Thioredoxin reductase를 표적으로 하는 항암 최신 연구 동향

황보현(Hyun Hwangbo),이혜숙(Hyesook Lee),정재훈(JaeHun Cheong),최영현(Yung Hyun Choi) 한국생명과학회 2022 생명과학회지 Vol.32 No.1

동상으로 인한 골수염에서 발생한 편평세포암

황보현 ( Hyun Hwangbo ),이택근 ( Taek Geun Lee ),정세원 ( Se Won Jung ),손현호 ( Hyun Ho Son ),이숙경 ( Sook Kyung Lee ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.7

Squamous cell carcinoma commonly originates from recalcitrant wound sites, including burn scars, pressure sores, stasis ulcers, osteomyelitis, and sites of frostbite. A 62-year-old male was referred to the dermatology department for skin necrosis of his right great toe and walking difficulty. He had a history of smoking, drinking alcohol, and frostbite of his right great toe 9 years prior, which deteriorated into osteomyelitis due to poor care. Although a skin biopsy was recommended before amputation, the two procedures were performed simultaneously due to a lack of toe function due to severe osteolysis. Biopsy of the amputated toe tip showed many lobules consisting of atypical keratinocytes with hyperchromatic nuclei, and severe dermal pleomorphism. After evaluation for distant metastasis, including a (99m) Tc-MDP bone scan, 18F-FDG positron emission tomography scan, computed tomography, and ultrasound, no metastasis was detected. (Korean J Dermatol 2015;53(7):556∼559)

산수유의 채취 부위에 따른 기능 성분 분석과 항산화 및 항염증 효과에 관한 연구

황보현(Hyun Hwangbo),정지숙(Ji-Suk Jeung),김민영(Min Young Kim),지선영(Seon Yeong Ji),윤선혜(Seonhye Yoon),김태희(Tae Hee Kim),김성옥(Sung Ok Kim),최영현(Yung Hyun Choi) 한국생명과학회 2021 생명과학회지 Vol.31 No.3

산수유 나무는 그 열매인 산수유와 함께 동아시아의 많은 국가에서 식용 및 약용으로 오랫동안 널리 사용되고 있다. 선행 연구들에 의하면 산수유 나무 추출물 및 구성 성분은 다양한 약리학적 잠재력을 가지고 있음에도 불구하고 부위별 추출물에 대한 체계적인 성분 분석은 아직 충분하지 않은 실정이다. 본 연구에서는 산수유 나무의 각 부위(청산수유, 적산수유, 씨앗, 줄기, 잎, 건피)의 유효 성분 함량을 분석하여 항산화 활성을 검증하였다. 본 연구의 결과에 따르면 조사된 3가지 지표 성분 중 morroniside은 청산수유와 적산수유에 가장 많이 함유하고 있었으며, loganin은 청산수유와 씨앗에 많았다. 잎, 적산수유, 건피의 함량은 비슷한 수준이었다. Cornin은 잎에 가장 많았으며, 청산수유, 적산수유 건피 순이었다. 또한 총 폴리페놀 함량은 적산수유, 청산수유, 잎 순으로 높았으며, 총 플라보노이드 함량은 잎이 가장 높았다. 그리고, DPPH radical 소거능은 잎, 씨앗, 적산수유 추출물 순으로 높은 소거 활성을 나타냈다. 따라서 항산화 활성이 가장 높은 잎 추출물의 항염증 효능을 조사하였으며, 이를 위하여 LPS로 자극된 RAW 264.7 대식세포에서 NO와 같은 염증성 매개 인자와 IL-1β와 IL-6를 포함한 염증성 사이토카인의 생성에 미치는 잎 추출물의 영향을 평가하였다. 본 연구의 결과에 의하면 세포독성이 없는 조건에서 잎 추출물은 LPS에 의하여 증가된 iNOS의 발현과 NO의 생성을 유의적으로 억제하였다. 또한 잎 추출물은 LPS에 의한 IL-1β 및 IL-6의 생성 및 발현을 현저하게 감소시켰다. 따라서 산수유 나무의 잎 추출물은 항산화제와 항염증 제의 개발을 위한 천연 재료로서 잠재력이 있음을 시사하며, 관련 기전 연구가 추가로 진행되어야 할 것이다. Cornus officinalis Siebold & Zucc. is traditionally used as an edible and medicinal plant in many countries in East Asia. Previous studies have shown the pharmacological potential of extracts and components of C. officinalis, but comparative analysis of the composition of the leaf, stem, and fruit extracts has been insufficient to date. In the present study, the content of active antioxidant and anti-inflammatory ingredients was verified in different C. officinalis parts (under-ripe sansuyu, ripe sansuyu, seed, leaf, stem, and dried sansuyu). One active component, morroniside, was high in fruit (under-ripe and ripe sansuyu), while loganin was high in fruit (under-ripe sansuyu) and cornin was high in seeds. Total polyphenol contents were highest in fruit (ripe sansuyu) and flavonoids were highest in leaves. DPPH radical scavenging activity was highest in leaves, followed by seeds and then ripe sansuyu extract. The anti-inflammatory efficacy of leaf extracts of C. officinalis (LCO) was further investigated by measuring their effects on levels of nitric oxide (NO) and the pro-inflammatory cytokines interleukin (IL)-1β and IL-6 in RAW 264.7 macrophages. Non-cytotoxic concentrations of LCO effectively decreased the lipopolysaccharide (LPS)-induced expression of inducible NO synthase, resulting in decreased NO production. LCO also significantly suppressed LPS-induced production and expression of IL-1β and IL-6. Taken together, the present findings suggest that C. officinalis leaves have potential as natural materials for the development of antioxidant and anti-inflammatory agents.

상법과 외부감사법 사이의 정합성 제고 방안

황보현 ( Hwangbo Hyun ) 한국상사판례학회 2021 상사판례연구 Vol.34 No.4

2011년 K-IFRS도입되고 2017년 외부감사법이 전부 개정되었음에도 불구하고, 상법의 회계처리 용어와 재무제표 작성 및 제출시기 등 외부감사법과 일치하지 않기 때문에 두 개의 법률 사이에 혼동이 발생한다. 이를 해결하기 위하여 회계처리 기준과 관련하여, 외부감사법과 상법상 재무제표의 개념을 비롯하여 재무제표 작성주체 및 제출시기를 일치시키고, 상법에 연결재무제표의 개념을 명확히 도입함으로써 배당의 기준이 되는 재무제표와 감사(위원회)의 연결재무제표 감사보고서 작성여부를 명확히 할 필요가 있다. 그리고 상법상감사(위원회)의 실질적 기능을 확보하기 위하여 감사(위원회)가 회계감사를 하는 경우 외부감사인과 상호 협력하여 의견을 일치시키는 방안, 외부감사인의 감사보고서 제출시기에 맞춰 감사(위원회)의 감사보고서 제출시기를 통일할 필요가 있다. 또한 내부통제의 두 개의 축인 내부회계관리제도와 준법지원인 제도가 각각 외부감사법과 상법에 규율되고 있으므로, 회사의 기본법인 상법에서 두 개의 제도를 통합하여 근거 규정을 만들고, 내부통제의 실질화를 위해 독립적인 내부감사부서에 관한 사항을 규율할 필요가 있다. 마지막으로, 법규 체계를 전반을 정비하여 상법 중 회사법을 별도로 제정하면서 외부감사법의 내용을 모두 회사법에 이관하거나, 회사의 회계에 관한 제반 규정을 모두 외부감사법에서 규율하여 ‘회계처리 및 외부감사에 관한 기본법’을 만들게 된다면, 상법과 외부감사법이 상호 모순되지 않고 정합성을 높이는 방법이 될 것으로 기대된다. Although K-IFRS was introduced in 2011 and the External Audit Act was completely revised in 2017, confusion arises between the two laws because they do not coincide with the External Audit Act, such as the accounting term of the Commercial Act and the timing of preparation and submission of financial statements. To solve this problem, with respect to accounting standards, the concept of financial statements should be clearly introduced into the Commercial Act, and subject and submission period of the financial statements should be consistent with the External Audit Act and the Commercial Act. When an auditor (committee) conducts a financial audit, it is necessary to cooperate with the external auditor to agree on their opinions, and to unify the audit report submission period by the auditor (committee) in line with the external auditor's audit report submission time. Since the two axes of internal control, the internal accounting management system and the compliance officer system, are regulated by the External Audit Act and the Commercial Act, respectively, it is necessary to create a basis for the regulation by integrating the two systems in the Commercial Act, the basic corporation of the company. Lastly, if the Company Act is enacted separately, all the contents of the External Audit Act are transferred to the Company Act, or the 'Basic Act on Accounting Processing and External Audit' is created by regulating all regulations related to the company's accounting in the External Audit Act, it is expected to enhance the consistency between the Commercial Act and the External Audit Act.

ICR 마우스를 이용한 전호의 단회경구투여 독성 실험

권다혜,김민영,황보현,지선영,박철,최영현,홍수현,Kwon, Da-hye,Kim, Min-young,Hwangbo, Hyun,Ji, Seon-yeong,Park, Cheol,Choi, Yung-hyun,Hong, Su-hyun 대한한방내과학회 2018 大韓韓方內科學會誌 Vol.39 No.4

Objectives: The aim of this study was to estimate the single oral toxicity of Peucedani Radix (PR) ethanol extracts. PR is one of the important herbs for removal of phlegm, the viscous turbid pathological product that can accumulate in the body and cause a variety of diseases. However, research on the pharmacologic toxicity of PR is lacking. Methods: In this study, PR was orally administered to 5-week-old male ICR mice at an oral dose of 2,000, 3,000, or 5,000 mg/kg. After a single-dose administration, the mortality and behavioral changes were observed daily and body weights were measured every two days. After 14 days, the organ weight, organ index, macroscopy, hematological analysis, and serum biochemistry analysis were determined. Results: No mortality, body weight changes, abnormal behavioral changes, or anatomical signs of toxicity were found. The organ weight, organ index, hematological analysis, and serum biochemistry analysis were also within the normal ranges. Conclusions: These results suggest that the 50% lethal dose of PR is more than 5,000 mg/kg. This could indicate that PR is a safe drug without acute toxicity and side effects.

산수유 추출물에 의한 testosterone으로 유발된 양성 전립선 비대증의 개선

지선영,김민영,황보현,이혜숙,홍수현,김태희,윤선혜,김현진,정하은,김성연,김태중,김민지,김성옥,최영현,Ji, Seon Yeong,Kim, Min Yeong,Hwangbo, Hyun,Lee, Hyesook,Hong, Su Hyun,Kim, Tae Hee,Yoon, Seonhye,Kim, Hyun Jin,Jung, Ha Eun,Kim, Sung Yeon,Kim, 한국생명과학회 2021 생명과학회지 Vol.31 No.6

양성 전립선 비대증(BPH)의 발병은 노화에 따른 남성 호르몬 수치의 변화와 연관된 내분비 기능 저하와 밀접한 관련이 있는 것으로 알려져 있다. 현재 BPH 치료를 위해 임상적으로 사용되는 약물은 다양한 부작용을 나타내므로 효과적인 대체 식의약 소재의 개발을 시급히 요구된다. 산수유나무의 열매인 산수유(Fructus Corni)는 오랫동안 다양한 질병의 예방 및 치료에 사용되어왔으며 최근 BPH의 진행을 억제할 수 있음이 밝혀졌다. 본 연구에서는 BPH에 대한 산수유 열수 추출물(CF)의 추가 효능을 평가하기 위해 비거세 및 거세 동물 모델에서 TP에 의한 BPH 유도에 미치는 효과를 조사하였으며, BPH 억제를 위한 양성대조군으로 FINA를 사용하였다. 본 연구의 결과에 의하면 CF 투여는 대조군 및 FINA 처리 그룹에 비하여 비거세 및 거세군 모두에서 전립선의 과도한 발달을 억제하였다. BPH에 대한 CF의 억제 효과는 BPH 유도에 관여하는 testosterone과 DHT의 발현 감소뿐만 아니라 HIF-1α, 5α-reductase type 2, SRC1, AR 및 PSA 발현의 과도한 발현 억제와 관련이 있었다. 또한, 스트레스 호르몬인 cortisol의 혈청 수준은 비거세 및 거세군 모두에서 TP에 의한 BPH 유도 동안 증가하였지만 CF 투여에 의하여 유의하게 감소되었다. 그러나 BPH 유도군에서 insulin 및 IGF-1은 증가되지 않았으며 CF에 의한 효과적인 결과는 나타나지 않았다. 이러한 결과는 AR 신호 전달 경로 활성의 억제를 통해 BPH에 대한 CF의 유익한 효과를 시사하며, 산수유가 BPH의 예방과 치료에 잠재적인 가능성을 가지고 있음을 시사한다. Fructus Corni, the fruit of Cornus officinalis, has long been used for the prevention and treatment of various diseases. We recently suggested that it was effective against benign prostatic hyperplasia (BPH). In this study, we investigated the inhibitory effect of Corni Fructus (CF) water extract on BPH induced by testosterone propionate (TP) in noncastrated and castrated animal models. BPH was induced in Sprague Dawley rats by an intramuscular injection of TP in castrated or noncastrated rats. Finasteride (FINA) treatment was used as a positive control for inhibition of BPH. According to our results, CF administration inhibited excessive enlargement of development of the prostate in both the noncastrated and castrated groups compared to the control and FINA-treated groups. The inhibitory effect of CF on BPH was associated with inhibition of expression of hypoxia-inducible factor-1α, 5α-reductase type 2, steroid receptor coactivator-1, androgen receptor (AR), and prostate-specific antigen. Serum levels of the stress hormone cortisol increased during BPH induction by TP in both the noncastrated and castrated groups, but they were attenuated significantly by CF administration. However, insulin and IGF-1 levels were not increased in the BPH-induced groups and CF, and no effective results were found by CF administration. These results point to a beneficial effect of CF on BPH through inhibition of AR signaling pathway activity and imply that CF shows excellent potential as a therapeutic agent for the prevention and treatment of BPH.

RAW 264.7 대식세포에서 MAPKs 신호 전달 경로의 활성화를 통한 침향의 면역 자극 활성

지선영(Seon Yeong Ji),황보현(Hyun Hwangbo),이혜숙(Hyesook Lee),구영태(Young Tae Koo),김진수(Jin Soo Kim),이기원(Ki Won Lee),노동진(Dong Jin Noh),최영현(Yung Hyun Choi) 한국생명과학회 2021 생명과학회지 Vol.31 No.8

면역 기능의 저하는 각종 감염에 대한 저항력의 부족을 초래하여 다양한 질병 유발에 기여하며, 면역 억제제의 부작용을 감소시키거나 면역력을 높이기 위해 면역 조절 생체 물질이 사용되고 있다. 침향은 침향나무의 방향족 수지 부분이며 전통적으로 다양한 질병을 치료하기 위한 목적으로 사용되어왔다. 비록 선행 연구들에 의하여 침향이 신체의 면역력을 향상시킬 수 있다는 사실이 밝혀졌지만 이에 대한 근거는 여전히 부족한 실정이다. 본 연구에서는 인도네시아에서 구입한 A. malaccensisd 침향 메탄올 추출물의 면역 자극 효과를 RAW 264.7 대식세포 모델에서 평가하였다. 본 연구의 결과에 의하면 침향 추출물은 세포 독성이 없는 조건에서 식작용을 현저하게 향상시켰으며다. 또한 침향 추출물 처리된 RAW 264.7 세포는 활성화된 대식세포의 전형적인 형태를 보였으며, iNOS 발현 증가에 따른 NO 생성의 생성을 크게 증가시켰다. 아울러 TNF-α, IL-1β 및 IL-6과 같은 cytokine의 발현과 분비를 증가시켰으며, MAPKs 신호 전달 경로를 활성화시켰다. 따라서 본 연구의 결과는 고대 서적을 기반으로 침향의 효과를 확인하는 데 중요한 의미가 있으며, 침향이 잠재적인 면역 강화 효과가 있다는 근거를 제시하는 것이다. Deterioration of the immune function weakens the body’s resistance to various infections, leading to a series of diseases. Immunomodulatory biomaterials have been used to reduce the side effects of immunosuppressants or to enhance immunity. Agarwood is the aromatic resinous portion of Aquilaria trees that has been traditionally used as a medicinal herb for the treatment of various diseases. Although previous studies have shown that agarwood can improve the body’s immunity, evidence for this claim is still lacking. In this study, the immune-enhancing effects of the agarwood methanol extracts of Aquilaria malaccensis Lamk were evaluated in a RAW 264.7 macrophage model. Based on the results, the agarwood extracts markedly enhanced phagocytosis in the absence of cytotoxicity. The agarwood extract-treated RAW 264.7 cells exhibited the typical morphology of activated macrophages, which are spindle-shaped with elongated filopodia. Agarwood extract also significantly increased the production of nitric oxide (NO), which is associated with the increased expression of inducible NO synthase. Moreover, the secretion and expression levels of cytokines, such as tumor necrosis factor-α and interleukin (IL)-1β and IL-6, were increased by agarwood treatment. Notably, these are also associated with a mitogen-activated protein kinase signaling pathway. Taken together, our findings provide scientific evidence that agarwood has potential immune-enhancing effects in vitro.

염분 섭취에 의한 시스플라틴 유도 급성 신장 손상의 촉진과 염증 반응과의 연관성

지선영(Seon Yeong Ji),황보현(Hyun Hwangbo),김민영(Min Yeong Kim),김다혜(Da Hye Kim),박범수(Beom Su Park),박정현(Joung-Hyun Park),이배진(Bae-Jin Lee),이혜숙(Hyesook Lee),최영현(Yung Hyun Choi) 한국해양바이오학회 2021 한국해양바이오학회지 Vol.13 No.2

A high salt diet contributes to kidney damage by causing hypoxia and oxidative stress. Recently, an increase in dietary salt has been reported to induce an inflammatory phenotype in immune cells, further contributing to kidney damage. However, studies on the exact mechanism and role of a high salt diet on the inflammatory response in the kidneys are still insufficient. In this study, a cisplatin-induced acute kidney injury model using C57BL/6 mice was used to analyze the effect of salt intake on kidney injury. Results showed that high salt administration aggravated kidney edema in mice induced by treatment with cisplatin. Moreover, the indicators of kidney and liver function impairment were significantly increased in the group cotreated with high salt compared with that treated with cisplatin alone. Furthermore, the exacerbation of kidney damage by high salt administration was also associated with a decrease in the number of cells in the immune regulatory system. Additionally, high salt administration further decreased renal perfusion functions along with increased cisplatin-induced damage to proximal tubules. This was accompanied by increased expression of T cell immunoglobulin, mucin domain 1 (a biomarker of kidney injury), and Bax (a pro-apoptotic factor). Moreover, cisplatin-induced expression of proinflammatory mediators and cytokines, including cyclooxygenase-2 and tumor necrosis factor-α in kidney tissue, was further increased by high salt intake. Therefore, these results indicate that the kidney’s inflammatory response by high salt treatment can further promote kidney damage caused by various pathological factors.

Relationship between Reactive Oxygen Species and Adenosine Monophosphate-activated Protein Kinase Signaling in Apoptosis Induction of Human Breast Adenocarcinoma MDA-MB-231 Cells by Ethanol Extract of Citrus unshiu Peel

Min Yeong Kim(김민영),Hyun HwangBo(황보현),Seon Yeong Ji(지선영),Su-Hyun Hong(홍수현),Sung Hyun Choi(최성현),Sung Ok Kim(김성옥),Cheol Park(박철),Yung Hyun Choi(최영현) 한국생명과학회 2019 생명과학회지 Vol.29 No.4

한의학에서는 진피(陳皮)라고 칭하는 귤의 껍질(Citrus unshiu peel) 추출물은 항산화, 항염증 및 항균 특성을 포함한 다양한 약리학적 효능을 갖는 것으로 알려져 있다. 최근 그들의 항암 활성에 대한 가능성이 보고되었지만 정확한 기전 연구는 여전히 미비한 실정이다. 본 연구에서는 인간 유방암 MDA-MB-231 세포를 대상으로 진피에탄올(EECU, ethanol extract of C. unshiu peel) 추출물의 항암 효능을 평가하고 그에 따른 기전 연구를 수행하였다. 본 연구의 결과에 의하면 EECU에 의한 MDA-MB-231 세포의 증식억제는 세포사멸(apoptosis) 유도와 관련이 있었다. EECU에 의한 apoptosis는 caspase-8, -9 및 -3의 활성화와 IAPs 계열의 발현 감소에 따른 PARP의 분해와 Bax : Bcl-2 비율의 증가와 연관이 있었다. 또한 EECU는 Bid의 truncation과 함께 미토콘드리아 막 잠재력의 감소와 세포질로 cytochrome c의 이동을 촉진시켰다. 아울러 EECU는 AMPK 및 ACC의 인산화를 촉진시켰으나, AMPK 효소 활성의 저해제는 EECU에 의한 apoptosis 유도와 생존력 저하를 현저하게 억제하였다. 부가적으로 EECU는 AMPK 활성화의 상류 신호로 작용하는 활성산소종(ROS)의 생성을 촉진시켰으며, 강력한 항산화제인 NAC는 EECU에 의한 AMPK의 활성화와 apoptosis를 역전시켰다. 결론적으로 EECU는 ROS/AMPK 의존적인 내인성 및 외인성 apoptosis 경로를 활성화시킴으로써 MDA-MB-231 세포 증식을 억제하였음을 알 수 있었다. Citrus unshiu peel extracts possess a variety of beneficial effects, and studies on their anticancer activity have been reported. However, the exact mechanisms underlying this activity remain unclear. In the current study, the apoptotic effect of ethanol extract of C. unshiu peel (EECU) on human breast adenocarcinoma MDA-MB-231 cells and related mechanisms were investigated. The results showed that the survival rate of MDA-MB-231 cells treated with EECU was significantly inhibited in a concentration-dependent manner, which was associated with the induction of apoptosis. EECU-induced apoptosis was associated with the activation of caspase-8 and caspase-9, which initiate extrinsic and intrinsic apoptosis pathways, respectively, and caspase-3, a representative effect caspase. EECU suppressed the expression of the inhibitor of apoptosis family of proteins, leading to an increased Bax/Bcl-2 ratio and proteolytic degradation of poly (ADP-ribose) polymerase. EECU also enhanced the loss of the mitochondrial membrane potential and cytochrome c release from the mitochondria to the cytosol, along with truncation of Bid. In addition, EECU activated AMP-activated protein kinase (AMPK), and compound C, an AMPK inhibitor, significantly weakened EECU-induced apoptosis and cell viability reduction. Furthermore, EECU promoted the generation of reactive oxygen species (ROS), which acted as upstream signals for AMPK activation as pretreatment of cells, with the antioxidant N-acetyl cysteine reversing both EECU-induced AMPK activation and apoptosis. Collectively, these findings suggest that EECU inhibits MDA-MB-231 adenocarcinoma cell proliferation by activating intrinsic and extrinsic apoptotic pathways, which was mediated through ROS/AMPK-dependent pathways.

통상적인 치료에 충분히 반응하지 않는 심한 급성 두드러기 환자에서 저용량 에피네프린의 지속적 정맥 내 투여 치료의 효과와 안전성에 대한 연구

정우석 ( Woo Seok Jeong ),황보현 ( Hyun Hwangbo ),이숙경 ( Sook Kyung Lee ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.4

Background: Acute urticaria sometimes accompanies severe systemic reactions that can be potentially life-threatening. Some patients do not achieve sufficient responses to conventional treatments. There has been no previous study on the effect of continuous intravenous infusion of epinephrine in patients with severe acute urticaria. Objective: This study investigated the efficacy and safety of continuous intravenous infusion of low-dose epinephrine in patients with severe acute urticaria who did not achieve a sufficient response to conventional treatments. Methods: We retrospectively reviewed the medical records of 74 patients with severe acute urticaria who were treated with continuous intravenous infusion of low-dose epinephrine between November 2008 and December 2016. One milligram (1 mL) of 1:1000 epinephrine was diluted in 1 L of saline to yield a concentration of 1 μg/mL. The solution was infused at 0.67 μg/min (40 mL/h). Vital signs were checked at 0, 30, 60, and 90 minutes after infusion of epinephrine. Epinephrine was discontinued after one symptom-free day. Results: Clinical symptoms initially resolved within 24.8 hours on average and symptoms were completely resolved within 73.4 hours on average. Twenty-four adverse events, including palpitation, chest discomfort, hand tremor, increased blood pressure, and elevated cardiac markers, were observed in 19 patients (25.7%). Most adverse events were mild and regressed spontaneously without further management. Four patients (5.4%) stopped the infusion due to adverse events, but all events regressed spontaneously after stopping epinephrine. Six weeks after completion of intravenous infusion of epinephrine, 68 patients (91.9%) were symptom-free and six patients required antihistamines. Conclusion: This study suggests that continuous intravenous infusion of low-dose epinephrine is a safe and effective treatment in patients with severe acute urticaria who do not achieve a sufficient response to conventional treatments. (Korean J Dermatol 2018;56(4):242∼250)