Alteration of CD4+CD25+Foxp3+ T cell level in Kawasaki disease / 소아과

PURPOSE: Exaggerated pro-inflammatory reactions during the acute phase of Kawasaki disease (KD) suggest the role of immune dysregulation in the pathogenesis of KD. We investigated the profiles of T regulatory cells and their correlation with the clinical course of KD. METHODS: Peripheral blood mononuclear cells were collected from 17 KD patients during acute febrile and subacute afebrile phases. T cells expressing CD4, CD25, and Foxp3 were analyzed using flow cytometry, and the results were correlated with the clinical course of KD. RESULTS: The percentage of circulating CD4+CD25highFoxp3+ T cells among CD4+ T cells was significantly higher during the subacute afebrile phase than during the acute febrile phase (1.10%+/-1.22% vs. 0.55%+/-0.53%, P=0.049). Although levels of CD4+CD25lowFoxp3+ T cells and CD4+CD25-Foxp3+ T cells were only slightly altered, the percentage of CD4+CD25+Foxp3- T cells among CD4+ T cells was significantly lower during the subacute afebrile phase than during the acute febrile phase (2.96%+/-1.95% vs. 5.64%+/-5.69%, P=0.036). Consequently, the ratio of CD25highFoxp3+ T cells to CD25+Foxp3- T cells was higher during the subacute afebrile phase than during the acute febrile phase (0.45%+/-0.57% vs. 0.13%+/-0.13%, P=0.038). CONCLUSION: Decreased CD4+CD25highFoxp3+ T cells and/or an imbalanced ratio of CD4+CD25highFoxp3+ T cells to CD4+CD25+Foxp3- T cells might play a role in KD development. Considering that all KD patients were treated with intravenous immunoglobulin (IVIG), recovery of CD4+CD25highFoxp3+ T cells during the subacute afebrile phase could be a mechanism of IVIG.

Effects of an intensive asthma education program on asthmatic children and their caregivers / 소아과

PURPOSE: Asthma is one of the most common chronic childhood disease. Education of asthmatic children and their families about asthma and its management may improve disease control, reduce symptoms, and improve school performance. The aim of the study was to evaluate the effects of an intensive asthma education program in asthmatic children and their families on outcome measure of asthma management behavior scale, knowledge about asthma, self efficacy scale and quality of life. METHODS: Fifteen asthmatic children and their families were invited the intensive asthma education program which including allergen avoidance, management of asthma, correct use of the inhalation devices and control of exercise-induced asthma (study group). Fifteen asthmatic children and their families those who did not participate this program were served as control group. Participants were asked to complete a written questionnaire before and 3-month after the program. RESULTS: After completing the intensive education program, significant improvement of the childrens asthma management behavior scale (27.1 vs. 32.2, P=0.011), belief and knowledge about asthma (14.2 vs. 17.9, P<0.001), self efficacy (47.9 vs. 49.7, P=0.091) and quality of life (79.6 vs. 88.6, P<0.001) was noted in the study group by measuring questionnaires. There are increasing tendencies in parental asthma management behavior scale and knowledge about asthma. CONCLUSION: This intensive asthma education program is effective in improving asthma control, self efficacy and quality of life of asthmatic children. This should serve as a national model for family-based programs for asthmatic children and their families.