Measurement of nasal airway conductance in the diagnosis of allergic rhinitis by allergen nasal provocation test / 천식및알레르기

BACKGROUND AND OBJECTIVES: Allergic rhinitis is one of the most common allergic diseases. Diagnosis and therapeutic improvement of allergic rhinitis have been evaluated using only subjective symptoms. However, it is important to assess nasal obstruction using objective parameters for the diagnosis and evaluation of therapeutic responses. The aim of this study was to evaluate the usefulness of the objective parameter for nasal obstruction: nasal airway conductance using rhinomanometry to diagnose allergic rhinitis by allergen specific nasal challenge test. SUBJECTS AND METHODS: A total of 56 individuals were included in this study. They were categorized into a patient group sensitized to house dust mite (n=32) and a control group (n=24). They responded to the questionnaire concerned on rhinitis symptoms, and underwent skin prick tests to 11 common inhalant allergens and Dermatophagoides pteronyssinus(D.P.)- specific nasal provocation tests with varying degrees of concentrations. Symptom scores based on subjective nasal symptoms such as runny nose, sneezing, nasal obstruction, and visual analogue scale (VAS) were recorded. Objective parameter i.e. nasal airway conductance using rhinomanometry was also measured before and after the inhalation of D.P. aerosol. RESULTS: Nine subjects of the patient group (28.1%) experienced sneezing, 12 (37.5%) rhinorrhea, 17 (53.1%) nasal obstruction, and 9 (32%) nasal or ocular itching. There were no significant differences between the patient and the control groups in baseline nasal conductance measured by anterior rhinomanometry (p>0.05). In the patient group, however, nasal conductance was significantly decreased after inhalation of the low D.P. concentration (250 B.E.U. of D.P. extract) compared to baseline value (p0.05). Symptom scores were more significantly increased in the high D.P. concentration (1000 B.E.U. of D.P. extract) than in the baseline concentration of the patient group (p0.05). As for VAS, the patient group showed significant differences after the high D.P.(5000 B.E.U. of D.P. extract) inhalation (p<0.05), while the control group showed no difference. CONCLUSION: Although nasal symptoms such as obstruction, itching, sneezing, and rhinorrhea should be considered in diagnosing allergic rhinitis, nasal conductance using rhinomanometry can be a more valuable objective index since it can discriminate the patient group from the control group more sensitively in lower allergen concentrations.

The effect of transforming growth factor-beta on the expression of CD8 in the CTLL-2 cell line / 천식및알레르기

BACKGROUND: Transforming growth factor-beta(TGF-beta) has multiple regulatory effects on cells of the immune system, and it has been suggested that differentiation of lymphoid cells is influenced by low concentra tions of this cytokine. OBJECTIVES: The aim or this study was to investigate the role of TGF-beta in regulation of T cell growth and differentiation, and to compare this effect with that of other cell signals known to be important in T cell ontogeny. METHODS: We used the CTLL-2 cell line in the presence of IL-2. Surface phenotype expression was analysed to see whether these cells could be switched to the other subtype of cells. RESULT: Treatment of CTLL-2 cells with TGF-beta resulted in dose dependent growth inhibition and morphological changes. Curing routine passage, less than 5% of cells were CD8alpha positive, whereas 38% of cells expressed CD8alpha when treated with IL-2 plus TGF-beta. However, TPA plus calcium ionophore, IFN-gamma, or TNF-alpha caused no significant changes in the proportion of CD8 cells. CONCLUSION: Our results show that this experiment can be a useful model for investigating CD8 precursor potentials in populations of CD4-CD8-(double negative) cells, and such a model may offer a way to study the molecular regulation of CD8 gene expression.

Changes of atopy prevalence among asthmatics visiting tertiary referral hospital (1983, 1990, 1997) / 천식및알레르기

BACKGROUND: The prevalence of atopy and atopy-related disease has been known to increase during the past decade. OBJECTIVE: This study was designed to evaluate the changes of atopy prevalence among asthmatic patients and the causative allergens. METHOD: A total of 698 asthmatic patients visiting Seoul National University Hospital in 1983, 1990 and 1997 was recruited. Skin prick test with common inhalant allergens was carried out and interpreted as positive when the mean wheal size formed by allergen was larger than 3mm. Atopy was defined when skin reaction to one or more allegens was positive. RESULT: The prevalence of atopy among asthmatic patients was 54% in 1983, 48.8% in 1990 and 53% in 1997, respectively. The prevalence of atopy decreased as the age of patients increased. Recently, old asthmatic patients (>55 years) showed a higher tendency to visit the tertiary referral hospital. When the data were analyzed according to age, the prevalence of atopy significantly increased among asthmatic patients aged 15-35 years, in whom the prevalence was 60.4% in 1983 and 81.3% in 1997 (p<0.05). The positive rate of skin test to Dermatophagoides pteronyssinus, cat fur, mugwort, ragweed, and grass pollen were significantly higher in 1997 than in 1983 (p<0.05). CONCLUSION: The prevalence of atopy among asthmatic patients aged 15-35 years showed significant increase in 1997 compared to 1983. The changes of skin response to Dermatophagoides pteronyssinus, cat fur, mugwort, ragweed, and grass pollen contributed to the increase of atopy.

A case of anticonvulsant hypersensitivity syndrome induced by phenobarbital / 천식및알레르기

No abstract available.

Relationship of eosinophils in induced sputum with bronchial responsiveness to methacholine or capsaicin and with responses to anti-asthmatic treatment in chronic cough patients / 천식및알레르기

BACKGROUND: The value of the induced sputum examination in chronic cough has not been determined. We performed this study to investigate the relationship between eosinophil percentage on induced sputum and bronchial responsiveness to methacholine or capsaicin, and responses to anti-asthmatic treatment in chronic cough patients. SUBJECTS AND METHODS: Forty-seven patients with chronic cough persisting for more than 1 month without current wheezing or dyspnea were studied. According to the eosinophil percentage on induced sputum, the subjects were divided into two groups: group A (sputum eosinophil > or = 3%) and group B (sputum eosinophil < 3%). Methacholine bronchial provocation test (MBPT) and capsaicin challenge, and responses to anti-asthmatic treatment were compared between the two groups. RESULTS: Group A consisted of 26 subjects and group B consisted of 21 subjects. There were no differences in sex, clinical characteristics of cough, atopy prevalence, and peripheral eosinophil counts except serum IgE level between the two groups. MBPT positivity was much higher in group A than group B (46.2% vs 0%, p<0.001), but there was no difference in capsaicin test positivity (44.0% vs 50.0%). Group A showed much higher response rates to anti-asthmatic treatments than in group B (73.1% vs 19.0%, p<0.001). CONCLUSION: Eosinophilic airway inflammation in chronic cough was related to methacholine bronchial hyperresponsiveness, but not to capsaicin cough threshold. Induced sputum eosinophil percentage was a good indicator in predicting the response to anti-asthmatic treatment in most chronic cough patients.

The production of interferon gamma by natural killer (NK) cells and proportion of NK cells in peripheral blood mononuclear cells in patients with severe bronchial asthma / 천식및알레르기

BACKGROUND AND OBJECTIVE: The natural killer (NK) cells which play an important role in defense immune system are supposed to be involved in the pathogenesis of bronchial asthma. The goal of this study is to analyze the role of NK cells in the pathogenesis of bronchial asthma by examining the proportion of NK cells in peripheral blood mononucler cells (PBMCs) and production of interferon gamma (IFN-gamma) in NK cells between normal group and asthmatic group. METHODS: Ten patients with moderate to severe persistent asthma sensitive to house dust mite were enrolled as asthmatic group. PBMCs were activated by 12-0-tetracanoylphorbol-13-acetate (TPA) and calcium inonophore for 18 hours. Surface CD3 and CD56 antigens with intracytoplasmic IFN-gamma staining were performed simultaneously and the results were analyzed by three color flow cytometer. RESULTS: The percentage of CD56+ positive NK cells in PBMCs from asthma group was lower compared to control group (15.4+/-3.9% vs 19.8+/-4.5%). However, There was no signficant difference of IFN-gamma production in CD56+ NK cells between two groups (30.3+/-3.9% vs 25.9+/-5.8%, p>0.05). IFN-gammaproducing CD3+ T cells were significantly higher in asthma group compared with normal control group (36.3+/-1.8% vs 28.4+/-5.7%, p<0.05). The ratio of TNK cells expressing both CD56 and CD3 was not different between asthma group and control group (4.7+/-1.4 % vs 5.9+/-1.8%, p<0.05). CONCLUSION: The results suggest that aggravation of asthma symptoms in severe asthma may be caused partly by decrease in NK cells. The increased production of IFN-gamma in asthma patients suggest that IFN-gammamay function as inflammatory cytokine.

Airway remodelling of severe bronchial asthma patients according to disease duration / 천식및알레르기

BACKGROUND: Bronchial asthma is classically defined as a reversible obstruction and hypsrresponsiveness of the airway attributed to an inflammatory process. However, some individuals with asthma show an irreversible component of airflow obstruction. It may be associated with structural changes in the airway resulting from severe or long standing air- way inflammation and remodelling. OBJECTIVE: The study was undertaken to compare the clinical characteristics of patient and airway remodelling as shown in bronchial wall thickness in HRCT according to the duration of asthma. MATERIALS AND METHODS: A retrospective clinical study was done on 119 patients with bronchial asthma, who had been admitted to Ewha Womans University Mokdong Hospital. Patients were divided to three groups according to disease duration and, clinical characteristics, pulmonary function test and HRCT were done. RESULTS: Basal FEV, and FVC was significantly lower in patient with longer duration. (p<0. 05) However pulmonary function was improved regardless of disease duration after 2 weeks steroid and bronchodilator therapy, and there was no significant difference in level changes according to the disease duration. The inner diameter of the bronchi and thickness of the bronchial wall at segmental and subsegmental bronchi increased significantly in patient with longer duration of asthma(p<0.05). Conclusion: These findings showed that airway remodelling was more extensive in patients with longer duration of disease resulting in decreased pulmonary function. These facts suggested that early anti-inflammatory therapy would be helpful for prevention of airway remodelling.

The effect of interleukin 2 on the induction Of Nk 1.1 expression in CD8+ and CD4-CD8-T Cell / 천식및알레르기

BACKGROUND: Murine IL-2-induced lymphokine-activated killers can be divided into two mutually exclusive subset:NK1.1'CD8 and NK1.1 CD8+. However, there is a strong evidence that NK cell may belong to T cell lineage. Recently novel lymphocyte subsets, present in the adult murine thymus, CD3+NK1.1'TCRap(TNK) cell is readily identifiable in fresh obtained murine adult CD4 CD8 thymocytes. MATERIAL AND METHOD: We sorted out CD4 and CD8 (double negative.' DN) cells and CD8+ cells from murine spleen and cultivated these cells with IL-2. And the surface B220, CD8, NK1. 1 and cytopasmic NK1.1 was analysed simultaneously to see whether these cells can be switched to the other subtype of cells. RESULT: Purified DN cells were switched to several subtype of cells'. CD8'B220+(LAK cells), NK1.1'B220+(LAK cells), CD8 B220, cytoplasmic NK1.1+B220 cells. Purified CD8 cells were switched to CD8+B220' LAK cells and cytoplasmic NK1.1+ CD8+ B220+ and cytoplasmic NK1.1' CD8 B220 cells. In addition, the CD8' cells originated from DN cells do not express the cytoplasmic NK1.1 in contrary to the sorted CD8 cells. CONCLUSION: Our results indicated that these will be useful models to investigating CD8 precursor potentials in populations of CD4 CD8 (doble negative) cells and relationship of NK1.1 These results also supports the hypothesis that T cells and NK cells have same ontogeny and CD8 effector functions are potentially diverse and could be exploited by various conditions that switch off host protected cytolytic response. These model offer a way to study the molecular regulation of CD8 gene expression.