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기관지 천식에 대한 면역치료의 효과 - 임상증상 , 말초혈액호산구수 , 피부반응검사 , 혈청내특이 IgE 치 , 히스타민 유발시험 및 세포성면역반응의 변화 -
이충섭(C . S . Lee),이영승(Y . S . Rhee),박영규(Y . K . Park),이양근(Y . K . Rhee),이용철 대한내과학회 1990 대한내과학회지 Vol.39 No.4
N/A The changes of symptom grade, peripheral eosinophil counts, specfic IgE levels, allergen skin test, histamine provocation test (HPT), and cell mediated immunity before and during immunotherapy were observed in 36 bronchial asthmatics and 10 healthy persons. Immunotherapy was performed with SDV, HDM, Alavac-S HDM, i.e., mixtures of multiple allergens specific for each patient. The clinical grade was improved by immunotherapy. The peripheral eosinophil counts significantly decreased by immunotherapy, but no significant difference was observd among the 6month-1 year, 1-2 years, 2-3 years, or over 3 years groups. The wheal size measured by prick test with specific allergens decreased by immunotherapy, but no statistically significant difference was observed among each group. All specific IgE levels measured by RAST showed either equal or decreased levels compared with the initial level of specific IgE measured before immunotherapy. When HPT was performed with histamine at a concentration of 2 mg/ml and 5 mg/ml, no treatment group among bronchial asthmatics showed a higher positive rate and progressively decreased during immunotherapy. The mean antigen score obtained by Multitest® CMI skin test for cell mediated immunity showed no significant differences among healthy, preimmunotherapy, and immunotherapy-groups. HDM: house dust mite vaccine-Dermatophagoides pteronyssinus allergen adsorbate SDV: specific desensitization vaccine Alavac-S HDM: alum adsorbed allergen house dust mite-D pteronyssinus and D. farinae.
다이프로피온산 베클로메타손과 부데소니드의 투여 용량에 따른 코르티솔 농도와 변화
이영승,김종구,이양근,최수미,송하숙,이용철 대한내과학회 1993 대한내과학회지 Vol.45 No.6
Background: Topical inhaled steroids, budesonide (Bu) and beclomethasone dipropionate (BDP) is now established in the management of chronic: asthma. These have high topical anti-inflammatory activity but low systemic activity. This study was performed to determine the effects of two inhaled corticosteroids, Bu and BDP, on the adrenocortical supression in thirty patients, eighteen chronic obstructive pumonary diseases and twelve bronchial asthma (aged 33-76 years). Methods: The adrenocortical function was assessed by measurement of plasma cortisol concentration at 8 o' clock in morning and free cortisol in 24-hour urine collection at interval, No steroid was taken during the pretreatment period of 10 days, thereafter each subject inhaled Bu or BDP aerosol, in daily doses of 800 or 1,600 micrograms for 12 days. The dose was delieved by metered dose inhaler (MDI) or diskhaler. No steroid was taken during the final 6 days of the study. Results: The plasma cortisol and 24-hour urinary free cortisol were decreased during the treatment period in patients inhaled Bu in daily doses of 800 and 1,600 micrograms. In contrast, plasma cortisol was decreased on the 12th day of treatment period in patients inhaled RDP, in daily doses of 800 micrograms (P less than 0.05). The plasma cortisol and 24-hour urinary free cortisol were decreased (P less than 0.05) on the 9 and 12 th day of treatment period in patients inhaled BDP in daily doses of 1,600 micrograms. Conclusion: These results suggested that suppression of the endogenous cortisol secretion occurs at inhaled budesonide and beclomethasone dipropionate is less suppressed on the adrenocortical function than budesonide in dose dependent fashion during the early periods,