Characteristics of the Elderly Asthma

( Deok In Kim ),( Hyouk Soo Kwon ),( Woo Jung Song ),( Sang Min Lee ),( Sae Hoon Kim ),( Seong Wook Sohn ),( Chang Han Park ),( Heung Woo Park ),( Sun Sin Kim ),( Sang Heon Cho ),( Kyung Up Min ),( Yo 대한천식알레르기학회 2008 천식 및 알레르기 Vol.28 No.2

배경: 노인 천식은 한 보고에서 우리나라 유병률이 12.7%에 달하며 전세계에서 가장 빠르게 고령화 사회로 진입하고 있는 우리나라에서 점차 더 임상적으로 중요한 위치를 차지할 것이다. 노인 천식에 대한 다각적인 연구가 필요한 시점이다. 목적: 노인 천식에서 성별, 발병 연령 등에 따른 임상적 차이를 알아보고자 하였다. 방법: 분당서울대학교병원 천식 및 알레르기 클리닉을 방문한 65세 이상의 환자들을 대상으로 성별, 발병 연령에 따른 임상 양상에 대해 연구하였다. 65세 이전 발병의 경우를 조기 발병 천식, 65세 이후 발병의 경우를 후기 발병 천식으로 분류하였다. 결과: 총 180명 중, 81명이 조기 발병 천식, 99명이 후기 발병 천식이었다. 조기 발병 천식의 유병 기간은 18.8±17.1년, 후기 발병 천식은 3.4±3.5년이었다. 조기 발병 천식에서 천명음, 피부단자검사 양성, 기관지확장 소견이 더 높게 나타났으며, 기도 폐쇄 정도가 더 심하였으나, 천명 외의 다른 호흡기계 증상, 약물 요구 정도, 혈청 총 IgE에는 차이가 없었다. 일부 환자에서 유도객담을 분석하였고 후기 발병 천식에서 호중구 분율이 높았다. 결론: 65세 이상의 천식 환자를 일반적으로 노인 천식 환자라 부르고 있으나, 발병 연령에 따라 임상적인 차이가 있으며 후기 발병 천식에서는 호중구의 역할을 시사하는 연구결과를 보였다. 따라서 관련 연구 진행이나 진료에 있어 발병 연령에 따른 고려가 필요할 것으로 사료된다. (Korean J Asthma Allergy Clin Immunol 2008;28:98-104)

알레르기 질환 환자에서의 알레르기 반응도와 인성 특성의 관계

김조자,김용순,박지원,강성숙,홍천수,이기영,박인용,민성길 대한천식알레르기학회 1989 천식 및 알레르기 Vol.9 No.2

The differences of psychologic tests were found between groups of allergic diseases, who noted the degree of skin reactivity on allergy skin test. In the present study the MMPI and allergy evaluations were given to 115 patients with bron- chial asthma, allergy rhinitis, both of them and other allergic diseases, who visted at Allergy Clinic in Severance Hospital, Yonsei University College of Medicine from March 1988 to September 198K There were differences of personality charac- teristics between groups of allergic reactions. The weak skin reactivity group scored higher on depression, psychasthenia, social introversion (p<0.05) and feminity (in male patients)(p<0.01) and scored lower on psychopathic deviste than those of strong skin reactivity group. Therefore these findings confirm the previous conclusion that there are measurable, important psychological differences within groups of allergy patients, related to degree of demonstrable allergy reactivity. And allergy p a.tients had neurotic tendence. The patients who noted that their allergic simptom- developed on psychic stresses showed higher scores on hypochondriasis (p<0.05), depression (p 0.05) and hyste'ria (p<0.05) than those of the patients who did not note any relationship between development of allergy symptoms and psychic stresses. And the patients who noted that their allergy simptoms were relapsed by psye4ic stresses showed higher scores on hypochondriasis (p,0.05), depression (p <0.05), hysteria(p<0.01) and social introversion (p <0.05) than those of patients who noted that the relapse of their allergy symptoms was not related to psychic stresses. The results repremnt that psychic factors in addition to pure antigen-antibody reactions will participate in development and aggravation of allergy symptoms.

메타콜린 기관지유발검사 시행방법: 대한천식알레르기학회 의견서

손경희 ( Kyoung-hee Sohn ),김환수 ( Hwan Soo Kim ),김병근 ( Byung-keun Kim ),김주희 ( Joo-hee Kim ),이상민 ( Sang Min Lee ),이재현 ( Jae-hyun Lee ),우성일 ( Sung-il Woo ),김철홍 ( Cheol Hong Kim ),정재원 ( Jae Won Jung ),김세훈 ( 대한천식알레르기학회 2023 Allergy Asthma & Respiratory Disease Vol.11 No.2

메타콜린 기관지유발검사는 천식의 감별 진단 및 기관지과민증을 측정하기 위해 널리 시행되어온 검사이다. 정확한 진단을 위해 표준화된 프로토콜로 검사가 이루어져야 하나, 최근 검사 장비의 변경 및 2017년 ERS가이드라인에서 프로토콜이 변경되었음에도 불구하고, 진료 일선에서는 과거 프로토콜이 여전히 사용되고 있다. 현재 국내에서 사용 가능한 APS 장비에서는 기존 KoKo dosimeter에서 사용되던 프로토콜을 적용할 수 없으므로 더 간소화되고 고도화된 프로토콜을 제안한다. 학회는 본 전문가 의견서를 통해 새로운 메타콜린 기관지유발검사 프로토콜을 제시하였으며, 개정된 프로토콜의 타당성과 정확성에 대해서는 향후 전향적인 다기관연구가 필요하다. The Korean Academy of Asthma, Allergy, and Clinical Immunology task force report aims to provide new protocols for methacholine challenge test (MCT). Although new devices have different delivery system compared to old ones, previous protocols are still used, which cannot guarantee adequate diagnoses of asthma. Another important issue is the recent recommendation in European Respiratory Society (ERS) technical standard guideline to use a delivered methacholine dose that causes a 20% decrease in forced expiratory volume in 1 second (FEV₁) (PD₂₀). Although the previous protocol based on the methacholine concentration causing a 20% decrease in FEV₁ (PC₂₀) has been used globally, several studies have reported that PD₂₀ is more reliable and applicable for new protocols of MCT. Indeed, a tidal breathing inhalation protocol using a breath-actuated or continuous nebulizer is recommended. Herein, we recommend 3 protocols for the MCT using new devices and provide a brief summary of the change in strategy based on the updated ERS guideline. (Allergy Asthma Respir Dis 2023;11:56-62)

학부모 및 학교 보건교사의 식품알레르기 인지도 조사: 2015년 전국역학조사

황정윤 ( Jeong Yun Hwang ),김민지 ( Minji Kim ),이지영 ( Ji Young Lee ),양혜경 ( Hea-kyoung Yang ),이기재 ( Kee-jae Lee ),전현영 ( Hyun-young Jeon ),한영신 ( Youngshin Han ),김양희 ( Yang Hee Kim ),김지현 ( Jihyun Kim ),안강모 ( K 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.2

Purpose: This study aimed to examine the perception of food allergy among parents and school health instructors in Korea. Methods: A nationwide epidemiological survey in Korea was conducted in September 2015. From 17 cities and provinces, a total of 1,000 elementary, middle and high schools were selected by stratified random sampling. Parents and school health instructors were surveyed using a questionnaire on the perception of food allergy. Results: The prevalence of food-induced anaphylaxis was 22.3%. Of 252 children with anaphylaxis, 47.6% were prescribed epinephrine auto-injector (EAI). Forty-three parents (37.7%) were educated about the use of EAI. Parents carrying their own EAI at all times or keeping them at schools were 5.6% and 3.8%, respectively. For the food allergen-labeling system, 42.1% of parents read food labels, and 32.1% were satisfied with the system. Only 35.2% of school health instructors received education on food allergy and anaphylaxis, and 42.5% of them knew how to use EAI. There were 70 children (9.4%) with anaphylaxis in school, and 75.9% of schools had the emergency management system. Conclusion: The awareness of Korean parents and school health instructors on food allergy is still low, and many parents are dissatisfied with the food allergen labeling system. Many school health instructors have difficulty in using EAI in case of anaphylaxis and are insufficiently educated about food allergy. Therefore, it is necessary to establish more systematic food allergy management plans by providing high-quality education to parents and school health instructors and by utilizing legal systems. (Allergy Asthma Respir Dis 2018;6:97-102)

대한천식알레르기학회 알레르기비염 진료지침: 파트 1. 약물치료의 업데이트

김민지 ( Minji Kim ),강성윤 ( Sung-yoon Kang ),양송이 ( Song-i Yang ),이일환 ( Il Hwan Lee ),류광희 ( Gwanghui Ryu ),김미애 ( Mi-ae Kim ),이상민 ( Sang Min Lee ),김현정 ( Hyun-jung Kim ),박도양 ( Do-yang Park ),이용주 ( Yong Ju Le 대한천식알레르기학회 2023 Allergy Asthma & Respiratory Disease Vol.11 No.3

The prevalence of allergic rhinitis (AR) and the socioeconomic burden associated with the medical cost and quality of life of AR have progressively increased. Therefore, practical guidelines for the appropriate management of AR need to be developed based on scientific evidence considering the real-world environment, values, and preferences of patients and physicians. The Korean Academy of Asthma, Allergy and Clinical Immunology revised clinical guidelines for AR to address key clinical questions of the management of AR. Part 1 of the revised guideline covers the pharmacological management of patients with AR in Korea. Through a meta-analysis and a systematic review, we made 4 recommendations for AR pharmacotherapy, including intranasal corticosteroid (INCS)/intranasal antihistamine combination therapy, oral antihistamine/INCS combination therapy, leukotriene receptor antagonist treatment in AR patients with asthma, and prophylactic treatment for patients with pollen-induced AR. However, all recommendations are conditional because of the low or very low evidence of certainty. Well-designed and strictly executed randomized controlled trials are needed to measure and report appropriate outcomes. (Allergy Asthma Respir Dis 2023;11:117-125)

영유아 식품알레르기 예방을 위한 최신 의견: 수유와 이유식을 중심으로

송태원 ( Tae Won Song ),안강모 ( Kang Mo Ahn ),이수영 ( Soo Young Lee ) 대한천식알레르기학회(구 대한알레르기학회) 2015 Allergy Asthma & Respiratory Disease Vol.3 No.5

Food allergy is common with the prevalence of 5%-7% in Korean children. The development of food allergy is likely to reflect interactions between genetic factors and environmental exposure. To prevent food allergy, early exposure to food allergens through maternal and infant diet have been investigated. Recently, guidelines for primary prevention of food allergy have been updated, and consensus communication on early peanut introduction has been demonstrated. For the first 4-6 months after birth, exclusive breast-feeding is recommended, and if impossible, extensively or partially hydrolyzed infant formula can be recommended in high-risk infants. Introducing complementary foods is recommended between 4 and 6 months of age, even in case of potentially allergenic foods such as egg, milk, and wheat. For the prevention of peanut allergy, early peanut introduction could be better than late peanut introduction in selected high-risk infants. However, infants who developed food allergy should avoid ingestion of specific offending foods. (Allergy Asthma Respir Dis 2015;3:320-325)

한국 소아 식품알레르기의 연구 현황과 과제

안강모 ( Kangmo Ahn ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.S

Food allergy is an immune-mediated adverse reaction that occurs mainly by consumption of food. Some of the children with food allergies have mild symptoms like urticaria and pruritus, while others manifest fatal symptoms like anaphylaxis. Many cases develop in infants and children, and disappear spontaneously over time. The prevalence of food allergy is known to be up to 6% of children and 3%-4% of adults. Growing concern is that prevalence of food allergy seems to be increasing. The prevalence, common allergens and natural course of food allergy vary according to the race, age, eating habits, and unknown factors. In Korea, many researchers have reported regional data on food allergy for comparison with those of foreign countries. Awareness is increasing and food labelling is being established to help people avoid allergenic foods. In the future, monitoring of prevalence and common food allergens at regular intervals is needed to make appropriate policies for children with food allergy. There are still lack of data on pathogenesis, natural course and clinical trials of immunotherapy in Korean children. In addition, it is necessary to form a consensus on primary prevention of food allergy by early exposure to allergenic foods. Further regional studies should be performed to expand our understanding of food allergy and to lead to proper management for Korean children with food allergy. (Allergy Asthma Respir Dis 2018;6 Suppl 1:S44-51)

소아 천식 환자에서 비염과 천식과의 관계: 알레르기비염과 비알레르기비염 비교

권은별 ( Eun Byul Kwon ),백지현 ( Ji Hyeon Baek ),김형윤 ( Hyeong Yun Kim ),윤정원 ( Jung Won Yoon ),신윤호 ( Youn Ho Shin ),지혜미 ( Hye Mi Jee ),최선희 ( Sun Hee Choi ),한만용 ( Man Yong Han ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.3

Purpose: We aimed to determine the prevalence of allergic rhinitis and nonallergic rhinitis, difference in symptoms between allergic rhinitis and nonallergic rhinitis, and the association between lung function and the degree of asthma control in children with asthma. Methods: One hundred seventy patients who were followed-up for asthma treatment at the department of pediatrics of CHA Bundang Medical Center were enrolled in this study. We conducted the questionnaire regarding coexistence of rhinitis, childhood asthma control test (C-ACT), and the basic lung function test. The patients were classified as allergic rhinitis group and nonallergic rhinitis group according to the response to 11 common inhalation and food allergens, and assessed the degree of asthma control and the severity of rhinitis. Results: One hundred thirty patients (73%) were found to have rhinitis. Of these, 79 patients (53%) had allergic rhinitis and 34 patients (20%) had nonallergic rhinitis. The allergic rhinitis group was older than the nonallergic rhinitis group or the nonrhinitis group (7.73±2.85 vs. 5.97±2.48 vs. 6.12±2.70, P<0.001). Nasal itching sense was more prevalent in the allergic-rhinitis group than in the nonallergic rhinitis group (3.23±1.90 vs. 2.44±1.56, P=0.036). There was an inverse correlation between the rhinitis and C-ACT (r= -0.329, P<0.05). Of note, nasal obstruction symptom was highly correlated with C-ACT (r=-0.334, P<0.001). Conclusion: Allergic rhinitis and nonallergic rhinitis were highly prevalent in the pediatric patients with asthma and both of them had a significantly adverse impact on asthma control by rhinitis-itself. Therefore, regardless of atopic status, clinicians should focus on relieving rhinitis symptoms. (Allergy Asthma Respir Dis 2013;1:241-247)

우리나라 신문 기사를 통해 살펴본 알레르기질환 (1920-1972년)

김규언 ( Kyu Earn Kim ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.S

Purpose: This study aimed to investigate which Korean newspaper articles were reported on allergic diseases before the establishment of the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI). Methods: This study was performed in 3 newspapers, Chosun Ilbo, DongA Ilbo, and JoongAng Ilbo, which were founded and used the databases established before the establishment of KAAACI in 1972. The databases were searched using 42 keywords associated with allergic diseases (allergy, asthma, rhinitis, etc.). Results: Among the 42 keywords, there were only 7 that were able to search: allergy, urticaria, asthma, dermatitis, rhinitis, pollen and eczema. The total number of articles related to allergic diseases were 62, as follows: allergy (n=21), urticaria (n=15), asthma (n=8), dermatitis (n=8), rhinitis (n=5), pollen (n=3), and eczema (n=2). There were 31 articles in Chosun Ilbo, 9 in DongA Ilbo, and 22 in JoongAng Ilbo. The first allergic disease published in the newspapers was asthma on the article entitled “Treat the cause of asthma” (on page 8 of November 10, 1960 DongA Ilbo). The first article that used the term allergy appeared in a column entitled, “Childhood illness and allergy” (on page 4 of May 30, 1960 DongA Ilbo). Conclusion: Since 1920, articles related to allergic diseases published in the Korean newspapers increased every year. These articles may have appeared due to the increase in the prevalence of allergic disease and the pioneering efforts of senior allergy researchers. (Allergy Asthma Respir Dis 2018;6 Suppl 1:S85-89)

특별기고 : 천식 및 알레르기 30년 약사(略史)

학회자료 대한천식알레르기학회(구 대한알레르기학회) 2011 천식 및 알레르기 Vol.31 No.3