1
|
Park SY, Lee YY, Kim MH, Kim CE. Deciphering the Systemic Impact of Herbal Medicines on Allergic Rhinitis: A Network Pharmacological Approach. Life (Basel) 2024; 14:553. [PMID: 38792575 PMCID: PMC11122645 DOI: 10.3390/life14050553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
Allergic rhinitis (AR) is a systemic allergic disease that has a considerable impact on patients' quality of life. Current treatments include antihistamines and nasal steroids; however, their long-term use often causes undesirable side effects. In this context, traditional Asian medicine (TAM), with its multi-compound, multi-target herbal medicines (medicinal plants), offers a promising alternative. However, the complexity of these multi-compound traits poses challenges in understanding the overall mechanisms and efficacy of herbal medicines. Here, we demonstrate the efficacy and underlying mechanisms of these multi-compound herbal medicines specifically used for AR at a systemic level. We utilized a modified term frequency-inverse document frequency method to select AR-specific herbs and constructed an herb-compound-target network using reliable databases and computational methods, such as the Quantitative Estimate of Drug-likeness for compound filtering, STITCH database for compound-target interaction prediction (with a high confidence score threshold of 0.7), and DisGeNET and CTD databases for disease-gene association analysis. Through this network, we conducted AR-related targets and pathway analyses, as well as clustering analysis based on target-level information of the herbs. Gene ontology enrichment analysis was conducted using a protein-protein interaction network. Our research identified 14 AR-specific herbs and analyzed whether AR-specific herbs are highly related to previously known AR-related genes and pathways. AR-specific herbs were found to target several genes related to inflammation and AR pathogenesis, such as PTGS2, HRH1, and TBXA2R. Pathway analysis revealed that AR-specific herbs were associated with multiple AR-related pathways, including cytokine signaling, immune response, and allergic inflammation. Additionally, clustering analysis based on target similarity identified three distinct subgroups of AR-specific herbs, corroborated by a protein-protein interaction network. Group 1 herbs were associated with the regulation of inflammatory responses to antigenic stimuli, while Group 2 herbs were related to the detection of chemical stimuli involved in the sensory perception of bitter taste. Group 3 herbs were distinctly associated with antigen processing and presentation and NIK/NF-kappa B signaling. This study decodes the principles of TAM herbal configurations for AR using a network pharmacological approach, providing a holistic understanding of drug effects beyond specific pathways.
Collapse
Affiliation(s)
- Sa-Yoon Park
- Department of Physiology, College of Korean Medicine, Gachon University, Seongnam 13120, Republic of Korea
- Biomedical Research Institute, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Yoon Yeol Lee
- Department of Physiology, College of Korean Medicine, Gachon University, Seongnam 13120, Republic of Korea
| | - Min Hee Kim
- Department of Ophthalmology, Otolaryngology, and Dermatology, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea
| | - Chang-Eop Kim
- Department of Physiology, College of Korean Medicine, Gachon University, Seongnam 13120, Republic of Korea
| |
Collapse
|
2
|
Abdelwahab HW, Sehsah R, El-Gilany AH, Shehta M. Factors affecting work productivity and activity impairment among chronic obstructive pulmonary disease patients. INDUSTRIAL HEALTH 2024; 62:20-31. [PMID: 37081622 PMCID: PMC10865086 DOI: 10.2486/indhealth.2022-0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) can negatively affect patients' employment and work-life activities with a significant indirect economic impact. The current study aimed to measure unemployment, work productivity, activity impairment, and their associated factors among COPD patients. A cross-sectional study was conducted in the Chest outpatient clinic, Mansoura University Hospital, Egypt. COPD patients completed an interviewer-administered questionnaire including sociodemographic, occupational data, clinical history, medical research council (mMRC) dyspnea scale, the COPD assessment test (CAT), and work productivity and activity impairment Questionnaire (WPAI-COPD). A total 140 patients were included in the study and 22.1% of them gave up their jobs because of their COPD. Due to COPD, the mean percentage of daily activity impairment was 39.8 among all patients. The mean percentages of absenteeism, presenteeism, and overall work impairment among the 84 working patients were 0.07, 24.4, and 24.5. The CAT score was the significant predictor of all components of WPAI. In conclusion, COPD causes early retirement, high work productivity loss, and impaired daily activities. Higher CAT scores and increased disease severity significantly increase absenteeism, presenteeism, overall work, and activity impairment. Thus, timely diagnosis of COPD with appropriate management can help improve outcomes and lower the disease burden and economic impact.
Collapse
Affiliation(s)
| | - Radwa Sehsah
- Industrial Medicine and Occupational Health, Public Health and Community Medicine Department, Faculty of Medicine, Mansoura University, Egypt
| | - Abdel-Hady El-Gilany
- Public Health, Public Health and Community Medicine Department, Faculty of Medicine, Mansoura University, Egypt
| | - Mohammed Shehta
- Chest Medicine Department, Faculty of Medicine, Mansoura University, Egypt
| |
Collapse
|
3
|
Bali V, Schelfhout J, Sher MR, Tripathi Peters A, Patel GB, Mayorga M, Goss D, Romano C(D. Patient-reported experiences with refractory or unexplained chronic cough: a qualitative analysis. Ther Adv Respir Dis 2024; 18:17534666241236025. [PMID: 38501735 PMCID: PMC10953008 DOI: 10.1177/17534666241236025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Chronic cough, defined as a cough lasting 8 or more weeks, affects up to 10% of adults. Refractory chronic cough (RCC) is a cough that is uncontrolled despite comprehensive investigation and treatment of comorbid conditions while unexplained chronic cough (UCC) is a cough with no identifiable cause despite extensive evaluation of comorbid conditions. RCC and UCC are often poorly controlled. Understanding individuals' lived experience of the symptoms and impacts of these conditions may guide therapeutic strategies. OBJECTIVES The primary objectives of this study were to assess respondents' perceptions of the key symptoms of RCC and UCC and the impacts of RCC and UCC and their symptoms on well-being, health-related quality of life, work productivity, and social relationships. DESIGN Qualitative study. METHODS This study enrolled 30 adults with physician-diagnosed RCC or UCC. Two trained qualitative researchers conducted individual, in-depth telephone interviews using a semi-structured interview guide. Interviews were audio-recorded, transcribed, coded, and systematically analyzed to identify content themes. RESULTS A total of 15 respondents with RCC and 15 with UCC were included in the study. Many respondents had RCC or UCC for a long duration (median 9 years, range: 0-24). Half of the respondents reported having a coughing episode at least once daily. Only 40% of respondents reported that medication had improved their symptoms. In over half of the respondents, RCC or UCC hindered communication, caused embarrassment, frustration, and worry, and lowered quality of life. Perceptions of meaningful treatment benefits in RCC or UCC varied widely across respondents. CONCLUSION RCC and UCC remained poorly managed in many individuals and were associated with a wide range of symptoms and cough triggers that hindered daily activities and reduced emotional well-being. Understanding individuals' lived experiences may inform the development of RCC and UCC therapeutic strategies.
Collapse
Affiliation(s)
- Vishal Bali
- Center for Observational and Real-World Evidence, Merck & Co. Inc., 351 North Sumneytown Pike, North Wales, PA 19454, USA
| | - Jonathan Schelfhout
- Center for Observational and Real-World Evidence, Merck & Co. Inc., Rahway, NJ, USA
| | | | | | - Gayatri B. Patel
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Diana Goss
- RTI Health Solutions, Research Triangle Park, NC, USA
| | | |
Collapse
|
4
|
Park JS, Kim B, Kim Y, Lee SG, Kim TH. Out-of-pocket costs associated with chronic respiratory diseases in Korean adults. Chron Respir Dis 2024; 21:14799731241233301. [PMID: 38385436 PMCID: PMC10893827 DOI: 10.1177/14799731241233301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES Chronic respiratory diseases (CRDs) are a burden on both individuals and society. While previous literature has highlighted the clinical burden and total costs of care, it has not addressed patients' direct payments. This study aimed to estimate the incremental healthcare costs associated with patients with CRDs, specifically out-of-pocket (OOP) costs. METHODS We used survey data from the 2019 Korea Health Panel Survey to estimate the total OOP costs of CRDs by comparing the annual hospitalizations, outpatient visits, emergency room visits, and medications of patients with and without CRDs. Generalized linear regression models controlled for differences in other characteristics between groups. RESULTS We identified 222 patients with CRDs, of whom 166 were aged 65 years and older. Compared with the non-CRD group, CRD patients spent more on OOP costs (238.3 USD on average). Incremental costs were driven by outpatient visits and medications, which are subject to a coinsurance of 30% or more and may include items not covered by public insurance. Moreover, CRD patients aged 50-64 years incurred the highest incremental costs. DISCUSSION The financial burden associated with CRDs is significant, and outpatient visits and medications constitute the largest components of OOP spending. Policymakers should introduce appropriate strategies to reduce CRD-associated burdens.
Collapse
Affiliation(s)
- Jun Su Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Bomgyeol Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Yejin Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Sang Gyu Lee
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Tae Hyun Kim
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| |
Collapse
|
5
|
Park SJ, Jung HJ, Park MW, Choi HG, Kim H, Wee JH. Association between Asthma and Periodontitis. Diagnostics (Basel) 2023; 13:3637. [PMID: 38132221 PMCID: PMC10742402 DOI: 10.3390/diagnostics13243637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
The current study aimed to investigate the association between asthma and periodontitis in the Korean adult population. Data from the Korean Genome and Epidemiology Study Health Examinees between 2004 and 2016 were considered. Of the 173,209 participants, 2521 asthmatic and 132,806 control participants were selected. The participants were categorized according to their current status of asthma, as 'well-controlled', 'being treated', and 'not being treated'. The prevalence of periodontitis was found to be significantly higher in the participants with asthma (13.1%) than in the controls (7.3%). In the fully adjusted model, the patients with asthma had a higher odds ratio (OR = 1.79, 95% confidence interval [CI] = 1.59-2.02, p < 0.001) for periodontitis than those without asthma. The results were consistent across all the age and sex subgroups. The adjusted ORs for periodontitis were 2.15 (95% CI = 1.68-2.76, p < 0.001) in the 'well-controlled' asthma group, 1.44 (95% CI = 1.16-1.78, p < 0.001) in the 'being treated' asthma group, and 1.86 (95% CI = 1.55-2.22, p < 0.001) in the 'not being treated' asthma group compared to the control group. Overall, we found asthma to be associated with periodontitis in Korean adults, and the participants with well-controlled asthma had the highest ORs for periodontitis.
Collapse
Affiliation(s)
- Sung Joon Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Seoul 06974, Republic of Korea;
| | - Hahn Jin Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea;
| | - Min Woo Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangdong Sacred Heart Hospital, Seoul 05355, Republic of Korea;
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mdanalytics, Suseoseoulent Clinic, Seoul 06349, Republic of Korea;
| | - Heejin Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| | - Jee Hye Wee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea;
| |
Collapse
|
6
|
Zhang Y, Luo X, Ma L, Ding G, Zhang B. Effect of Ambient Temperature on Hospital Admissions for Respiratory Disease in Suburban Rural Villages of a Semi-Arid Region in Northwest China. J Occup Environ Med 2023; 65:1023-1031. [PMID: 37705416 DOI: 10.1097/jom.0000000000002962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
OBJECTIVE This study evaluated the effects of extreme temperatures on hospital admissions for respiratory diseases (RDs) in a semi-arid region in the Northwest of China. METHODS Distributed lag nonlinear model was constructed, and stratified analysis by gender and age was performed. RESULTS The exposure-response curve between temperature and RD hospital admissions was almost W-shaped. Either extremely cold temperatures or moderately cold temperatures presented a short-term acute harmful effect, and the relative risks were higher among males (1.976, 95% confidence interval [CI]: 1.773-2.203; 1.242, 95% CI: 1.203-1.282) and the elderly (2.363, 95% CI: 1.724-3.240; 1.267, 95% CI: 1.154-1.390). Both extreme and moderately hot temperatures had higher risks among females (2.040, 95% CI: 1.815-2.292; 1.328, 95% CI: 1.276-1.381). CONCLUSIONS The relationship between air temperature and RD hospital admissions was nonlinear. Vulnerable populations varied according to extreme temperature conditions.
Collapse
Affiliation(s)
- Yanan Zhang
- From the School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | | | | | | | | |
Collapse
|
7
|
Goniotakis I, Perikleous E, Fouzas S, Steiropoulos P, Paraskakis E. A Clinical Approach of Allergic Rhinitis in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1571. [PMID: 37761533 PMCID: PMC10528841 DOI: 10.3390/children10091571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
Allergic rhinitis is an important disease with a global footprint and a growing prevalence, affecting children and adults. Although it is commonly under-diagnosed and under-treated, it causes important social and economic effects (diminished quality of life, poor academic performance, escalated medical visits, heightened medication usage, and effects in other chronic conditions, e.g., asthma). It is characterized by distinctive, easily identifiable symptoms (sneezing, nasal discharge, nasal congestion, nasal-eye-palatal itching) and indirect accompanying indicators (fatigue and decreased school performance). The classification of allergic rhinitis hinges upon its nature and chronic distribution (seasonal or perennial) and its intensity, which spans from mild to moderate and severe. The diagnostic process primarily relies upon recognizing key clinical indicators, evaluating historical records, and considering risk factors. It is supported by abnormal laboratory findings, like in vitro allergen-specific IgE tests (enzyme immunoassay-EIA, chemiluminense immunoassay-CLIA) or in vivo skin prick tests for specific allergens. In the differential diagnosis, other chronic diseases manifesting with chronic rhinitis should be excluded (e.g., rhinosinusitis, chronic non-allergic rhinitis, rhinitis triggered by medications). The treatment of allergic rhinitis in children is mainly chronic and is focused on allergen exposure prevention, drug therapy, and immunotherapy in severe cases. Locally administered intranasal corticosteroids are the cornerstone of therapy. They are safe, effective, and have a favorable safety profile even during long-term use. Choosing a suitable intranasal corticosteroid drug with low systemic bioavailability makes long-term treatment even safer. Combinations of intranasal corticosteroids and H1 antihistamines are available in several countries and are widely used in more severe cases and the presence of year-round symptoms. Adding newer-generation oral H1-antihistamines broadens the available therapeutic inventory without significant effects compared to using previous-generation, once widely available, H1-antihistamines. Treatment of allergic rhinitis is complex and multi-dimensional, requiring an effective approach by a specialized group of specialized pediatricians, and is severely affected by the concurrent presence or development of other diseases in the spectrum of allergic diseases (conjunctivitis, asthma).
Collapse
Affiliation(s)
- Ioannis Goniotakis
- Pediatric Respiratory Unit, Pediatric Department, University of Crete, 70013 Heraklion, Greece; (I.G.); (E.P.)
| | - Evanthia Perikleous
- Pediatric Emergency Department, General Hospital of Nicosia, 2031 Nicosia, Cyprus;
| | - Sotirios Fouzas
- Pediatric Respiratory Unit, University Hospital of Patras, 26504 Patras, Greece;
| | - Paschalis Steiropoulos
- Department of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Emmanouil Paraskakis
- Pediatric Respiratory Unit, Pediatric Department, University of Crete, 70013 Heraklion, Greece; (I.G.); (E.P.)
| |
Collapse
|
8
|
Conti DM, Hellings PW, Diamant Z, Bjermer L, Jesenak M, Backer V, Fokkens W, Lau S, Van Staeyen E, Scadding GK. A EUFOREA comment on a lost comorbidity of asthma. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2023; 19:56. [PMID: 37391838 DOI: 10.1186/s13223-023-00816-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
"Epidemiology of comorbidities and their association with asthma control" (Tomisa, G., Horváth, A., Sánta, B. et al. Epidemiology of comorbidities and their association with asthma control. Allergy Asthma Clin Immunol 17, 95 (2021). https://doi.org/10.1186/s13223-021-00598-3 ) is an interesting paper reflecting data collection from more than 12,000 asthmatic patients in Hungary regarding their condition and associated comorbidities. We found it valuable that the paper provides an overview of asthma comorbidities not usually considered in similar reports. Nevertheless, we believe that chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP or CRSsNP) should have been listed due to its high incidence and prevalence, its association with asthma which is also endorsed in both GINA and EPOS, as well as in several peer-reviewed scientific papers, and to reflect the role of this comorbidity in poor control and a most severe presentation of asthma for the patient. Consequently, several targeted therapies (especially monoclonal antibodies) used for several years in severe forms of asthma are now indicated also for the effective treatment of nasal polyps.
Collapse
Affiliation(s)
- Diego M Conti
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium.
| | - Peter W Hellings
- KU Leuven Department of Microbiology and Immunology, Allergy and Clinical Immunology Research Unit, Leuven, Belgium
- Clinical Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Otorhinolaryngology, Laboratory of Upper Airways Research, University of Ghent, Ghent, Belgium
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Zuzana Diamant
- KU Leuven Department of Microbiology and Immunology, Allergy and Clinical Immunology Research Unit, Leuven, Belgium
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
- Department Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Leif Bjermer
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
| | - Milos Jesenak
- Department of Pulmonology and Phthisiology, Department of Pediatrics, Department of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
| | - Vibeke Backer
- Department of Otorhinolaryngology, Head & Neck surgery, and Audiology. Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Wytske Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Susanne Lau
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Elizabeth Van Staeyen
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
| | - Glenis K Scadding
- Department of Allergy & Rhinology, Royal National ENT Hospital, London, UK
- Division of Immunity and Infection, University College, London, UK
| |
Collapse
|
9
|
Park MB, Lee TS, Lee JH, Lee J. Most patients with COPD are unaware of their health threats and are not diagnosed: a national-level study using pulmonary function test. Sci Rep 2023; 13:5893. [PMID: 37041257 PMCID: PMC10090160 DOI: 10.1038/s41598-023-32485-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/28/2023] [Indexed: 04/13/2023] Open
Abstract
This study aimed to investigate national-level prevalence of COPD, proportion of patients diagnosed with and without COPD. We performed pulmonary function test (PFT) in 24,454 adults aged > 40 years for 8 years (2010-2017). The annual COPD prevalence increased from 13.1% in 2010 to 14.6% in 2012, followed by 13.3% in 2017. However, patients diagnosed with COPD ranged between 0.5 and 1.0% in the last 8 years, which means that only 5% of all COPD patients were diagnosed with COPD by doctors. We defined potential high-risk individuals as those with a FEV1/FVC ratio of < 0.70, who have not been diagnosed with COPD and other respiratory diseases tuberculosis, asthma, lung cancer. The proportion of this group was 80.8% in 2010 and 78.1% in 2017. The older age group, women, low-educated group, and current smokers who have been smoking for a long time are more likely to be in the high-risk group having a higher possibility to develop COPD but are not diagnosed with COPD appropriately. Although COPD prevalence was high in the ever, current, and heavy smokers, only the diagnosis rate of COPD in ever smokers was 2.38 times higher than never smokers, indicating that a system is needed to screen and intervention for these groups.
Collapse
Affiliation(s)
- Myung-Bae Park
- Department of Health and Welfare, Pai Chai University, Daejeon, Republic of Korea
| | - Tae Sic Lee
- Department of Family Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Ji-Ho Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Ilsan-Ro, Wonju, 26426, Republic of Korea.
| | - Jinhee Lee
- Department of Psychiatry, Yonsei University Wonju College of Medicine, 20 Ilsan-Ro, Wonju, 26426, Republic of Korea.
| |
Collapse
|
10
|
Kim SH, Lee H, Kim Y, Rhee CK, Min KH, Hwang YI, Kim DK, Park YB, Yoo KH, Moon JY. Recent Prevalence of and Factors Associated With Chronic Obstructive Pulmonary Disease in a Rapidly Aging Society: Korea National Health and Nutrition Examination Survey 2015-2019. J Korean Med Sci 2023; 38:e108. [PMID: 37038644 PMCID: PMC10086381 DOI: 10.3346/jkms.2023.38.e108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/03/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND The prevalence of chronic obstructive pulmonary disease (COPD) increases with age, and aging is an important risk factor for COPD development. In the era of global aging, demographic information about the prevalence of and factors associated with COPD are important to establish COPD care plans. However, limited information is available in rapidly aging societies, including Korea. METHODS We conducted a cross-sectional observational study using Korea National Health and Nutrition Examination Survey data from 2015-2019. We included 15,613 participants and analyzed trends of and factors associated with COPD. RESULTS During the study period, the overall prevalence of COPD was 12.9%. Over five years, the yearly prevalence of COPD was fairly constant, ranging from 11.5% to 13.6%. Among individuals aged ≥ 70 years, nearly one-third met COPD diagnostic criteria. In the multivariable analysis, age 70 years or older was the most strong factor associated with COPD (adjusted odds ratio [aOR], 17.86; 95% confidence interval [CI], 14.16-22.52; compared with age 40-49), followed by asthma (aOR, 3.39; 95% CI, 2.44-4.71), male sex (aOR, 2.64; 95% CI, 2.18-3.19), and current smokers (aOR, 2.60; 95% CI, 2.08-3.25). Additionally, ex-smokers, low income, decreased forced expiratory volume in 1 second %pred, and a history of pulmonary tuberculosis were associated with COPD. On the other hand, body mass index (BMI) ≥ 25 kg/m² (aOR, 0.62; 95% CI, 0.54-0.71; compared with BMI 18.5-24.9 kg/m²) had an inverse association with COPD. CONCLUSION Recent trends in the prevalence of COPD in South Korea are relatively stable. Approximately one-third of participants aged 70 years and older had COPD. Aging was the most important factor associated with COPD.
Collapse
Affiliation(s)
- Sang Hyuk Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Youlim Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Hoon Min
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Yong Il Hwang
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Yong Bum Park
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Ji-Yong Moon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
| |
Collapse
|
11
|
Andaloro C, Saibene AM, La Mantia I. Quail egg homogenate with zinc as adjunctive therapy in seasonal allergic rhinitis: a randomised, controlled trial. J Laryngol Otol 2023; 137:432-437. [PMID: 35582999 DOI: 10.1017/s0022215122001219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Because most available treatments for managing seasonal allergic rhinitis show some side effects without reducing recurrence, natural anti-allergic products could represent an interesting treatment addition. This study aimed to analyse the efficacy and tolerance of quail egg as adjunctive therapy in seasonal allergic rhinitis. METHOD In a Consolidated Standards of Reporting Trials compliant framework, patients with seasonal allergic rhinitis were prospectively randomised to receive mometasone nasal spray for four weeks or the same topical corticosteroid therapy plus commercially available oral quail egg and zinc tablets. RESULTS Forty patients were enrolled. The mometasone + quail egg and zinc tablets group showed a greater reduction in nasal itching, sneezing and total nasal symptom scores than the mometasone nasal spray only group. A higher proportion of participants in the mometasone + quail egg and zinc tablets group had good rhinitis control than in the mometasone nasal spray only group, with no need for rescue medications. CONCLUSION Despite the need for a further larger study, quail egg preliminarily appears to be an effective adjunct to topical steroid therapy in seasonal allergic rhinitis.
Collapse
Affiliation(s)
- C Andaloro
- Unit of Otorhinolaryngology, Department of Medical Sciences Surgical and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - A M Saibene
- Otolaryngology Unit, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milano, Italy
| | - I La Mantia
- Unit of Otorhinolaryngology, Department of Medical Sciences Surgical and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| |
Collapse
|
12
|
Wise SK, Damask C, Roland LT, Ebert C, Levy JM, Lin S, Luong A, Rodriguez K, Sedaghat AR, Toskala E, Villwock J, Abdullah B, Akdis C, Alt JA, Ansotegui IJ, Azar A, Baroody F, Benninger MS, Bernstein J, Brook C, Campbell R, Casale T, Chaaban MR, Chew FT, Chambliss J, Cianferoni A, Custovic A, Davis EM, DelGaudio JM, Ellis AK, Flanagan C, Fokkens WJ, Franzese C, Greenhawt M, Gill A, Halderman A, Hohlfeld JM, Incorvaia C, Joe SA, Joshi S, Kuruvilla ME, Kim J, Klein AM, Krouse HJ, Kuan EC, Lang D, Larenas-Linnemann D, Laury AM, Lechner M, Lee SE, Lee VS, Loftus P, Marcus S, Marzouk H, Mattos J, McCoul E, Melen E, Mims JW, Mullol J, Nayak JV, Oppenheimer J, Orlandi RR, Phillips K, Platt M, Ramanathan M, Raymond M, Rhee CS, Reitsma S, Ryan M, Sastre J, Schlosser RJ, Schuman TA, Shaker MS, Sheikh A, Smith KA, Soyka MB, Takashima M, Tang M, Tantilipikorn P, Taw MB, Tversky J, Tyler MA, Veling MC, Wallace D, Wang DY, White A, Zhang L. International consensus statement on allergy and rhinology: Allergic rhinitis - 2023. Int Forum Allergy Rhinol 2023; 13:293-859. [PMID: 36878860 DOI: 10.1002/alr.23090] [Citation(s) in RCA: 65] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/11/2022] [Accepted: 09/13/2022] [Indexed: 03/08/2023]
Abstract
BACKGROUND In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document. METHODS ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. RESULTS ICAR-Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. CONCLUSION The ICAR-Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.
Collapse
Affiliation(s)
- Sarah K Wise
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Cecelia Damask
- Otolaryngology-HNS, Private Practice, University of Central Florida, Lake Mary, Florida, USA
| | - Lauren T Roland
- Otolaryngology-HNS, Washington University, St. Louis, Missouri, USA
| | - Charles Ebert
- Otolaryngology-HNS, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joshua M Levy
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Sandra Lin
- Otolaryngology-HNS, University of Wisconsin, Madison, Wisconsin, USA
| | - Amber Luong
- Otolaryngology-HNS, McGovern Medical School of the University of Texas, Houston, Texas, USA
| | - Kenneth Rodriguez
- Otolaryngology-HNS, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Ahmad R Sedaghat
- Otolaryngology-HNS, University of Cincinnati, Cincinnati, Ohio, USA
| | - Elina Toskala
- Otolaryngology-HNS, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Baharudin Abdullah
- Otolaryngology-HNS, Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia
| | - Cezmi Akdis
- Immunology, Infectious Diseases, Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
| | - Jeremiah A Alt
- Otolaryngology-HNS, University of Utah, Salt Lake City, Utah, USA
| | | | - Antoine Azar
- Allergy/Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fuad Baroody
- Otolaryngology-HNS, University of Chicago, Chicago, Illinois, USA
| | | | | | - Christopher Brook
- Otolaryngology-HNS, Harvard University, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Raewyn Campbell
- Otolaryngology-HNS, Macquarie University, Sydney, NSW, Australia
| | - Thomas Casale
- Allergy/Immunology, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Mohamad R Chaaban
- Otolaryngology-HNS, Cleveland Clinic, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fook Tim Chew
- Allergy/Immunology, Genetics, National University of Singapore, Singapore, Singapore
| | - Jeffrey Chambliss
- Allergy/Immunology, University of Texas Southwestern, Dallas, Texas, USA
| | - Antonella Cianferoni
- Allergy/Immunology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | | | | | - Anne K Ellis
- Allergy/Immunology, Queens University, Kingston, ON, Canada
| | | | - Wytske J Fokkens
- Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | | | - Matthew Greenhawt
- Allergy/Immunology, Pediatrics, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Amarbir Gill
- Otolaryngology-HNS, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashleigh Halderman
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Jens M Hohlfeld
- Respiratory Medicine, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Hannover Medical School, German Center for Lung Research, Hannover, Germany
| | | | - Stephanie A Joe
- Otolaryngology-HNS, University of Illinois Chicago, Chicago, Illinois, USA
| | - Shyam Joshi
- Allergy/Immunology, Oregon Health and Science University, Portland, Oregon, USA
| | | | - Jean Kim
- Otolaryngology-HNS, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adam M Klein
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Helene J Krouse
- Otorhinolaryngology Nursing, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Edward C Kuan
- Otolaryngology-HNS, University of California Irvine, Orange, California, USA
| | - David Lang
- Allergy/Immunology, Cleveland Clinic, Cleveland, Ohio, USA
| | | | | | - Matt Lechner
- Otolaryngology-HNS, University College London, Barts Health NHS Trust, London, UK
| | - Stella E Lee
- Otolaryngology-HNS, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Victoria S Lee
- Otolaryngology-HNS, University of Illinois Chicago, Chicago, Illinois, USA
| | - Patricia Loftus
- Otolaryngology-HNS, University of California San Francisco, San Francisco, California, USA
| | - Sonya Marcus
- Otolaryngology-HNS, Stony Brook University, Stony Brook, New York, USA
| | - Haidy Marzouk
- Otolaryngology-HNS, State University of New York Upstate, Syracuse, New York, USA
| | - Jose Mattos
- Otolaryngology-HNS, University of Virginia, Charlottesville, Virginia, USA
| | - Edward McCoul
- Otolaryngology-HNS, Ochsner Clinic, New Orleans, Louisiana, USA
| | - Erik Melen
- Pediatric Allergy, Karolinska Institutet, Stockholm, Sweden
| | - James W Mims
- Otolaryngology-HNS, Wake Forest University, Winston Salem, North Carolina, USA
| | - Joaquim Mullol
- Otorhinolaryngology, Hospital Clinic Barcelona, Barcelona, Spain
| | - Jayakar V Nayak
- Otolaryngology-HNS, Stanford University, Palo Alto, California, USA
| | - John Oppenheimer
- Allergy/Immunology, Rutgers, State University of New Jersey, Newark, New Jersey, USA
| | | | - Katie Phillips
- Otolaryngology-HNS, University of Cincinnati, Cincinnati, Ohio, USA
| | - Michael Platt
- Otolaryngology-HNS, Boston University, Boston, Massachusetts, USA
| | | | | | - Chae-Seo Rhee
- Rhinology/Allergy, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Sietze Reitsma
- Otolaryngology-HNS, University of Amsterdam, Amsterdam, Netherlands
| | - Matthew Ryan
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Joaquin Sastre
- Allergy, Fundacion Jiminez Diaz, University Autonoma de Madrid, Madrid, Spain
| | - Rodney J Schlosser
- Otolaryngology-HNS, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Theodore A Schuman
- Otolaryngology-HNS, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Marcus S Shaker
- Allergy/Immunology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Aziz Sheikh
- Primary Care, University of Edinburgh, Edinburgh, Scotland
| | - Kristine A Smith
- Otolaryngology-HNS, University of Utah, Salt Lake City, Utah, USA
| | - Michael B Soyka
- Otolaryngology-HNS, University of Zurich, University Hospital of Zurich, Zurich, Switzerland
| | - Masayoshi Takashima
- Otolaryngology-HNS, Houston Methodist Academic Institute, Houston, Texas, USA
| | - Monica Tang
- Allergy/Immunology, University of California San Francisco, San Francisco, California, USA
| | | | - Malcolm B Taw
- Integrative East-West Medicine, University of California Los Angeles, Westlake Village, California, USA
| | - Jody Tversky
- Allergy/Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Matthew A Tyler
- Otolaryngology-HNS, University of Minnesota, Minneapolis, Minnesota, USA
| | - Maria C Veling
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Dana Wallace
- Allergy/Immunology, Nova Southeastern University, Ft. Lauderdale, Florida, USA
| | - De Yun Wang
- Otolaryngology-HNS, National University of Singapore, Singapore, Singapore
| | - Andrew White
- Allergy/Immunology, Scripps Clinic, San Diego, California, USA
| | - Luo Zhang
- Otolaryngology-HNS, Beijing Tongren Hospital, Beijing, China
| |
Collapse
|
13
|
Yang SI, Lee IH, Kim M, Ryu G, Kang SY, Kim MA, Lee SM, Kim HJ, Park DY, Lee YJ, Kim DK, Kim SW, Kim DH, Jun YJ, Park SC, Kim BS, Chung SJ, Lee HJ, Kim HB, Choi JH, Choi GS, Yang HJ. KAAACI Allergic Rhinitis Guidelines: Part 1. Update in Pharmacotherapy. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:19-31. [PMID: 36693355 PMCID: PMC9880301 DOI: 10.4168/aair.2023.15.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023]
Abstract
The prevalence of allergic rhinitis (AR) and the socioeconomic burden associated with the medical cost and quality of life (QOL) of AR have progressively increased. Therefore, practical guidelines for the appropriate management of AR need to be developed based on scientific evidence while considering the real-world environment, values, and preferences of patients and physicians. The Korean Academy of Asthma, Allergy and Clinical Immunology revised clinical guidelines of 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 systematic review, we made 4 recommendations for AR pharmacotherapy, including intranasal corticosteroid (INCS)/intranasal antihistamine (INAH) 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.
Collapse
Affiliation(s)
- Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Il Hwan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Minji Kim
- Department of Pediatrics, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Gwanghui Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-Yoon Kang
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Mi-Ae Kim
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang Min Lee
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Hyun-Jung Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Do-Yang Park
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Yong Ju Lee
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Dong-Kyu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.,Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Hallym University College of Medicine, Chuncheon, Korea
| | - Soo Whan Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Joon Jun
- Department of Otorhinolaryngology-Head and Neck surgery, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea
| | - Sang Chul Park
- Department of Otorhinolaryngology-Head and Neck surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Bong-Seong Kim
- Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Soo Jie Chung
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.,Allergy and Clinical Immunology Research Center, Hallym University College of Medicine, Chuncheon, Korea
| | - Hyun Jong Lee
- Lee and Hong ENT Sleep and Cosmetic Center, Seongnam, Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Asthma and Allergy Center, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Jeong-Hee Choi
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.,Allergy and Clinical Immunology Research Center, Hallym University College of Medicine, Chuncheon, Korea
| | - Gil-Soon Choi
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, Korea
| |
Collapse
|
14
|
Identifying patients who suffered from post-discharge cough after lung cancer surgery. Support Care Cancer 2022; 30:7705-7713. [PMID: 35695932 DOI: 10.1007/s00520-022-07197-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To establish a discharge cutoff point (CP) on a simple patient-reported cough score to identify patients requiring post-discharge cough intervention. METHODS Data were extracted from a prospective cohort study of patients undergoing lung cancer surgery. Symptoms were assessed using the MD Anderson Symptom Inventory-Lung Cancer Module. Group-based trajectory modeling was used to identify patient subgroups defined by post-discharge cough trajectories. Generalized linear model and bootstrap resampling with 2000 samples were used to determine the optimal cutoff points of discharge cough scores and their robustness. Analysis of variance, chi-square test, and mixed-effects model were used to validate the optimal cutoff points. RESULTS The cough trajectories of post-discharge followed three patterns (high, middle, low); higher cough was associated with poor recovery of the enjoyment of life within 4 weeks after discharge (P < 0.001). The CP (3, 6) of discharge cough demonstrated as the optimal CP (F = 21.72). When discharged, 45.66% (179/392) of patients suffered a none/mild cough (0-2 points), 41.82% (164/392) suffered a moderate cough (3-5 points), and 12.5% (49/392) suffered a severe cough (6-10 points). Among these patients, there was a significant difference in the proportion of returning to work at 1 month after discharge (non-mild: 77.70%; moderate: 60.74%; severe: 48.57%; p < 0.001). CONCLUSIONS Moderate-to-severe cough is relatively common in patients undergoing lung cancer surgery, and the higher the cough trajectory, the worse the recovery to normal life. Therefore, these patients with a cough score ≥ 3 or ≥ 6 at discharge may require additional medical intervention and extensive care.
Collapse
|
15
|
Lyu YR, Lee SW, Kim SY, Han HB, Yang WK, Kim SH, Jung IC, Kwon OJ, Kim AR, Kim J, Lee MY, Park YC. Herbal Medicines for the Treatment of Chronic Obstructive Airway Diseases (Asthma or Chronic Obstructive Pulmonary Disease): A Prospective Observational Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:3485757. [PMID: 35677382 PMCID: PMC9168097 DOI: 10.1155/2022/3485757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 12/02/2022]
Abstract
Background Obstructive airway disease is a major health problem and has a great impact on global socioeconomic burden. Despite therapeutic advances in recent decades, there is still a need for effective and safe therapeutic agents for patients with asthma or chronic obstructive pulmonary disease (COPD). Methods This prospective observational study explored the effects of herbal medicines in patients with asthma and COPD. All participants visited the hospital at least every 4 weeks for 12 weeks to receive their herbal medicines based on their pattern identification and to evaluate safety and efficacy endpoints. We followed the diagnostic criteria used by Korean medicine doctors to prescribe herbal medicines, explored variations in prescribed herbal medicines, and explored a number of clinical features in patients with asthma or COPD. Results A total of 24 patients were enrolled: 14 were diagnosed with asthma and 10 with COPD and 19 completed the study. After 12 weeks of herbal medicine treatment, herbal medicines significantly improved the modified Clinical Asthma Measurement Scale in Oriental Medicine-V in asthma patients and the modified Medical Research Council Dyspnoea Scale and St. George's Respiratory Questionnaire in COPD patients. For all patients, modified Medical Research Council Dyspnoea Scale score and interleukin-13 were found to be significantly different after treatment. Additionally, the majority of patients were satisfied with our herbal medicine treatments, and no severe adverse events were reported during the study. Conclusions Our study provides preliminary clinical data on the safety and efficacy of herbal medicines in patients with asthma and COPD.
Collapse
Affiliation(s)
- Yee Ran Lyu
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Su-Won Lee
- Division of Respiratory Medicine, Department of Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Si-Yeon Kim
- Clinical Trial Center, Daejeon Korean Medicine Hospital, Daejeon University, Daejeon, Republic of Korea
| | - Hye-Bin Han
- Clinical Trial Center, Daejeon Korean Medicine Hospital, Daejeon University, Daejeon, Republic of Korea
| | - Won-Kyung Yang
- Division of Respiratory Medicine, Department of Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
- Immunotherapy Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Seung-Hyung Kim
- Immunotherapy Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - In Chul Jung
- Department of Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - O-jin Kwon
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ae-Ran Kim
- Clinical Medicine Division, R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jinhee Kim
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Mi Young Lee
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Yang-Chun Park
- Division of Respiratory Medicine, Department of Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| |
Collapse
|
16
|
Yang D, Li K, Mingwei Chua D, Song Y, Bai C, Powell CA. Application of Internet of Things in Chronic Respiratory Disease Prevention, Diagnosis, Treatment and Management. CLINICAL EHEALTH 2022. [DOI: 10.1016/j.ceh.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
17
|
Baik D, Kim BW, Ki M. Increasing trends in mortality and costs of infectious diseases in Korea: trends in mortality and costs of infectious diseases. Epidemiol Health 2022; 44:e2022010. [PMID: 34990527 PMCID: PMC9117094 DOI: 10.4178/epih.e2022010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/02/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES In an era when the average life expectancy and overall mortality rate have improved, Korea remains at risk for infectious disease outbreaks that place substantial burdens on the healthcare system. This study investigated trends in mortality and the economic burden of infectious diseases. METHODS Healthcare data from the Health Insurance Review and Assessment Service (2009-2019) and the Korean Statistics Information Service (1997-2019) were used. We selected 10 infectious disease groups (intestinal infections, tuberculosis, vaccine- preventable diseases, sepsis, viral hepatitis, HIV-related diseases, central nervous system infections, rheumatic heart diseases, respiratory tract infections, and arthropod-borne viral diseases). RESULTS The age-standardized mortality rate for infectious diseases increased from 27.2 per 100,000 population in 1997 to 37.1 per 100,000 population in 2019 and has had an upward trend since 2004. During this same period, significant increases were seen in respiratory tract infections and among elderly persons, especially those aged ≥85 years. The costs for infectious diseases increased from 4.126 billion US dollar (USD) in 2009 to 6.612 billion USD in 2019, with respiratory tract infections accounting for 3.699 billion USD (69%). The annual cost per patient for visits for medical care due to infectious diseases increased from 131 USD in 2009 to 204 USD in 2019. CONCLUSIONS Mortality among elderly persons and those with respiratory tract infections increased during the study period. The economic burden of infectious diseases has consistently increased, especially for respiratory tract infections. It is therefore essential to establish effective management policies that considers specific infectious diseases and patient groups.
Collapse
Affiliation(s)
- Dahye Baik
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Byung-Woo Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Moran Ki
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| |
Collapse
|
18
|
Ecevit MC, Özcan M, Haberal Can İ, Çadallı Tatar E, Özer S, Esen E, Atan D, Göde S, Elsürer Ç, Eryılmaz A, Uslu Coşkun B, Yazıcı ZM, Dinç ME, Özdoğan F, Günhan K, Bilal N, Korkut AY, Kasapoğlu F, Türk B, Araz Server E, Önerci Çelebi Ö, Şimşek T, Kum RO, Adalı MK, Eren E, Yüksel Aslıer NG, Bayındır T, Çakır Çetin A, Enise Göker A, Adadan Güvenç I, Köseoğlu S, Soylu Özler G, Şahin E, Şahin Yılmaz A, Güne C, Aksoy Yıldırım G, Öca B, Durmuşoğlu M, Kantekin Y, Özmen S, Orhan Kubat G, Köybaşı Şanal S, Altuntaş EE, Selçuk A, Yazıcı H, Baklacı D, Yaylacı A, Hancı D, Doğan S, Fidan V, Uygur K, Keleş N, Cingi C, Topuz B, Çanakçıoğlu S, Önerci M. Turkish Guideline for Diagnosis and Treatment of Allergic Rhinitis (ART). Turk Arch Otorhinolaryngol 2021; 59:1-157. [PMID: 34212158 PMCID: PMC8221269 DOI: 10.4274/tao.2021.suppl.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECT To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients. METHODS The study was conducted by three authors, namely the writing support team. The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors. A workshop was organized at the very beginning to explain the details of the study to the team. Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors. After key words were determined by the authors, literature search was done in various databases. The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study. National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline. Only Guideline and meta-analyses published in last seven years (2013-2017) and randomized controlled studies published in last two years (2015-2017) were included. After all work was completed by the subgroups, support team brought all work together and edited the article. RESULTS A detailed guideline about all aspects of allergic rhinitis was created. CONCLUSION The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals. This guideline is the first in the field of Otolaryngology in Turkey. It should be updated at regular intervals.
Collapse
Affiliation(s)
- Mustafa Cenk Ecevit
- Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, İzmir
| | - Müge Özcan
- Department of Otorhinolaryngology, University of Health Sciences Turkey Faculty of Medicine, Ankara
| | - İlknur Haberal Can
- Department of Otorhinolaryngology, Yozgat Bozok University Faculty of Medicine, Yozgat
| | - Emel Çadallı Tatar
- Department of Otorhinolaryngology, University of Health Sciences Turkey Faculty of Medicine, Ankara
| | - Serdar Özer
- Department of Otorhinolaryngology, Hacettepe University Faculty of Medicine, Ankara
| | - Erkan Esen
- Department of Otorhinolaryngology, Derince Training and Research Hospital, İzmit
| | - Doğan Atan
- Department of Otorhinolaryngology, Lokman Hekim Hospital, Ankara
| | - Sercan Göde
- Department of Otorhinolaryngology, Ege University Faculty of Medicine, İzmir
| | - Çağdaş Elsürer
- Department of Otorhinolaryngology, Selçuk University Faculty of Medicine, Konya
| | - Aylin Eryılmaz
- Department of Otorhinolaryngology, Adnan Menderes University Faculty of Medicine, Aydın
| | - Berna Uslu Coşkun
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Zahide Mine Yazıcı
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Faculty of Medicine, İstanbul
| | - Mehmet Emre Dinç
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Fatih Özdoğan
- Department of Otorhinolaryngology, Derince Training and Research Hospital, İzmit
| | - Kıvanç Günhan
- Department of Otorhinolaryngology, Celal Bayar University, Manisa
| | - Nagihan Bilal
- Department of Otorhinolaryngology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş
| | - Arzu Yasemin Korkut
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Fikret Kasapoğlu
- Department of Otorhinolaryngology, Uludağ University Faculty of Medicine, Bursa
| | - Bilge Türk
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Ela Araz Server
- Department of Otorhinolaryngology, University of Health Sciences Turkey, İstanbul Training and Research Hospital, İstanbul
| | - Özlem Önerci Çelebi
- Department of Otorhinolaryngology, University of Health Sciences Turkey, İstanbul Training and Research Hospital, İstanbul
| | - Tuğçe Şimşek
- Department of Otorhinolaryngology, Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital, Amasya
| | - Rauf Oğuzhan Kum
- Department of Otorhinolaryngology, University of Health Sciences Turkey Faculty of Medicine, Ankara
| | - Mustafa Kemal Adalı
- Department of Otorhinolaryngology, Trakya University Faculty of Medicine, Edirne
| | - Erdem Eren
- Department of Otorhinolaryngology, Atatürk Training and Research Hospital, İzmir
| | - Nesibe Gül Yüksel Aslıer
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Bursa Yüksek İhtisas Training and Research Hospital, Bursa
| | - Tuba Bayındır
- Department of Otorhinolaryngology, İnönü University Faculty of Medicine, Malatya
| | - Aslı Çakır Çetin
- Department of Otorhinolaryngology, Dokuz Eylül University Faculty of Medicine, İzmir
| | - Ayşe Enise Göker
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Işıl Adadan Güvenç
- Department of Otorhinolaryngology, Bakırçay University Faculty of Medicine, Çiğli Training and Research Hospital, İzmir
| | - Sabri Köseoğlu
- Department of Otorhinolaryngology, Sıtkı Koçman University Faculty of Medicine, Muğla
| | - Gül Soylu Özler
- Department of Otorhinolaryngology, Mustafa Kemal University Faculty of Medicine, Hatay
| | - Ethem Şahin
- Bayındır Heathcare Group İçerenköy Hospital, İstanbul
| | - Aslı Şahin Yılmaz
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Ümraniye Training and Research Hospital, İstanbul
| | - Ceren Güne
- Department of Otorhinolaryngology, Atatürk Training and Research Hospital, İzmir
| | - Gökçe Aksoy Yıldırım
- University of Health Sciences Turkey, Bozyaka Training and Research Hospital, Department of Otorhinolaryngology, İzmir
| | - Bülent Öca
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Mehmet Durmuşoğlu
- Department of Otorhinolaryngology, Bakırçay University Faculty of Medicine, Çiğli Training and Research Hospital, İzmir
| | - Yunus Kantekin
- Department of Otorhinolaryngology University of Health Sciences Turkey, Kayseri City Hospital, Kayseri
| | - Süay Özmen
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Bursa Yüksek İhtisas Training and Research Hospital, Bursa
| | - Gözde Orhan Kubat
- Department of Otorhinolaryngology, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya
| | - Serap Köybaşı Şanal
- Department of Otorhinolaryngology, Abant İzzet Baysal University Faculty of Medicine, Bolu
| | - Emine Elif Altuntaş
- Department of Otorhinolaryngology, Sivas Cumhuriyet University Faculty of Medicine, Sivas
| | - Adin Selçuk
- Department of Otorhinolaryngology, Bahçeşehir University Faculty of Medicine, İstanbul
| | - Haşmet Yazıcı
- Department of Otorhinolaryngology, Balıkesir University Faculty of Medicine, Balıkesir
| | - Deniz Baklacı
- Department of Otorhinolaryngology, Bülent Ecevit University Faculty of Medicine, Zonguldak
| | - Atılay Yaylacı
- Department of Otorhinolaryngology, Kocaeli University Faculty of Medicine, Kocaeli
| | - Deniz Hancı
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul
| | - Sedat Doğan
- Department of Otorhinolaryngology, Adıyaman University Faculty of Medicine, Adıyaman
| | - Vural Fidan
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Eskişehir City Hospital, Eskişehir
| | - Kemal Uygur
- Department of Otorhinolaryngology, Gazi University Faculty of Medicine, Ankara
| | - Nesil Keleş
- Department of Otorhinolaryngology, İstanbul University İstanbul Faculty of Medicine, İstanbul
| | - Cemal Cingi
- Department of Otorhinolaryngology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir
| | - Bülent Topuz
- Department of Otorhinolaryngology, Pamukkale University Faculty of Medicine, Denizli
| | - Salih Çanakçıoğlu
- Department of Otorhinolaryngology, İstanbul University İstanbul Faculty of Medicine, İstanbul
| | - Metin Önerci
- Department of Otorhinolaryngology, Hacettepe University Faculty of Medicine, Ankara
| |
Collapse
|
19
|
Xu Y, Bi M, Tan KS, Mi J, Hong H. Biologics in Treatment for Chronic Rhinosinusitis with Comorbid Asthma. CURRENT TREATMENT OPTIONS IN ALLERGY 2021. [DOI: 10.1007/s40521-021-00282-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
20
|
Wee JH, Park MW, Min C, Byun SH, Park B, Choi HG. Association between asthma and cardiovascular disease. Eur J Clin Invest 2021; 51:e13396. [PMID: 32888313 DOI: 10.1111/eci.13396] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/25/2020] [Accepted: 08/29/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Epidemiological studies on the association between asthma and cardiovascular disease have reported conflicting results. This cross-sectional study evaluated the association between asthma and ischaemic heart disease (IHD)/stroke in Korean adults. MATERIALS AND METHODS Data from the Korean Genome and Epidemiology Study-Health Examinees were used. Among 173 209 participants, 3162 asthmatic and 159 408 control participants were selected. Histories of asthma, IHD and stroke were obtained. Participants were categorized according to their current status of asthma management: 'well-controlled', 'being treated', and 'not being treated'. Crude and adjusted (age, gender, body mass index, income, smoking, alcohol consumption, hypertension, diabetes, dyslipidaemia and nutritional intake) odds ratios (ORs) for IHD and stroke in asthmatic patients were analysed using a multiple logistic regression model. RESULTS Participants with asthma reported a significantly higher prevalence of IHD (6.0% vs 3.0%) and stroke (2.3% vs 1.4%) than those without asthma (P < .001). Asthmatic participants had a higher OR (1.46, 95% confidence interval [CI] = 1.251-1.71, P < .001) for IHD than those without asthma. The association between asthma and IHD was significant only in patients aged ≥53 years (men: adjusted OR = 1.31, 95% CI = 1.01-1.70, P = .046; women: adjusted OR = 1.64, 95% CI = 1.32-2.03, P < .001) according to age and sex and in the 'not being treated' asthma group (adjusted OR = 1.47, 95% CI = 1.14-1.91, P = .003) according to the asthma management status. Stroke was not significantly associated with asthma (adjusted OR = 1.17, 95% CI = 0.92-1.48, P = .203) in the adjusted model and all subgroup analyses. CONCLUSION Asthma was associated with IHD, mainly in older patients and untreated asthma patients, but not with stroke.
Collapse
Affiliation(s)
- Jee Hye Wee
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Min Woo Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Soo Hwan Byun
- Department of Oral & Maxillofacial Surgery, Dentistry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Bumjung Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.,Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea
| |
Collapse
|
21
|
Kim MK, Park HS, Park CS, Min SJ, Albers FC, Yancey SW, Mayer B, Kwon N. Efficacy and safety of mepolizumab in Korean patients with severe eosinophilic asthma from the DREAM and MENSA studies. Korean J Intern Med 2021; 36:362-370. [PMID: 32450626 PMCID: PMC7969054 DOI: 10.3904/kjim.2019.198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/15/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND/AIMS The efficacy and safety of mepolizumab in patients with severe eosinophilic asthma has been evaluated in a global clinical trial programme. This post hoc analysis assesses the efficacy and safety of mepolizumab in Korean patients. METHODS Data from Korean patients in the Phase III, placebo-controlled, randomised DREAM (MEA112997/NCT01000506) and MENSA (MEA115588/ NCT01691521) studies were included. Patients ≥ 12 years old with severe eosinophilic asthma received mepolizumab (DREAM: 75, 250 or 750 mg intravenously [IV]; MENSA: 75 mg IV or 100 mg subcutaneously [SC]), or placebo every 4 weeks for 52 weeks (DREAM) or 32 weeks (MENSA). The primary outcome was the rate of clinically significant asthma exacerbations. Secondary outcomes included forced expiratory volume in 1 second (FEV1), Asthma Control Questionnaire (ACQ) and St George's Respiratory Questionnaire (SGRQ) scores (MENSA only). Blood eosinophil counts (BEC) and safety were assessed throughout. RESULTS Reductions in the rate of clinically significant asthma exacerbations were observed with the approved (100 mg SC) and bioequivalent (75 mg IV) doses of mepolizumab in Korean patients who participated in DREAM and MENSA. In MENSA, trends for improvements from baseline at week 32 in pre-bronchodilator FEV1 (75 mg IV group), ACQ-5 and SGRQ scores (in both treatment groups) were seen versus placebo in Korean patients. Incidence of on-treatment adverse events was similar in Korean patients versus non-Korean patients as were observed reductions from baseline in BEC. CONCLUSION Mepolizumab treatment provided clinical benefits for Korean patients with severe eosinophilic asthma; the safety profile is consistent with the overall population.
Collapse
Affiliation(s)
- Mi-Kyeong Kim
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
- Correspondence to Hae-Sim Park, M.D. Department of Allergy and Clinical Immunology, Ajou University School of Medicine, 206 World cup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: +82-31-219-5150 Fax: +82-31-219-5154 E-mail:
| | - Choon-Sik Park
- Department of Pulmonology and Allergy, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | | | - Frank C. Albers
- Global Respiratory Medical Franchise, GSK, Research Triangle Park, NC, USA
| | - Steven W. Yancey
- Respiratory Therapeutic Area, GSK, Research Triangle Park, NC, USA
| | | | - Namhee Kwon
- Respiratory Medical Franchise, GSK, Brentford, UK
| |
Collapse
|
22
|
Kim NE, Lee S, Kim BY, Hwang AG, Shin JH, Yang HJ, Won S. The nationwide retrospective cohort study by Health Insurance Review and Assessment Service proves that asthma management decreases the exacerbation risk of asthma. Sci Rep 2021; 11:1442. [PMID: 33446854 PMCID: PMC7809363 DOI: 10.1038/s41598-021-81022-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 12/21/2020] [Indexed: 11/09/2022] Open
Abstract
Medical costs have recently increased in South Korea due to the rising rate of asthma. Primary clinics serve an important role in asthma management, as they are the first stop for patients presenting with symptoms. The Health Insurance Review and Assessment Service (HIRA) in South Korea has assessed asthma-management quality since 2013, but studies are lacking on whether these assessments have been performed properly and contribute toward reducing asthma exacerbations. Therefore, we investigated whether the HIRA’s quality assessments have decreased asthma exacerbations using national health insurance claims data from 2013 to 2017 of 83,375 primary-clinic and 15,931 tertiary-hospital patients with asthma. These patients were classified into four groups based on disease severity according to the monthly prescribed amount of asthma medication using K-means clustering. The associations between HIRA assessments and asthma exacerbation were analyzed using a generalized estimating equation. Our results showed that exacerbation odds gradually decreased as the HIRA assessments progressed, especially in the mild-severity group, and that exacerbation risk among patients with asthma decreased in the order of assessment grades: “Unsatisfactory,” “Satisfactory,” and “Tertiary.” Therefore, we may conclude that asthma exacerbations may decrease with high quality asthma management; appropriate quality assessment could be helpful in reducing asthma exacerbations.
Collapse
Affiliation(s)
- Nam-Eun Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Sanghun Lee
- Department of Medical Consilience, Graduate School of Dankook University, Jukjeon, Korea
| | - Bo Yeon Kim
- Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju, Korea
| | - Ae Gi Hwang
- Chronic Disease Assessment Division, Health Insurance Review and Assessment Service, Wonju, Korea
| | - Ji Hyeon Shin
- Quality Assessment Management Division, Health Insurance Review and Assessment Service, Wonju, Korea
| | - Hyeon-Jong Yang
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea. .,Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
| | - Sungho Won
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea. .,Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, Korea. .,Institute of Health and Environment, Seoul National University, Seoul, Korea.
| |
Collapse
|
23
|
Chung RS, Huang YC, Chen YH, Fu LS, Lin CH. Impact of antipyretics on acute asthma exacerbation during respiratory infection-A nationwide population-based study. Pediatr Neonatol 2020; 61:475-480. [PMID: 32331972 DOI: 10.1016/j.pedneo.2020.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 03/31/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Antipyretics are frequently used in pediatric practice. Both acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to increase the risk of asthma exacerbation. The study investigated antipyretic use during respiratory infection in children and analyzed the risk of acetaminophen and NSAID for severe asthma exacerbation (AE) in asthmatic children in Taiwan. METHODS We used the data from the National Health Insurance Research Database in 2005. There were 27,095 pediatric asthmatic patients having at least one respiratory infection episode, and 27,095 age- and sex-matched non-asthmatic children with respiratory infection served as controls. These patients were divided into groups with acetaminophen use, NSAID cyclooxygenase-1 (COX-1) use, and no antipyretic use. The rate of AE occurrence within the first 7 days after respiratory infection diagnosis was compared among the groups. RESULTS During a single episode of respiratory infection, asthmatic patients used fewer antipyretics than controls (48.51% vs. 55.50%, p < 0.001). No difference was observed in the risk of AE occurrence within 7 days after respiratory infection between antipyretic users and antipyretic nonusers (22/13,144 [0.167%] vs. 12/13,951 [0.086%], p = 0.058). Compared with asthmatic children using acetaminophen, those using no antipyretic and COX-1 have lower risks for AE (OR: 0.26, 95% CI: 0.12-0.54, p < 0.001; and OR: 0.14, 95% CI: 0.03-0.61, p = 0.009). CONCLUSION In asthmatic children, the rate of AE after a single respiratory infection episode was around 0.144%. The risk of AE was higher in those who took acetaminophen.
Collapse
Affiliation(s)
- Ruei-Sian Chung
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Pediatrics, Chang-Hua Hospital, Ministry of Health and Welfare, Taiwan
| | - Yung-Chieh Huang
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Huei Chen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Lin-Shien Fu
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan.
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
| |
Collapse
|
24
|
Burkin AV, Svistushkin VM, Nikiforova GN, Dukhanin AS. [Glucosaminylmuramyl dipeptide in treatment of respiratory tract diseases]. Vestn Otorinolaringol 2020; 84:118-131. [PMID: 32027335 DOI: 10.17116/otorino201984061118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Immunomodulators are used as part of a comprehensive therapy of respiratory tract diseases. The systematization of the accumulated data on the use of glucosaminylmuramyldipeptide (GMDP) has great scientific and practical interest. PURPOSE To study the data on the effectiveness and safety of GMDP in the treatment of infectious diseases of the respiratory tract. MATERIAL AND METHODS Literature search was carried out in Scientific Electronic Library (elibrary.ru), Google Scholar, ScienceDirect, Cochrane library, Pubmed/MEDLINE and search engines. The level of evidence reliability and methodological quality of researches were assessed. RESULTS 17 full-text publications were selected based on the results of 13 prospective clinical trials with acceptable methodological quality (including one blind placebo-controlled trial). The effectiveness of GMDP in acute respiratory viral infections, influenza, recurrent respiratory tract infections, rhinosinusitis and chronic tonsillitis was demonstrated. DISCUSSION An important advantage is that a significant part of the studies was performed with the participation of the child population. Since the use of GMDP in multiple therapy significantly reduces antibiotic consumption (often unjustified). It seems reasonable to estimate the pharmacoeconomic costs of managing adult patients with respiratory tract diseases. Further research can improve understanding of the role of GMDP in the treatment of various medical conditions. CONCLUSION The use of GMDP in the treatment of respiratory tract diseases makes it possible to faster achieve a clinical effect, reduce the number of relapses, lengthen the relapse-free period, as well as to potentiate the effect of antibacterial therapy (if necessary), reducing the need for antibiotics.
Collapse
Affiliation(s)
- A V Burkin
- Federal State Budgetary Institution Scientific and Clinical Center of Otorhinolaryngology of the Federal Medical and Biological Agency of the Russian Federation, Moscow, Russia, 123182
| | - V M Svistushkin
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia, 119991
| | - G N Nikiforova
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia, 119991
| | - A S Dukhanin
- Pirogov Russian National Research Medical University, Moscow, Russia, 117997
| |
Collapse
|
25
|
Trinh HKT, Nguyen TVT, Kim SH, Cao TBT, Luu QQ, Kim SH, Park HS. Osteopontin contributes to late-onset asthma phenotypes in adult asthma patients. Exp Mol Med 2020; 52:253-265. [PMID: 32009132 PMCID: PMC7062758 DOI: 10.1038/s12276-020-0376-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/25/2019] [Accepted: 12/09/2019] [Indexed: 01/07/2023] Open
Abstract
Patients with late-onset asthma (LOA) have poor clinical outcomes. Osteopontin (OPN) is associated with airway inflammation and remodeling. To investigate the role of OPN in LOA compared to early-onset asthma (EOA), serum OPN levels were compared between 131 adult asthma patients (48 LOA and 83 EOA patients) and 226 healthy controls (HCs). BALB/c mice were sensitized with ovalbumin with/without polyinosinic-polycytidylic acid (poly(I:C)) from week 6 (A6 mice) or week 12 (A12 mice) after birth. Airway hyperresponsiveness (AHR), bronchoalveolar lavage fluid (BALF), cell counts, histology, and Spp1 expression were assessed. The levels of OPN, transforming growth factor β1 (TGF-β1), chitinase 3-like 1 (CH3L1), and interleukin (IL) 5 were measured by ELISA. The expression of Smad3 phosphorylation and tissue transglutaminase 2 (TGM2) was evaluated by Western blot. The serum OPN levels were significantly higher in asthma patients than in HCs and in LOA patients than in those with EOA (P < 0.05) and were positively correlated with serum TGF-β1 and CH3L1 (r = 0.174, r = 0.264; P < 0.05). A12 mice showed elevated AHR with increased levels of OPN/TGF-β1/IL-5 in BALF and Spp1 compared to A6 mice. Poly(I:C) induced remarkable TGF-β1, CH3L1, Th2 cytokine, and OPN levels in BALF and the expression of phosphorylated Smad3, TGM2, and Spp1 in the lungs. OPN triggered TGF-β1/Smad3 signaling in the lungs, which was suppressed by dexamethasone and anti-IL5 antibody. In conclusion, aging and exposure to viral infections may induce OPN release and consequently modulate inflammation and TGF-β1/Smad3-related remodeling, contributing to the development of LOA. Aging and viral infections in older individuals may combine to spur the release of an inflammatory protein implicated in late-onset asthma. A team led by Hae-Sim Park from Ajou University School of Medicine, Suwon, South Korea, showed that people who develop asthma after age 40 have higher blood levels of osteopontin, a multifunctional protein with roles in airway inflammation and tissue remodeling, than people who develop asthma at a younger age or healthy individuals. The researchers developed two ovalbumin-induced asthma models in younger and older mice, and found that older mice developed more severe airway hyperresponsiveness with higher levels of osteopontin, among other inflammatory markers, which were emnhanced by viral infection. Drug therapies that target osteopontin signaling could help combat the late-onset asthma.
Collapse
Affiliation(s)
- Hoang Kim Tu Trinh
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, South Korea.,Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thuy Van Thao Nguyen
- Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Seo-Hee Kim
- Department of Biomedical Science, Graduate School of Ajou University, Suwon, South Korea
| | - Thi Bich Tra Cao
- Department of Biomedical Science, Graduate School of Ajou University, Suwon, South Korea
| | - Quoc Quang Luu
- Department of Biomedical Science, Graduate School of Ajou University, Suwon, South Korea
| | - Seung-Hyun Kim
- Translational Research Laboratory for Inflammatory Disease, Clinical Trial Center, Ajou University Medical Center, Suwon, South Korea
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, South Korea. .,Department of Biomedical Science, Graduate School of Ajou University, Suwon, South Korea.
| |
Collapse
|
26
|
Kang SY, Jung JH, Lee SM, Lee SP. Intralymphatic allergen-specific immunotherapy. ALLERGY ASTHMA & RESPIRATORY DISEASE 2020. [DOI: 10.4168/aard.2020.8.2.53] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sung-Yoon Kang
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Joo Hyun Jung
- Department of Otolaryngology-Head and Neck Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Sang Min Lee
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Sang Pyo Lee
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| |
Collapse
|
27
|
Wang M, Wang S, Wang X, Tian Y, Wu Y, Cao Y, Song J, Wu T, Hu Y. The association between PM 2.5 exposure and daily outpatient visits for allergic rhinitis: evidence from a seriously air-polluted environment. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:139-144. [PMID: 31754771 DOI: 10.1007/s00484-019-01804-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/06/2019] [Accepted: 09/13/2019] [Indexed: 05/22/2023]
Abstract
Limited evidence was seen as the association between fine particulate matter (PM2.5) and physician visits for allergic rhinitis (AR), especially in countries with extreme air pollution exposure. This paper addressed the issues about the association between PM2.5 and daily outpatient visits for AR among individuals residing in Beijing, China. Data on daily outpatient visits for AR obtained from Beijing Medical Claim Data for Employees and daily PM2.5 concentrations available from US embassy reports were linked by date from January 1, 2010, to June 30, 2012. A time-series analysis was conducted with a generalized additive Poisson model to assess the association between PM2.5 and AR, adjusting for daily average temperature, relative humidity, day of the week, calendar time, and public holiday. Totally, 229,685 outpatient visits for AR were included in the analysis. The daily mean (SD) concentration of PM2.5 was 99.5 (75.3) μg/m3 during the study period. We found that a 10-μg/m3 increase in PM2.5 content was associated with a 0.47% (95% CI: 0.39% to 0.55%) increase in the number of outpatient visits on the same day. Furthermore, results from subgroup analyses suggested that the association was consistently significant among the groups of different ages (< 65 years and ≥ 65 years) and gender. However, this study failed to find a statistically significant association in the autumn season but found significant positive associations during the spring and summer seasons (P for interaction < 0.001). This study indicated a possible association between PM2.5 and AR outpatients, which may benefit further researches in studying PM2.5 and its influence on diseases in a real and seriously air-polluted context.
Collapse
Affiliation(s)
- Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| |
Collapse
|
28
|
Syrigou E, Psarros F, Makris M, Grapsa D, Syrigos K. Efficacy of a Quail Eggs-Based Dietary Supplement for Allergic Rhinitis: Results of a Single-Arm Trial. J Diet Suppl 2019; 18:17-30. [PMID: 31762363 DOI: 10.1080/19390211.2019.1694121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Previous data suggested the potential treatment effect of a proprietary quail eggs-based blend on allergic rhinitis (AR) symptoms, induced by allergen challenge. We herein aimed to investigate the efficacy and safety of a similar dietary supplement, comprising the bioactive ingredients of quail eggs and the zinc mineral, in the setting of active AR. Adult patients (n = 77), aged 18- 60 years, with mild, intermittent AR were enrolled in this single-arm, open-label trial. Patients' responses were assessed based on peak nasal inspiratory flow (PNIF) measurements at two visits (Day 1/Visit 1 and Day 7/Visit 2) and self-rating of AR-associated symptoms on a Visual Analog Scale (VAS) throughout the entire 7-day study period. PNIF values at 15, 30, 60, 90 and 120 min (Visit 1) following administration of an oral dose of the study product were the primary efficacy endpoint. PNIF values (Visit 1) gradually increased from baseline (pre-treatment), with statistical significance first reached 30 min later (p = 0.002). VAS scores (Visit 1) for all AR symptoms gradually decreased with statistical significance first reached at 15 min (rhinorrhea, p = 0.042; itchy nose, p = 0.001; sneezing p < 0.001), 30 min (nasal congestion, p < 0.001; itchy eyes, p = 0.003) or 60 min (watery eyes, p = 0.04). PNIF improvement and decline of VAS scores were significantly more apparent at Visit one vs. Visit 2. Treatment-emergent adverse events were limited to cough and muscle strain (one patient each). Our results support the efficacy, rapid mode of action and tolerability of the investigated product for symptomatic treatment of mild intermittent AR.
Collapse
Affiliation(s)
- Ekaterini Syrigou
- Allergy Department, "Sotiria" Athens General Hospital, Athens, Greece
| | - Fotis Psarros
- Allergy Department, Naval Hospital of Athens, Athens, Greece
| | - Michael Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
| | - Dimitra Grapsa
- 3rd Department of Medicine, Medical School, National and Kapodistrian University of Athens, "Sotiria" Athens General Hospital, Athens, Greece
| | - Konstantinos Syrigos
- 3rd Department of Medicine, Medical School, National and Kapodistrian University of Athens, "Sotiria" Athens General Hospital, Athens, Greece
| |
Collapse
|
29
|
Han D, Lee HY, Kim K, Kim T, Oh YM, Rhee CK. Burden and clinical characteristics of high grade tuberculosis destroyed lung: a nationwide study. J Thorac Dis 2019; 11:4224-4233. [PMID: 31737307 DOI: 10.21037/jtd.2019.09.63] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background Little clinical information on high grade tuberculosis destroyed lung (TDL) is available. The aim of this study was to investigate the characteristics and healthcare utilization of high grade TDL patients, and compared the differences between acute exacerbation and healthcare burden according to inhaler compliance. Methods This was an observational retrospective cohort study using the Korean Health Insurance Review and Assessment (HIRA) service database (2011-2015). Patients diagnosed with high grade TDL in 2011 were enrolled and reviewed for 5 years. The patients were further divided into adherent and non-adherent groups. Their socioeconomic outcomes according to treatment adherence in 2012 were analyzed. Results Among the 13,346 patients diagnosed with high grade TDL, 3,637 were assigned to the adherent group and 9,709 to the non-adherent group. Overall, 65.91% of the enrolled patients were male and the mean age of the study population was 64.68±10.06 years. All patients visited a tertiary hospital, but 99.04% and 69.74% also visited primary and secondary hospitals, respectively. The mean number of hospital admissions per year was 1.38±2.03 times per patient. The average total annual per-patient cost was US$4,140.95±3,715.01 and each patient spent a total of 56.21±45.28 days per year using hospital services. The majority of the patients in the adherent group were male (80.09% vs. 60.60%, P<0.01), and were of older age (65.71±9.35 vs. 64.29±10.28, P<0.01) than the non-adherent group. The frequencies of visiting a tertiary hospital (96.87 vs. 90.12%, P<0.01), the total mean healthcare utilization costs (US$4,151.77±4,084.76 vs. US$3,592.54±4,229.93, P<0.01), and the frequencies of exacerbations (0.72±2.03 vs. 0.46±1.51, P<0.01) were higher in the adherent group. However, healthcare services were used on significantly fewer days in the adherent group (52.96±50.87 vs. 56.67±50.81, P<0.01). Conclusions High grade TDL imposes a high socioeconomic burden in Korea. Estimated medical costs and exacerbation event rate were higher in the adherent group whereas number of days of healthcare usage was significantly lower.
Collapse
Affiliation(s)
- Deokjae Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hwa Young Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyeongju Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Taehoon Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
30
|
Lee HY, Han DJ, Kim KJ, Kim TH, Oh YM, Rhee CK. Clinical characteristics and economic burden of tuberculous-destroyed lung in Korea: a National Health Insurance Service-National Sample Cohort-based study. J Thorac Dis 2019; 11:2324-2331. [PMID: 31372269 DOI: 10.21037/jtd.2019.06.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background Tuberculous destroyed lung (TDL) contributes to patient mortality via acute exacerbation and combined medical comorbidities. This study characterized the clinical characteristics and economic burden of patients with TDL using large scale database, Health Insurance Review and Assessment Service (HIRA) data. Methods We searched the HIRA national database to identify patients diagnosed with TDL from January 01, 2011 to December 31, 2015. The clinical characteristics of the patients were collected and the 5-year claims data were analyzed. Results In total, 645,031 patients (55% male, mean age, 59.6 years) were enrolled over the 5 years. During the study period, 98.5% of the patients visited a primary care clinic and 71.1% and 93.2% visited secondary and tertiary hospitals, respectively. Patients spent a median of 5 days for inpatient services, and were admitted to the hospital a median of 0.62±1.2 times per person annually. Annual total cost per person was $1,838 and half of the total cost was expended for inpatient services. About 68.9% of the patients were prescribed respiratory medications, and $12 million was paid. Oral bronchodilators (46.5%) and methylxanthine (35.2%) were used more frequently than inhaled corticosteroids (ICSs)/long-acting β2 agonist (LABA) combination agents (11.6%) or inhaled long-acting muscarinic antagonists (LAMAs) (7.5%). Conclusions TDL imposes a high medical economic burden in Korea. The estimated economic costs were mainly made up of inpatient services and outpatient medication prescriptions. Interventions to prevent acute disease exacerbations and progression of comorbid conditions should be accompanied to alleviate the clinical and economic burden of TDL.
Collapse
Affiliation(s)
- Hwa Young Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, The Catholic University of Korea, Seoul, Korea
| | - Deok Jae Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Joo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae Hoon Kim
- Department of Internal medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
31
|
The Economic Burden of Chronic Obstructive Pulmonary Disease in the Asia-Pacific Region: A Systematic Review. Value Health Reg Issues 2019; 18:121-131. [DOI: 10.1016/j.vhri.2019.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/26/2018] [Accepted: 02/28/2019] [Indexed: 11/20/2022]
|
32
|
Park HS, Yoon D, Lee HY, Ban GY, Wan Yau Ming S, Jie JLZ, Carter V, Hardjojo A, Van Boven JFM, Price DB. Real-life effectiveness of inhaler device switch from dry powder inhalers to pressurized metred-dose inhalers in patients with asthma treated with ICS/LABA. Respirology 2019; 24:972-979. [PMID: 31038269 DOI: 10.1111/resp.13559] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 01/10/2019] [Accepted: 03/04/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Mixed inhaler device use for asthma is associated with worse inhaler technique and outcomes. Given that relievers are commonly prescribed as pressurized metred-dose inhalers (pMDI), changing preventers from dry powder inhalers (DPI) to pMDI may improve asthma outcomes. This study aimed to assess the persistence and effectiveness of switching from DPI to pMDI for inhaled corticosteroid and long-acting β2 -agonist combination therapy (ICS/LABA). METHODS This was a historical cohort study using Ajou University Hospital (Korea) patient records. Persistence of switch was defined as receiving ≥1 pMDI and no DPI after the switch. Effectiveness of switch was assessed as the proportion without severe asthma exacerbation and the proportion achieving risk domain asthma control (RDAC; no asthma-related hospitalization, antibiotics without upper respiratory diagnosis or acute course of oral corticosteroids) and overall asthma control (OAC; RDAC and ≤ 200 μg salbutamol/≤500 μg terbutaline average daily dose) comparing 1 year after and before the switch. RESULTS Within 85 patients who switched from DPI to pMDI and persisted for a year, higher proportion were free from asthma exacerbation after the switch (mean difference in proportion = 0.129, 95% CI: 0.038-0.220). Switching to pMDI was also associated with better RDAC (75.3% vs 57.7%, P = 0.001) and OAC (57.7% vs 45.9%, P = 0.021). From the entire 117 patients who switched to fixed-dose combination (FDC)/ICS LABA pMDI, 76.1% (95% CI: 69.0-100.0%) patients persisted in the following 6 months. CONCLUSION Switching to and persisting with pMDI was associated with decreased asthma exacerbations and improved asthma control. The majority of patients persisted with the switch to pMDI for ICS/LABA treatment.
Collapse
Affiliation(s)
- Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University Medical Center, Suwon, Korea
| | - Dukyong Yoon
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Young Lee
- Department of Biostatistics, Ajou University Medical Center, Suwon, Korea
| | - Ga-Young Ban
- Department of Pulmonary, Allergy and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | | | | | | | | | - Job F M Van Boven
- Department of Clinical Pharmacy and Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - David B Price
- Observational and Pragmatic Research Institute, Singapore.,Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
33
|
Denneny JC, Cyr DD, Witsell DL, Brereton J, Schulz K. A pathway to value-based care of chronic rhinosinusitis using a claims database. Laryngoscope Investig Otolaryngol 2019; 4:193-206. [PMID: 30828639 PMCID: PMC6383304 DOI: 10.1002/lio2.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/10/2018] [Accepted: 11/12/2018] [Indexed: 11/29/2022] Open
Abstract
Objective To construct a comprehensive picture of the typical chronic rhinosinusitis (CRS) patient in the United States including the demographics, comorbidities, and geographic prevalence. The study will also identify the diagnostic and treatment regimens, their cost, and pattern of use for both medically and surgically managed patients. Study Design Historical cohort study utilizing private and public payer databases. Methods Medical claims data from the Truven Health MarketScan Research Databases from the years 2010 to 2012 for patients with acute rhinosinusitis (ARS) and CRS 18 and older were analyzed. Results There were 54 million unique patients in the databases from 2010 to 2012. Approximately 8 million had at least one diagnosis of ARS and 298,337 had a diagnosis of CRS. Females represented 63.7% of patients with ARS and 59.4% with CRS. Medicare patients represented 6.7% of the ARS population and 10.2% of the CRS population. The mean cost of a CRS episode for those commercially insured was $1024 and $762 in Medicare. CRS patients underwent diagnostic procedures including diagnostic endoscopy (55.1%), cultures (23.6%), sinus CT scan (82.1%) and MRI (0.2%). Endoscopic sinus surgery (ESS) was performed on 14.4% of those patients with CRS. Change in frequency of medication use from the 6 months prior to ESS to the 6 months post‐ESS yielded a reduction in total costs of 34.2% or $3.9 M. The most commonly operated sinuses (with or without septoplasty on same day as ESS) were the maxillary (94%/76.1%); followed by ethmoid (82.1%/66.6%); frontal (38.8%/35.1%); and sphenoid (28.5%/28.1%). In total, 16.6% had one sinus operated on, 39.1% had two, 24.6% had three, and 18.7% had four sinuses operated on. Conclusions This data paints a much clearer understanding of the current medical and surgical management. This study confirms the previously described “value proposition” for the surgical management of those CRS patients refractory to medical management. Level of Evidence 4
Collapse
Affiliation(s)
- James C Denneny
- Department of Otolaryngology-Head and Neck Surgery Johns Hopkins School of Medicine Baltimore Maryland
| | - Derek D Cyr
- Duke Clinical Research Institute Durham, North Carolina
| | - David L Witsell
- Duke University Medical Center Division of Head & Neck Surgery and Communications Sciences Durham, North Carolina
| | - Jean Brereton
- American Academy of Otolaryngology-Head and Neck Surgery Alexandria, Virginia
| | - Kristine Schulz
- Duke University Medical Center Division of Head & Neck Surgery and Communications Sciences Durham, North Carolina
| |
Collapse
|
34
|
Seo MY, Kim KR, Lee JJ, Ryu G, Lee SH, Hong SD, Dhong HJ, Baek CH, Chung SK, Kim HY. Therapeutic effect of topical administration of red onion extract in a murine model of allergic rhinitis. Sci Rep 2019; 9:2883. [PMID: 30814581 PMCID: PMC6393461 DOI: 10.1038/s41598-019-39379-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 01/23/2019] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to evaluate the effect of topical administration of onion (Allium cepa) extract on nasal cavity for treatment of allergic rhinitis (AR). BALB/c mice were sensitized by intraperitoneal injection of ovalbumin (OVA) and challenged with intranasal instillation of OVA with or without onion extracts for five times a week on 3 consecutive weeks. Allergic symptom score according to frequencies of sneezing, serum total and OVA specific immunoglobulin E (IgE) level, cytokine levels of nasal mucosa and eosinophilic infiltration were analyzed. Allergic symptom score, serum total and OVA specific IgE, cytokine levels of nasal mucosa (interleukin (IL)-4, IL-5, IL-10, IL-13, IFN-γ, TNF-α and COX-2) and eosinophilic infiltration were higher in allergic mouse group than negative control group. Topical application of onion extracts significantly reduced allergic symptoms and OVA specific IgE levels. Cytokine levels of IL-4, IL-5, IL-10, IL-13 and IFN-γ were significantly decreased in groups treated with onion extract. In addition, eosinophil infiltration of nasal turbinate mucosa was also significantly decreased after treatment with onion extract. Topical administration of onion extract significantly reduces allergic rhinitis symptom and allergic inflammatory reaction in a murine allergic model. It can be assumed that the topical application of onion extract regulates allergic symptoms by suppressing the type-1 helper (Th1) and type-2 helper (Th2) responses and reducing the allergic inflammatory reaction.
Collapse
Affiliation(s)
- Min Young Seo
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Ki Ryung Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Joo Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gwanghui Ryu
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Hoon Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Sang Duk Hong
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hun-Jong Dhong
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chung-Hwan Baek
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung-Kyu Chung
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyo Yeol Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| |
Collapse
|
35
|
Rai KK, Adab P, Ayres JG, Jordan RE. Systematic review: chronic obstructive pulmonary disease and work-related outcomes. Occup Med (Lond) 2019. [PMID: 29528460 DOI: 10.1093/occmed/kqy012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Several studies have assessed the impact of chronic obstructive pulmonary disease (COPD) on work ability and work productivity; however, this relationship is poorly understood. Aims To undertake a systematic review to assess the effects of COPD on employment, absenteeism and presenteeism. Methods A comprehensive search using CINAHL, Embase, MEDLINE and the Cochrane Library was conducted to include epidemiological studies from 1937 to August 2017. One reviewer screened all citations. Shortlisted full-text articles were independently assessed by a second reviewer. Data were extracted by one reviewer with a random sample of papers (45%) checked by a second reviewer. Results Forty-four studies were included; the majority of evidence was from cross-sectional studies, and some cohort studies. COPD patients had lower employment rates than those without COPD. Among those in work, most studies showed patients with COPD took more time off work than those without and reported poorer work performance (presenteeism), although evidence for this association was weaker. The influence of disease severity on these outcomes was unclear; however, it appeared that increasing severity of airflow obstruction was associated with reduced likelihood of being employed. A number of methodological limitations were found among the evidence, including the lack of adjustment for important confounders. Conclusions Future studies are required which assess the impact of COPD on presenteeism using validated presenteeism instruments and consistent reporting methods. Robust studies are now needed to identify modifiable factors associated with these poorer working outcomes to inform future interventions aimed at improving work productivity among those with COPD.
Collapse
Affiliation(s)
- K K Rai
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - P Adab
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - J G Ayres
- Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - R E Jordan
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
| |
Collapse
|
36
|
Kim MH, Kim SH, Park SY, Ban GY, Kim JH, Jung JW, Moon JY, Song WJ, Kwon HS, Kwon JW, Lee JH, Kang HR, Park JS, Kim TB, Park HW, Yoo KH, Oh YM, Koh YI, Jang AS, Lee BJ, Cho YJ, Cho SH, Park HS, Park CS, Yoon HJ, Cho YS. Characteristics of Adult Severe Refractory Asthma in Korea Analyzed From the Severe Asthma Registry. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2019; 11:43-54. [PMID: 30479076 PMCID: PMC6267188 DOI: 10.4168/aair.2019.11.1.43] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/24/2018] [Accepted: 08/28/2018] [Indexed: 12/18/2022]
Abstract
Purpose Although mild to moderate asthma is much more common, the morbidity and mortality of severe asthma are much higher. This study was performed to identify and analyze the clinical characteristics of severe asthma in Korea. Methods We registered patients with severe refractory asthma into the Severe Asthma Registry supported by the Severe Asthma Work Group of the Korean Academy of Asthma, Allergy and Clinical Immunology. Patients were enrolled since 2010 from the 15 university hospitals nationwide in Korea. Severe asthma was defined according to modified European Respiratory Society/American Thoracic Society criteria. Information on demographics, medical history, pulmonary function tests and skin prick tests was collected; the clinical characteristics of severe asthmatics were analyzed from the collected data. Results A total of 489 patients were enrolled with a mean age of 62.3; 45% are male. Sixty percent of patients received Global Initiative for Asthma step 4 treatment, and 30% received step 5 treatment. The most common comorbidities were allergic rhinitis (58.7%). Aspirin hypersensitivity was observed in 14.0%. Approximately half (53.9%) are non-smokers. Atopy was proven in 38.5% of the patients. Regarding asthma medications, inhaled corticosteroids and long-acting β-agonist combination inhalers were most commonly prescribed (96.5%), followed by leukotriene antagonists (71.0%). A recombinant anti-immunoglobulin E monoclonal antibody (omalizumab) has been used in 1.8% of the patients. The mean forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC were 78.7%, 67.5% and 67.9% of predicted values, respectively. The mean Asthma Control Test and quality of life questionnaire scores were 16.5 out of 25 and 59.5 out of 85, respectively. Conclusions The baseline characteristics of severe asthma patients in the Korea Severe Asthma Registry were analyzed and reported for the first time. With this cohort, further prospective studies should be performed to search for ways to improve management of severe refractory asthma.
Collapse
Affiliation(s)
- Min Hye Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Sang Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - So Young Park
- Department of Allergy and Respiratory Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Ga Young Ban
- Department of Pulmonary, Allergy and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Joo Hee Kim
- Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Jae Woo Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ji Yong Moon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Woo Jung Song
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyouk Soo Kwon
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Woo Kwon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae Hyun Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Ryun Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Sook Park
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Tae Bum Kim
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heung Woo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang Ha Yoo
- Department of Allergy and Respiratory Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Yeon Mok Oh
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Il Koh
- Department of Internal Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - An Soo Jang
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Byung Jae Lee
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Joo Cho
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Sang Heon Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hae Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Choon Sik Park
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
| | - You Sook Cho
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| |
Collapse
|
37
|
Lee Y, Lee JH, Yang EM, Kwon E, Jung CG, Kim SC, Choi Y, Cho YS, Kim CK, Park HS. Serum Levels of Eosinophil-Derived Neurotoxin: A Biomarker for Asthma Severity in Adult Asthmatics. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2019; 11:394-405. [PMID: 30912328 PMCID: PMC6439192 DOI: 10.4168/aair.2019.11.3.394] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 12/29/2022]
Abstract
Purpose Eosinophilic inflammation is a key component of severe asthma (SA). However, there has been no reliable serum biomarker for the eosinophilic inflammation of SA. We hypothesized that serum eosinophil-derived neurotoxin (EDN) could predict the eosinophilic inflammation of SA in adult asthmatics. Methods Severe asthmatics (n = 235), nonsevere asthmatics (n = 898), and healthy controls (n = 125) were enrolled from Ajou University Hospital, South Korea. The serum levels of EDN and periostin were measured by enzyme-linked immunosorbent assay and compared between severe and nonsevere asthmatics. Their associations with total eosinophil count (TEC) and clinical parameters were evaluated; clinical validation of the K-EDN kit for the measurement of serum EDN was evaluated. Results Severe asthmatics were older and had longer disease duration with significantly lower levels of forced expiratory volume in 1 second and methacholine PC20 than nonsevere asthmatics. Significant differences were found in TEC or sputum eosinophil count (%) between the groups. The serum levels of EDN and periostin were significantly higher in severe asthmatics than in nonsevere asthmatics and in healthy controls (all P < 0.05). Although significant correlations were found between serum EDN levels measured by the 2 kits (ρ = 0.545, P < 0.0001), higher correlation coefficients between serum EDN levels measured by the K-EDN kit and TEC were higher (ρ = 0.358, P < 0.0001) than those between serum EDN levels measured by the MBL kit and TEC (ρ = 0.319, P < 0.0001) or serum periostin level (ρ = 0.222, P < 0.0001). Multivariate regression analysis demonstrated that serum EDN levels measured by the K-EDN kit predicted the phenotype of SA (P = 0.003), while 2 other biomarkers did not. Conclusions The serum EDN level may be a useful biomarker for assessing asthma severity in adult asthmatics.
Collapse
Affiliation(s)
- Youngsoo Lee
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Ji Ho Lee
- Department of Pulmonology and Allergy, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Eun Mi Yang
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - EunMi Kwon
- Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Chang Gyu Jung
- Department of Allergy, Keimyung University School of Medicine, Daegu, Korea
| | - Su Chin Kim
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Youngwoo Choi
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - You Sook Cho
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Keun Kim
- Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Hae Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
| |
Collapse
|
38
|
Kim MH, Rhee CK, Shim JS, Park SY, Yoo KH, Kim BY, Bae HW, Sim YS, Chang JH, Cho YJ, Lee JH. Inhaled Corticosteroids in Asthma and the Risk of Pneumonia. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2019; 11:795-805. [PMID: 31552715 PMCID: PMC6761075 DOI: 10.4168/aair.2019.11.6.795] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 12/29/2022]
Abstract
Purpose Asthma is a common disease that is expensive and burdensome for patients. Inhaled corticosteroids (ICS) are the most important drugs for asthma treatment and are often prescribed long-term. However, the use of ICS has been reported to increase pneumonia, though this remains controversial. We evaluated whether the use of ICS increases the risk of pneumonia in asthmatic patients using the Health Insurance Review and Assessment Service (HIRA) database in Korea. Methods The Asthma Management Adequacy Assessment was performed by the HIRA in Korea. Patients with claimed insurance benefits for asthma disease codes and who were prescribed asthma medications more than 2 times were enrolled. Patient demographics, asthma medications, healthcare use, and complications were analyzed. Results The total number of asthma patients was 831,613. Patients using ICS were older and had more comorbidities than those not using ICS; they also visited outpatient clinics and emergency departments, and were more often hospitalized. Pneumonia and other complications occurred more often in patients using ICS, and they used more respiratory medications, except for theophylline. Multiple logistic regression analysis showed that ICS prescription was associated with pneumonia (odds ratio, 1.38; 95% confidence interval, 1.36-1.41). Age, sex, medical care, use of secondary and tertiary hospitals, and hospitalization due to asthma in the previous year were also associated with pneumonia. Conclusions ICS use was associated with increasing pneumonia in asthmatic patients in Korea. Therefore, it is critical to acknowledge that the use of ICS may increase the risk of pneumonia and should be meticulously monitored in asthmatics.
Collapse
Affiliation(s)
- Min Hye Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Su Shim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - So Young Park
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Kwang Ha Yoo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Bo Yeon Kim
- Health Insurance Review and Assessment Service, Wonju, Korea
| | - Hye Won Bae
- Health Insurance Review and Assessment Service, Wonju, Korea
| | - Yun Su Sim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Jung Hyun Chang
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Young Joo Cho
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Jin Hwa Lee
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
| |
Collapse
|
39
|
Choi JP, Jeon SG, Kim YK, Cho YS. Role of house dust mite-derived extracellular vesicles in a murine model of airway inflammation. Clin Exp Allergy 2018; 49:227-238. [PMID: 30312497 DOI: 10.1111/cea.13295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 09/30/2018] [Accepted: 10/03/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND House dust mite (HDM) is the major source of indoor allergens that cause airway disease. Recent evidence suggests that Gram-negative/positive bacteria produce nano-sized extracellular vesicles (EVs) containing diverse components, including various immunostimulatory molecules. However, the association between bacteria-derived EVs and development of airway disease is unclear. OBJECTIVE To identify and isolate HDM-derived EVs and to evaluate their effect on the development of airway inflammation. METHODS Extracellular vesicles were isolated from crude HDM extracts by ultra-centrifugation, and their physical and immunological characteristics and roles in airway inflammation were tested in vitro and in murine models of airway inflammation. In addition, 16s metagenome analysis of nucleic acid from EVs was performed to identify their origin. RESULTS Round, bilayered vesicles measuring 80-100 nanometres and containing abundant amounts of LPS were isolated. These vesicles induced innate immune responses both in vitro and in vivo. Intranasal exposure of naïve mice to HDM EVs induced production of cytokines associated with development of Th2-mediated and mixed (Th1-/Th2-/Th17-mediated) airway inflammation to allergen. Metagenome analysis identified Bacteroidetes and Proteobacteria as the probable sources of HDM EVs. CONCLUSION House dust mite EVs originating from Gram-negative bacteria may play an important role on the development of airway inflammation.
Collapse
Affiliation(s)
- Jun-Pyo Choi
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | | | | - You Sook Cho
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
40
|
Liu Y, Zheng J, Zhang HP, Zhang X, Wang L, Wood L, Wang G. Obesity-Associated Metabolic Signatures Correlate to Clinical and Inflammatory Profiles of Asthma: A Pilot Study. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:628-647. [PMID: 30306746 PMCID: PMC6182193 DOI: 10.4168/aair.2018.10.6.628] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/27/2018] [Accepted: 06/01/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE Obesity is associated with metabolic dysregulation, but the underlying metabolic signatures involving clinical and inflammatory profiles of obese asthma are largely unexplored. We aimed at identifying the metabolic signatures of obese asthma. METHODS Eligible subjects with obese (n = 11) and lean (n = 22) asthma underwent body composition and clinical assessment, sputum induction, and blood sampling. Sputum supernatant was assessed for interleukin (IL)-1β, -4, -5, -6, -13, and tumor necrosis factor (TNF)-α, and serum was detected for leptin, adiponectin and C-reactive protein. Untargeted gas chromatography time-of-flight mass spectrometry (GC-TOF-MS)-based metabolic profiles in sputum, serum and peripheral blood monocular cells (PBMCs) were analyzed by orthogonal projections to latent structures-discriminate analysis (OPLS-DA) and pathway topology enrichment analysis. The differential metabolites were further validated by correlation analysis with body composition, and clinical and inflammatory profiles. RESULTS Body composition, asthma control, and the levels of IL-1β, -4, -13, leptin and adiponectin in obese asthmatics were significantly different from those in lean asthmatics. OPLS-DA analysis revealed 28 differential metabolites that distinguished obese from lean asthmatic subjects. The validation analysis identified 18 potential metabolic signatures (11 in sputum, 4 in serum and 2 in PBMCs) of obese asthmatics. Pathway topology enrichment analysis revealed that cyanoamino acid metabolism, caffeine metabolism, alanine, aspartate and glutamate metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, pentose phosphate pathway in sputum, and glyoxylate and dicarboxylate metabolism, glycerolipid metabolism and pentose phosphate pathway in serum are suggested to be significant pathways related to obese asthma. CONCLUSIONS GC-TOF-MS-based metabolomics indicates obese asthma is characterized by a metabolic profile different from lean asthma. The potential metabolic signatures indicated novel immune-metabolic mechanisms in obese asthma with providing more phenotypic and therapeutic implications, which needs further replication and validation.
Collapse
Affiliation(s)
- Ying Liu
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Zheng
- Department of Integrated Traditional Chinese and Western Medicine, Xinqiao Hospital, Third Military University, Chongqing, China
| | - Hong Ping Zhang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Zhang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Wang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lisa Wood
- Center for Asthma and Respiratory Diseases, Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW, Australia
| | - Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
41
|
Lee M, Kim Y, Lee JA. Okbyungpoongsan (Yupingfeng) for treating allergic rhinitis: A protocol for the systematic review of controlled trials. Medicine (Baltimore) 2018; 97:e13227. [PMID: 30407365 PMCID: PMC6250543 DOI: 10.1097/md.0000000000013227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/22/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Okbyungpoongsan (OBPS) is widely used as a treatment for allergic rhinitis (AR) in Far East countries. Many clinical trials have assessed the efficacy and safety of the OBPS formula for treating AR. Here, we systematically will review the clinical evidence for and against administration of OBPS. METHODS AND ANALYSIS All RCTs of decoctions or modified decoctions will be included. The methodological quality of the RCTs will be analyzed using the Cochrane Collaboration tool for assessing risk of bias, while confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. ETHICS AND DISSEMINATION This systematic review will be published in a peer-reviewed journal and will also be disseminated electronically and in print. The review will be updated to provide additional information and guide healthcare practices.Registration number: CRD42017080292.
Collapse
|
42
|
Shin JY, Sohn KH, Shin JE, Park M, Lim J, Lee JY, Yang MS. Changing patterns of adult asthma incidence: results from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database in Korea. Sci Rep 2018; 8:15052. [PMID: 30302007 PMCID: PMC6177405 DOI: 10.1038/s41598-018-33316-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 09/24/2018] [Indexed: 11/09/2022] Open
Abstract
This study was conducted to assess the changes in the annual incidence of adult asthma in Korea where the prevalence of asthma had increased steadily in recent decades. A population-based cohort study was conducted using the National Health Insurance Service–National Sample Cohort (NHIS-NSC), which consisted of 746,816 adults aged >20 years between 2004 and 2012. Asthma was defined by two or more physician claims on the basis of a primary diagnostic code for asthma and administration of asthma medications within 1 year. The incidence rates and annual percent change were calculated, and the influence of age and sex on the incidence rates was studied. The annual asthma incidence increased from 3.63 in 2004 to 6.07 per 1,000 person-years in 2008. Since 2008, the asthma incidence did not change significantly. The asthma incidence was higher in women than in men throughout the study periods (p < 0.001) and higher in older than younger age groups (p < 0.001). The asthma incidence did not change in all ages since 2008, except for the 20 s who showed a steady increase. The incidence of asthma in adults reached plateau in Korea, which is consistent with the results from studies in other countries.
Collapse
Affiliation(s)
- Ji-Yeon Shin
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kyoung-Hee Sohn
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Eun Shin
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Korea
| | - Mira Park
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Korea
| | - Jiseun Lim
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Korea
| | - Jin Yong Lee
- Public Health Medical Service, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
| | - Min-Suk Yang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. .,Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
| |
Collapse
|
43
|
Kim C, Kim Y, Yang DW, Rhee CK, Kim SK, Hwang YI, Park YB, Lee YM, Jin S, Park J, Hahm CR, Park CH, Park SY, Jung CK, Kim YI, Lee SH, Yoon HK, Lee JH, Lim SY, Yoo KH. Direct and Indirect Costs of Chronic Obstructive Pulmonary Disease in Korea. Tuberc Respir Dis (Seoul) 2018; 82:27-34. [PMID: 30302958 PMCID: PMC6304326 DOI: 10.4046/trd.2018.0035] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/25/2018] [Accepted: 06/27/2018] [Indexed: 11/24/2022] Open
Abstract
Background Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.
Collapse
Affiliation(s)
- Changhwan Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Younhee Kim
- Institute of Health and Environment, School of Public Health, Seoul National University, Seoul, Korea
| | - Dong Wook Yang
- Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Chin Kook Rhee
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Kyoung Kim
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Yong Il Hwang
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yong Bum Park
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | | | | | - Jinkyeong Park
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Cho Rom Hahm
- Department of Internal Medicine, Gwangmyeong Sungae Hospital, Seoul, Korea
| | - Chang Han Park
- Department of Internal Medicine, Sungae Hospital, Seoul, Korea
| | | | | | - Yu Il Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Sang Haak Lee
- Department of Internal Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyoung Kyu Yoon
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Hwa Lee
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Seong Yong Lim
- Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang Ha Yoo
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
| |
Collapse
|
44
|
Navarro-Locsin CG, Lim-Jurado M. Aeroallergen sensitization and associated comorbid diseases of an adult Filipino population with allergic rhinitis. Asia Pac Allergy 2018; 8:e25. [PMID: 30079303 PMCID: PMC6073179 DOI: 10.5415/apallergy.2018.8.e25] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 07/12/2018] [Indexed: 01/24/2023] Open
Abstract
Background There is a large global variation in sensitization patterns to aeroallergens due to differences in climate, urbanization, and lifestyle. Knowledge of the most common inhalant allergens is important for appropriate prevention and management of allergic rhinitis (AR). Objective This study aims to provide data on aeroallergen sensitization patterns and associated comorbid diseases of adult Filipinos with AR. Methods Medical records of adult Filipinos seen in an Otolaryngology-Allergy Clinic from January 2011 to 2016 were reviewed. Inclusion criteria used was presence of clinically defined AR and positive skin test to at least one aeroallergen in the test panel. Demographics, comorbid conditions, and results of skin prick test were determined. Standard descriptive statistics were used for analysis. Results One hundred ninety-one adult patients were included in this study. Mean age was 38.8 years, and majority lived in an urban area (71.2%). Most patients exhibited polysensitization (97.4%). All exhibited sensitization to indoor and 86.9% to outdoor allergens. The most common indoor allergens were Dermatophagoides pteronyssinus (97.4%), Dermatophagoides farinae, (95.8%), cockroach (80.1%), and molds (72.8%). Bermuda (67%), Johnson grass (58.7%), and Acacia (58.2%) were the most common outdoor allergens. Urticaria (18.8%), dermatitis (16.8%), and asthma (11.5%) were the most common associated comorbid disease. Twelve percent of patients had more than one associated comorbid disease. Asthma + urticaria followed by asthma + dermatitis were the most common co-morbid combinations. One patient had three comorbid diseases: asthma + urticaria + rhinosinusitis. Conclusion Compared to earlier studies, aeroallergen sensitization patterns of Filipinos remain unchanged. This study also identifies for the first time, the associated comorbid diseases of AR in this population. Understanding these factors can guide treatment strategies to reduce disease burden.
Collapse
Affiliation(s)
| | - Margaret Lim-Jurado
- Department of Otolaryngology-Head & Neck Surgery, St. Luke's Medical Center-Quezon City, Quezon City 1112, the Philippines
| |
Collapse
|
45
|
Han M, Chen Y, Wang M. Sublingual immunotherapy for treating adult patients with allergic rhinitis induced by house dust mite among Chinese Han population: A retrospective study. Medicine (Baltimore) 2018; 97:e11705. [PMID: 30045332 PMCID: PMC6078716 DOI: 10.1097/md.0000000000011705] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The objective of this retrospective study was to evaluate the efficacy and safety of sublingual immunotherapy (SLIT) for treating adult patients with allergic rhinitis (AR) induced by house dust mite (HDM) among Chinese Han population.A total of 201 adult patients with AR induced by HDM were included. All of them received SLIT treatment. The outcomes consisted of AR symptoms, and quality of life. In addition, any adverse events were also recorded in this study.Compared with the AR symptoms and quality of life before the treatment, significant differences were found after 1-year treatment (P < .01), and 2-year treatment (P < .01). Additionally, only mild and acceptable adverse events were observed in this study.This study demonstrated that SLIT may be efficacious and safety for adult patients with HDM induced by AR among Chinese Han population.
Collapse
|
46
|
Wang DY, Cho SH, Lin HC, Ghoshal AG, Bin Abdul Muttalif AR, Thanaviratananich S, Tunceli K, Urdaneta E, Zhang D, Faruqi R. Practice Patterns for Chronic Respiratory Diseases in the Asia-Pacific Region: A Cross-Sectional Observational Study. Int Arch Allergy Immunol 2018; 177:69-79. [PMID: 29874659 DOI: 10.1159/000489015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/04/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Allergic rhinitis (AR), asthma, chronic obstructive pulmonary disease (COPD), and rhinosinusitis are common and little studied in the Asia-Pacific region. OBJECTIVES We sought to investigate real-world practice patterns for these respiratory diseases in India, Korea, Malaysia, Singapore, Taiwan, and Thailand. METHODS This cross-sectional observational study enrolled adults (age ≥18 years) presenting to general practitioners (GP) or specialists for physician-diagnosed AR, asthma, COPD, or rhinosinusitis. Physicians and patients completed study-specific surveys at one visit, recording patient characteristics, health-related quality of life (QoL), work impairment, and healthcare resource use. Findings by country and physician category (GP or specialist) were summarized. RESULTS Of the 13,902 patients screened, 7,243 (52%) presented with AR (18%), asthma (18%), COPD (7%), or rhinosinusitis (9%); 5,250 of the 7,243 (72%) patients were eligible for this study. Most eligible patients (70-100%) in India, Korea, Malaysia, and Singapore attended GP, while most (83-85%) in Taiwan and Thailand attended specialists. From 42% (rhinosinusitis) to 67% (AR) of new diagnoses were made by GP. On average, patients with COPD reported the worst health-related QoL, particularly to GP. Median losses of work productivity for each condition and activity impairment, except for asthma, were numerically greater for patients presenting to GP vs. specialists. GP prescribed more antibiotics for AR and asthma, and fewer intranasal corticosteroids for AR, than specialists (p < 0.001 for all comparisons). CONCLUSIONS Our findings, albeit mostly descriptive and influenced by between-country differences, suggest that practice patterns differ between physician types, and the disease burden may be substantial for patients presenting in general practice.
Collapse
Affiliation(s)
- De Yun Wang
- Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Sang-Heon Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Horng-Chyuan Lin
- Division of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | | | | | | | - Kaan Tunceli
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Eduardo Urdaneta
- Global Medical Affairs, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Dongmu Zhang
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Rab Faruqi
- Medical Affairs Asia-Pacific Region, Merck & Co., Inc., Kenliworth, New Jersey, USA
| |
Collapse
|
47
|
Kulthanan K, Chusakul S, Recto MT, Gabriel MT, Aw DCW, Prepageran N, Wong A, Leong JL, Foong H, Quang VT, Zuberbier T. Economic Burden of the Inadequate Management of Allergic Rhinitis and Urticaria in Asian Countries Based on the GA²LEN Model. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:370-378. [PMID: 29949833 PMCID: PMC6021592 DOI: 10.4168/aair.2018.10.4.370] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 02/09/2018] [Accepted: 02/27/2018] [Indexed: 11/29/2022]
Abstract
Purpose Across Hong Kong, Malaysia, the Philippines, Singapore, Thailand and Vietnam, (referred to as Asia) approximately 30–53 million individuals of the 151 million employed suffer from allergic rhinitis (AR) and urticaria. It is estimated that approximately 90% of patients with these allergic conditions are insufficiently treated, impacting the socioeconomic burden in terms of absence from work and decreased productivity. This study aims to estimate the socioeconomic burden of allergies in Asia and the cost savings that their adequate management can provide. Due to the limited availability of regional data, this study focused AR and urticaria in selected countries. Methods Published literature, information from statistical bureaus, clinician surveys and extrapolation of selected data from the European Union were used to determine the socioeconomic costs of AR and urticaria. Results Many patients in Asia suffer from perennial allergies and experience symptoms of AR and urticaria for up to 298 days per year. An estimate of the indirect costs of patients insufficiently treated for AR and urticaria amounts to USD 105.4 billion a year, which equates to USD 1,137–2,195 per patient due to absenteeism and presenteeism. Adherence to guideline-approved treatment can lead to estimated savings of up to USD 104 billion. Conclusions The current study suggests that within Asia, the socioeconomic impact of AR and urticaria is similar to that seen in the European Union in spite of the lower wages in Asia. This is due to the mainly perennial allergens prevailing in Asia, whereas the sensitization patterns observed in the European Union are dominated by seasonal exposure to pollen. These results underline the need for governmental initiatives to increase public awareness on the prevention and treatment of these and other allergic diseases as well as greater research funding and large-scale studies to reduce their growing socioeconomic burden in coming years.
Collapse
Affiliation(s)
- Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supinda Chusakul
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Marysia Tiongco Recto
- Section of Allergy and Immunology, Department of Pediatrics, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Ma Teresita Gabriel
- Department of Dermatology, Research Institute for Tropical Medicine, Manila, Philippines
| | | | - Narayanan Prepageran
- Department of Otorhinolaringology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Henry Foong
- Foong Skin Specialist Clinic, Ipoh, Malaysia
| | - Vo Thanh Quang
- National Hospital of Otorhinolaryngology, Hanoi, Vietnam
| | - Torsten Zuberbier
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology and Allergy, Allergy-Centre-Charité, Berlin, Germany.
| |
Collapse
|
48
|
Choi JY, Lee HY, Hur J, Kim KH, Kang JY, Rhee CK, Lee SY. TRPV1 Blocking Alleviates Airway Inflammation and Remodeling in a Chronic Asthma Murine Model. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:216-224. [PMID: 29676068 PMCID: PMC5911440 DOI: 10.4168/aair.2018.10.3.216] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/17/2018] [Accepted: 01/29/2018] [Indexed: 12/22/2022]
Abstract
Purpose Asthma is a chronic inflammatory airway disease characterized by airway hyperresponsiveness (AHR), inflammation, and remodeling. There is emerging interest in the involvement of the transient receptor potential vanilloid 1 (TRPV1) channel in the pathophysiology of asthma. This study examined whether TRPV1 antagonism alleviates asthma features in a murine model of chronic asthma. Methods BALB/c mice were sensitized to and challenged by ovalbumin to develop chronic asthma. Capsazepine (TRPV1 antagonist) or TRPV1 small interfering RNA (siRNA) was administered in the treatment group to evaluate the effect of TPV1 antagonism on AHR, airway inflammation, and remodeling. Results The mice displayed increased AHR, airway inflammation, and remodeling. Treatment with capsazepine or TRPV1 siRNA reduced AHR to methacholine and airway inflammation. Type 2 T helper (Th2) cytokines (interleukin [IL]-4, IL-5, and IL-13) were reduced and epithelial cell-derived cytokines (thymic stromal lymphopoietin [TSLP], IL-33, and IL-25), which regulate Th2 cytokine-associated inflammation, were also reduced. Airway remodeling characterized by goblet cell hyperplasia, increased α-smooth muscle action, and collagen deposition was also alleviated by both treatments. Conclusions Treatment directed at TRPV1 significantly alleviated AHR, airway inflammation, and remodeling in a chronic asthma murine model. The TRPV1 receptor can be a potential drug target for chronic bronchial asthma.
Collapse
Affiliation(s)
- Joon Young Choi
- Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hwa Young Lee
- Division of Pulmonology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Jung Hur
- Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyung Hoon Kim
- Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ji Young Kang
- Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sook Young Lee
- Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
| |
Collapse
|
49
|
An TJ, Yoon HK. Prevalence and socioeconomic burden of chronic obstructive pulmonary disease. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2018. [DOI: 10.5124/jkma.2018.61.9.533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Tai Joon An
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
50
|
Kim BG, Lee PH, Lee SH, Baek AR, Park JS, Lee J, Park SW, Kim DJ, Park CS, Jang AS. Impact of the Endothelial Tight Junction Protein Claudin-5 on Clinical Profiles of Patients With COPD. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:533-542. [PMID: 30088372 PMCID: PMC6082819 DOI: 10.4168/aair.2018.10.5.533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/27/2018] [Accepted: 04/29/2018] [Indexed: 12/26/2022]
Abstract
Purpose The tight junction protein claudin-5 (CLDN5) is critical to the control of endothelial cellular polarity and pericellular permeability. The role of CLDN5 in chronic obstructive pulmonary disease (COPD) remains unclear. The aim of this study was to investigate the association between CLDN5 levels and clinical variables in patients with COPD. Methods In total, 30 patients with COPD and 30 healthy controls were enrolled in the study. The plasma CLDN5 level was checked in patients with stable or exacerbated COPD and in healthy controls. Results The mean plasma CLDN5 level of patients with COPD was 0.63 ± 0.05 ng/mL and that of healthy controls was 6.9 ± 0.78 ng/mL (P = 0.001). The mean plasma CLDN5 level was 0.71 ± 0.05 ng/mL in exacerbated COPD patients and 0.63 ± 0.04 ng/mL in patients with stable COPD (P < 0.05). The plasma CLDN5 level among COPD subjects was correlated with the smoking amount (r = −0.530, P = 0.001). The plasma CLDN5 level in stable COPD patients was correlated with forced expiratory volume in one second (FEV1, %pred.) (r = −0.481, P = 0.037). Conclusions The plasma CLDN5 level was not correlated with age. CLDN5 may be involved in the pathogenesis of COPD. Further studies having a larger sample size will be needed to clarify CLDN5 in COPD.
Collapse
Affiliation(s)
- Byeong Gon Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Pureun Haneul Lee
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sun Hye Lee
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Ae Rin Baek
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jong Sook Park
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Junehyuk Lee
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sung Woo Park
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Do Jin Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Choon Sik Park
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - An Soo Jang
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
| |
Collapse
|