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)

대한천식알레르기학회 알레르기 면역요법 진료지침

이화영,강성윤,김경훈,김주희,류광희,민진영,박경희,박소영,성명순,이영수,양은애,지혜미,하은교,신유섭,이상민,정은희,최선희,고영일,김선태,남동호,박중원,심정연,안영민,한두희,한만용,이용원,최정희,대한천식알레르기학회 면역요법/알레르겐연구팀,Hwa Young Lee,Sung-Yoon Kang,Kyunghoon Kim,Ju Hee Kim,Gwanghui Ryu,J 대한천식알레르기학회 2024 Allergy Asthma & Respiratory Disease Vol.12 No.3

Allergen immunotherapy (AIT) is a causative treatment of allergic diseases in which allergen extracts are regularly administered in a gradually escalated doses, leading to immune tolerance and consequent alleviation of allergic diseases. The need for uniform practice guidelines in AIT is continuously growing as the number of potential candidates for AIT increases and new therapeutic approaches are tried. This updated version of the Korean Academy of Asthma Allergy and Clinical Immunology recommendations for AIT, published in 2010, proposes an expert opinion by specialists in allergy, pediatrics, and otorhinolaryngology. This guideline deals with the basic knowledge of AIT, including mechanisms, clinical efficacy, allergen standardization, important allergens in Korea, and special consideration in pediatrics. The article also covers the methodological aspects of AIT, including patient selection, allergen selection, schedule and doses, follow-up care, efficacy measurements, and management of adverse reactions. Although this guideline suggests the optimal dosing schedule, an individualized approach and modifications are recommended considering the situation for each patient and clinic.

대한천식알레르기학회 알레르기 면역요법 진료지침

이화영 ( Hwa Young Lee ),강성윤 ( Sung-yoon Kang ),김경훈 ( Kyunghoon Kim ),김주희 ( Ju Hee Kim ),류광희 ( Gwanghui Ryu ),민진영 ( Jin-young Min ),박경희 ( Kyung Hee Park ),박소영 ( So-young Park ),성명순 ( Myongsoon Sung ),이영수 대한천식알레르기학회 2024 Allergy Asthma & Respiratory Disease Vol.12 No.3

Allergen immunotherapy (AIT) is a causative treatment of allergic diseases in which allergen extracts are regularly administered in a gradually escalated doses, leading to immune tolerance and consequent alleviation of allergic diseases. The need for uniform practice guidelines in AIT is continuously growing as the number of potential candidates for AIT increases and new therapeutic approaches are tried. This updated version of the Korean Academy of Asthma Allergy and Clinical Immunology recommendations for AIT, published in 2010, proposes an expert opinion by specialists in allergy, pediatrics, and otorhinolaryngology. This guideline deals with the basic knowledge of AIT, including mechanisms, clinical efficacy, allergen standardization, important allergens in Korea, and special consideration in pediatrics. The article also covers the methodological aspects of AIT, including patient selection, allergen selection, schedule and doses, follow-up care, efficacy measurements, and management of adverse reactions. Although this guideline suggests the optimal dosing schedule, an individualized approach and modifications are recommended considering the situation for each patient and clinic.

대한천식알레르기학회 설하면역요법 진료지침

류광희,지혜미,이화영,강성윤,김경훈,김주희,박경희,박소영,성명순,이영수,양은애,민진영,하은교,이상민,이용원,정은희,최선희,고영일,김선태,남동호,박중원,심정연,안영민,한만용,최정희,신유섭,한두희,대한천식알레르기학회 면역요법/알레르겐연구팀,Gwanghui Ryu,Hye Mi Jee,Hwa Young Lee,Sung-Yoon Kang,Kyunghoon Kim,J 대한천식알레르기학회 2024 Allergy Asthma & Respiratory Disease Vol.12 No.3

Allergen immunotherapy (AIT) has been used for over a century and has been demonstrated to be effective in treating patients with various allergic diseases. AIT allergens can be administered through various routes, including subcutaneous, sublingual, intra-lymphatic, oral, or epicutaneous routes. Sublingual immunotherapy (SLIT) has recently gained clinical interest, and it is considered an alternative treatment for allergic rhinitis (AR) and asthma. This review provides an overview of the current evidence-based studies that address the use of SLIT for treating AR, including (1) mechanisms of action, (2) appropriate patient selection for SLIT, (3) the current available SLIT products in Korea, and (4) updated information on its efficacy and safety. Finally, this guideline aims to provide the clinician with practical considerations for SLIT.

성인에서 발생한 우유 알레르기 환자에서 쇠고기와 돼지고기 알레르기를 동시에 나타낸 환자

최성진 ( Sung Jin Choi ),허규영 ( Gyu Young Hur ),신승엽 ( Seung Youp Shin ),박해심 ( Hae Sim Park ) 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.3

Cow`s milk has been recognized for many years as one of the leading causes of food allergy. The prevalence of cow`s milk allergy is reported to be 1% to 2%. It has been reported that 13∼20% of milk allergy children react to beef. We experienced a case of 47-year-old female patient presenting with severe food allergy symptoms including abdominal pain, dizziness, dyspnea, nasal stuffiness and vaginal spotting 2∼3 hours after ingestion of cow`s milk, beef, or pork which developed 8 months ago. Laboratory findings showed high total IgE levels (1,295 kU/L) and high specific IgE levels to milk, beef, and pork (3.04 kU/L, 9.26 kU/L, and 4.58 kU/L, respectively) using the immuno-CAP system, while allergy skin tests for milk, beef, and pork showed negative results. In bovine serum albumin (BSA) IgE ELISA test, the patient showed a high serum specific IgE binding activity to the BSA compared to healthy controls. She received regular inhaled corticosteroid and antihistamines and restricted ingestion of cow`s milk, beef and pork meats. We report a rare case of adult-onset milk allergy showing concurrent reactivity to beef and pork. (Korean J Asthma Allergy Clin Immunol 2007;27:200-203)

성인 기관지천식 환자에서 알레르기 비염에 대한 평가와 비염이 천식에 미치는 영향

김철우 ( Cheol Woo Kim ),이찬우 ( Chan Woo Lee ),허규영 ( Gyu Young Hur ),예영민 ( Young Min Ye ),박해심 ( Hae Sim Park ),( Carina Study Group ) 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.4

Background: Allergic rhinitis (AR) is the most common comorbid condition in bronchial asthma (BA), which is associated with increased morbidity and difficulty in asthma control. Recent guidelines have emphasized an integrated approach in the management of patients with both BA and AR. Objective: This study evaluated the prevalence of AR in patients with BA and evaluated its impact on asthma. Method: Adult patients with BA who visited outpatient clinics of general hospitals and primary clinics for asthma management were enrolled sequentially between October 2005 and March 2006. The prevalence and symptom scores of AR and BA were assessed using an ISAAC questionnaire. The severity of BA and AR was classified according to the GINA and ARIA guidelines, respectively. Result: A total of 460 patients with BA were recruited from two university hospitals (n=109) and 49 primary care units (n=351). The prevalence of AR symptoms was 72.6% (334/460). Although the prevalence was higher in younger patients, AR symptoms were also prevalent in elderly patients (59.1% in patients aged ≥ 65 years). Of the 334 patients with concomitant BA and AR symptoms, 59 (17.7%) were not diagnosed with AR, even though the patients reported AR symptoms. The cure-rate of AR in patients with both BA and AR was 65.3% (218/334). The most common level for AR severity was mild intermittent (38.3%) followed by moderate-severe intermittent (26.6%), mild persistent (24.3%) and moderate-severe persistent (10.8%). The prevalence of AR was not different according to the asthma severity. The patients experienced AR symptoms more frequently in November, followed by October, March and April. The BA patients combined with AR tended to present higher asthma symptom sores and suffered from significantly higher night symptoms than those with BA alone (P<0.05). Conclusion: The prevalence of AR was 73% in adult asthma patients; however, AR has been underdiagnosed and under-managed. AR should be evaluated and managed properly in all asthmatic patients to achieve a better asthma control. (Korean J Asthma Allergy Clin Immunol 2007;27:248-256)

소아천식환자에 대한 RAST 및 알레르기 피부검사의 진단적 가치 평가

이기영 대한천식알레르기학회 1987 천식 및 알레르기 Vol.7 No.2

RAST has been used frequently as a test to detect specific IgE for the diagnosis of atopic allergic diseases. But many reports have shown that RAST is correlated well with allergy skin test and not better than the latter in its significance for confirming causative allergens. The purpose of this study is to know whether RAST can detect the patients who could not be detected by allergy skin test. 108 cases who had asthma like symptoms and shown negative or equivocal reactions to D. farinae or D. pteronyssinus by allergy skin test as a screc.,'ng test were performed RAST with about 10 allergens which are frequently positive in Korean children including house dust mite allergen. In cases who were positive by RAST, allergy skin test with same allergens were performed and the results were analyzed. The results obtained from this study were as fol- lows: 1. Ninty-nine cases(91.6%) were negative to house dust mite allergen and only 9 cases(8.4%) showed equivocal or positive reactions to same allergen by RAST. 2. Seven out of 9 cases who had equivocal or positive reactions to house dust mite by RAST were per- formed allergy skin test with same allergen as a follow-up study. The result of allergy skin test on house dust mite was correlated very well with RAST. The possibility of correlation with RAST on the other 2 cases who had not performed allergy skin test were also discussed. 3. Twenty-one allergens other than house dust mite were equivocal or positive reactions by RAST. Allergy skin tests were performed with same allergens on these cases. Seven allergens (cat hair in 5 cases, house dust and ragweed in each case) were negative by allergy skin test. Therefore, it can be concluded that detection of house dust mite allergen by allergy skin test in the diagnosis of atopic respiratory diseases is reliable method because skin test is correlated very well with RAST. But it is recommendable to perform allergy skin test more than once in suspicious cases in diagnosis.

조영제 과민반응

오미정 ( Mi Jung Oh ) 대한천식알레르기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.5

의료영상기기의 발전과 보급으로 환자뿐 아니라 일반인에서도 건강검진 등으로 영상검사를 받는 사람들의 수가 늘어나고 1970년도에 저삼투압성, 비이온성 조영제가 나온 이래로 조영제를 이용한 영상검사가 급속하게 증가함에 따라 조영제 유해반응이 적지 않게 발생하며 간혹 사망 사고와 같은 중증 유해반응이 발생하여 사회적인 문제가 되고 있다. 이에 2011년 대한영상의학회와 대한천식알레르기학회에서 임상진료지침서1)가 발간되었으며 최근 국내에서 조영제 과민반응에 대한 관심과 연구가 활발해지고 있다.

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

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)

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.