RESUMEN
Oak pollen allergy is common all over the world and an important cause of pollinosis. The molecular properties of some component allergens have been clearly characterized, while some of them are still waiting for characterization. Studies on some oak component allergens are neglected, possibly because of its high cross-reactivity to birch. However, the utilization of culprit allergen molecules is expected to increase the diagnostic sensitivity and efficacy of immunotherapy. Sensitization to oak pollen along with birch often causes pollen food allergy syndrome to fruits and vegetables. Acorn and wood dust from oak can cause allergic disease. We summarize the distribution and taxonomic classification of oak trees of allergenic importance. Molecular characteristics of the identified component allergens, cross-reactivity, and clinical aspects for diagnosis and immunotherapy are also described with an emphasis on Korean situations.
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Hipersensibilidad a los Alimentos , Quercus , Rinitis Alérgica Estacional , Humanos , Rinitis Alérgica Estacional/complicaciones , Polen , Inmunoglobulina E , Alérgenos , Reacciones Cruzadas , Hipersensibilidad a los Alimentos/diagnóstico , República de Corea/epidemiologíaRESUMEN
Allergen repertoire should reflect the region's climate, flora, and dining culture to allow for a better diagnosis. In Korea, tree pollens of oak and birch in the spring in conjunction with weed pollens of mugwort, ragweed, and Japanese hop are the main causes of seasonal allergic rhinitis. More specifically, the sawtooth oak in Korea and the Japanese hop in East Asia make a difference from western countries. Among food allergens, the sensitization to silkworm pupa and buckwheat is also common in Korean patients. Honey bee venom due to apitherapy in traditional medicine and Asian needle ant, Pachycondyla chinensis, are important causes of anaphylaxis in Korea. Climate change, frequent overseas traveling, and international product exchanges make situations more complicated. Ragweed, for example, was not native to Korea, but invaded the country in the early 1950s. Recently, Japanese hop and Asian needle ants have been recognized as important invasive ecosystem disturbing species in western countries. However, the molecular properties of the component allergens from these unique culprit allergens have been poorly characterized. The present review summarizes the molecular studies on the allergens of regional importance in Korea.
RESUMEN
BACKGROUND: Japanese hop is an important cause of weed pollinosis in East Asia. Its pollen is abundant in autumn. This pollen is known to be the cause of many allergic diseases. However, molecular characteristics of its allergens have not been elucidated. OBJECTIVE: In this study, we produced recombinant proteins of allergen homologues from Japanese hop by the analysis of expressed sequence tags (EST), and evaluated its allergenicity. METHODS: cDNA library was constructed using as little as 50 ng of total RNA from Japanese hop pollen. Allergen homologues were identified by the initial screening of 963 EST clones. Recombinant proteins were overexpressed in the E. coli expression system and purified using Ni-nitrilotriacetic acid-agarose. Purified proteins were analyzed by ELISA. RESULTS AND DISCUSSION: Japanese hop pathogenesis-related 1 protein (PR-1) shares 37.0 to 44.4% of amino acid sequence identity with Art v 2, Cuc m 3, and Cyn d 24. Pectin methyl esterase (PME) shows 23.2 to 50.2% of identities to Act d 7, Ole e 11, and Sal k 1. Polygalacturonase (PGs) shows 16.7 to 19.3% of identities to Phl p 13, Cry j 2, Cha o 2, Jun a 2, Pla a 2, and Pla or 2. IgE antibodies from Japanese hop allergy patients' sera recognized PR-1 (3.4%), PME (13.8%), PGs (3.7%), and profilin (13.8%), respectively. CONCLUSION: Novel allergenic components were identified, even though low IgE reactivity was displayed reflecting the low degree of cross-reactivity with other pollen allergens. We believe that these molecules have worth further studies.
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Alérgenos , Hidrolasas de Éster Carboxílico , Humulus , Proteínas de Plantas , Polen , Poligalacturonasa , Alérgenos/química , Alérgenos/genética , Hidrolasas de Éster Carboxílico/química , Hidrolasas de Éster Carboxílico/genética , Humanos , Humulus/química , Humulus/genética , Proteínas de Plantas/química , Proteínas de Plantas/genética , Polen/química , Polen/genética , Poligalacturonasa/química , Poligalacturonasa/genética , Proteínas Recombinantes/química , Proteínas Recombinantes/genéticaRESUMEN
Vitamin D (VitD) has pleiotropic effects. VitD deficiency is closely involved with obesity and may contribute to the development of lung fibrosis and aggravation of airway hyperresponsiveness (AHR). We evaluated the causal relationship between VitD deficiency and the lung pathologies associated with obesity. In vivo effects of VitD supplementation were analyzed using high-fat diet (HFD)-induced obese mice and TGF-ß1 (transforming growth factor-ß1) triple transgenic mice. Effects of VitD supplementation were also evaluated in both BEAS-2B and primary lung cells from the transgenic mice. Obese mice had decreased 25-OH VitD and VitD receptor expressions with increases of insulin resistance, renin and angiotensin-2 system (RAS) activity, and leptin. In addition, lung pathologies such as a modest increase in macrophages, enhanced TGF-ß1, IL-1ß, and IL-6 expression, lung fibrosis, and AHR were found. VitD supplementation to HFD-induced obese mice recovered these findings. TGF-ß1-overexpressing transgenic mice enhanced macrophages in BAL fluid, lung expression of RAS, epithelial-mesenchymal transition markers, AHR, and lung fibrosis. VitD supplementation also attenuated these findings in addition to the attenuation of the expressions of TGF-ß1, and phosphorylated Smad-2/3 in lung. Supplementing in vitro-stimulated BEAS-2B and primary lung cells with VitD inhibited TGF-ß1 expression, supporting the suppressive effect of VitD for TGF-ß1 expression. These results suggest that obesity leads to VitD deficiency and worsens insulin resistance while enhancing the expression of leptin, RAS, TGF-ß1, and proinflammatory cytokines. These changes may contribute to the development of lung fibrosis and AHR. VitD supplementation rescues these changes and may have therapeutic potential for asthma with obesity.
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Obesidad/complicaciones , Fibrosis Pulmonar/etiología , Hipersensibilidad Respiratoria/etiología , Deficiencia de Vitamina D/etiología , Animales , Biomarcadores/metabolismo , Peso Corporal/efectos de los fármacos , Células Cultivadas , Citocinas/metabolismo , Dieta Alta en Grasa , Suplementos Dietéticos , Transición Epitelial-Mesenquimal/efectos de los fármacos , Prueba de Tolerancia a la Glucosa , Inflamación/patología , Insulina/metabolismo , Leptina/sangre , Pulmón/metabolismo , Pulmón/patología , Masculino , Cloruro de Metacolina , Ratones Endogámicos C57BL , Ratones Transgénicos , Obesidad/sangre , Fibrosis Pulmonar/sangre , Receptores de Calcitriol/metabolismo , Renina/sangre , Sistema Renina-Angiotensina/efectos de los fármacos , Hipersensibilidad Respiratoria/sangre , Factor de Crecimiento Transformador beta1/metabolismo , Vitamina D/análogos & derivados , Vitamina D/sangre , Vitamina D/farmacología , Deficiencia de Vitamina D/sangreRESUMEN
BACKGROUND/AIMS: Accurate diagnosis and the effects of allergen-specific immunotherapy for pollinosis are greatly dependent on the potency and stability of the extract. This study aimed to examine factors, such as temperature and storage buffer composition, that affect the stability of allergen extracts from pollens of allergenic importance in Korea. METHODS: We prepared four pollen allergen extracts from ragweed, mugwort, Japanese hop, and sawtooth oak, which are the most important causes of seasonal rhinitis in Korea. Changes of protein and major allergen concentration were measured over 1 year by Bradford assay, two-site enzyme-linked immunosorbent assay, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis after reconstitution of the lyophilized allergen extract in various buffers and stored at room temperature (RT, 18°C to 26°C) or refrigerated (4°C). RESULTS: More than 90% of the original protein concentration in all four extracts examined was detected over 1 year when 50% glycerol was added and refrigerated, whereas 57.9% to 94.5% remained in the extracts at RT. The addition of 50% glycerol to the storage buffer was found to prevent protein degradation at RT. Amb a 1, a major allergen of ragweed, was almost completely degraded in 9 weeks at RT when reconstituted in a buffer without 50% glycerol. However, 55.6% to 92.8% of Amb a 1 content was detected after 1 year of incubation at 4°C in all buffer conditions except 0.3% phenol. CONCLUSION: Addition of 50% glycerol as well as refrigeration was found to be important in increasing the shelf-life of allergen extracts from pollens of allergenic importance.
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Alérgenos , Polen , Humanos , Immunoblotting , Extractos Vegetales , República de CoreaRESUMEN
PURPOSE: The current study was undertaken to investigate whether Brazilian green propolis (BGP) can increase the viability of retinal ganglion cells (RGCs) in ischemic mouse retina, and examined the possible mechanisms underlying this neuroprotection. MATERIALS AND METHODS: C57BL/6J mice were subjected to constant elevation of intraocular pressure for 60 min to establish retinal ischemia-reperfusion injury. Mice then received saline or BGP (200 mg/kg) intraperitoneally once daily until sacrifice. The expression of hypoxia-inducing factor (HIF)-1α and glial fibrillary acidic protein (GFAP) and the level of histone acetylation were assessed at 1, 3, and 7 days after injury. The expression of Bax, Bcl-2, p53, NF-κB, Nrf2, and HO-1 were also analyzed at 3 days after injury. The neuroprotective effect of BGP treatment on RGC survival was evaluated using Brn3a immunohistochemical staining. RESULTS: The expression of HIF-1α and GFAP was increased and the level of histone acetylation decreased in saline-treated ischemic retinas within 7 days. BGP treatment effectively attenuated the elevated expression of HIF-1α, GFAP, Bax, NF-κB and p53. The expression of Bcl-2, Nrf2, HO-1 and the level of histone acetylation increased by BGP treatment, resulting in a significant difference between BGP-treated and saline-treated retinas. Immunohistochemical staining for Brn3a also revealed that BGP treatment protected against RGC loss in ischemic retina. CONCLUSIONS: Our results suggest that BGP has a neuroprotective effect on RGCs through the upregulation of histone acetylation, downregulation of apoptotic stimuli, and suppression of NF-κB mediated inflammatory pathway in ischemic retina. These findings suggest that BGP is a potential neuroprotective agent against RGC loss under oxidative stress.
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Fármacos Neuroprotectores/uso terapéutico , Própolis/uso terapéutico , Daño por Reperfusión/tratamiento farmacológico , Enfermedades de la Retina/tratamiento farmacológico , Células Ganglionares de la Retina/efectos de los fármacos , Acetilación , Animales , Brasil , Supervivencia Celular , Proteína Ácida Fibrilar de la Glía/metabolismo , Histonas/metabolismo , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Inyecciones Intraperitoneales , Ratones , Ratones Endogámicos C57BL , Fármacos Neuroprotectores/química , Estrés Oxidativo , Própolis/química , Daño por Reperfusión/metabolismo , Daño por Reperfusión/patología , Enfermedades de la Retina/metabolismo , Enfermedades de la Retina/patología , Células Ganglionares de la Retina/metabolismo , Células Ganglionares de la Retina/patología , Factor de Transcripción Brn-3A/metabolismo , Regulación hacia ArribaRESUMEN
Oral allergy syndrome (OAS) is the most common food allergy-related condition in adults. This study aimed to investigate whether subcutaneous immunotherapy (SCIT) with Fagales pollen-containing extracts can improve the clinical symptoms of OAS in Korea. In total, 56 OAS patients were included: 19 subjects treated with SCIT, which included Fagales pollen extracts, and 37 not treated with immunotherapy (IT). We reviewed the patients' medical records and administered a telephone questionnaire at one point to assess baseline OAS features and changes in the patients' OAS and allergic rhinoconjunctivitis (ARC) symptoms after treatment. Only 12 patients who received SCIT and 15 patients that did not receive SCIT could report on changes in OAS symptoms after treatment because the other patients practiced strict avoidance of their culprit fruits and vegetables, and they could not respond to the status of OAS. SCIT reduced the severity of OAS (p=0.005). Nine of the 12 patients (75%) that received SCIT reported a more than 50% reduction in OAS symptoms. In contrast, only three of the 15 patients (20%) that did not receive IT reported more than a 50% reduction in OAS symptoms. SCIT also reduced the severity of ARC symptoms (p<0.001). The results indicate that SCIT with Fagales pollen-containing extracts is associated with improved OAS symptoms in Korea.
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Fagales , Hipersensibilidad a los Alimentos/terapia , Inmunoterapia/métodos , Extractos Vegetales/administración & dosificación , Polen , Adolescente , Adulto , Alérgenos , Fagales/química , Femenino , Humanos , Inyecciones Subcutáneas , Masculino , Persona de Mediana Edad , Extractos Vegetales/inmunología , Polen/inmunología , República de Corea , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
PURPOSE: Japanese hop (Humulus japonicus) is a major cause of weed pollinosis in East Asia. However, supplies of commercial allergen extract from this plant have not met clinical demand. The pollen of common hop (Humulus lupulus), a closely related species, may provide an alternative source if there is strong IgE cross-reactivity between these two species. We aimed to compare the IgE cross-reactivity and allergenicity of common hop and Japanese hop pollen. MATERIALS AND METHODS: Cross-reactivity was measured by inhibition ELISA. One- and two-dimensional (2D) gel analyses combined with IgE immunoblotting and mass spectrometry [liquid chromatography coupled to electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS)] were performed to detect IgE-reactive pollen components. RESULTS: Up to 16.7% of IgE reactivity to Japanese hop was inhibited by common hop. A 12-kDa protein component of Japanese hop pollen that showed the most potent IgE reaction was absent from common hop. Six IgE-reactive components from Japanese hop were detected by 2D gel electrophoresis and LC-ESI-MS/MS, but showed low Mascot scores, preventing positive identification. CONCLUSION: No significant IgE cross-reaction was observed for Japanese and common hop pollen allergens. Development of allergy diagnostic and immunotherapeutic reagents based on Japanese hop pollen are urgently needed.
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Alérgenos/inmunología , Reacciones Cruzadas , Inmunoglobulina E/inmunología , Polen/química , Ionización del Aire , Alérgenos/análisis , Cromatografía Liquida , Electroforesis en Gel Bidimensional , Ensayo de Inmunoadsorción Enzimática , Humanos , Humulus , Hipersensibilidad , Immunoblotting , Inmunoglobulina E/sangre , Japón , Polen/inmunología , Espectrometría de Masas en TándemRESUMEN
BACKGROUND: Oaks are the most common trees in Korean forests, and Mongolian oak, Quercus mongolica, is the dominant species. However, no allergen has been characterized from Mongolian oak. In this study, we tried to characterize a major allergen from Mongolian oak. METHODS: A molecule homologous to pathogenesis-related 10 (PR-10)-like protein, Que m 1, was cloned by RT-PCR. Its recombinant protein, along with Que a 1, an allergen from white oak (Q. alba), was produced. The allergenicity and diagnostic value of recombinant Que m 1, Que a 1, and Bet v 1 proteins were compared by ELISA using sera from oak-sensitized subjects. A basophil activation test was also performed using CD63 expression as an activation marker. RESULTS: Que m 1 sequence shares 57.5-96.2% amino acid sequence identity with PR-10-like allergens from various plants. Specific IgE to recombinant Que m 1, Que a 1, and Bet v 1 were detected in 92.0, 74.0, and 38.0% of 50 serum samples from Korean tree pollinosis patients. Recombinant Que m 1 was able to inhibit IgE reactivity to Que a 1 and Bet v 1, indicating its strong cross-reactivity. The activation patterns of basophils from 5 patients were similar in terms of the CD63 expression and protein concentration of challenged Bet v 1 and Que m 1. CONCLUSIONS: A major allergen, Que m 1, was cloned, and its recombinant protein was produced from Mongolian oak, a dominant species in Korea. Recombinant Que m 1 is potentially useful for the diagnosis and treatment of tree pollinosis in Korea.
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Antígenos de Plantas/inmunología , Proteínas de Plantas/inmunología , Quercus/química , Quercus/inmunología , Rinitis Alérgica Estacional/diagnóstico , Adolescente , Adulto , Anciano , Secuencia de Aminoácidos , Antígenos de Plantas/química , Antígenos de Plantas/genética , Secuencia de Bases , Basófilos/inmunología , Niño , Clonación Molecular , Femenino , Humanos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Masculino , Persona de Mediana Edad , Polen/inmunología , Estructura Secundaria de Proteína , República de Corea , Rinitis Alérgica Estacional/inmunología , Árboles/inmunología , Adulto JovenRESUMEN
Oak and birch trees belong to Fagales order. Specific IgE to pollen allergens of both trees are frequently found in Korea pollinosis patients. Oak trees which comprise 40% of forest area are common in Korea. However, birch trees are sparse. We compared the allergenicity of pollen extracts of white oak, sawtooth and Mongolian oaks which are prevalent species in Korea, with the pollen extract of birch. The cross-reactivity of four pollen extracts was examined with pooled sera of 12 patients by ELISA, immunoblotting and CAP inhibitions. A protein of 17 kDa, putatively homologous to a major birch allergen Bet v 1, displayed strong IgE reactivity from white oak and sawtooth oak pollen extract but not from Mongolian oak pollen. Notably, a 23-kDa protein from sawtooth and white oaks showed strong IgE reactivity and inhibited by Bet v 1. IgE binding to white oak was inhibited a maximum of 94.6% by white oak, 93.4% by sawtooth oak, 83.2% by Mongolian oak, and 68.8% by birch. Furthermore, sawtooth oak, white oak, and Mongolian oak extracts were able to inhibit up to 78.5%, 76.6% and 67.3% of IgE binding to birch extract, while birch extract itself inhibited up to 94.3%. Specific IgE to Bet v 1 was inhibited a maximum of 79.1% by sawtooth oak, 77.4% by white oak, and 72.7% by Mongolian oak, while 81.5% inhibition was shown by birch. Bet v 1 was able to partially inhibit its homologous molecules from sawtooth oak and white oak in immunoblotting. Birch pollen extract was found to be cross-reactive primarily with Bet v 1-homologous allergen from oak pollens in Korea pollinosis patients. Considering the sparseness of birch tree in Korea, oak, especially sawtooth oak may be the main cause of tree pollinosis in Korea, rather than birch.
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Alérgenos/inmunología , Betula/inmunología , Hipersensibilidad/diagnóstico , Polen/inmunología , Quercus/inmunología , Adolescente , Adulto , Pueblo Asiatico , Betula/crecimiento & desarrollo , Niño , Reacciones Cruzadas , Electroforesis en Gel de Poliacrilamida , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Immunoblotting , Inmunoglobulina E/sangre , Masculino , Persona de Mediana Edad , Quercus/crecimiento & desarrollo , República de CoreaRESUMEN
BACKGROUND: Silica nanoparticles (SNPs) can easily enter in respiratory system via inhalation because of their low molecular weight and ease of dispersion. Toxicity and adverse effects of SNPs vary according to the physical characteristics of the particle. METHODS: To evaluate the toxic and adjuvant effects of 3 types of SNPs in the airway system, six-week-old female BALB/c mice were intranasally administered 3 types of SNPs (spherical [S-SNP], mesoporous [M-SNP], and polyethylene glycol-conjugated [P-SNP]) alone or SNPs/ovalbumin (OVA), three times weekly for 2 weeks. Airway hyper-responsiveness (AHR), bronchoalveolar lavage fluid (BALF), cytokine levels, and histology of the lungs were analyzed. RESULTS: The S-SNPs/OVA group and M-SNPs/OVA group showed significant AHR, compared to the control group. Among all SNP-treated groups, the group administered SNPs/OVA showed greater inflammatory cell infiltration in BALF, extensive pathological changes, and higher cytokine levels (IL-5, IL-13, IL-1ß, and IFN-γ) than those administered SNPs alone or saline/OVA. CONCLUSION: Exposure to SNPs alone and SNPs/OVA induced toxicity in the respiratory system. SNPs alone showed significant toxic effects on the airway system. Meanwhile, SNPs/OVA exerted adjuvant effects to OVA of inducing allergic airway inflammation. In particular, M-SNPs showed the most severe airway inflammation in both direct toxicity and adjuvant effect assays. P-SNPs induced less inflammation than the other types of SNPs in both models.
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Pulmón/efectos de los fármacos , Nanopartículas/toxicidad , Ovalbúmina , Neumonía/inducido químicamente , Dióxido de Silicio/toxicidad , Animales , Hiperreactividad Bronquial/inducido químicamente , Hiperreactividad Bronquial/fisiopatología , Líquido del Lavado Bronquioalveolar/química , Broncoconstricción/efectos de los fármacos , Citocinas/metabolismo , Modelos Animales de Enfermedad , Femenino , Mediadores de Inflamación/metabolismo , Exposición por Inhalación , Pulmón/inmunología , Pulmón/metabolismo , Pulmón/fisiopatología , Ratones Endogámicos BALB C , Nanopartículas/química , Neumonía/inmunología , Neumonía/metabolismo , Neumonía/fisiopatología , Polietilenglicoles/toxicidad , Porosidad , Dióxido de Silicio/químicaRESUMEN
PURPOSE: Japanese hop (Humulus spp.) and mugwort (Artemisia spp.) are notable causes of autumn pollinosis in East Asia. However, Japanese hop and mugwort pollen extracts, which are widely used for the diagnosis, have not been standardized. This study was performed to standardize Japanese hop and mugwort pollen extracts. MATERIALS AND METHODS: Allergen extracts were prepared in a standardized way using locally collected Humulus japonicus and purchased Artemisia vulgaris pollens. The immunoglobulin E (IgE) reactivities of prepared extracts were compared with commercial extracts via IgE immunoblotting and inhibition analyses. Intradermal skin tests were performed to determine the bioequivalent allergy unit (BAU). RESULTS: The IgE reactive components of the extracts via IgE immunoblotting were similar to those of commercial extracts. A 11-kDa allergen showed the strongest IgE reactivity in Japanese hop, as did a 28-kDa allergen in mugwort pollen extracts. Allergenic potencies of the investigatory Japanese hop and mugwort extracts were essentially indistinguishable from the commercial ones. Sums of erythema of 50 mm by the intradermal skin test (ΣED50) were calculated to be 14.4th and 13.6th three-fold dilutions for Japanese hop and mugwort extracts, respectively. Therefore, the allergenic activity of the prepared extracts was 90827.4 BAU/mg for Japanese hop and 34412 BAU/mg for mugwort. CONCLUSION: We produced Japanese hop and mugwort pollen extracts using a standardized method. Standardized Japanese hop and mugwort pollen extracts will facilitate the production of improved diagnostic and immunotherapeutic reagents.
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Alérgenos/análisis , Alérgenos/inmunología , Artemisia , Inmunoglobulina E/inmunología , Polen/química , Polen/inmunología , Especificidad de Anticuerpos , Hiperreactividad Bronquial/sangre , Hiperreactividad Bronquial/inmunología , Reacciones Cruzadas , Ensayo de Inmunoadsorción Enzimática , Humanos , Immunoblotting , Inmunoglobulina E/sangre , Estándares de Referencia , República de Corea , Rinitis Alérgica EstacionalRESUMEN
PURPOSE: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but fatal adverse mucocutaneous reactions to certain drugs. Recent studies suggest that ethnicity and genetic predisposition may play a crucial role in the manifestation of the reaction. In this study, we described the role of human leukocyte antigen (HLA)-B alleles in the development of clinical characteristics and treatment outcomes of SJS/TEN in a single Korean tertiary hospital. METHODS: We retrospectively reviewed the medical records (from March 1, 2010 to February 28, 2014) of 30 patients diagnosed with SJS and/or TEN. RESULTS: The main causative drugs were anticonvulsants (26.7 %) and allopurinol (26.7 %), followed by antibiotics (16.7 %), acetazolamide (10.0 %), acetaminophen (10.0 %), and herbal medication (6.7 %). The mean latencies of these drugs were variable. Liver damage was the most common symptom (observed in 63.3 % of the patients). Of the five patients with lamotrigine-induced SJS/TEN, three expressed the HLA-B*4403 allele (60.0 %). Of the seven patients with allopurinol-induced SJS/TEN, five expressed the HLA-B*5801 allele (71.4 %). CONCLUSIONS: The major SJS/TEN-inducing drugs were found to be allopurinol and anticonvulsants (such as lamotrigine). We speculated that Korean individuals expressing the HLA-B*4403 allele may be highly susceptible to lamotrigine-induced SJS/TEN.
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Anticonvulsivantes/efectos adversos , Pueblo Asiatico/genética , Predisposición Genética a la Enfermedad , Antígenos HLA-B/genética , Síndrome de Stevens-Johnson/genética , Triazinas/efectos adversos , Acetaminofén/efectos adversos , Acetazolamida/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Alelos , Alopurinol/efectos adversos , Antibacterianos/efectos adversos , Femenino , Humanos , Lamotrigina , Masculino , Persona de Mediana Edad , Plantas Medicinales/efectos adversos , República de Corea , Síndrome de Stevens-Johnson/etiología , Centros de Atención Terciaria , Adulto JovenRESUMEN
BACKGROUND: Though insurance claims data are useful for researching asthma, they have important limitations, such as a diagnostic inaccuracy and a lack of clinical information. To overcome these drawbacks, we used the novel method by merging the clinical data from our asthma cohort with the National Health Insurance (NHI) claims data. METHODS AND RESULTS: Longitudinal analysis of asthma-related healthcare use from the NHI claims database, merged with data of 736 patients registered in a Korean asthma cohort, was conducted for three consecutive years from registration of the cohort. Asthma-related asthma healthcare referred to outpatient and emergency department visits, hospitalizations, and the use of systemic corticosteroids. Univariate and multivariate logistic regression analysis was used to evaluate risk factors for asthma-related healthcare. Over three years after enrollment, many patients changed from tertiary to primary/secondary hospitals with a lack of maintenance of inhaled corticosteroid-based controllers. An independent risk factor for emergency visits was a previous history of asthma exacerbation. In hospitalizations, old age and Asthma Control Test (ACT) score variability were independent risk factors. An independent risk factor for per person cumulative duration of systemic corticosteroids was the FEV1 (Forced expiratory volume in one second)%. The use of systemic corticosteroids was independently associated with being female, the FEV1%, and ACT score variability. CONCLUSION: We found that old age, being female, long-standing asthma, a low FEV1%, asthma brittleness, asthma drug compliance, and a history of asthma exacerbation were independent risk factors for increased asthma-related healthcare use in Korea.
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Asma/patología , Atención a la Salud , Administración por Inhalación , Corticoesteroides/uso terapéutico , Adulto , Factores de Edad , Anciano , Pueblo Asiatico , Asma/tratamiento farmacológico , Asma/economía , Estudios de Cohortes , Bases de Datos Factuales , Servicio de Urgencia en Hospital , Femenino , Volumen Espiratorio Forzado , Hospitales , Humanos , Modelos Logísticos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Programas Nacionales de Salud , Oportunidad Relativa , Fenotipo , República de Corea , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores SexualesRESUMEN
OBJECTIVE: The prevalence of asthma is increasing, and asthma causes considerable socioeconomic burden worldwide. Few studies have been conducted to evaluate the risk factors associated with economic cost of asthma in Korea. This study evaluated asthma cost according to severity, control, and patient factors in Korean tertiary hospitals. METHODS: Direct and indirect costs were assessed in physician-diagnosed adult asthmatics recruited from eight tertiary hospitals in Korea. Official direct medical costs were derived from the analysis of 1-year expenditures related to hospital care utilization and asthma medication. Nonofficial medical costs, nonmedical direct costs, and indirect costs were investigated using a questionnaire designed specifically for the study. RESULTS: A total of 314 patients with persistent asthma were recruited. Both direct and indirect costs were significantly higher for patients with severe persistent asthma than for those with mild and moderate persistent asthma ($2214 vs. $871 and $978, p < .001; $2927 vs. $490 and $443, p < .001, respectively). Costs of asthma increased significantly in poorly controlled compared with somewhat controlled and well-controlled asthma ($7009.8 vs. $2725.3 vs. $1517.3, respectively; p < .001). After stratification for severity, a significant cost increase in the poorly controlled asthma group was observed only for indirect costs and not for direct costs. A multivariate analysis showed that female gender was a risk factor for increased indirect costs. CONCLUSION: The burden of asthma was higher both for patients with severe persistent asthma and for patients with poorly controlled asthma. More effective strategies are needed to improve control status, particularly targeting patients with severe asthma.
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Asma/economía , Costo de Enfermedad , Costos de la Atención en Salud/estadística & datos numéricos , Hospitales/clasificación , Anciano , Atención Ambulatoria/economía , Antiasmáticos/economía , Asma/diagnóstico , Asma/fisiopatología , Asma/terapia , Terapias Complementarias/economía , Femenino , Volumen Espiratorio Forzado/fisiología , Hospitalización/economía , Humanos , Masculino , Medicina Tradicional de Asia Oriental/economía , Persona de Mediana Edad , Calidad de Vida , República de Corea , Factores Sexuales , Encuestas y CuestionariosRESUMEN
PURPOSE: To evaluate the prevalence, compliance, pattern of use, and economic cost of OM in Korean allergy patients. METHODS: A total of 647 allergy patients were enrolled from 10 general hospitals, and were surveyed by the questionnaire. It consisted of 12 items and regarded the prescription rates, reasons for referring, their opinions for the efficacy of OM, and economic costs. RESULTS: A total of 259 (40.5%) patients had used OM, and 35.5% of these patients experienced two or more kinds of these practices. A patients' income or education level did not affect the prescription rates of OM. Of the patients that used OM, 34.6% of them were satisfied with the effect of OM treatment, and 40.9% of them were inclined to continue with their OM treatments. The most frequent reasons for choosing OM were the patient's belief that OM can predispose 'allergic constitution to normal' (30.2%), worries about the possible adverse reactions of the long-term administration of the proven drugs (20.2%), and the safety of OM (15.6%). However, 18.9% of these patients experienced perceived adverse events to their OM treatment such as skin rashes, gastrointestinal discomfort, and hepatitis. The patients that have used OM spent on average $915 US dollars annually for OM treatment. CONCLUSIONS: Many Korean allergy patients are cliental to OM. Some patients experienced a satisfactory treatment effect from OM, however, others had no treatment effect, even adverse event. Therefore, it is important to educate people to use OM appropriately to make harmony with modern medicine.
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Hipersensibilidad/tratamiento farmacológico , Medicina Tradicional de Asia Oriental , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Prescripciones de Medicamentos , Femenino , Humanos , Masculino , Medicina Tradicional de Asia Oriental/efectos adversos , Medicina Tradicional de Asia Oriental/economía , Persona de Mediana Edad , República de Corea , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Mechanical laundry is an effective tool for the environmental control of allergens, but the optimal conditions for removing allergens are not yet clear. OBJECTIVE: To evaluate the optimal conditions of mechanical laundry for the removal of house dust mite (HDM), dog dander, and pollen allergens. METHODS: The 4 washing modes of 30 degrees C (86 degrees F), 40 degrees C (104 degrees F), 60 degrees C (140 degrees F), and steam water (SW) with detergent were evaluated. Allergen removal performance was assayed using a 2-site enzyme-linked immunosorbent assay (ELISA) or an ELISA inhibition test. RESULTS: Using the 30 degrees C and 40 degrees C washing modes, only 6.5% and 9.6% of Dermatophagoides farinae, respectively, were killed. However, using the 60 degrees C and SW washing modes, all HDMs were killed. The amounts of Der f 1 remaining after the 30 degrees C, 40 degrees C, 60 degrees C, and SW washing modes were 26.8%, 2.4%, 1.3%, and 0.6%, respectively, with unmanipulated contaminated sheets. The effects of rinse on Der f 1 levels after the 30 degrees C washing were greater compared with those after the 40 degrees C, 60 degrees C, and SW modes. The amounts of Can f 1 in the extractions after washing were 0.3% to 1.3% for all modes, and all extracts, even without a rinse, did not inhibit specific IgE binding to dog allergens according to ELISA. The remaining pollen allergen levels after washing were lower in the 60 degrees C and SW modes than in the lower temperature modes. However, the levels did not differ among the various washing modes after rinsing once. CONCLUSION: Water temperature and number of rinses are critical factors for the removal of HDM, dog dander, and pollen allergens.
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Alérgenos/análisis , Antígenos Dermatofagoides/análisis , Lavandería/métodos , Polen/inmunología , Piel/inmunología , Alérgenos/inmunología , Animales , Antígenos Dermatofagoides/inmunología , Antígenos de Plantas , Proteínas de Artrópodos , Ropa de Cama y Ropa Blanca , Cisteína Endopeptidasas , Dermatophagoides farinae/inmunología , Detergentes/química , Perros , Ensayo de Inmunoadsorción Enzimática , Hipersensibilidad/prevención & control , Hipersensibilidad/terapia , Inmunoglobulina E/inmunología , Vapor , TemperaturaRESUMEN
BACKGROUND: The 16-kDa protein of buckwheat (BW) has been implicated as a major allergen in BW allergy. OBJECTIVE: To characterize the 16-kDa allergen and evaluate its clinical significance as an indicator of BW allergy. METHODS: Complementary DNA from the 16-kDa allergen was cloned and expressed in Escherichia coli. Allergenicity was confirmed with IgE immunoblotting or with an enzyme-linked immunosorbent assay. The clinical utility of the recombinant protein (r16 kDa) for diagnosis of BW reactivity was evaluated in 18 BW-allergic and in 20 asymptomatic BW-sensitized subjects. RESULTS: The 16-kDa allergen, composed of 127 amino acids, has 50% homology to the reported 8-kDa BW allergen, which belongs to the 2 S storage albumin. The r16-kDa protein can inhibit specific IgE (sIgE) antibody binding to the native BW 16-kDa allergen but minimally inhibited sIgE binding to crude BW extract. Approximately 77.8% of patients with the BW allergy produced sIgE antibodies to the r16-kDa protein, compared with a complete lack of reactivity in the 20 asymptomatic BW-sensitized subjects. The areas of the receiver operating characteristic curves for the skin prick test (mean, 0.93; 95% confidence interval, 0.85 to approximately 1.01; P < .001) and the rl6-kDa enzyme-linked immunosorbent assay (mean, 0.93; 95% confidence interval, 0.84 to approximately 1.01; P < .001) were higher than the area of the BW IgE measurement curve determined by ImmunoCAP (a system for assaying serum IgE) (mean, 0.80; 95% confidence interval, 0.66 to approximately 0.94; P = .002). CONCLUSIONS: The 16-kDa allergen belongs to the 2 S storage albumin. Measurement of rl6-kDa sIgE was more discriminating than measurement of ImmunoCAP sIgE in whole BW extracts for the diagnosis of clinical reactivity to BW.
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Antígenos de Plantas/inmunología , Fagopyrum/inmunología , Hipersensibilidad a los Alimentos/diagnóstico , Proteínas de Plantas/inmunología , Albuminas 2S de Plantas , Adolescente , Adulto , Secuencia de Aminoácidos , Antígenos de Plantas/genética , Antígenos de Plantas/metabolismo , Unión Competitiva , Niño , Intervalos de Confianza , Método Doble Ciego , Ensayo de Inmunoadsorción Enzimática , Fagopyrum/genética , Fagopyrum/metabolismo , Femenino , Hipersensibilidad a los Alimentos/inmunología , Humanos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Masculino , Datos de Secuencia Molecular , Extractos Vegetales/inmunología , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Curva ROC , Proteínas Recombinantes/inmunología , Proteínas Recombinantes/metabolismo , Homología de Secuencia de Aminoácido , Pruebas Cutáneas/métodosRESUMEN
BACKGROUND: The 19-kD protein of buckwheat (BW) has been suggested to be a major allergen, but its characteristics and clinical significance are poorly defined. METHODS: cDNA of the 19-kD BW allergen was cloned and expressed in Escherichia coli. Allergenicity and cross-allergenicity were confirmed by inhibition immunoblotting or by ELISA inhibition. The recombinant (r19-kD) protein was assessed for clinical utility in the diagnosis of BW reactivity in 18 BW-allergic and 19 BW-asymptomatic sensitized subjects using receiver operating characteristic analysis. RESULTS: The 19-kD BW allergen, which is composed of 135 amino acids, has a weak homology to the vicilin-like allergens of cashew (Ana o 1), English walnut (Jug r 2) and 7 S globulin from Sesamum indicum. The r19-kD protein can inhibit sIgE binding to native 19-kD BW allergen. The maximum percentage inhibition of sIgE binding to crude BW extract was 56%. About 83.3% of the BW allergy patients had sIgE bound to r19-kD protein, compared to only 1 of the 19 BW-asymptomatic sensitized subjects. The areas under the receiver operating characteristic curves for the skin prick tests [0.925 (95% confidence interval: 0.839-1.012), p < 0.001] as well as r19-kD protein sIgE ELISAs [0.860 (95% confidence interval: 0.725-0.995), p <0.001] were higher than that of BW sIgE coated allergen particle test results [0.803 (95% confidence interval: 0.661-0.945), p = 0.002]. CONCLUSIONS: The 19-kD BW allergen may be the major allergen from BW. For the diagnosis of clinical reactivity to BW, the r19-kD protein sIgE ELISA test was more discriminative than the coated allergen particle sIgE measurement using whole BW extract.