한국인 무릎 골 관절염 환자들의 임상 양상과 Apo-1/Fas (CD95) 유전자 다형성과의 상관관계에 관한 연구

홍승재,양형인,임성빈,정주호,정영옥,김호연,Hong, Seung-Jae,Yang, Hyung-In,Yim, Sung-Vin,Chung, Joo-Ho,Jung, Young-Ok,Kim, Ho-Youn 대한면역학회 2003 Immune Network Vol.3 No.2

Background: Apoptosis has been implicated in pathogenesis of various disease. Apo-1/Fas (CD95) is one of the main pathway of apoptosis. To examine the possible relationship between Apo-1/Fas (CD95) and primary knee osteoarthritis, MvaI restriction length polymorphism (RFLP) in human Apo-1/Fas (CD95) gene was assessed. Methods: Genotype and allele frequencies in promoter region in the Apo-1/Fas (CD95) gene were studied by PCR-RFLP in 226 Korean controls and 148 Korean patients with primary knee osteoarthritis. Results: No statistically significant difference in the genotypic distribution and allelic frequencies was found between the control and the knee oateoarthritis patients. But in the severe grade (grade 3, 4) Kellgren-Lawrence score patients, the frequency of $MvaI^*1$ (G) allele was significantly decreased (P=0.0392) and the of $MvaI^*2$ (A) allele frequency was significantly increased (P=0.0473) compared to the normal controls. Conclusion: Apo-1/Fas (CD95) gene polymorphism is a part a determinant factor of severity in knee osteoarthritis, the patients with $MvaI^*2$ (A) allele is more severe radiologic progression. Further substantiation studies are needed in larger patient samples and various other apoptosis related genes to elucidate the mechanism of osteoarthritis, including the Fas ligand gene analysis.

Cyclooxygenase-2 Specific Inhibitor (SC-58635)가 Lipopolysaccharide로 자극한 대식세포에서 Nitric Oxide와 Prostaglandin E₂ 생산에 미치는 영향

홍승재,양형인,윤휘중,이명수,강효종,김완욱,이상헌,조철수,김호연,Hong, Seung-Jae,Yang, Hyung-In,Yoon, Hwi-Joong,Lee, Myoung-Soo,Kang, Hyo-Jong,Kim, Wan-Uk,Lee, Sang-Heon,Cho, Chul-Soo,Kim, Ho-Youn 대한면역학회 2003 Immune Network Vol.3 No.1

Background: Celecoxib, a COX-2 specific inhibitor, has recently been used for the treatment of rheumatoid arthritis. However, the molecular and cellular mechanisms of celecoxib against RA inflammation remain to be defined. To elucidate the action mechanism of celecoxib on inflammatory cells, we investigated the effect of celecoxib on the production of two important mediators of inflammation, nitric oxide and PGE2 Methods: RAW 264.7 cells stimulated with LPS were preincubated with various concentrations of celecoxib (from $10^{-8}$ to $10^{-5}$ M) and $10{\mu}M$ hydrocortisone, respectively. The production of NO and PGE2, the end products of iNOS and COX-2 genes, were estimated in culture supernatants by Greiss method and EIA, respectively. The expression of iNOS gene, COX-2 gene, $NF-{\kappa}B$, and $I-{\kappa}B$ were determined by RT-PCR and western blot analysis. Results: Celecoxib and hydrocortisone inhibited the production of NO and PGE2 in dose dependent manner, when RAW 264.7 cells were stimulated with LPS. The expression of iNOS was also down-regulated by celecoxib and hydrocortisone. Interestingly, COX-2 gene differentially expressed according to the dose of celecoxib, a decrease with lower dose ($10^{-8}$ M) but an increase with higher dose ($10^{-5}$ M). $NF-{\kappa}B$ binding activity was decreased by lower dose of celecoxib, whereas was not affected by higher dose of it. The expression of $I-{\kappa}B$ was suppressed by higher dose of celecoxib. Conclusion: The celecoxib strongly suppressed the production of NO and PGE2 in LPS-stimulated RAW264.7 cells. The decrease of NO seems to be linked to the inhibition of iNOS by celecoxib. The lower and higher dose of celecoxib differentially regulated the COX-2 expression and $NF-{\kappa}B$ activity.

Cyclooxygenase-2 Specific Inhibitor (SC-58635)가 Lipopolysaccharide로 자극한 대식세포에서 Nitric Oxide와 Prostaglandin E2 생산에 미치는 영향

홍승재(Seung-Jae Hong),양형인(Hyung-In Yang),윤휘중(Hwi-Joong Yoon),이명수(Myoung-Soo Lee),강효종(Hyo-Jong Kang),김완욱(Wan-Uk Kim),이상헌(Sang-Heon Lee),조철수(Chul-Soo Cho),김호연(Ho-Youn Kim) 대한면역학회 2003 Immune Network Vol.3 No.1

무작위 대조 이중맹검 시험을 통한 봉독 약침의 류마티스 관절염 치료 효과 연구

이상훈,홍승재,김수영,양형인,이재동,최도영,이두익,이윤호,Lee, Sang-hoon,Hong, Seung-jae,Kim, Su-young,Yang, Hyung-in,Lee, Jae-dong,Choi, Do-young,Lee, Doo-ik,Lee, Yun-ho 대한침구의학회 2003 대한침구의학회지 Vol.20 No.6

Objective : This study was performed in order to evaluate the effect of bee venom therapy on rheumatoid arthritis by randomized controlled double blind method. Methods : RA patients were recruited and divided into an experiment group and a control group by random selection. As a double blind test, the experiment group was treated with bee venom injection on acupoints, and the control group was treated with normal saline injection on acupoints twice a week for 8 weeks. Tender joint count, swollen joint count, morning stiffness, pain, health assessment questionnaire, ESR, and CRP were estimated and analyzed at baseline, and at 1 month and 2 months after bee venom therapy. Results : Compared to the control group, the experiment group showed significant decrease in tender joint count, swollen joint count, morning stiffness, and health assessment questionnaire after 2 months. Pain, ESR and CRP showed significant decrease in the experiment group after 1 & 2 months. Conclusions : These results suggests that bee venom therapy could be an effective method in the treatment of patients with rheumatoid arthritis.

종양 괴사 인자 억제제 전환으로 호전된 강직성 척추염 1예

이재건 ( Jae Gun Lee ),박현진 ( Hyun Jin Park ),이연아 ( Yeon Ah Lee ),홍승재 ( Seung Jae Hong ),이상훈 ( Sang Hoon Lee ),양형인 ( Hyung In Yang ) 대한내과학회 2008 대한내과학회지 Vol.75 No.1S

함라마을 부농주거의 건축특성 연구

유은미,홍승재,Yu, Eun-Mi,Hong, Seung-Jae 한국주거학회 2006 한국주거학회 논문집 Vol.17 No.6

Ham-ra is a village that belongs to Ham-yuel Ri, Ik-san city and also known as the village where 4 millionaire modem age rich farmer households are residing in the center of the village. Originally, central point of the village was Gaeksa and Hyanggyo that is in Suodong, but early 1900s, rich farmers found new Places beside Suodong and built large-scale houses and around it, houses of tenant and commercial places were formed and became the new center of the village. Therefore, Ham-ra village shows well about the changes of the traditional village in the end of Chosun Dynasty aspect that of existent village space according to rich farmer's growth. Especially, the large scaled Korean traditional houses which were built newly in the year between 1917 to 1939 shows main road and Natural stream surrounding the village which are not found in any other village. 3 rich farmers (Lee Bae-won, Jo Hae-young, Kim An-gyun house) and Lee Jib-cheon's houses built a large scaled Sarang-chae and An-chae to compete and to show off there wealth. This residing imitated High-classe house yet accommodated social changes and through a voluntary experiment, is expressing modernity of Han-ok very well. Similarity and creativity in residing form appears well in buildings similar time and village. This research analyzed space composition change of the village and characteristic of Architecture who appear at modern process of typical farmer houses which make a strong resolution to Ham-ra hereupon.

재발성 다발연골염에 동반된 강직척추염 1예

박재현 ( Jae Hyun Park ),오원택 ( Won Taek Oh ),이연아 ( Yeon Ah Lee ),이상훈 ( Sang Hoon Lee ),양형인 ( Hyung In Yang ),이선 ( Sun Lee ),홍승재 ( Seung Jae Hong ) 대한내과학회 2008 대한내과학회지 Vol.75 No.4

다른 면역 질환들이 재발성 다발연골염에 동반되어 나타나기도 하나 강직척추염이 동반되어 나타나는 경우는 드물다. 재발성 다발연골염과 강직척추염을 유발하는 공통적인 병인은 아직 밝혀지지 않았다. 따라서 이 두 질환의 상관관계에 대해 좀더 많은 연구가 필요하며 저자 등은 재발성 다발연골염에 동반된 강직척추염 1예를 발견하였기에 이를 문헌고찰과 함께 보고하는 바이다. Relapsing polychondritis is a rare condition of unknown etiology in which recurrent episodes of inflammation are followed by the destruction of cartilaginous structures, which predominantly include the nose, ears, and tracheobronchial tree. Although many autoimmune disorders, such as systemic vasculitis, rheumatoid arthritis, lupus erythematosus, Sjogren`s syndrome, and Behcet`s disease, are commonly found in patients with relapsing polychondritis, ankylosing spondylitis is rarely associated with this disease. We report a case of relapsing polychondritis with ankylosing spondylitis in the same patient. (Korean J Med 75:467-470, 2008)

류마티스 관절염 병인에서 제2형 콜라겐에 대한 면역반응의 역할

정영옥,홍승재,김호연,Jung, Young Ok,Hong, Seung-Jae,Kim, Ho-Youn 대한면역학회 2003 Immune Network Vol.3 No.1

Type II collagen (CII), major component of hyaline cartilage, has been considered as an auto-antigen in rheumatoid arthritis (RA). However, the clinical and biological significances with regard to the CII autoimmunity need to be clarified in human RA. The presence of antibodies to CII has been identified in sera, synovial fluid, and cartilage of patients with RA. In our study, the increased titer of IgG anti-CII in sera was well correlated with C-reactive protein, suggesting that this antibody may reflect the inflammatory status of RA. The titer of anti-CII antibodies (anti-CII Abs) tended to be higher in early stages of diseases. In our extending study, among 997 patients with RA, 269 (27.0%) were positive for circulatory IgG antibody to CII, those levels were fluctuated over time. It is hard to assess the significant amount of T cell responses to CII and CII (255~274) in RA. By using a sensitive method of antigen specific mixed lymphocyte culture, we can detect the presence of CII-reactive T cells in peripheral blood mononuclear cells of RA patients. Sixty seven (46.9%) of 143 patients showed positive CII reactive T cell responses to CII or CII (255~274). The frequencies of CII reactive T cells were more prominent in inflamed synovial fluid (SF) than in peripheral blood. These T cells could be clonally expanded after consecutive stimulation of CII with feeding of autologous irradiated antigen presenting cells (APC). Moreover, the production of Th1-related cytokine, such as IFN-${\gamma}$, was strongly up-regulated by CII reactive T cells. These data suggest that T cells responding to CII, which are probably presenting the IFN-${\gamma}$ producing cells, may play an important role in the perpetuation of inflammatory process in RA. To evaluate the effector function of CII reactive T cells, we investigated the effect of CII reactive T cells and fibroblasts-like synoviocytes (FLS) interaction on the production of pro-inflammatory cytokines. When the CII reactive T cells were co-cultured with FLS, the production of IL-15 and TNF-${\alpha}$ from FLS were significantly increased (2 to 3 fold increase) and this increase was clearly presented in accord to the expansion of CII reactive T cells. In addition, the production of IFN-${\gamma}$ and IL-17, T cell derived cytokines, were also increased by the co-incubation of CII reactive T cells with FLS. We also examined the impact of CII reactive T cells on chemokines production. When FLS were co-cultured with CII stimulated T cells, the production of IL-8, MCP-1, and MIP-1${\alpha}$ were significantly enhanced. The increased production of these chemokines was strongly correlated with increase the frequency of CII reactive T cells. Conclusively, immune response to CII was frequently found in RA. Activated T cells in response to CII contributed to increase the production of proinflammatory cytokines and chemokines, which were critical for inflammatory responses in RA. The interaction of CII-reactive T cells with FLS further augmented this phenomenon. Taken together, our recent studies have suggested that autoimmunity to CII could play a crucial role not only in the initiation but amplification/perpetuation of inflammatory process in human RA.

종설 : 통풍 관절염 치료의 최신지견

최인아 ( In Ah Choi ),홍승재 ( Seung Jae Hong ) 대한내과학회 2009 대한내과학회지 Vol.76 No.2

Gout is the most common inflammatory arthritis in men over 40 years old and the prevalence is increasing. Asymptomatic hyperuricemia is predisposing condition of gout but the frequency of progression to acute gout is not high enough to need prophylactic treatment. In acute gout flare, first line therapy is non-steroid anti-inflammatory agents (NSAIDs) or corticosteroids, depending on comorbidities. Colchicine is now second line therapy. Urate lowering therapy for gout needs to be initiated when the second attack occurs in a year. Allopurinol, a xanthine oxidase inhibitor, has been the most widely used agent for the treatment of chronic gout. Now, febuxostat has emerged as a new xanthine oxidase inhibitor that is expected to be useful in patients with mildly decreased renal function. Uricosuric agents are alternative therapies for patients with preserved renal function and no history of nephrolithiasis. During urate lowering therapy, the dose should be titrated upward until the serum uric acid level is kept less than 6mg/dL. When initiating urate lowering therapy, concurrent prophylactic therapy with NSAIDs or low dose colchicine for more than six months is recommended for reducing flare-ups. In chronic gout treatment, dietary modification seems to have minimal effect, but alcohol drinking and weight control can be recommended. (Korean J Med 76:151-162. 2009)

류마티스관절염의 최신 치료와 관리

최지영 ( Ji Young Choi ),홍승재 ( Seung Jae Hong ) 경희대학교 경희의료원 2014 慶熙醫學 Vol.29 No.1

Department of Rheumatology, Department of Rheumatology, Kyung Hee University Medical Center, School of Medicine, Kyung Hee University, Seoul, Korea The American College of Rheumatology (ACR) and European Leagues against Rheumatism (EULAR) updated management guideline for Rheumatoid Arthritis (RA) recently. The management of RA based on the use of disease-modifying anti-rheumatic drugs (DMARDs). Hence novel biologic agents with different targets have emerged, it is composed a significant proportion at RA treatment. The key concept of RA treatment is that therapy with DMARDs should be started as soon as possible. Methotrexate (MTX) should be part of first line treatment. The target of treatment are to reach remission or low disease activity. These guidelines recommend rapid changing drugs if it is not efficient. To effective treatment of RA, non-pharmacologic treatment is also important. Patients should be educated about treatment and drug side effect, exercise and lifestyle modification. Physiotherapy and walking aids are helpful and some patients may need operative treatment.