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CD30 활성화에 의한 호산구 자멸사에서 caspase-9 의 매개작용
이혜진 ( Hye Jin Lee ),이근영 ( Keun Young Lee ),김유진 ( Yoo Jin Kim ),장필상 ( Pil Sang Jang ),윤종서 ( Jong Seo Yoon ),김현희 ( Hyun Hee Kim ),고영률 ( Young Yull Koh ),김진택 ( Jin Tack Kim ),이준성 ( Joon Sung Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2011 소아알레르기 및 호흡기학회지 Vol.21 No.2
Purpose: Although CD30 is known to be expressed more on eosinophils undergoing apoptosis, it is still not known how CD30 activation leads to eosinophil apoptosis. In this study, we evaluated whether ligation of CD30 incites apoptosis and investigated whether the mechanisms of CD30 induced eosinophil apoptosis are dependent on caspase activation. Methods: We drew 90 mL of peripheral blood from healthy donors and then purified eosinophils using a MACS system. Expression of CD30 on eosinophils was measured, and eosinophils were cultured in wells pretreated with anti-CD30 mAb, isotype control immunoglobulin G1, interleukin (IL)-5, and dexamethasone in Roswell Park Memorial Institute 1640 media supplemented with 10% fetal bovine serum. Their rates of apoptosis were then compared using flow cytometry. To evaluate whether caspase-9 is involved in CD30-induced eosinophil apoptosis, the apoptotic rate was evaluated after the addition of caspase-9 inhibitor. The expression of procaspase-9 was also measured using Western blot. Results: Expression of CD30 molecules on eosinophils increased steadily as the culture time lapse. The apoptotic rates of eosinophils cultured in the presence of anti-CD30 mAb were significantly increased to 29.1±6.1% and 47.3±4.7% compared to 17.1±6.7% and 29.4±9.2% of the control at 4 and 24 hours, respectively (both P<0.05). The apoptotic rates of eosinophils treated with anti-CD30 mAb were even faster than those of eosinophils treated with dexamethasone, and the mAb also suppressed the IL-5-induced enhancing effect of eosinophil survival. Caspase-9 inhibitor suppressed mAb induced eosinophil apoptosis from 54.8±6.9% and 71.5±11.6% to 24.5±6.0% and 47.8±11.4% at 18 and 36 hours, respectively (both P<0.001). We also demonstrated that the expression of procaspase-9 with mAb was diminished compared to that of the control and of IL-5. Conclusion: This study showed CD30 activation enhances eosinophil apoptosis, and the effect is mediated by caspase-9 activation. [Pediatr Allergy Respir Dis(Korea) 2011;21:115-122]
Polymerase chain reaction 양성 소아 마이코플라스마 폐렴에서 혈청 IgM enzyme-linked immunosorbent assays의 진단적 가치
이혜진 ( Hye Jin Lee ),이윤태 ( Yoon Tae Lee ),김경훈 ( Kyung Hoon Kim ),양은애 ( Eun Ae Yang ),김환수 ( Hwan Soo Kim ),전윤홍 ( Yoon Hong Chun ),윤종서 ( Jong-seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.5
Purpose: Mycoplasma pneumoniae (MP) is a common cause of community-acquired pneumonia (CAP) in children. MP serum IgM and polymerase chain reaction (PCR) are the methods that enable early diagnosis in patients with MP pneumonia. The objective of this study was to investigate the clinical value of serum MP-specific IgM antibodies in PCR-positive MP pneumonia for the early diagnosis of MP pneumonia in children with CAP. Methods: Out of 129 patients with lower respiratory tract infection aged over 3 years, 90 CAP children were enrolled in the study. Throat swab MP real-time PCR and serum enzyme-linked immunosorbent assays (ELISA) IgM antibodies were performed. A positive rate of MP PCR and serum IgM, the level of IgM index, clinical features, and laboratory findings were analyzed. Results: MP PCR was positive in 57 cases. Longer fever duration before admission (P<0.001), higher rates of lobar or segmental pneumonia (P=0.048), unilateral infiltration (P=0.038), and extrapulmonary symptoms (P=0.049) were associated with MP PCR-positive pneumonia. Serum IgM index was significantly higher in MP PCR-positive pneumonia them in MP PCR-negative pneumonia (3.9±3.0 vs. 0.8±1.3, P<0.001). Using MP PCR as a gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of serum IgM were 85.5%, 82.1%, 91.4%, and 71.9%, respectively. The area under the curves for serum IgM index was 0.892, and the ROC analysis indicated that an optimal cutoff value of 1.05 for serum IgM provided the highest sensitivity and specificity interestingly (83.9% vs. 85.7%, P<0.001). Conclusion: Serum IgM ELISA has useful diagnostic value in PCR-positive MP pneumonia. Applying an IgM index cutoff of 1.05 improves diagnostic accuracy. (Allergy Asthma Respir Dis 2018;6:248-254)
정우진 ( Woo Jin Chung ),윤다혜 ( Da Hye Yoon ),이의경 ( Eui Gyung Lee ),방경원 ( Kyong Won Bang ),김환수 ( Hwan Su Kim ),전윤홍 ( Yoon Hong Chun ),윤종서 ( Jong Seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ),이준성 ( 대한소아알레르기호흡기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.2
Purpose: Children admitted to pediatric intensive care unit (PICU) with respiratory tract disease, often have a tendency to be readmitted to PICU with disease progression. We studied the risk factors for readmission to PICU, with respiratory disease progression. Methods: Among 286 children admitted to Seoul St. Mary’s Hospital PICU from April 2009 to March 2012, 129 children admitted with respiratory tract disease were enrolled. We grouped the children readmitted to PICU with respiratory tract disease progression within 2 weeks (readmission group), and the others (control group). We compared basic and respiratory tract disease characteristics at initial PICU admission between them, by retrospective chart review. Results: Among 129 children, 8 were included in the readmission group, and 121 in the control group. Mortality and underlying disease incidence were higher in the readmission group (P=0.003 and P=0.033, respectively). The readmission group showed higher parenchymal lung disease incidence, and lower initial saturation by pulse oxymeter (SpO2)/fraction of inspiratory oxygen (FiO2), despite underlying disease influence (P=0.035 and P=0.041, respectively). Logistic regression on the underlying disease and respiratory variables showed no single factor with a significantly independent influence on readmission, but parenchymal lung disease had more independent influence. Conclusion: For PICU readmission with respiratory tract disease progression, parenchymal lung disease and lower initial SpO2/FiO2 can be a risk factor despite underlying disease influence. Underlying disease and each respiratory characteristic were not significantly independent risk factors, suggesting a correlation of factors. But, parenchymal lung disease can be a more independent risk factor. (Allergy Asthma Respir Dis 2014;2:128-133)
객담 배출이 어려운 소아청소년 결핵 의심 환자에서 굴곡성 기관지 내시경검사의 유용성
이혜진 ( Hye Jin Lee ),박유미 ( Yumi Park ),양은애 ( Eun Ae Yang ),김환수 ( Hwan Soo Kim ),전윤홍 ( Yoon Hong Chun ),윤종서 ( Jong-seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ) 대한천식알레르기학회(구 대한알레르기학회) 2017 Allergy Asthma & Respiratory Disease Vol.5 No.5
Purpose: To assess the usefulness of flexible bronchoscopy in patients with suspected pulmonary tuberculosis (PTB) who have diffi-culty in sputum expectoration. Methods: The subjects of this study were patients who were suspected of PTB and visited the Division of Pediatric Pulmonology at a tertiary hospital from April 2006 to March 2016. PTB suspects were determined by clinical symptoms, radiologic findings, and im-munologic studies. We aimed to examine the value and safety of bronchoscopy in diagnosis and differential diagnosis of PTB in PTB- suspected patients. The diagnostic criteria for PTB were defined when Mycobacterium tuberculosis was cultured in the sputum speci-men or in the bronchial washing fluid. Results: A total of 19 PTB suspects were included. One patient was diagnosed with PTB by using the sputum study. However, the re-maining 18 patients could not expectorate sputum or showed no evidence of Mycobacterium tuberculosis infection from the spu-tum study. Of the 18 patients, 15 underwent bronchoscopy. After bronchoscopy, 6 patients were diagnosed with PTB and 9 patients were diagnosed with Mycoplasma, viral, or fungal pneumonia, and tumors. For antituberculous drug resistance, there were 1 case of isoniazid (INH) resistance and 1 case of concurrent resistance to INH and prothionamide. There was no multidrug-resistant tubercu-losis. None of the patients had significant complications due to bronchoscopy. Conclusion: Flexible bronchoscopy appears to be a definitive and safe procedure for the differential diagnosis of patients suspect-ing PTB in children who have difficulty expectorating sputum. (Allergy Asthma Respir Dis 2017;5:287-293)
경증 급성 하기도 감염을 앓는 소아에서의 혈청 사이토카인과 임상 양상의 상관관계
김건주 ( Geon Ju Kim ),박유미 ( Yu Mi Park ),원설 ( Sul Mui Won ),최승준 ( Seung Jun Choi ),김환수 ( Hwan Soo Kim ),전윤홍 ( Yoon Hong Chun ),윤종서 ( Jong-seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ) 대한천식알레르기학회(구 대한알레르기학회) 2017 Allergy Asthma & Respiratory Disease Vol.5 No.2
Purpose: Acute lower respiratory infection (ALRI), which is frequently encountered in pediatric patients, is the leading cause of hospitalization. We aimed to identify particular cytokines that correlated with ALRI clinical characteristics. We also aimed to identify any differences in cytokines between respiratory syncytial virus (RSV)-related ALRI and non-RSV-related ALRI. Methods: Cytokine levels were measured in the sera sampled from 103 pediatric patients diagnosed with ALRI and admitted to Seoul St. Mary`s Hospital between May 2012 and April 2013. The correlations between cytokine levels and the length of hospitalization, the number of days with fever, body temperature, pulse rate, respiration rate, oxygen saturation upon admission, and duration of oxygen supplementation were analyzed. Results: In children with ALRI, the level of interleukin (IL)-6, granulocyte-colony stimulating factor (G-CSF), and IL-10 were correlated with a higher body temperature on admission. In addition, the IL-8 level was correlated with pulse rate and respiration rate, and IL-1β level was related with oxygen saturation on admission. In children with RSV-related ALRI, the IL-6 was correlated the with duration of fever, and the IL-1β, IL-2, and IL-8 levels were related to pulse rate and respiration rate. In addition, the increase in interferon-gamma-inducible protein-10 (IP-10) level was correlated with a higher body temperature on admission and a longer duration of hospitalization in children with RSV-related ALRI. Conclusion: In children with ALRI, the levels of IL-6, IL-8, IL-1β, G-CSF, and IP-10 were correlated with its clinical features. In children with RSV-related ALRI, the IL-1β, IL-2, IL-6, IL-8, and IP-10 level was correlated with the severity of the disease. (Allergy Asthma Respir Dis 2017:5:99-104)