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Asthma-COPD Overlap Syndrome: What We Know and What We Don't
Sin, Don D. The Korean Academy of Tuberculosis and Respiratory 2017 Tuberculosis and Respiratory Diseases Vol.80 No.1
Approximately one in four patients with chronic obstructive pulmonary disease (COPD) have asthmatic features consisting of wheezing, airway hyper-responsiveness or atopy. The Global initiative for Asthma/Globalinitiative for chronic Obstructive Lung Disease committee recently labelled these patients as having asthma-COPD overlap syndrome or ACOS. ACOS also encompasses patients with asthma, ${\geq}40$ years of age, who have been cigarette smokers (more than 5-10 pack years) or have had significant biomass exposure, and demonstrate persistent airflow limitation defined as a post-bronchodilator forced expiratory volume in 1 second ($FEV_1$)/forced vital capacity of <70%. Data over the past 30 years indicate that patients with ACOS have greater burden of symptoms including dyspnea and cough and show higher risk of COPD exacerbations and hospitalizations than those with pure COPD or pure asthma. Patients with ACOS also have increased risk of rapid $FEV_1$ decline and COPD mortality. Paradoxically, experimental evidence to support therapeutic decisions in ACOS patients is lacking because traditionally, patients with ACOS have been systematically excluded from therapeutic COPD and asthma trials to maintain homogeneity of the study population. In this study, we summarize the current understanding of ACOS, focusing on definitions, epidemiology and patient prognosis.
Asthma-COPD Overlap Syndrome: What We Know and What We Don`t
( Don D. Sin ) 대한결핵 및 호흡기학회 2017 Tuberculosis and Respiratory Diseases Vol.80 No.1
Approximately one in four patients with chronic obstructive pulmonary disease (COPD) have asthmatic features consisting of wheezing, airway hyper-responsiveness or atopy. The Global initiative for Asthma/Globalinitiative for chronic Obstructive Lung Disease committee recently labelled these patients as having asthma-COPD overlap syndrome or ACOS. ACOS also encompasses patients with asthma, ≥40 years of age, who have been cigarette smokers (more than 5-10 pack years) or have had significant biomass exposure, and demonstrate persistent airflow limitation defined as a post-bronchodilator forced expiratory volume in 1 second (FEV<sub>1</sub>)/forced vital capacity of <70%. Data over the past 30 years indicate that patients with ACOS have greater burden of symptoms including dyspnea and cough and show higher risk of COPD exacerbations and hospitalizations than those with pure COPD or pure asthma. Patients with ACOS also have increased risk of rapid FEV<sub>1</sub> decline and COPD mortality. Paradoxically, experimental evidence to support therapeutic decisions in ACOS patients is lacking because traditionally, patients with ACOS have been systematically excluded from therapeutic COPD and asthma trials to maintain homogeneity of the study population. In this study, we summarize the current understanding of ACOS, focusing on definitions, epidemiology and patient prognosis.
Chronic Obstructive Pulmonary Disease and the Airway Microbiome: What Respirologists Need to Know
( Don D. Sin ) 대한결핵 및 호흡기학회 2023 Tuberculosis and Respiratory Diseases Vol.86 No.3
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. The lower airways contain a rich and diverse microbiome, which may play a significant regulatory role in both health and disease. In COPD, the microbiome becomes perturbed, causing dysbiosis. Increased representation of members in the Proteobacteria phylum and certain members in the Firmicutes phylum has been associated with increased risk of exacerbations and mortality. Therapies such as inhaled corticosteroids and azithromycin may modulate the airway microbiome or its metabolites in patients with COPD. This paper provides an up-to-date overview of the airway microbiome and its importance in the pathophysiology of COPD and as potential therapeutic target in the future.
Don D. Sin 대한결핵및호흡기학회 2023 Tuberculosis and Respiratory Diseases Vol.86 No.2
Chronic obstructive pulmonary disease (COPD) affects close to 400 million peopleworldwide. COPD is characterized by significant airflow limitation on spirometry. Mostpatients with COPD are diagnosed in their fifth or sixth decades of life. However, thedisease begins much earlier. By the time airflow limitation is detected on spirometry,patients with COPD have lost close to 50% of their small airways. Thus, identification ofpatients with early COPD, defined as persons with preserved spirometry, who demonstratepathologic or functional hallmarks of COPD, is essential for disease modificationand ultimately disease elimination. This paper provides an up-to-date overview of thecurrent case definition of early COPD, its importance, the novel technologies requiredfor its detection in young adults and future directions in therapeutics for treatment.
The Role of Granzyme B Containing Cells in the Progression of Chronic Obstructive Pulmonary Disease
( Won-dong Kim ),( Hyun-sook Chi ),( Kang-hyeon Choe ),( Woo-sung Kim ),( James C. Hogg ),( Don D. Sin ) 대한결핵 및 호흡기학회 2020 Tuberculosis and Respiratory Diseases Vol.83 No.-
Background: Lung inflammation plays a vital role in the pathogenesis of chronic obstructive pulmonary disease (COPD), but the characteristics of the inflammatory process remain unclear. There is growing interest in the role of granzyme B (GzmB) because CD8<sup>+</sup> T cells can induce apoptosis of target cells by releasing GzmB, which in turn may cause tissue injury and remodeling. However, Gzm<sup>B</sup> is also expressed by regulatory cells, which are able to suppress CD8<sup>+</sup> T cell. The role of GzmB+ cells needs to be defined in COPD. Methods: GzmB<sup>+</sup> and CD8<sup>+</sup> cells on alveolar wall of surgically resected lungs of microscopically classified 12 nonsmoking control, 12 panlobular emphysema (PLE) and 30 centrilobular emphysema (CLE) subjects were localized by immunohistochemical method. Positively stained cells on alveolar wall were counted and length of corresponding alveolar wall was measured. The results were expressed as mean number of positively stained cells per mm of alveolar wall in each subject. Results: The number of GzmB<sup>+</sup> and CD8<sup>+</sup> cells on alveolar wall of CLE was greater than that of control or PLE subjects (p<0.05 and p<0.001, respectively). There was a positive relationship between the number of alveolar GzmB<sup>+</sup> cells and forced expiratory volume in 1 second (FEV<sub>1</sub>) (r=0.610, p=0.003) in CLE subjects. The number of alveolar GzmB<sup>+</sup> cells progressively decreased with decline of FEV<sub>1</sub>. Conclusion: Our finding that number of alveolar GzmB<sup>+</sup> cells was associated with FEV<sub>1</sub> suggests that GzmB<sup>+</sup> cells might have protective role in the progression of lung destruction and airflow limitation in CLE, which is the predominant emphysema subtype of COPD.
한국 재래돼지 브랜드 돈육 원산지 검증을 위한 유전자 감식 기법 활용 연구
최봉암 ( Choi Bong-am ),이학교 ( Lee Hak-kyo ),전광주 ( Jeon Gwang-joo ),오재돈 ( Oh Jean-don ),최일신 ( Choi Il-sin ),박미현 ( Park Mi-hyun ),공홍식 ( Kong Hong-sik ),정일정 ( Jung Il-jung ),김태헌 ( Kim Tae-hun ),윤두학 ( Yoon D 한국유기농업학회 2004 韓國有機農業學會誌 Vol.12 No.2
Identification of animals has been used with an ear tag with dummy code and blood typing has been used for paternity and individual identification in live animals. Various genetic markers are different for breeds of pig and hence, it is necessary to identity the discrete genetic marker in korean native pig. A total of 240 pigs were used to find korean native pig population specific markers that expressed in population of korean native pigs. To identify the individual traceability, 20 animals were randomly chosen and tested for a whole process from being live to slaughter stages. The candidate genetic marker used in the study were 18 DNA microsatellites which were identified in pig genome. The number of alleles of those DNA microsatellites ranged form a minimum of 3 to maximum of 6. The heterozygote frequency ranged from 0.44 to 0.69. Effective number of alleles for each DNA microsatellotes were 2 to 4. By choosing 6 candidate genetic markers among all, the traceability of individual identification was estimated as accurate as 99.99%(p>0.0014), nearly.