Medical Center from March 1997 to December 2002. RESULTS: Three hundred seventy (12.2%) of 3, 044 patients showed positive skin prick test results due to fungal allergens. The most common positive allergenic reaction among fungal allergens was to Alternaria (7.8%). In 370 patients with positive skin prick test results caused by fungal allergens, 77% of the patients showed positive results to Dermatophagoides farinae, 76% to Dermatophagoides pteronyssinus, and 39% to house dust. Significant differences were observed in distribution of month of birth in subjects with fungal sensitization, with higher proportions being born in April and July. However, month of birth did not show a consistent seasonal preference in patients sensitized to mite or the non- sensitized group. CONCLUSION: Fungal sensitization is often associated with sensitization to other allergens. Month of birth seems to be related with sensitization to fungal allergens. Our results show that children born in April and July are at a higher risk of development of fungal sensitization in Korea.

Two Cases of Urticaria Developed by Antianemics which Contain Cow's Milk Protein (casein) or Egg White Protein (ovalbumin) / 소아알레르기및호흡기학회지

Hemo-Q (R) and Albumax (R) solution are widely used antianemics. Hemo-Q (R) contains cow's milk protein (casein) and Albumax (R) contains egg white protein (ovalbumin). Cow's milk protein and egg protein can cause common allergic diseases in infants and young children. We reported two cases of young children with milk and egg allergy who presented skin symptoms after ingestion or cutaneous contact with Hemo-Q (R) or Albumax (R) solution. When Hemo-Q (R) or Albumax (R) solution was taken or rubbed on, erythematous papules and wheals were developed in 10-20 minutes, but other antianemics which don't contain milk or egg protein contents didn't show skin manifestations.

Effect of Delayed Intensification on Survival of Childhood Acute Lymphoblastic Leukemia

PURPOSE: In 1970, the Berlin-Frankfurt-Munster(BFM) group introduced an intensification therapy after remission induction to reduce relapse of acute lymphoblastic leukemia(ALL) in childhood. Delayed intensification(DI) phase has been included for treatment of ALL in our hospital since the mid-1990s. The purpose of this study is to evaluate the outcome with vs. without DI phase and the outcome with two vs. one DI phase for intermediate risk patients. METHODS: One hundred and thirty nine children with ALL who were treated at the Department of Pediatrics of Wonju Christian Hospital and Yonsei University Medical Center between March, 1990 and July, 2002 were analysed retrospectively. RESULTS: Thirty-eight patients were treated with a DI phase, and 101 patients were treated without a DI phase. Among the DI patients, seven patients were treated with a double DI phase. Five-year overall survival(OS) in the low, intermediate, and high risk groups were 68%, 66% and 58%, respectively. 5-year OS in DDI, DI, and control were 95%, 86% and 40%, espectively. In the low risk group, 5-year event free survival(EFS) in DI, and control were 94% and 58%, respectively. CONCLUSIONS: Delayed intensification improved EFS on childhood ALL in all risk groups.

A Comparative Analysis between Flow Cytometry and RT-PCR Methods for the Detection of Minimal Residual Disease in Neuroblastoma / 대한소아혈액종양학회지

PURPOSE: A sensitive assay to detect minimal residual disease in neuroblastoma is necessary for accurate assessment of disease status and optimal treatment. In this study, we compared the usefulness of sensitive methods, flow cytometry and RT-PCR for the detection of minimal residual disease in neuroblastoma. METHODS: Eighteen patients who were newly diagnosed and treated at Severance Hospital since 1999 were included in this study. Samples from bone marrow, peripheral blood, and peripheral blood stem cell product were examined for tumor cell contamination by RT-PCR (TH RT-PCR) to detect tyrosine hydroxylase mRNA and by flow cytometry identifying CD9+/CD56+/CD45- cells. RESULTS: We analyzed 20 cases from 18 patients, which were assayed by both methods at the same time. Among 20 cases, 16 cases showed same results, which were compatible with histologic results and clinical course, and 4 cases showed different results. One case of them showed positive result in histology and flow cytometry, but negative result in TH RT-PCR. The other 3 cases showed negative results in flow cytometry, but positive results in TH RT-PCR, and 1 patient of them relapsed. Among 16 patients, 2 patients, showing positive results in only TH RT-PCR, relapsed. CONCLUSION: Detection of minimal residual disease using TH RT-PCR and flow cytometry was effective and useful in evaluating disease status and deciding for proper treatment.

A Successful Transplant of HLA-3 Loci Mismatched Umbilical Cord Blood into a Patient with Acute Myeloid Leukemia from an Unrelated Donor

Cord blood is a useful source of allogeneic hematopoietic stem cells for bone marrow reconstitution. The number of umbilical cord blood transplants is increasing worldwide. In this a case 15- month-old boy with acute myeloid leukemia was treated with umbilical cord blood transplant from an HLA-3 loci mismatched unrelated donor. Granulocyte recovery greater than 500/mm3 occurred at day 49, and the platelet recovered greater than 20,000/mm3 independent of transfusion at day 81 after stem cell infusion.