• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.1-5
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• 2011

Asthma in childhood is a heterogeneous disease with different phenotypes and variable clinical manifestations, which depend on the age, gender, genetic background, and environmental influences of the patients. Several longitudinal studies have been conducted to classify the phenotypes of childhood asthma, on the basis of the symptoms, triggers of wheezing illness, or pathophysiological features of the disease. These studies have provided us with important information about the different wheezing phenotypes in young children and about potential mechanisms and risk factors for the development of chronic asthma. The goal of these studies was to provide a better insight into the causes and natural course of childhood asthma. It is well-known that complicated interactions between genes and environmental factors contribute to the development of asthma. Because childhood is a period of rapid growth in both the lungs and the immune system, developmental factors should be considered in the pathogenesis of childhood asthma. The pulmonary system continues to grow and develop until linear growth is completed. Longitudinal studies have reported significant age-related immune development during postnatal early life. These observations suggest that the phenotypes of childhood asthma vary among children and also in an individual child over time. Improved classification of heterogeneous conditions of the disease will help determine novel strategies for primary and secondary prevention and for the development of individualized treatment for childhood asthma.

• Environmental Analysis Health and Toxicology
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• v.20 no.3 s.50
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• pp.209-213
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• 2005

Due to steady increase of childhood asthma, exposure to air toxics including PAHs have been thought as an etiology for the asthma. PAHs -involvement in airway inflammation, such as IgE production, is the potential mechanism of the PAHs-induced asthma. Cytochrome P450s (CYPs), particularly CYP1A1 is known enzyme to metabolite PAHs and to be induced by PAHs. The CYP1A1 expression has been emphasized as an biomarker for PAHs - exposure. The present study was performed to clarify the etiology of childhood asthma with PAHs-exposure using mRNA expression of CYP1A1 . The study Objects were Korean children who were asthma patients (cases) or other hospital controls (N=20; age,3 $\~$ 16; boys,56$\%$). As result, we detected expression of the CYP1A1 in all peripheral blood specimens which were collected from the subjects. Moreover, we found approx. 300 fold-higher expression of the CYP1A1 in the cases than that in the controls (p(<)0.01). When we considered age which was related to Asthma, the above significant trend was somewhat diluted, however, the relation between asthma and the Cypih i expression waL stronger than that between asthma and age (chi square,7.99 vs. 3.34). Therefore, our study supports that PAHs induce or worse childhood asthma and suggests application of expression of the CYP1A1 as an initiation or progress biomarker for PAHs - induced childhood asthma.

• Journal of Preventive Medicine and Public Health
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• v.51 no.6
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• pp.275-280
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• 2018

Objectives: The project Seoul Atopy Asthma-friendly School investigated the current status of childhood asthma to enable formulation of a preventative policy. We evaluated the current prevalence of childhood asthma in Seoul and its trends and related factors. Methods: The project was conducted annually from 2011 to 2016 and involved around 35 000 children aged 1-13 years. Based on the International Study of Asthma and Allergies in Childhood guidelines, the survey involved parents. The associations of the particulate matter ($PM_{10}$) concentration, and the number of days on which the daily air quality guidance level was exceeded in the 25 districts of Seoul, with the prevalence of asthma were assessed. Results: The age-standardized asthma prevalence in 2011 and 2016 was 6.74 and 4.02%, respectively. The prevalence of lifetime asthma treatment and treatment during the last 12 months tended to decrease from 2011 to 2016. Asthma treatment was significantly correlated with the number of days on which the daily air quality guidance level was exceeded, but not with the $PM_{10}$ concentration. Conclusions: This study reports the prevalence of asthma among children in Seoul and confirmed the relationship between childhood asthma and known risk factors in a large-scale survey.

• Clinical and Experimental Pediatrics
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• v.59 no.11
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• pp.432-439
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• 2016

Asthma is recognized as a complex disease resulting from interactions between multiple genetic and environmental factors. Accumulating evidence suggests that respiratory viral infections in early life constitute a major environmental risk factor for the development of childhood asthma. Respiratory viral infections have also been recognized as the most common cause of asthma exacerbation. The advent of molecular diagnostics to detect respiratory viruses has provided new insights into the role of human rhinovirus (HRV) infections in the pathogenesis of asthma. However, it is still unclear whether HRV infections cause asthma or if wheezing with HRV infection is simply a predictor of childhood asthma. Recent clinical and experimental studies have identified plausible pathways by which HRV infection could cause asthma, particularly in a susceptible host, and exacerbate disease. Airway epithelial cells, the primary site of infection and replication of HRV, play a key role in these processes. Details regarding the role of genetic factors, including ORMDL3, are beginning to emerge. This review discusses recent clinical and experimental evidence for the role of HRV infection in the development and exacerbation of childhood asthma and the potential underlying mechanisms that have been proposed.

• Journal of Korean Society for Atmospheric Environment
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• v.17 no.5
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• pp.425-437
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• 2001

This study is based on the uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies between air pollutants exposure and childhood asthma. Studies for this meta-analysis were conducted by reviewing previous results and by asking researcher active in this field for recommendations. Overall, 10 cases of air pollutants exposures and childhood asthma were reviewed. A variety of statistical methods for meta-analysis have been used to assess the combined effects, to identify heterogeneity, and to provide a single summary risk estimate based on a set of simiar epidemiologic studies. In this study, classification of exposure metircs on air environmental epidemiologic studies are reported for (1) aggravation of childhood asthma by a 50 ppb increase SO$_2$(6 individual studies); (2) aggravation of childhood asthma by a 50 ppb increase NO$_2$(5 individual studies); (3) aggravation of childhood asthma by a 50 ppb increase $O_3$(7 individual studies); (4) aggravation of childhood asthma by a 10$\mu\textrm{g}$/m$^3$increase PM$_{10}$ (4 individual studies); (5) aggravation of childhood asthma by a 1 ppm increase CO (2 individual studies); and (6) comparison of results between a Korean study results and this meta-analytic study. Results of this study indicated that an inverse-variance weighted pooling of the hospital admission risk at a 1ppm increment of CO levels was 1.12% (95% CI : 1.01 ~ 1.24). The hospital admission risk was estimated to increase 5% (95% CI : 1.02~1.08), 6%(95% CI : 1.04~1.09), and 5% (95% CI : 1.02~1.09) with each 50ppb increase of SO$_2$, NO$_2$, and $O_3$, respectively. In addition, our results lead to a small but significant elevation in risk of 2% (RR = 1.02, 95% CI = 1.01~1.04) with each 10$\mu\textrm{g}$/m$^3$increase of PM$_{10}$ among 4 individual studies. We found a small elevation in risk of childhood asthma, and pooled results of 10 epidemiologic studies of childhood asthma using increase a cut-off-point levels of air pollutants showed a few pieces of evidence. The results of this meta-analysis suggested that air pollution associated with an increased incidence of childhood asthma. According to this study, relationship between exposure to air pollutants and childhood asthma in Korea seem to be high than results of this meta-analysis.sis.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.121-128
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• 2010

In recent years, environmental tobacco smoke (ETS) has become an important worldwide public health issue. Children are particularly vulnerable to ETS because they are still developing. ETS exposure causes a wide range of adverse health effects on childhood asthma. There is convincing evidence that ETS exposure is causally associated with an increased prevalence of asthma, increased severity of asthma and worsening asthma control in children who already have the disease, even though a causal relationship with asthma onset is not yet established for asthma incidence. Mechanisms underlying these adverse effects of ETS are not clearly elucidated but e studies on this issue suggest that genetic susceptibility, impaired lung function, and augmented airway inflammation and remodeling may be involved. Children with asthma are just as likely to be exposed to ETS as children in general and there is no risk-free level of exposure. Therefore, providing a smoke-free environment may be of particular importance to the asthmatic children exposed to ETS who have adverse asthma outcomes, as well as to children with genetic susceptibility who are at increased risk of developing asthma upon exposure to ETS in early childhood.

• Journal of Korean Biological Nursing Science
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• v.10 no.1
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• pp.53-61
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• 2008

Purpose: This study was conducted to estimate the prevalence of asthma and its risk factors in childhood asthma. Method: Random samples of 10,236 were selected from 43 kindergarten (1,418) and 57 elementary (8,718) in K city between september and November (2007). 1,079 (kindergarten children) and 7,271 (elementary children) were in the final analysis. The Korean-translated modified version of the questionnaire for the International Study of Asthma and Allergies in Childhood was used in this cross-sectional survey. Parents were surveyed to answer for the questionnaire. Result: The lifetime and 12-month prevalence of wheezing were 11.50%; 11.06% in kindergarten children and 19.24%; 4.80% in elementary children. The lifetime prevalence of asthma diagnosis and the 12-month prevalence of asthma treatment were 11.59%; 4.43% in kindergarten children and 4.43%; 10.78% in elementary children. The 12-month prevalence of night cough and exercise-induced wheezing were 12.90%; 3.33% in kindergarten children and 20.72%; 4.74% in elementary children. Risk factors analysis showed that age, paternal and maternal asthma, allergic disease, carpet use, monthly income, indoor environment were associated with a higher risk of asthma. Conclusion: The study suggests that prevalence of asthma has increased among the community children. These data have been used to manage a possible role of risk factors as predictors of childhood asthma.

• Journal of Environmental Health Sciences
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• v.38 no.3
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• pp.223-232
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• 2012

Objective: We performed this study to determine the association between childhood asthma and residential environment risk factors including VOCs and formaldehyde exposure. Methods: We selected an asthma group (30) and a control gorup (30) through physicain diagnosis and assessed the VOCs and formaldehyde levels of exposure of elementary school children in Seoul. Results: In the results, there were no significant differences in socioeconomic factors between case and control groups. However, there were significant differences in family asthma history, amount of sunlight, level of humidity and number of household residents (p < 0.05). The level of VOC (toluene, ethylbenzene, stylene, m,p-xylene) exposure level of the case group was significantly higher than that of the control group (p < 0.05) and the result of logistic regression showed that asthma family history, amount of humidity and number of household residents were significant predictors of childhood asthma (p < 0.05). Conclusion: Some residential environments such as lower amounts of sunlight, greater amounts of humidity and smaller numbers of household residents and VOC exposure were determinded as risk factors for childhood asthma.

• Clinical and Experimental Pediatrics
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• v.64 no.5
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• pp.229-238
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• 2021

Background: Bronchial hyperresponsiveness (BHR), an important physiological feature of asthma, is a prognostic marker of childhood asthma. Purpose: We aimed to investigate the factors associated with BHR in adolescents with childhood asthma. Methods: Two hundred and fifteen adolescents (≥13 years of age; 149 males, 66 females) who were diagnosed with asthma during childhood were enrolled, underwent methacholine challenge tests, and were divided into the BHR group (<25 mg/mL of provocation concentration causing a 20% fall in forced expiratory volume in 1 second [FEV₁] [PC₂₀], n=113) or non-BHR group (≥25 mg/mL of PC₂₀, n=102). We examined longitudinal changes in BHR and the risk factors for its persistence in the 108 adolescents for whom baseline data, including methacholine PC₂₀ at age 6 years, were available. Multivariate logistic regression analyses were performed to assess the factors associated with BHR in adolescents. Results: Mold sensitization (adjusted odds ratio [aOR], 5.569; P=0.005) and increased blood eosinophil count (aOR, 1.002; P=0.026) were independently associated with BHR in boys but not girls. The odds of BHR decreased by 32% with each 1-year increase in age in boys (aOR, 0.683; P=0.010) but not girls. A reduced FEV₁/forced vital capacity ratio (<90%) was independently related with BHR in female patients only (aOR, 7.500; P=0.007). BHR decreased with age throughout childhood. A low methacholine PC₂₀ at age 6 years was independently associated with persistent BHR throughout childhood in male and female patients, whereas early mold sensitization was a risk factor for persistent BHR in male patients only (aOR, 7.718; P=0.028). Conclusion: Our study revealed sex-specific differences in the factors associated with BHR in adolescents with childhood asthma. Our findings suggest the risk factors that might affect asthma transition from childhood to adolescence and adulthood.

• International Journal of Advanced Culture Technology
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• v.8 no.3
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• pp.275-279
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• 2020

Due to the recent rapid industrialization worldwide, the number of pediatric asthma patients is increasing. And the fine dust containing heavy metals is linked to the characteristics of high toxic lead due to the increase heating in factory operation and automobile driving. It is the reason of arsenic increasing. In the treatment of pediatric asthma patients, drug administration, oral drug entry, and HMPC (Home Management Plan of Care) are used. In this paper, we analyze the relationship between the onset of asthma and the method of prescription for specific childhood asthma in the United States using EM (Expectation Maximization) and MDL (Minimum Description Length) algorithms. And the association is also analyzed by comparing the nature of specific congestion between the past prevalence of digestive asthma and the recent prevalence of environmental pollution.