Spermidine Protects against Oxidative Stress in Inflammation Models Using Macrophages and Zebrafish

Spermidine is a naturally occurring polyamine compound that has recently emerged with anti-aging properties and suppresses inflammation and oxidation. However, its mechanisms of action on anti-inflammatory and antioxidant effects have not been fully elucidated. In this study, the potential of spermidine for reducing pro-inflammatory and oxidative effects in lipopolysaccharide (LPS)-stimulated macrophages and zebrafish was explored. Our data indicate that spermidine significantly inhibited the production of pro-inflammatory mediators such as nitric oxide (NO) and prostaglandin E2 (PGE2), and cytokines including tumor necrosis factor-α and interleukin-1β in RAW 264.7 macrophages without any significant cytotoxicity. The protective effects of spermidine accompanied by a marked suppression in their regulatory gene expression at the transcription levels. Spermidine also attenuated the nuclear translocation of NF-κB p65 subunit and reduced LPS-induced intracellular accumulation of reactive oxygen species (ROS) in RAW 264.7 macrophages. Moreover, spermidine prevented the LPS-induced NO production and ROS accumulation in zebrafish larvae and was found to be associated with a diminished recruitment of neutrophils and macrophages. Although more work is needed to fully understand the critical role of spermidine on the inhibition of inflammation-associated migration of immune cells, our findings clearly demonstrate that spermidine may be a potential therapeutic intervention for the treatment of inflammatory and oxidative disorders.

Study on Persistence of Egg Allergy and Its Risk Factors in Infants and Young Children with Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: We attempted to observe the natural course of egg allergy and to investigate the risk factors predicting the likelihood of persistence of egg allergy in infants and young children with atopic dermatitis. METHODS: A total of 125 infants with atopic dermatitis and egg allergy were enrolled in this study. Egg allergy was defined when the serum egg white-specific IgE was equal or greater than 2 U/mL by CAP-FEIA.(Pharmacia, Uppsala, Sweden) After follow-up evaluation of serum egg white-specific IgE, they were classified into two groups: "persistent" group(egg white- specific IgE> or =2 U/mL in children younger than 2 years and > or =7 U/mL in those older than 2 years) and "non-persistent" group. Median follow-up duration was 15 months. Specific IgE levels at first visit, family histories of allergic diseases, histories of breast milk feeding and the presence of sensitization to multiple food allergens were compared between the two group. RESULTS: The numbers of the "persistent" group and the "non-persistent" group were 75(60%) and 50(40%), respectively. The "persistent" group had higher egg white-specific IgE levels at first visit, more sensitization to multiple food allergens, and more breast-feeding than the non-persistent group.(P0.05) CONCLUSION: Sixty percent of infants with atopic dermatitis and egg allergies showed persistent egg allergies during the median follow-up of 15 months. Infants with higher egg white-specific IgE level and sensitization to multiple food allergens at the initial evaluation are likely to develop persistent egg allergies.

An Epidemiological Study of Mycoplasmal penumoniae Pneumonia in Children from 1995 to 2004 in a Tertiary Hospital in Seoul / 소아알레르기및호흡기학회지

PURPOSE: Mycoplasma pneumoniae is the major cause of respiratory infections in school- aged children and young adults. This study aimed to investigate the epidemiological features of M. pneumoniae pneumonia in Korean children, between 1995 and 2003. METHODS: We retrospectively reviewed the medical record of 575 patients with M. pneumoniae pneumonia. In patients with pneumonia who visited Samsung Medical Center from January 1995 to December 2003, M. pneumoniae infection was confirmed by mycoplasma antibody titer > 1: 320 or four-fold increase. We analyzed age and sex distribution, monthly and annual epidemics, and mixed infection with respiratory viruses. RESULTS: The mean age was 4.49+/-2.80 years (range 0-16 years). There were 281 females and 294 males. The peak incidence was at 4 years of age (17.6 percent) and there were 333 person from 3 to 6 years of age (57.2 percent). Infants younger than 2 years accounted for 23.8 percent. M. pneumoniae pneumonia occurred mostly from September to December (64.8 percent) ; in November (18.1 percent), in December (16.2 percent), and in October (16.0 percent). Annual incidences were 9.6 percent in 1997 and 10.9 percent in 2000, 18.7 percent in 2003, respectively, while much lower incidences were noted in the other years. Seven cases showed mixed infection with respiratory viruses; adenovirus (n=3), RSV (n=2), Influenza virus (n=1), parainfluenza virus type 2 (n=1). CONCLUSION: In Seoul, Korea, epidemic outbreaks of M. pneumoniae pneumonia occurred every three years with peak incidences in the fall. These epidemiological data will be helpful for the prediction of occurrences of M. pneumoniae infection.

A Clinical Study of Primary Immunodeficiency Disease in a Single Center in Seoul from 1996 to 2004 / 소아알레르기및호흡기학회지

PURPOSE: Although primary immunodeficiency disorders are relatively rare, early diagnosis provides the opportunity to reduce morbidity and mortality. The aim of this study was to investigate disease distribution, clinical manifestations, genetic mutation, treatment and prognosis of primary immunodeficiency disorders of childhood. METHODS: We retrospectively reviewed the medical records of 15 cases with primary immunodeficiency disorders between 1996 and 2004 in Samsung Seoul Hospital, Seoul, Korea. RESULTS: The most common primary immunodeficiency was common variable immunodeficiency (CVID) (n=7), followed by X-linked agammaglobulinemia (XLA) (n=3), severe combined immunodeficiency (SCID) (n=2), hyper IgM syndrome (n=1), selective IgA deficiency (n=1), and chronic granulomatous disease (CGD) (n=1). Most cases had recurrent infections such as otitis media, bacterial pneumonia, sinusitis and other respiratory infections during infancy. The age at diagnosis ranged from 4 months to 17 years with a median age of 5 years. The male to female ratio was 11 to 4. Eleven patients were diagnosed with primary immunodeficiency diseases following respiratory infection, while the other 4 patients had pulmonary tuberculosis, perianal abscess, bacterial meningitis, septic arthritis. All the patients with XLA and CVID were regularly treated with IVIG. Two cases of SCID underwent successful bone marrow transplantation without complications. The patients with hyper IgM syndrome died due to severe infection even after bone marrow transplantation. CONCLUSION: Fifteen variable cases of primary immunodeficiency were diagnosed during 9 years. A high index of suspicion is required in children with recurrent or severe infections for the diagnosis of primary immunodeficiency, because early diagnosis and treatment can reduce mortality and morbidity.

Risk Factors of Moderate to Severe Atopic Drmatitis in the First 6 Months of Life / 소아알레르기및호흡기학회지

PURPOSE: The aim of this study was to analyze the risk factors of moderate to severe atopic dermatitis (AD) in the first 6 months of life. METHODS: Children aged less than 6 months with AD were divided into two groups according to Six Area, Six Sign Atopic Dermatitis (SASSAD) Score. Children with scores of less than 14 were classified as Mild AD (n=90) and above 15 as Moderate to Severe (Mod-severe) AD (n=44). These patients were fed with breast milk or cow's milk formula, and no allergenic food was given except rice and some vegetables. We analyzed the gender, feeding patterns, family history of allergy, number of siblings, total IgE and specific IgE to common food allergens (egg white, cow's milk, soy, wheat) by CAP assay (Pharmacia, Uppsala, Sweden). RESULTS: Total IgE was 180.6+/-44.7 U/mL in mod-severe AD and 32.2+/-6.1 U/mL in mild AD (P=0.002). Specific IgE to egg white, soy and wheat (19.03+/-4.48 U/mL; 7.07+/-0.40 U/mL, 4.68+/-1.89 U/mL in mod-severe AD; 1.78+/-0.43 U/mL, 0.09+/-0.03 U/mL, 0.15+/-0.11 U/mL in mild AD; P< 0.05) were associated with mod-severe AD, but cow's milk (4.34+/-2.50 U/mL in mod-severe AD; 0.80+/-0.44 U/mL in mild AD) showed no statistical difference. Gender, feeding patterns, family history and number of siblings were not significantly associated with mod-severe AD. The total IgE level and egg white specific IgE level significantly increased as the duration of breast feeding increased (P< 0.05). CONCLUSION: Mod-severe atopic dermatitis in the first 6 months of life is associated with sensitization to food allergens, which might be transferred via breast milk.

The Experience of High Frequency Oscillatory Ventilation in Children with Respiratory Failure / 소아알레르기및호흡기학회지

PURPOSE: High frequency oscillatory ventillation (HFOV) is an alternative to conventional ventilation (CV) when oxygenation deteriorates. This study evaluates the efficacy and safety of HFOV in children with respiratory failure. METHODS: Ten cases with respiratory failure (age 8.7+/-7.6 mo, body weight 6.8+/-2.6 kg) that underwent HFOV for more than 3 days because of failure of oxygenation by CV were enrolled. PaO2/FiO2, oxygenation index (OI), (A-a) DO2, mean airway pressure (MAP), blood pressure, heart rate, PEediatric Logistic Organ Dysfunction (PELOD) score and complications were evaluated before and at 6, 12, 24, 48, 72 hours of HFOV. The influencing factors were compared between an HFOV success group and a failure group, and outcomes were evaluated. RESULTS: 1) Lower FiO2 was required for proper oxygenation by HFOV, although MAP was significantly increased. (P< 0.05) 2) PaO2/FiO2 was higher (P=0.002) and (A-a) DO2 was lower than baseline (P< 0.001) during HFOV. However, no significant difference was observed for OI, PaO2, PaCO2 or pH. 3) In the HFOV success group, (A-a) DO2 was significantly lower than failure group at baseline, (P=0.045) and OI was also significantly lower than in the failure group at 6 hours of HFOV. (P=0.032) PaO2/FiO2 was significantly improved in the success group at 6 hours of HFOV. (P=0.045) 4) Complications were air leak, 20% (2/10), and hypotension, 40% (4/10), which was corrected by using inotropics. PELOD scores decreased in all patients compared to at baseline throughout HFOV. (P=0.03) 5) Sixty percent patients survived for 3 months after HFOV were 60% (6/10). The success of HFOV related to survival. (P=0.048) CONCLUSION: HFOV can be used to improve oxygenation effectively and safely in children with respiratory failure who did not improve with CV.