A Case of Perilla Allergy in a 2-Year-old Boy

Even though perilla is one of the most commonly consumed grain in Asia including Korea, perilla allergy is rare. A 2 year-old boy had erythematous popular urticaria on his whole body, as well as vomiting and diarrhea after ingestion of boiled perilla. On the second day of admission, old blood clots in the vomitus and blood tinged stool were shown. He underwent an esophago gastro duodenoscopy which showed a large duonenal ulcer. After treatment, his general condition improved. We report a case of perilla allergy with brief review of related literature.ope

소아 천식 환자에서 혈청 retinol-binding protein 4의 임상적 의미

Dept. of Medicine/석사[한글] 목적 : 최근 천식과 비만의 유병률이 증가하고 있어 천식과 비만 사이의 연관성을 밝히고자 하는 연구가 지속되고 있다. Retinol-binding protein (RBP) 4는 지방세포(adipocyte)에서 분비되는 물질로서 최근 비만 및 당뇨병과 밀접한 연관이 있는 것으로 알려지고 있다. 본 연구에서는 비만과 관련된 천식의 병인에 관한 연구의 일환으로 소아 천식에서 RBP4의 의의를 규명하고자 하였으며, 아토피 인자, 폐기능 지표 및 기관지 과민성과의 연관성에 대해 알아보고자 하였다.대상 및 방법 : 만 6세에서 10세 사이의 160명을 대상으로 하였다. 천식 환아는 122명, 대조군은 38명이었다. 전체 대상아에서 폐기능 검사, 메타콜린 유발시험을 시행하였고, 혈액 총호산구수, 혈청 총 IgE, eosinophil cationic protein(ECP), RBP4 농도 및 키와 몸무게를 측정하였다. Body mass index (BMI)를 구하여 각 성별, 연령에 따른 BMI 백분위수 곡선을 이용하여 BMI 백분위수를 구하였다.결과 : 전체 대상아에서 혈청 RBP4 농도는 천식군과 대조군 사이에 의미있는 차이를 보이지 않았으며 두 군 모두에서 BMI와 관련이 없었다. 전체 대상아와 여아에서 혈청 RBP4 농도는 혈액 총호산구수, 혈청 총 IgE, ECP 농도, 폐기능 및 PC20와 연관성을 나타내지 않았으나 남아에서 혈청 RBP4 농도는 FEV1/FVC 및 FEF25%-75%와 의미있는 상관관계를 보였다.결론 : 혈청 RBP4는 천식과 직접적인 관련은 보이지 않았으나, 사춘기 이전 남아에서 폐기능과 연관성을 나타내었다. 이는 사춘기 이전 소아에서의 천식 유병률이 남아에서 증가되어 있는 경향을 간접적으로 뒷받침하는 것으로 사료된다. [영문] Aim : Recently the prevalence of both asthma and obesity have increased substantially in many countries. The aim of this study was to evaluate the role of retinol-binding protein 4 (RBP4) in childhood asthma and its association with atopy markers, pulmonary function, and bronchial hyperresponsiveness in relation to obesity.Methods : We studied 160 children aged 6 to 10 years old, including 122 asthmatics and 38 controls. The body mass index, pulmonary function tests, and methacholine challenge tests were measured on the same day. Total eosinophil count, total serum IgE, serum eosinophil cationic protein, and serum RBP4 were measured in all subjects.Results : There was no difference in serum RBP4 levels between asthmatics and the control group. In all subjects or subgroups, serum RBP4 did not associate with total eosinophil count, total serum IgE, serum eosinophil cationic protein, or PC20. There was no relationship between serum RBP4 and pulmonary function in female subjects. But, FEV1/FVC and FEF25-75% contributed to serum RBP4 in male subjects.Conclusion : Our findings show an association between RBP4 and pulmonary function in prepubertal males. This relationship may indirectly affect the high prevalence of childhood asthma in males.ope

Clinical Implication of Sputum CXCLl3 in Children with Asthma

Purpose: CXCL13 is known to be a chemokine delivering B cell to the secondary lymphatic follicles, such as spleen, lymph nodes, and Peyer`s patches. Recently, there have been some reports that CXCL13 is important for T cell inflammation and expressed by Th17 cell which produces IL-17. This study attempted to examine the clinical implication of CXCL13 in children with asthma. Methods: This study included a total of 160 children aged 6 to 15 years who visited Severance Children`s Hospital. There were 80 children with asthma and 80 children without. the pulmonary function test and the methacholine challenge test were performed. Total eosinophi1 count, eosinophil cationic protein (ECP) and total IgE in serum and eosinophils, ECP and CXCL13 in sputum were measured. Results: the mean age of the subjects was 8.3±2.3 years for the asthma group and 9.3±2.5 years for the control group. the male to female ratio was 67.5% and 55.0% respectively. the sputum CXCL13 level for the asthma group was significantly higher than that level for the control group (P=0.003). This significance persisted even after adjustment for age and sex (P=0.010). the sputum CXCL13 level showed a positive correlation with that of sputum eosinophils (r=0.190, P=0.017) and ECP (r=0.285, P=0.002). Conclusion: Our results suggest that CXCL13 may play an important role in the pathophysiology of asthma related to eosinophilic inflammation. Further studies on sputum CXCL13 could help to reveal the role of chemokines in asthmaope

소아 천식과 호산구성 기관지염에서 혈관 내피세포 성장인자(VEGF)의 의의

Purpose: Vascular endothelial growth factor (VEGF) is an important mediator of airway inflammation and remodeling in asthma. We aimed to explore whether VEGF is expressed at elevated levels in asthmatic airways or eosinophilic bronchitis (EB) and associated with eosinophilic inflammation, pulmonary function, and airway hyperresponsiveness (AHR) in children. Methods: One hundred seventeen asthmatic children, 77 children with EB, and 84 healthy children were enrolled. Sputum supernatants were collected and VEGF and eosinophil cationic protein (ECP) levels were measured. Results: Asthmatic children had significantly higher levels of VEGF in induced sputum [89.04 (29.95-178.09) pg/mL] compared to children with EB [25.30 (11.02-80.23) pg/mL] and healthy children [37.37 (16.56-71.30) pg/mL; P=0.0003]. VEGF in sputum positively correlated with sputum ECP (r=0.524; P<0.0001). Negative significant correlations were found between sputum VEGF and FEV1, (r=-0.252; P=0.001) or post-bronchodilator FEV1 (r=-0.181; P=0.038) whereas nonsignificant correlations were found between sputum VEGF and sputum eosinophils. Conclusion: Our findings suggest that VEGF is associated with activated eosinophils in the asthmatic airway, but not EB. Sputum VEGF could be a supportive marker that represents activation of airway eosinophils and persistent airflow limitation in asthmatic children.ope

Relationship between amphiregulin and airway inflammation in children with asthma and eosinophilic bronchitis

BACKGROUND: Amphiregulin, a member of the epidermal growth factor family, has been shown to promote the growth of fibroblasts, to be associated with the T-helper type 2 cell adaptive immune response, and to up-regulate mucin gene expression. We aimed to determine whether sputum amphiregulin is expressed at elevated levels in patients with asthma or eosinophilic bronchitis (EB), and whether it is associated with eosinophilic inflammation, pulmonary function, and bronchial hyperresponsiveness in children. METHODS: A total of 117 children with asthma, 77 with EB, and 84 control subjects were enrolled in this study. Amphiregulin and eosinophil cationic protein (ECP) levels were measured in sputum supernatants. We performed pulmonary function and methacholine challenge tests while measuring total eosinophil count, and serum levels of total IgE and ECP in all children. RESULTS: The children with asthma had significantly higher levels of sputum amphiregulin (mean, 10.80 pg/mL; range, 4.07 to 38.75 pg/mL) than both the children with EB (mean, 5.76 pg/mL; range, 0.61 to 21.65 pg/mL; p = 0.013) and the control subjects (mean, 6.56 pg/mL; range, 0.51 to 17.98 pg/mL; p = 0.003). Sputum amphiregulin levels positively correlated with levels of sputum eosinophils (gamma = 0.221; p = 0.007) and sputum ECP (gamma = 0.601; p < 0.0001). Negative significant correlations were found between sputum amphiregulin and FEV(1) (gamma = -0.181; p = 0.006) or post-bronchodilator therapy FEV(1) (gamma = -0.233; p = 0.002). In children with asthma who were not receiving any controller medications, sputum amphiregulin level was negatively correlated with the provocative concentration of methacholine causing a 20% fall in FEV(1) (r = -0.398; p = 0.008). CONCLUSIONS: Our findings suggest that childhood asthma is associated with sputum amphiregulin, whereas EB is not, and that sputum amphiregulin would be a supportive marker of airway inflammation in asthma.ope