일과성 Immunoglobulin G 결핍증이 있는 아토피피부염 환아에서 면역글로불린 치료

백종욱 ( Jong Uk Baek ),이혜란 ( Hae Ran Lee ),이소연 ( So Yeon Lee ) 대한천식알레르기학회 2012 천식 및 알레르기 Vol.32 No.3

Background: Some studies have reported that intravenous immunoglobulin is an effective treatment of severe atopic dermatitis. Case History: A 3-month-old by present suffered from atopic dermatitis with skin infection since the age of 50 days. He was fed on breast milk and had no familial history of allergy. Upon admission, his body weight was 6.9 kg (50 percentile), and the Severity Scoring of Atopic Dermatitis was 80. Laboratory test results were as follows: white blood cell 23.1×103/uL, eosinophil (%) 29%, immunoglobulin E 696.2 IU/mL, immunoglobulin G 126 mg/dL (176∼601 mg/dL), immunoglobulin A 14.7 mg/dL (1.3∼53 mg/dL), immunoglobulin M 31.7 mg/dL (17∼105 mg/dL). Staphylococcus aureus was detected in the erosive cheek by skin cultures. Specific immunoglobulin E levels to egg white, soy, and peanut were elevated. He was initially treated with intravenous antibiotics, wet dressing, steroid ointments, and mother`s dietary restriction. However, the skin infection and atopic dermatitis remained uncontrolled, and the immunoglobulin G level was still below the normal range. The patient was given intravenous immunoglobulin 1 g/kg/day for 2 consecutive days. Results: After 4 days, the skin infection was controlled. After 9 months, immunoglobulin G level was normalized. Conclusion: We reported a patient who was diagnosed with severe atopic dermatitis with transient immunoglobulin G deficiency and whose symptoms improved after intravenous administration of immunoglobulin.

한국인 모유에 관한 면역학적 연구 ( 제 2편 ) 정상모유에 함유된 Immunoglobulin의 정성분석

이성근(SK Lee),권영조(YJ Kwon),옹상길(SK Ong) 대한산부인과학회 1966 Obstetrics & Gynecology Science Vol.9 No.11

Quantitative measurement of the IMMUNOGLOBULINS in the milk of the Korean women was performed using IMMUNO-PLATE Human γM, γG, γA Immunoglobulin Test. Seven cases of normal women were followed up, whose sera and colostrums were measured for the immunoglobulins in the previous paper. The levels of the immunoglobulins in the mature milk were as follows; IgG 40.6 17.3mg%; IgA 53.9 19.3mg%; IgM 20.0 9.0mg%. The content in the milk was much lowered as compared with that of the colostrum, and any fraction of the immunoglobulins in the milk did not exceed those in the maternal serum and colostrum.

한국인에서 면역글로불린-저항성 가와사키병 환자의 예측

최명현,박청수,김동수,김기환,Choi, Myung Hyun,Park, Chung Soo,Kim, Dong Soo,Kim, Ki Hwan 대한소아감염학회 2014 Pediatric Infection and Vaccine Vol.21 No.1

Purpose: The objective of this study was to find the predictors and generate a prediction scoring model of nonresponse to intravenous immunoglobulin in patients with Kawasaki disease. Methods: We examined 573 children diagnosed with KD at the Severance Children's Hospital between January 2009 and december 2012. We retrospectively reviewed their medical records. These patients were divided into 2 groups; the experimental group (N=433) and the validation group (N=140). Each group were divided into 2 groups the intravenous immunoglobulin nonresponders and the responders. Multivariate logistic regression analysis identified predictive factors of intravenous immunoglobulin nonresponders which make predictive scoring model. We practice internal validation and external validation. Results: Multivariate logistic regression analysis identified male, cervical lymphadenopathy, changes of the extremities, platelet, total bilirubin, alkaline phophatase, lactate dehydrogenase, C-reactive protein as significant predictors for nonresponse to intravenous immunoglobulin. We generated prediction score assigning 1 point for (1) male, (2) cervical lymphadenopathy, (3) changes of the extremities, (4) platelet (${\leq}368,000/mm^3$), (5) total bilirubin (${\geq}0.4mg/dL$), (6) alkaline phophatase (${\geq}227IU/L$), (7) lactate dehydrogenase (${\geq}268IU/L$), (8) C-reactive protein (>77.1 mg/dL). Using a cut-off point of 4 and more with this prediction score, we could identify the intravenous immunoglobulin nonresponder group. Sensitivity and specificity were 52.5% and 82.4% in experimental group and 37.8% and 81.8% in validation group, respectively. Conclusion: Our predictive scoring models had high specificity and low sensitivity in Korean patients. Therefore it is useful in predicting nonresponse to intravenous immunoglobulin with Kawasaki disease. 목적: 이 연구의 목적은 면역글로불린-저항성 가와사키병의 예측 인자를 찾고 점수화된 예측 모델을 만들고자 하는 것이다. 방법: 2009년 1월부터 2012년 12월까지 세브란스 어린이 병원에서 가와사키병으로 진단된 573명의 환자를 대상으로 하였다. 실험군과 검증군으로 나누었고, 각 군들은 면역글로불린-반응성과 저항성으로 나누었다. 실험군에서 면역글로불린의 예측 인자를 찾았고, 점수화된 예측모델을 만들었다. 그리고 외적, 내적 타당성 검증을 시행하였다. 결과: 남성, 경부림프절종대, 손과 발의 변화, 혈소판, 총빌리루빈, 젖산탈수효소, CRP가 면역글로불린-저항성 가와사키병의 예측 인자로 나타났다. 점수화된 예측 모델을 만들었고, 민감도와 특이도가 실험군에서는 52.5%와 82.4%, 검증군에서는 37.8%와 81.8%로 나타났다. 결론: 우리의 점수화된 예측 모델은 한국 환자에 적용하였을 때 높은 특이도와 낮은 민감도를 갖는다.

댄스스포츠 운동강도가 여성고령자의 면역글로블린에 미치는 영향

신희수(Hee Soo Shin),양점홍(Jum Hong Yang) 한국발육발달학회 2005 한국발육발달학회지 Vol.13 No.4

The main purpose of this dissertation is to discuss and analyze the effect of immunoglobulin on exercise intensity in the elderly women over 70. For the purpose, this researcher 6 elderly women 70 or over who had no experience of exercise program participation, had no problem in using motor functions for daily life and agreed to participate in the study. Those elderly women were asked to participate in dance sport Dance sport programs were performed one time per week for three weeks with RPE 9~13 intensity corresponding to 45-70%HRmax(low intensity : 45~53%HRmax, middle intensity : 55~60%HRmax, high intensity : 65~70%HRmax). The following conclusion can be obtained by analyzing and comparing the change of immunoglobulin on exercise intensity in the elderly women over 70 years. IgG is increase in 55~60%HRmax and 65~70%HRmax. If we judge the result of analyzing immunoglobulin on exercise intensity, immunoglobulin of 55~60%HRmax and 65~70%HRmax are better than 45~50%HRmax, but their concrete and detailed mechanism is not yet explained fully. Elderly people`s disease is mainly due to the degeneration of their immunoglobulin. For this reason, exercise intensity suitable for those people should be carefully considered in exercise intensity and exercise program. Therefore, there needs more continuous and profound researches on the immunoglobulin.

자연과학편 : 저강도 해변 걷기운동이 고령자의 면역글로블린에 미치는 영향

신희수(HeeSooShin) 한국체육학회 2006 한국체육학회지 Vol.45 No.1

The purpose of this study is to investigate effects of low intensity beach walking exercise on elderly men`s immunoglobulin. For the purpose, this researcher 6 old men aged 70 or over who had no experience of exercise program participation, had no problem in using motor functions for daily life and agreed to participate in the study. Those men were asked to participate in low intensity beach walking exercise.Low intensity beach walking exercise were performed two times per week for 12 weeks with RPE 9~10 intensity corresponding to 45~50%HRmax. It is observed that immunogloulin IgA, IgG, IgM. All date were expressed as mean and standard deviations by using SPSS window 10.0 package programs and were analyzed by using paired t-test to evaluate the change of within group.The following conclusion can be obtained by analyzing and comparing the change of immunoglobulin on low intensity beach walking exercise in the elderly men.IgA and IgG are increased in 4550%HRmax.The present study supposed that the low intensity beach walking exercise can have positive effects on immunoglobulin in elderly men. but their concrete and detailed mechanism is not yet explained fully. Elderly people's disease is mainly due to the degeneration of their immunoglobulin. For this reason, exercise intensity suitable for those people should be carefully considered in exercise intensity and exercise program.Therefore, there needs more continuous and profound researches on the immunoglobulin.

치근단 병소에서 면역 글로불린의 분포에 관한 연구

박동수,조수진,윤태철 大韓齒科保存學會 1995 Restorative Dentistry & Endodontics Vol.20 No.1

AbstractPeriapical lesions develop as a result of immunopathologic response to irritants from infected root canal systems. Removal of these irritants from the root canal system and sealing the root canal space may induce healing of the periapical lesions. 83 periapical lesions diagnosed as periapical abscess, periapical granuloma, chronic nons- pecific inflammation, fibrosis and periapical cyst were evaluated for the distribution of immu- noglobulin containing cells. The influence of the state of root canal treatment on the distribu- tion of immunoglobulin containing cells has evaluated. All lesions were divided into a group with no treatment, a group with canal enlargement, a group filled with gutta percha, and a group filled with VitapexC calcium hydroxide). The distribution of immunoglobulin-contai- ning cells according to the presence of pain and fistula was also evaluated.The following results were obtained. 1. Statistically significant difference in the distribution of immunoglobulin-containing cells among periapical abscess, periapical granuloma, chronic nonspecific inflammation/fibrosis and periapical cyst were found.(Kruskal-Wallis analysis, P<^0.05) The number of immu- noglobulin-containing cells in fibrosis was remarkably lower than that of periapical abs- cess, granuloma and cyst. 2. IgM and IgA containing cells were predominantly observed in periapical abscesses and periapical cysts, respectively. 3. All periapical lesions showed a large number of IgG containing cells followed by IgM, IgA and IgE containing cells. 4. There was a decrease in all Ig-containing cells in the group with canal filling compared to groups without treatment or with enlargement. That is, there is a decrease in Ig -containing cells as treatment progresses. 5. No significant correlation existed between the presence of pain and fistula and the distri- bution of immunoglobulin containing cells in periapical lesions, (t-test) Results appear to support that immune response are actively involved in the development and progress in periapical lesions. The fact that distribution of immunoglobulins differ according to the state of endodontic treatment suggests that root canal treatment may alter the humoral immune response of the periapical lesions.

만성면역혈소판감소자색반에서의 Anti-D immunoglobulin 치료

김혜정 ( Hye Jeong Kim ),정윤진 ( Yun Jin Jung ),황의남 ( Eui Nam Hwang ),김영훈 ( Young Hoon Kim ),최진성 ( Jin Sung Choi ),남승현 ( Seung Hyun Nam ),김봉석 ( Bong Seog Kim ),오도연 ( Do Yeon Oh ),윤성수 ( Sung Soo Yoon ),박선양 대한내과학회 2008 대한내과학회지 Vol.74 No.2

목적: 성인 만성 면역혈소판감소자색반 환자에서 anti-D 면역글로불린을 투여하여 혈소판 상승에 대한 효과와 부작용을 확인하고자 본 연구를 시행하였다. 방법: 이전 치료에 반응을 하지 않거나 재발한 전체 14명의 성인 만성 면역혈소판감소자색반 환자를 대상으로 하였다. 14명 환자가 스테로이드 요법을 받았고, 10명의 환자는 비장절제술을 시행 받았다. Anti-D 면역글로불린의 주입량은 50~70 μg/kg이었으며 단 한번 주입하여 반응을 확인하였고, 치료 반응의 평가는 혈소판 및 혈색소 수치를 추적 검사하였다. 결과: 치료 반응이 확인된 경우는 전체 환자의 36% 인 5명이었고, 혈소판 상승이 지속된 기간은 평균 7일이었으며 심각한 합병증은 없었다. 결론: 본 연구에서는 성인의 만성 면역혈소판감소자색 반증에서 Fc 수용체 차단제인 anti-D 면역글로불린을 이용한 치료가 임상적 유용성이 있는 것으로 나타났다. Background/Aims: Immune thrombocytopenic purpura (ITP) is an autoimmune disease that is mediated by anti-platelet antibodies. Based on the pathogenesis of ITP we evaluated the efficacy of intravenous anti-D immunoglobulin for adult chronic ITP. Methods: Fourteen patients (4 without splenectomy and 10 with splenectomy) with refractory chronic ITP were treated with 50-70μg/kg of intravenous anti-D immunoglobulin only once. Treatment effects were evaluated by measuring the platelet counts and hemoglobin levels. Results: Five patients (36%) showed a response; improvement in the platelet count lasted for on average 7 days (range: 2~24 days). There were no serious adverse effects. Conclusion: Anti-D immunoglobulin, which is associated with an Fc receptor blockade, appeared to be safe and effective for the treatment of adults with chronic ITP. Further studies are needed to confirm these findings and define further potentially effective treatment protocols with intravenous anti-D immunoglobulin. (Korean J Med 74:176-180, 2008)

Case Reports : High-dose Immunoglobulin Infusion for Thrombotic Thrombocytopenic Purpura Refractory to Plasma Exchange and Steroid Therapy

Seh Jong Park,Seok Jin Kim,Hee Yun Seo,Moon Ju Jang,Do Yeun Oh,Byung Soo Kim,Jun Suk Kim 대한내과학회 2008 The Korean Journal of Internal Medicine Vol.23 No.3

The outcomes of the treatment of thrombotic thrombocytopenic purpura (TTP) have been shown to be improved by the administration of plasma exchange. However, treatment options are currently limited for cases refractory to plasma exchange. The autoantibodies that block the activity of ADAMTS13 have been demonstrated to play a role in the pathogenesis of TTP; therefore, high-dose immunoglobulin, which can neutralize these autoantibodies, may be useful for refractory TTP. However, successful treatment with high-dose immunoglobulin for TTP refractory to plasma exchange and corticosteroids has yet to be reported in Korea. Herein, we describe a refractory case which was treated successfully with high-dose immunoglobulin. A 29-year-old male diagnosed with TTP failed to improve after plasma exchange coupled with additional high-dose corticosteroid therapy. As a salvage treatment, we initiated a 7-day regimen of high-dose immunoglobulin (400 mg/kg) infusions, which resulted in a complete remission, lasting up to the last follow-up at 18 months. High-dose immunoglobulin may prove to be a useful treatment for patients refractory to plasma exchange; it may also facilitate recovery and reduce the need for plasma exchange.

한국인 모유에 관한 면역학적 연구 ( 제1편 ) 초유에 함유된 Immunoglobulin의 정량분석

권영조(YJ Kwon),이성근(SK Lee),임수덕(SD Lim) 대한산부인과학회 1966 Obstetrics & Gynecology Science Vol.9 No.11

Comparative and immunochemical analyses of the milk and serum immunoglobulins IgG, IgA&IgM were attempted in a series of experiments. In this paper, quantitative meaurements of the immunoglobulins in the colostrum and maternal serum using Oudin`s capillary tube technique were presented. Smaples were obtained from 21 normal Korean puerperas, totalling 21 colostrums and 11 maternal sera. Levels of the immunoglobulins in the colostrum were: IgG 118.2 64.35mg%, IgA 334.9 162.2mg%, IgM 50.4 23.1mg%,: and those of maternal sera were: IgG 1,979.1 702.5mg%, IgA 227.6 43.1mg%, IgM 88.4 15.2mg%. The high concentration of IgA immunoglobilin in the colostrum was most noticeable finding. In addition to the experiments, recent findings and knowledsge about the immunoglobulins were also described.

4주간 집중 트레이닝이 고등학교 유도선수의 체력변화 및 Immunoglobulin과의 관련성

신승윤 ( Seung Yun Shin ),신진이 ( Jhin Yi Shin ) 대한무도학회 2010 대한무도학회지 Vol.12 No.2

본 연구는 4주간 집중 트레이닝에 따른 고등학교 유도 선수의 체력변화 및 체력(근지구력, 유연성, 근력, 순발력, 민첩성)과 Immunoglobulin(IgG, IgA, IgM)의 관련성을 분석하는데 목적이 있다. 연구의 대상은 고등학교 남자 유도선수 29명이었으며, 4주간의 유도집중 프로그램과 웨이트 트레이닝을 실시하였다. 자료처리는 SPSS 17.0 Program을 이용하여 4주간 집중트레이닝에 따른 체력의 변화는 Paired t-test를 사용하여 분석하였고, 체력과 면역력의 상호관련성은 pearson`s correlation을 이용하였다. 연구결과 유도 집중 트레이닝(복합트레이닝)에 따른 체력의 변화에서 윗몸일으키기, 앉아윗몸 앞으로굽히기, 악력, 제자리멀리뛰기, 사이드스텝은 통계적 유의한 차이를 나타내었으며, 집중 훈련 트레이닝 프로그램 적용 전보다 후에 향상된 것을 알 수 있었다. 또한, 배근력에서만 트레이닝 전보다 후에 감소한 것으로 나타났다. 체력(근지구력, 유연성, 근력, 순발력, 민첩성)과 Immunoglobulin(IgG, IgA, IgM)의 관련성 분석 결과 IgG와 근력(악력, 배근력), 유연성(앉아윗몸 앞으로굽히기) 민첩성(사이드 스텝), 근지구력(윗몸일으키기)과는 통계적으로 유의한 관련성이 없는 것으로 나타났다(p>.05). 하지만 민첩성(사이드스텝)에서는 통계적으로 유의한 역상관(p<.05)이 있는 것으로 나타났다. IgA와 체력의 관련성에서는 모든 체력변인에서 통계적으로 유의한 상관이 나타나지 않았다(p>.05). IgM와 체력과의 관련성에서는 근지구력과 유연성에서는 통계적으로 유의한 상관이 없었다. 하지만 민첩성(사이드스텝, p<.05), 순발력(제자리멀리뛰기, p<.01), 근력(배근력, p<.05) 에서는 통계적으로 유의한 역상관이 있는 것으로 나타났다. 이와 같은 결과로 보아 단기적인 강한 트레이닝으로 체력은 향상 시킬 수 있으나 IgG, IgA, IgM과 같은 Immunoglobulin에 부정적인 영향을 주어 면역력 약화를 초래할 수 있을 것으로 사료된다. This purpose of this study is to analysis a correlation between change physical fitness and immunoglubulin about high school judo players for 4 weeks concentration training to provide the training program model for improving the judo game performance. Subjects were participated 29 judo player, they did judo program and weight training. It used program SPSS 17.0 to data analysis. Also, Differences in physical fitness factors before and after the training program were examined using a paired t-test. pearson`s correlation was used to correlation between change physical fitness and immunoglubulin. The results of this study are following. First, muscle strength(grip strength), flexibility(sit-and-reach), ability to react instantly(standing long jump), muscle endurance(sit-up), Agility(side-step), before and after training were statistically significant(p<.05). Also there has been a gradual increase in the result. However, the test of back strength showed a decrease and it was not a significant difference. Second, when the physical fitness and immunoglubulin were compared, there was a meaningful correlation between them. Specifically, IgG was muscle strength(grip strength, back strength) and flexibility(sit-and-reach) showed the positive correlation with the agility(side-step) and muscle endurance(sit-up) showed the negative correlation. IgA was all physical fitness factor which exclude muscle endurance(sit-up) showed the positive correlation. IgM was all physical fitness factors showed the negative correlation. In conclusion, acute concentration training improve physical fitness, but immunocompetence could be decreased by decrease of immunoglobulin, such as IgG, IgA, IgM. Therefore, the current finding of the study suggest that in case of acute concentration training, additional plan need to prevent athlete`s infection.