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Hong SW, Choi EB, Min TK, Kim JH, Kim MH, Jeon SG, Lee BJ, Gho YS, Jee YK, Pyun BY, Kim YK. An important role of α-hemolysin in extracellular vesicles on the development of atopic dermatitis induced by Staphylococcus aureus. PLoS One 2014; 9:e100499. [PMID: 24992681 PMCID: PMC4084635 DOI: 10.1371/journal.pone.0100499] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 05/28/2014] [Indexed: 01/05/2023] Open
Abstract
Skin barrier disruption and dermal inflammation are key phenotypes of atopic dermatitis (AD). Staphylococcus aureus secretes extracellular vesicles (EVs), which are involved in AD pathogenesis. Here, we evaluated the role of EVs-associated α-hemolysin derived from S. aureus in AD pathogenesis. α-hemolysin production from S. aureus was detected using western blot analyses. The cytotoxic activity of α-hemolysin on HaCaT keratinocytes was evaluated by measuring cell viability after treating cells with soluble and EVs-associated α-hemolysin. To determine the type of cell death, HaCaT keratinocytes were stained with annexin V and 7-AAD. The in vivo effects of α-hemolysin were evaluated by application of soluble and EV-associated α-hemolysin on the mouse skin. The present study showed that increased α-hemolysin was produced by S. aureus colonized on AD patients compared to healthy subjects. α-hemolysin production was also related to AD severity. In addition, EV-associated α-hemolysin was more cytotoxic to HaCaT keratinocytes than soluble α-hemolysin, and α-hemolysin-negative EVs did not induce keratinocyte death. EV-associated α-hemolysin induced necrosis, but soluble α-hemolysin induced apoptosis of keratinocytes. In vivo, skin barrier disruption and epidermal hyperplasia were induced by soluble and EV-associated α-hemolysin. However, AD-like dermal inflammation was only caused by EV-associated α-hemolysin. Moreover, neither skin barrier disruption nor AD-like skin inflammation was induced by α-hemolysin-negative EVs. Taken together, α-Hemolysin secreted from S. aureus, particularly the EV-associated form, induces both skin barrier disruption and AD-like skin inflammation, suggesting that EV-associated α-hemolysin is a novel diagnostic and therapeutic target for the control of AD.
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Affiliation(s)
- Sung-Wook Hong
- Department of Life Sciences, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea
| | - Eun-Byul Choi
- Department of Life Sciences, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea
| | - Taek-Ki Min
- Department of Pediatrics, Sooncheonhyang University College of Medicine, Seoul, Republic of Korea
| | - Ji-Hyun Kim
- Department of Life Sciences, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea
| | - Min-Hye Kim
- Department of Medicine and Institute of Convergence Medicine, Ewha Womans Medical Center, Seoul, Republic of Korea
| | - Seong Gyu Jeon
- Department of Life Sciences, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea
| | - Byung-Jae Lee
- Department of Allergy and Clinical Immunology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Song Gho
- Department of Life Sciences, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea
| | - Young-Koo Jee
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Bok-Yang Pyun
- Department of Pediatrics, Sooncheonhyang University College of Medicine, Seoul, Republic of Korea
- * E-mail: (BYP); (YKK)
| | - Yoon-Keun Kim
- Department of Medicine and Institute of Convergence Medicine, Ewha Womans Medical Center, Seoul, Republic of Korea
- * E-mail: (BYP); (YKK)
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Yang HJ, Kim HJ, Yu J, Lee E, Jung YH, Kim HY, Seo JH, Kwon GY, Park JH, Gwack J, Youn SK, Kwon JW, Jun BY, Kim KW, Ahn K, Lee SY, Park JD, Kwon JW, Kim BJ, Lee MS, Do KH, Jang SJ, Pyun BY, Hong SJ. Inhalation toxicity of humidifier disinfectants as a risk factor of children's interstitial lung disease in Korea: a case-control study. PLoS One 2013; 8:e64430. [PMID: 23755124 PMCID: PMC3673956 DOI: 10.1371/journal.pone.0064430] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/15/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The occurrence of numerous cases of interstitial lung disease in children (chILD) every spring in Korea starting in 2006 raised suspicion about a causal relationship with the use of humidifier disinfectants (HDs). The aim of this study was to evaluate the association between HD use and the risk of chILD. METHODS This retrospective, 1∶3 matched case-control study consisted of 16 cases of chILD that had developed between 2010 and 2011. The three groups of parallel controls (patients with acute lobar pneumonia, asthma, and healthy children) were matched by age, gender, and index date. Indoor/outdoor environmental risk factors, including HD use, were investigated by asking the guardians to complete a questionnaire. RESULTS The median age of the affected children (43.8% male) was 26 months (18.25-36.25). The chILD group did not differ significantly from the control groups with respect to socio-demographic and clinical variables. Indoor and outdoor environmental factors were not associated with a risk of chILD. However, the previous use of HDs (OR; 2.73. 95% CI; 1.41-5.90, P = 0.00) were independently associated with an increased risk. CONCLUSIONS This study showed that HDs, which are widely used in South Korea in the winter season, independently increased the risk of chILD in spring. Therefore, continuous monitoring and, if needed, changes in policy are essential to prevent and control pediatric diseases caused by toxic chemicals.
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Affiliation(s)
- Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hwa-Jung Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Cancer Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Ho Jung
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyung-Young Kim
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea
| | - Geun-Yong Kwon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Ji-Hyuk Park
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Jin Gwack
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Seung-Ki Youn
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Jun-Wook Kwon
- Center for Infectious Disease Surveillance and Response, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Byung-Yool Jun
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
- Center for Infectious Disease Surveillance and Response, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Kyung Won Kim
- Department of Pediatrics and Institute of Allergy, Biomolecule Secretion Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Young Lee
- Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - June-Dong Park
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul University College of Medicine, Seoul, Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul University College of Medicine, Seungnam, Korea
| | - Byoung-Ju Kim
- Department of Pediatrics, Inje University Haeundae Paik Hospital, University of Inje College of Medicine, Busan, Korea
| | - Moo-Song Lee
- Department of Preventive Medicine, Asan Cancer Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Hyun Do
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se-Jin Jang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bok-Yang Pyun
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- * E-mail: (BYP); (SJH)
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- * E-mail: (BYP); (SJH)
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Park YJ, Jin JY, Yang HJ, Lee WR, Lee DH, Pyun BY, Suh ES. Clinical characteristics of 2009 pandemic influenza A (H1N1) infection in children and the performance of rapid antigen test. Korean J Pediatr 2011; 54:405-8. [PMID: 22232622 PMCID: PMC3250593 DOI: 10.3345/kjp.2011.54.10.405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 08/03/2011] [Accepted: 09/14/2011] [Indexed: 11/27/2022]
Abstract
PURPOSE In autumn 2009, the swine-origin influenza A (H1N1) virus spread throughout South Korea. The aims of this study were to determine the clinical characteristics of children infected by the 2009 H1N1 influenza A virus, and to compare the rapid antigen and real-time polymerase chain reaction (PCR) tests. METHODS We conducted a retrospective review of patients ≥18 years of age who presented to Soonchunhyang University Hospital in Seoul with respiratory symptoms, including fever, between September 2009 and January 2010. A real-time PCR test was used to definitively diagnose 2009 H1N1 influenza A infection. Medical records of confirmed cases were reviewed for sex, age, and the time of infection. The decision to perform rapid antigen testing was not influenced by clinical conditions, but by individual factors such as economic conditions. Its sensitivity and specificity were evaluated compared to real-time PCR test results. RESULTS In total, 934 patients tested positive for H1N1 by real-time PCR. The highest number of patients (48.9%) was diagnosed in November. Most patients (48.2%) were aged between 6 and 10 years. Compared with the H1N1 real-time PCR test results, the rapid antigen test showed 22% sensitivity and 83% specificity. Seventy-eight patients were hospitalized for H1N1 influenza A virus infection, and fever was the most common symptom (97.4%). CONCLUSION For diagnosis of 2009 H1N1 influenza A virus infection, the rapid antigen test was inferior to the real-time PCR test in both sensitivity and specificity. This outcome suggests that the rapid antigen test is inappropriate for screening.
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Affiliation(s)
- Yong-Jae Park
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Cho SH, Jeong JW, Park HW, Pyun BY, Chang SI, Moon HB, Kim YY, Choi BW. Effectiveness of a computer-assisted asthma management program on physician adherence to guidelines. J Asthma 2010; 47:680-6. [PMID: 20632781 DOI: 10.3109/02770903.2010.481342] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Asthma is an example of a chronic disease for which there are evidence-based guidelines for primary care. The authors undertook this study to demonstrate that physicians' use and adherence to asthma management guidelines are improved when the guidelines are furnished in a computer-based format. METHODS Based on established guidelines, the authors devised a practical and simple computer-assisted program focused on asthma treatment and monitoring. They then undertook a preliminary investigation, "Easy Asthma Management (EAM)" study, using this program. Finally, the authors evaluated the program's effectiveness by measuring clinical outcomes and changes in prescription patterns before and after the study. RESULTS A total of 4682 asthma patients followed by 377 physicians were recruited, and 2187 completed the study (46.7%). The means of diurnal and nocturnal symptom scores were significantly reduced after a 3-month enrollment in the EAM study. Interestingly, the fraction of prescriptions for oral beta(2)-agonists, oral methylxanthines, and systemic steroids (oral or injection) significantly decreased after the EAM study (p = .02, p <.001, p <.001, respectively), whereas the fraction of prescriptions for inhaled forms of steroids combined with beta(2)-agonists increased significantly (p <.001). CONCLUSIONS These findings suggest that a computer-assisted asthma management program can be used to improve the clinical outcomes of patients with asthma, and increase physician adherence to established guidelines.
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Affiliation(s)
- Sang-Heon Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Park HW, Park CH, Park SH, Park JY, Park HS, Yang HJ, Ahn KM, Kim KH, Oh JW, Kim KE, Pyun BY, Lee HB, Min KU. Dermatologic adverse reactions to 7 common food additives in patients with allergic diseases: a double-blind, placebo-controlled study. J Allergy Clin Immunol 2008; 121:1059-61. [PMID: 18325576 DOI: 10.1016/j.jaci.2007.12.1162] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 11/14/2007] [Accepted: 12/18/2007] [Indexed: 12/01/2022]
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Choi BW, Yoo KH, Jeong JW, Yoon HJ, Kim SH, Park YM, Kim WK, Oh JW, Rha YH, Pyun BY, Chang SI, Moon HB, Kim YY, Cho SH. Easy diagnosis of asthma: computer-assisted, symptom-based diagnosis. J Korean Med Sci 2007; 22:832-8. [PMID: 17982231 PMCID: PMC2693849 DOI: 10.3346/jkms.2007.22.5.832] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Diagnosis of asthma is often challenging in primary-care physicians due to lack of tools measuring airway obstruction and variability. Symptom-based diagnosis of asthma utilizing objective diagnostic parameters and appropriate software would be useful in clinical practice. A total of 302 adult patients with respiratory symptoms responded to a questionnaire regarding asthma symptoms and provoking factors. Questions were asked and recorded by physicians into a computer program. A definite diagnosis of asthma was made based on a positive response to methacholine bronchial provocation or bronchodilator response (BDR) testing. Multivariate logistic regression analysis was used to evaluate the significance of questionnaire responses in terms of discriminating asthmatics. Asthmatic patients showed higher total symptom scores than non-asthmatics (mean 5.93 vs. 4.93; p<0.01). Multivariate logistic regression analysis identified that response to questions concerning the following significantly discriminated asthmatics; wheezing with dyspnea, which is aggravated at night, and by exercise, cold air, and upper respiratory infection. Moreover, the presence of these symptoms was found to agree significantly with definite diagnosis of asthma (by kappa statistics). Receiver-operating characteristic curve analysis revealed that the diagnostic accuracy of symptom-based diagnosis was high with an area under the curve of 0.647 +/- 0.033. Using a computer-assisted symptom-based diagnosis program, it is possible to increase the accuracy of diagnosing asthma in general practice, when the facilities required to evaluate airway hyperresponsiveness or BDR are unavailable.
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Affiliation(s)
- Byoung Whui Choi
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kwang-Ha Yoo
- Department of Internal Medicine, Konkuk University College of Medicine, Seoul, Korea
| | - Jae-Won Jeong
- Department of Internal Medicine, Ilsan-paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Yong-Mean Park
- Department of Pediatrics, Konkuk University College of Medicine, Seoul, Korea
| | - Wo-Kyung Kim
- Department of Pediatrics, Inje University College of Medicine, Seoul, Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Yeong-Ho Rha
- Department of Pediatrics, Kyunghee University College of Medicine, Seoul, Korea
| | - Bok-Yang Pyun
- Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Suk-Il Chang
- Department of Internal Medicine, Sungae General Hospital, Seoul, Korea
| | - Hee-Bom Moon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - You-Young Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Heon Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Oh JW, Pyun BY, Choung JT, Ahn KM, Kim CH, Song SW, Son JA, Lee SY, Lee SI. Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000. J Korean Med Sci 2004; 19:716-23. [PMID: 15483350 PMCID: PMC2816337 DOI: 10.3346/jkms.2004.19.5.716] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Little is known about the prevalence of atopic dermatitis and food allergy outside North America and Europe. We evaluated the prevalence of atopic dermatitis and food allergy with the comparison of prevalence between 1995 and 2000 in Korea and evaluated the correlation of prevalence between atopic dermatitis and food allergy. A cross-sectional questionnaire survey was conducted on random samples of schoolchildren 6 to 14 yr at two time points, 1995 and 2000 throughout Korea. The last twelve months prevalence of atopic dermatitis in Korean school-aged children was increased from 1995 to 2000. The twelve-month prevalence of atopic dermatitis and food allergy were higher in Seoul than in any other provincial cities in 1995, but the prevalence of both diseases in Seoul and Provincial Centers became to be similar in 2000. The rate responded to food allergy of children with atopic dermatitis (9.5%) was lower than that of the western countries (60%). And our data demonstrated paternal and maternal allergy history is very significantly correlated to developing atopic dermatitis in their offspring. The further objective evaluations are required to confirm these outcomes because the environmental and risk factors may be different among the countries according to their living cultures.
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Affiliation(s)
- Jae-Won Oh
- Department of Pediatrics, Hanyang University, Korea
| | - Bok-Yang Pyun
- Department of Pediatrics, Soonchunhyang University, Korea
| | | | - Kang-mo Ahn
- Department of Pediatrics, Sungkyunkwan University, Korea
| | - Chul-Hong Kim
- Department of Pediatrics, Kwandong University, Korea
| | | | - Jin-Ah Son
- Department of Pediatrics, National Medical Center, Korea
| | | | - Sang-Il Lee
- Department of Pediatrics, Sungkyunkwan University, Korea
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Pyun BY, Odajima Y, Kishida M, Obata T, Nagakura T, Iikura Y. Effect of single dose intravenous aminophylline in asthma. Acta Paediatr Jpn 1987; 29:827-32. [PMID: 3144147 DOI: 10.1111/j.1442-200x.1987.tb00387.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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