• Tuberculosis and Respiratory Diseases
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• v.86 no.3
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• pp.151-157
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• 2023

The introduction of inhaled corticosteroids (ICS) for the management of asthma has led to a decrease in acute exacerbation of asthma. However, there are concerns regarding the safety of long-term ICS use, particularly pneumonia. Growing evidence indicates that ICS use is associated with an increased risk of pneumonia in patients with chronic obstructive pulmonary disease, whereas the risk in patients with asthma remains unclear. This review discusses the effect of ICS on pneumonia among patients with asthma to update the existing literature. Asthma is associated with an increased risk of pneumonia. Several hypotheses have been proposed to explain this association, including that asthma impairs the clearance of bacteria owing to chronic inflammation. Therefore, controlling airway inflammation with ICS may prevent the occurrence of pneumonia in asthma. In addition, two meta-analyses investigating randomized control trials showed that ICS use was associated with a protective effect against pneumonia in asthma.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.113-118
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• 2017

Objective: International institutes such as Global institute for Asthma(GINA), KAAACI(Republic of Korea), NHLBI(USA), BTS(UK) and JSA(Japan) have published guidelines for asthma treatment. The aim of this study was to compare the representatives' international guidelines of pharmacotherapy for pediatric asthma. Methods: The recommendations related to pharmacotherapy for pediatric asthma were extracted from the latest representatives' international guidelines, and comprehensive comparisons were conducted. Results: Major comparison outcomes between international guidelines were evaluated as follows: classification system on severity and pediatric age group, recommendation for inhaled corticosteroid dose, recommendation for pediatric age group of theophylline in mild asthma, and recommendation for pediatric age group of tiotropium in severe asthma. Clinical trials emphasized the adverse effects of theophylline, whereas tiotropium demonstrated beneficial actions for pediatric asthma. Therefore, theophylline was recommended for older patients with persistent asthma, and tiotropium was considered to be suitable for younger patients with severe asthma according to GINA guidelines. Conclusion: These findings address the requirement to harmonize international guidelines of pharmacotherapy in pediatric asthma. In addition, the findings suggest that KAAACI needs to update its pharmacotherapy guidelines of theophylline, tiotropium and other medicines recently approved.

• 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.

• Korean Parent-Child Health Journal
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• v.5 no.2
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• pp.191-205
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• 2002

This study was conducted to provide the baseline data for preparing an educational program for mothers of pediatric asthma patients by identifying the knowledge about asthma, mother's educational demand and the perceived educational performance. This study used survey design. The subjects were chosen from the mothers whose children have received pediatric asthma treatment or who have admitted in the pediatric unit of major hospitals using selection criteria. The total number of subjects were 63 mothers. The data collection period was from May 1st, 2001 to April 17th, 2001. Instruments used for this study were knowledge examination, educational demand evaluation, and educational performance. The data were analysed using t-test, ANOVA with SPSS PC(Version 10.0). The results of this study were as follows. 1. Mean score of knowledge about pediatric asthma was 17.95, which suggests the mothers of children with asthma have a medium knowledge level. The highest grade was knowledge about treatment and follow management and the lowest grade was knowledge about diet. 2. Demand for education showed 4.23, which suggests the mothers of children with asthma have high educational demand. The highest score was about exercise and activity in daily life and the lowest score was medication. 3. Perceived educational performance score of themselves showed 2.40, which suggests the mothers of children with asthma thought that health team do not give enough education to them. The highest score was knowledge about pediatric asthma itself and the lowest score was exercise and activity in daily life. 4. Demand for education and perceived educational performance about pediatric asthma showed significant difference in all areas. 5. There were no statistically significant difference noted between general characteristics and degree of knowledge, educational demand and perceived educational performance about pediatric asthma. In conclusion, there needed a systematic educational program development for the mothers of children with asthma. Especially, an education program for mothers in the beginning period of pediatric asthma should be emphasized.

• Tuberculosis and Respiratory Diseases
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• v.71 no.2
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• pp.81-87
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• 2011

Asthma is the most common chronic illness to affect children and is a major cause of morbidity in adults, affecting 4~17% of children and 7.3~10.1% of adults, which translates to approximately 300 million people globally. This article reviews recently published data over the past 1~2 years on asthma, and covers the 3 aspects of current advancement for the diagnosis of severe asthma, including the controversy to long-acting bronchodilator treatment for treatment of asthma, and the role of long-acting anticholinergics treatment in asthma patients.

• Clinical and Experimental Pediatrics
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• v.56 no.5
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• pp.191-195
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• 2013

Severe childhood asthma is a complicated and heterogeneous disorder with distinct phenotypes. Children with severe asthma have more persistent symptoms despite receiving treatment, more atopy, greater airway obstruction, and more air trapping than those with mild-to-moderate asthma. They also have higher morbidity and substantial airflow limitations that persist throughout adulthood. Identification of the phenotype clusters and endotypes of severe asthma can allow further modulation of the natural history of severe asthma and may provide the pathophysiologic rationale for appropriate management strategies.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.411-417
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• 2010

This review highlights articles pertaining to the following 5 topics: the relationship between asthma, allergic and non-allergic rhinitis; the novel asthma phenotypes using cluster analysis; the diagnostic properties of inhaled dry-powder mannitol for the diagnosis of asthma; the value of mepolizumab therapy in exacerbations of refractory eosinophilic asthma; the role of bronchial thermoplasty in the treatment of severe asthma.

• Tuberculosis and Respiratory Diseases
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• v.69 no.4
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• pp.265-270
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• 2010

Background: Psychological factors are increasingly recognized for their influence on the course of asthma, on a worldwide basis. The aim of this study was to assess the presence of depression, anxiety, and asthma-related quality of life in patients with asthma and to evaluate their impact on severity and control of asthma. Methods: We assessed the severity of asthma by comparing patients' current medications to GINA guideline. The patients were classified into the controlled group (asthma patients with controlled disease) or into the uncontrolled group (asthma patients with uncontrolled disease), which included partly controlled and uncontrolled patients, again based on GINA guideline 2004. Patient-reported depressive symptoms, anxiety, and asthma-related quality of life were evaluated using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and Korean asthma quality of life (KAQLQ). Results: One hundred and twenty patients were enrolled (mean age, $55{\pm}1$ years; 65% women). Among the 120 patients, 14 (12%) patients were classified as having mild asthma, 88 (73%) as having moderate asthma, and 18 (15%) as having severe asthma. Eighty-one (67%) of the 120 patients were controlled. The asthma-related quality of life showed the difference according to severity of asthma (p=0.002). The prevalence of depression was lower (10% vs 26%, p=0.024) and the asthma-related quality of life was higher (59.951 (29~75) vs 35.103 (18~72), $p{\leq}0.001$) in the controlled group. Higher trait anxiety score and lower asthma-related quality of life were associated with depression (p<0.001, p=0.002, respectively). Conclusion: Psychological factors, such as anxiety and depression, are strongly associated with asthma control. Therefore, screening and management of depression is needed in patients with asthma.

• Clinical and Experimental Pediatrics
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• v.56 no.10
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• pp.424-430
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• 2013

Exhaled nitric oxide (NO) has been extensively investigated as a noninvasive marker of airway inflammation in asthma. The increased NO expression induced by inflammatory mediators in airways can be monitored easily in exhaled air from asthmatic children. Based on the relationship between the increased NO expression and eosinophilic airway inflammation, fractional exhaled nitric oxide (FeNO) measurements become an important adjunct for the evaluation of asthma. In addition, the availability of portable devices makes it possible to measure FeNO more easily and frequently in the routine pediatric practice. Despite various confounding factors affecting its levels, FeNO can be applicable in diagnosing asthma, monitoring treatment response, evaluating asthma control, and predicting asthma exacerbations. Thus, although pulmonary function tests are the standard tools for objective measurements of asthmatic control, FeNO can broaden the way of asthma monitoring and supplement standard clinical asthma care guidelines.

• Clinical and Experimental Pediatrics
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• v.50 no.4
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• pp.335-339
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• 2007

The link between upper airway disease (allergic rhinitis and sinusitis) and lower airway disease (asthma) has long been of interest to physicians. Many epidemiological and pharmacological studies have provided a better understanding of pathophysiologic interrelationship between allergic rhinitis and asthma. The vast majority of patients with asthma have allergic rhinitis, and rhinitis is a major independent risk factor for asthma in cross-sectional and longitudinal studies. The association between sinusitis and asthma has long been appreciated. Through the recent evidences, allergic rhinitis, sinusitis, and asthma may not be considered as different diseases but rather as the expression in different parts of the respiratory tract of same pathological process in nature. Various mechanisms have been proposed to explain the relationship between asthma and upper airway diseases, but the underlying mechanisms are not completely discovered. The implications for the one-airway hypothesis are important not only academically but also clinically for diagnostic and therapeutic purposes.