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Depression is an important comorbidity of asthma. However, little information is availableabout depression and its potential impact on asthma control in Korean adult asthmapatients. We aimed to estimate the prevalence and risk factors for depression in Koreanadults with persistent asthma. The 127 non-elderly (20-64 yr) and 75 elderly ( ≥ 65 yr)patients with asthma were recruited. Demographic and clinical data were extracted, andthe patients completed the Asthma Specific Quality of Life (AQOL) questionnaire andasthma control test (ACT). Depression status was defined using the Korean version of thePatient Health Questionnaire-9 (PHQ-9). Depression was more prevalent in non-elderly(18.9%) than in elderly patients with asthma (13.3%). Patients with depression weresignificantly younger, had lower economic status, shorter disease duration, poorer asthmacontrol, and worse AQOL scores (P < 0.05). Within the non-elderly group, younger ageand shorter disease duration were significantly associated with depression (P < 0.05). Within the elderly group, a higher body mass index and current smoking status weresignificantly associated with depression (P < 0.05). The PHQ-9 score was significantlycorrelated with worse ACT and AQOL scores in both groups. In conclusion, depression isstrongly associated with poor asthma control and quality of life in Korean adult asthmapatients. Our results provide important clues that used to target modifiable factors whichcontribute to development of depression in asthma patients.
Toluene diisocyanate (TDI) exposure induces oxidative stress and epithelial cell-derived inflammation, which affect the pathogenesis of TDI-induced occupational asthma (TDI-OA). Recent studies suggested a role for clusterin (CLU) and progranulin (PGRN) in oxidative stress-mediated airway inflammation. To evaluate CLU and PGRN involvement in airway inflammation in TDI-OA, we measured their serum levels in patients with TDI-OA, asymptomatic exposed controls (AECs), and unexposed healthy normal controls (NCs). Serum CLU and PGRN levels were significantly lower in the TDI-OA group than in the AEC and NC groups (P < 0.05). The sensitivity and specificity for predicting the TDI-OA phenotype were 72.4% and 53.4% when either CLU or PGRN levels were below the cutoff values (≤125 μg/mL and ≤68.4 ng/mL, respectively). If both parameters were below the cutoff levels, the sensitivity and specificity were 58.6% and 89.8%, respectively. To investigate CLU and PGRN function, we evaluated their production by human airway epithelial cells (HAECs) in response to TDI exposure and co-culturing with neutrophils. TDI-human serum albumin stimulation induced significant CLU/PGRN release from HAECs in a dose-dependent manner, which positively correlated with IL-8 and folliculin levels. Co-culturing with neutrophils significantly decreased CLU/PGRN production by HAECs. Intracellular ROS production in epithelial cells co-cultured with neutrophils tended to increase initially, but the ROS production decreased gradually at a higher ratio of neutrophils. Our results suggest that CLU and PGRN may be involved in TDI-OA pathogenesis by protecting against TDI-induced oxidative stress-mediated inflammation. The combined CLU/PGRN serum level may be used as a potential serological marker for identifying patients with TDI-OA among TDI-exposed workers.
Malaria has been reemerged in Korea since 1993 and the number of the patients has been increasing to reach over 4,000 cases in 2000. We, herein, report a case of congenital malaria. A 36-day-old boy, who presented with cough and rhinorrhea lasting for several days and looked pale, was referred to us for evaluation. The laboratory examination revealed hemolytic anemia, thrombocytopenia, hepatosplenomegaly and blood smears showed schizonts of Plasmodium vivax. The mother of the patient was found to have been treated for malaria due to Plasmodium vivax at eighth month of gestation. The health condition of the patient has gradually been improving on hydroxychloroquine. This may be the first reported case of domestic congenital malaria in Korea. (Korean J Infect Dis 33:223∼226, 2001)