알레르겐의 물리생화학적 특성

정경용 ( Kyoung Yong Jeong ) 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.3

What makes a certain molecule to elicit allergic responses? It has been a long-running question in allergology and immunology. Molecular properties of allergens have been characterized for last 30 years. However, it has become evident that allergen alone cannot induce allergic reactions. The way of introduction to the immune system and adjuvant-like activity of concomitantly administered molecules are thought to be important. Physical properties which facilitate delivery may characterize inhalant allergens. Buoyant and sticky antigens with small molecular weight (10.50 kDa) may be carried by particles and remain airborne. Most allergens could be grouped into allergen families according to biochemical properties. Protease, lipid-binding/transfer protein, actin-binding protein, Ca-binding protein, α-amylase/trypsin inhibitor, and pectate lyase account for a significant number of allergens. Biochemical properties which enhance the activation of Th2-immune responses could be another characteristic of allergens. The protease activity of allergens can help break the skin barrier or mucus membrane and its penetration into the body. The capacity of allergen to carry immunologically active substances could increase the allergenicity. Lipid-binding ability is believed to play a role in this aspect. Danger signals, such as endotoxin, β-glucan, and chitin derived from the pathogens, commensals and from the environment can enhance the immune response to allergens. The known characteristics of food allergens are resistance to heat, acid, and digestive enzymes. However, food processing makes it more complex. Understanding the intrinsic properties of allergens may shed light on the mechanisms on the pathogenesis of allergic disorders and improve the diagnostic and therapeutic approaches. (Allergy Asthma Respir Dis 2016;4:157-166)

Avoidance Behavior against Positive Allergens Detected with a Multiple Allergen Simultaneous Test Immunoblot Assay in Patients with Urticaria: Factors Associated with Avoidance Success/Failure

( Min Kyung Lee ),( In Ho Kwon ),( Han Su Kim ),( Heung Yeol Kim ),( Eun Byul Cho ),( Youin Bae ),( Gyeong Hun Park ),( Eun Joo Park ),( Kwang Ho Kim ),( Kwang Joong Kim ) 대한피부과학회 2016 Annals of Dermatology Vol.28 No.1

Background: Avoidance behavior against positive allergens detected by using multiple allergen simultaneous test (MAST)-immunoblot assay in patients with urticaria has been rarely reported. Objective: We aimed to assess the avoidance behavior of patients with urticaria against positive allergens detected with a MAST. Methods: One hundred and one urticaria patients who showed positivity to at least one allergen on a MAST completed a questionnaire regarding their test results. The avoidance behavior of the patients was evaluated, and relevant determining factors of avoidance success/failure were statistically assessed. Results: We detected 144 different data (n=51, food allergens; n=17, pollen allergens;and n=76, aeroallergens) from 101 patients with urticaria. The avoidance failure rates were 33. 3% for food allergens, 70. 6% for pollen allergens, and 30. 3% for aeroallergens. The pollen group showed a significantly higher avoidance failure rate than the food and aeroallergen groups (p<0. 05). The patients with higher educational levels or more severe urticaria tended to successfully avoid allergens (p<0. 05). The monthly household income level and patients reliability to the test showed borderline correlations (p=0 . 057and p=0. 075, respectively). Conclusion: We believe that the results of this study could be helpful in predicting avoidance success or failure against allergens in patients with urticaria when clinicians conduct allergen-specific immunoglobulin E tests.

알레르기 증상으로 내원한 한국인에서의 음식물 알레르겐에 대한 감작율 조사: 다기관 공동연구

김세훈 ( Kim Se Hun ),강혜련 ( Kang Hye Lyeon ),김경묵 ( Kim Gyeong Mug ),김태범 ( Kim Tae Beom ),김선신 ( Kim Seon Sin ),장윤석 ( Jang Yun Seog ),김철우 ( Kim Cheol U ),반준우 ( Ban Jun U ),김윤근 ( Kim Yun Geun ),조상헌 ( Jo San 대한천식알레르기학회 2003 천식 및 알레르기 Vol.23 No.3

Allergen Sensitization Pattern by Sex: A Cluster Analysis in Korea

( Jungyoon Ohn ),( Seung Hwan Paik ),( Eun Jin Doh ),( Hyun-sun Park ),( Hyun-sun Yoon ),( Soyun Cho ) 대한피부과학회 2017 Annals of Dermatology Vol.29 No.6

Background: Allergens tend to sensitize simultaneously. Etiology of this phenomenon has been suggested to be allergen cross-reactivity or concurrent exposure. However, little is known about specific allergen sensitization patterns. Objective: To investigate the allergen sensitization characteristics according to gender. Methods: Multiple allergen simultaneous test (MAST) is widely used as a screening tool for detecting allergen sensitization in dermatologic clinics. We retrospectively reviewed the medical records of patients with MAST results between 2008 and 2014 in our Department of Dermatology. A cluster analysis was performed to elucidate the allergen-specific immunoglobulin (Ig)E cluster pattern. Results: The results of MAST (39 allergen-specific IgEs) from 4,360 cases were analyzed. By cluster analysis, 39 items were grouped into 8 clusters. Each cluster had characteristic features. When compared with female, the male group tended to be sensitized more frequently to all tested allergens, except for fungus allergens cluster. Conclusion: The cluster and comparative analysis results demonstrate that the allergen sensitization is clustered, manifesting allergen similarity or co-exposure. Only the fungus cluster allergens tend to sensitize female group more frequently than male group. (Ann Dermatol 29(6) 735∼741, 2017)

Patterns of Inhalant Allergen Sensitization and Geographical Variation in Korean Adults: A Multicenter Retrospective Study

강민규,김미영,송우정,김수정,조은정,이승은,권재우,이상민,박찬선,박혜경,박흥우,장윤석,이재천,이영민,지영구,이종명,InseonS.Choi,조상헌 대한천식알레르기학회 2017 Allergy, Asthma & Immunology Research Vol.9 No.6

Purpose: Inhalant allergen sensitization is one of the major factors involved in the pathogenesis of allergic respiratory diseases. However, the sensitization is determined by interactions between genetic and environmental factors. Thus, testing panels of inhalant allergens may differ among geographical areas. Here we aimed to determine 10 common inhalant allergens in Korean adult patients with suspected respiratory allergies and to examine the variation between different geographical locations. Methods: A total of 28,954 patient records were retrieved for retrospective analysis, from 12 referral allergy clinics located in 9 different areas. Inclusion criteria were Korean adults (≥18 years old) who underwent the inhalant allergen skin prick test for suspected history of respiratory allergy. The primary outcome was inhalant allergen skin prick response. Demographic and clinical information were also collected. Positive skin prick responses to allergens were defined as allergen-to-histamine wheal ratio ≥1. Based on skin test results, the most prevalent aeroallergens were determined. Results: The overall prevalence of allergic sensitization was 45.3%. Dermatophagoides farinae and Dermatophagoides pteronyssinus were the most commonly sensitized allergens. Other common inhalant allergens were cat epithelium (8.1%), birch (7.7%), mugwort (6.9%), alder (6.7%), hazel (6.7%), beech (6.7%), oak (6.6%), and Tyrophagus putres (6.2%), in decreasing order frequency. These 10 inhalant allergens explained 90% of inhalant allergen sensitization in the study participants. However, distinct patterns of the 10 inhalant sensitization were observed in patients living in Chungnam and Jeju. American cockroach, Gernam cockroach, and Trichophyton metagrophytes were unique in Chungnam. Orchard, Japanese cedar, and Velvet were unique in Jeju. Conclusions: The present analysis suggests a panel of 10 most common inhalant allergens in Korean adult patients with suspected respiratory allergies, which explained 90% of inhalant allergen sensitization. This panel can be utilized as a practical and convenient tool for primary practice and epidemiological surveys of respiratory allergic diseases.

Clinical Characteristics According to Sensitized Allergens in Adult Korean Patients With Bronchial Asthma

최병휘,정재우,최재철,신종욱,김재열,박인원 대한천식알레르기학회 2010 Allergy, Asthma & Immunology Research Vol.2 No.2

Purpose: Allergic sensitization is a risk factor for the development of bronchial asthma. This study was conducted to investigate clinical manifestations according to sensitized allergens in adult Korean patients with bronchial asthma. Methods: In total, 523 adult patients who were diagnosed with bronchial asthma between March 2002 and March 2008 were included in the study. All patients underwent skin prick tests for approximately 45 allergens or a specific IgE test. Sensitized allergens were grouped into the following categories: house dust mites, fungus, pollen, and animal dander. Atopy was defined as a positive skin prick test response or the presence of a specific IgE to one or more allergens. Results: Of the 523 patients,295 (56%) were sensitized to one or more allergens. A younger median age, greater proportion of males, higher eosinophil counts, and higher total IgE levels were observed in the atopic asthma group compared to the non-atopic asthma group. The PC20 value was negatively correlated with eosinophil counts and total IgE in the atopic asthma group. In the subgroup analysis, patients sensitized to Cladosporium showed poorer pulmonary function and a higher response to bronchodilators. In addition, patients sensitized to Alternaria showed severer bronchial hyperresponsiveness than non-atopic patients with asthma. Finally, a gradual increase in the number of sensitized allergens was noted with increasing age, eosinophil counts,and total IgE levels. Conclusions: We suggest the need for identifying the existence of atopy and exact offending allergens at the time of asthma diagnosis, since significant differences in sex, age, blood test results, and lung function were observed according to atopy and sensitized allergens.

집먼지진드기 알레르겐의 다양한 측정법 비교

김지현 ( Ji Hyun Kim ),하종목 ( Jong Mok Ha ),김상원 ( Sang Won Kim ),임인석 ( In Seok Lim ),신미용 ( Mee Yong Shin ),한영신 ( Young Shin Han ),안강모 ( Kang Mo Ahn ),이상일 ( Sang Il Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2010 소아알레르기 및 호흡기학회지 Vol.20 No.4

목적: 반정량적 집먼지진드기 농도 측정 시약 판매와 이를 이용한 측정 대행 업체들이 증가하고 있는 실정이지만 이들 사이의 상관성과 정확성에 대해서는 규명된 바가 거의 없다. 따라서 국내에 유통되고 있는 반정량적 시약들 간의 관련성을 알아보고, ELISA와의 비교를 통해 그 정확성을 알아보고자 하였다. 방법: 호흡기 혹은 알레르기 증상으로 본원 외래를 방문한 소아 환자 14명의 39개 침구류를 대상으로 국내에 유통되는 4가지 반정량적 측정 시약을 이용하여 집먼지진드기 농도를 측정하고 ELISA로 Der p 1, Der f 1, 제2군 집먼지진드기 알레르겐을 측정한 뒤 비교 분석하였다. 결과: 제품 Acarex(R)와 Rapid test for Mite Allergen(R)를 제외한 제품들 사이에 상관관계가 있는 것으로 나타났다. ELISA로 측정한 Der f 1 농도와 SD CHECK Quick Mite Test(R), Mitey checker(R), Rapid test for Mite Allergen(R) 사이에 상관성을 나타냈고, Acarex(R)의 결과와는 관련이 없었다. 제2군 알레르겐의 농도는 SD CHECK Quick Mite Test(R), Rapid test for Mite Allergen(R)의 결과와 상관관계가 있었으나, Acarex(R), Mitey checker(R)의 결과와는 관련이 없었다. 결론: 국내에서 판매되고 있는 반정량적 집먼지진드기 농도 측정 시약들 간의 상관성이 확인되었으나 민감도와 특이도의 경우 제품별로 차이가 있어 이에 대한 대책 마련이 필요할 것으로 판단된다. Purpose: This study was conducted to evaluate the accuracy of semiquantitative tests targeting house dust mite (HDM) allergens. Methods: Thirty-nine dust samples were collected from the homes of 14 patients. These samples were evaluated using the following semi-quantitative tests: Rapid test for Mite Allergen(R), Acarex(R), Mitey checker(R), and SD CHECK Quick Mite Test(R). The samples were then assayed by enzyme-linked immunosorbent assay (ELISA) for Der p 1, Der f 1 and group 2 allergens. Finally, the results from the 4 kits were compared and the correlation with ELISA was determined. Results: Concentrations of HDM allergens determined using Acarex(R) were associated with those of SD CHECK Quick Mite Test(R) and Mitey checker(R), (P=0.004 and 0.035, respectively; ρ=0.454 and 0.339, respectively). The concentrations determined by SD CHECK Quick Mite Test(R) were associated with those of Mitey checker(R) and Rapid test for Mite Allergen(R) (P=0.000 and 0.001, respectively; ρ=0.664 and 0.518, respectively). There was also a significant correlation between the results obtained using Mitey checker(R) and Rapid test for Mite Allergen(R) (P=0.000, ρ=0.602). The Der f 1 levels were associated with the concentrations determined by SD CHECK Quick Mite Test(R), Mitey checker(R) and Rapid test for Mite Allergen(R) (P=0.003, 0.000 and 0.005, respectively; ρ=0.467, 0.544 and 0.438, respectively). Group 2 allergen levels were associated with the concentrations determined by SD CHECK Quick Mite Test(R) and Rapid test for Mite Allergen(R) (P=0.019 and 0.038, respectively; ρ=0.374 and 0.334, respectively). Conclusion: Four popular semiquantitative test kits may be adequate for detecting HDM allergens at home. However, quality assurance is needed for clinical usage because they showed variable sensitivity and specificity. [Pediatr Allergy Respir Dis(Korea) 2010;20:226-231]

인천과 아산지역 소아청소년의 흡입 알레르겐 감작률 및 다항원 감작과 알레르기질환 발병과의 관계

김형영 ( Hyung Young Kim ),서주희 ( Ju Hee Seo ),정영호 ( Young Ho Jung ),이은 ( Eun Lee ),양송이 ( Song I Yang ),하미나 ( Min A Ha ),권호장 ( Ho Jang Kwon ),임종한 ( Jong Han Lim ),김환철 ( Hwan Chul Kim ),이기재 ( Kee Jae Lee ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.1

Purpose: Sensitization to allergens is considered as major mechanism of allergy and related to the development of allergic diseases. The objective of this study was to evaluate overall sensitization rates of inhalant allergens and the relationship between polysensitization and prevalence of allergic diseases in children and adolescents. Methods: A cross-sectional pilot study of 122 elementary school students, 114 middle school students, and 115 high school students from Incheon and Asan was conducted by using the International Study of Asthma and Allergies in Childhood (ISSAC) questionnaire. The skin prick tests were performed with 14 common inhalant allergens on 339 students. Results: The inhalant allergen that has a significantly different sensitization rate according to age was Dermatophagoides farinae. And the inhalant allergen that has significantly different sensitization rate according to region was Japanese hop. In addition, girls have higher sensitization rate to any mold allergens than boys. In case of having sensitization more than two allergens, the risks of diagnosis of asthma and allergic rhinitis on questionnaire were increased. Asthma is related to sensitization of dog or cat and allergic rhinitis is related to sensitization of house dust mites. However, atopic dermatitis is not related to sensitization of any inhalant allergens. Conclusion: The sensitization rates of inhalant allergens may differ among age, gender, and region in children and adolescents of Incheon and Asan area. The polysensitized children and adolescents with inhalant allergens showed higher prevalences of allergic diseases such as asthma and allergic rhinitis on questionnaire than monosensitized group. (Allergy Asthma Respir Dis 1?1):41-49, 2013)Allergy Asthma Respir Dis 1(1):41-49, 2013)

집먼지진드기 알레르겐의 다양한 측정법 비교

하종목,김상원,임인석,신미용,한영신,안강모,이상일,김지현 대한 소아알레르기 호흡기학회 2010 Allergy Asthma & Respiratory Disease Vol.20 No.4

Purpose:This study was conducted to evaluate the accuracy of semiquantitative tests targeting house dust mite (HDM) allergens. Methods:Thirty-nine dust samples were collected from the homes of 14 patients. These samples were evaluated using the following semi-quantitative tests: Rapid test for Mite AllergenⓇ, AcarexⓇ, Mitey checkerⓇ, and SD CHECK Quick Mite TestⓇ. The samples were then assayed by enzyme-linked immunosorbent assay (ELISA) for Der p 1, Der f 1 and group 2 allergens. Finally, the results from the 4 kits were compared and the correlation with ELISA was determined. Results:Concentrations of HDM allergens determined using AcarexⓇ were associated with those of SD CHECK Quick Mite TestⓇ and Mitey checkerⓇ, (P=0.004 and 0.035, respectively; ρ=0.454 and 0.339, respectively). The concentrations determined by SD CHECK Quick Mite TestⓇ were associated with those of Mitey checkerⓇ and Rapid test for Mite AllergenⓇ (P=0.000 and 0.001, respectively; ρ=0.664 and 0.518, respectively). There was also a significant correlation between the results obtained using Mitey checkerⓇ and Rapid test for Mite AllergenⓇ (P=0.000, ρ=0.602). The Der f 1 levels were associated with the concentrations determined by SD CHECK Quick Mite TestⓇ, Mitey checkerⓇ and Rapid test for Mite AllergenⓇ (P=0.003, 0.000 and 0.005, respectively; ρ=0.467, 0.544 and 0.438, respectively). Group 2 allergen levels were associated with the concentrations determined by SD CHECK Quick Mite TestⓇ and Rapid test for Mite AllergenⓇ (P=0.019 and 0.038, respectively; ρ=0.374 and 0.334, respectively). Conclusion:Four popular semiquantitative test kits may be adequate for detecting HDM allergens at home. However, quality assurance is needed for clinical usage because they showed variable sensitivity and specificity. 목적:반정량적 집먼지진드기 농도 측정 시약 판매와 이를 이용한 측정 대행 업체들이 증가하고 있는 실정이지만 이들 사이의 상관성과 정확성에 대해서는 규명된 바가 거의 없다. 따라서 국내에 유통되고 있는 반정량적 시약들 간의 관련성을 알아보고, ELISA와의 비교를 통해 그 정확성을 알아보고자 하였다. 방법:호흡기 혹은 알레르기 증상으로 본원 외래를 방문한 소아 환자 14명의 39개 침구류를 대상으로 국내에 유통되는 4가지 반정량적 측정 시약을 이용하여 집먼지진드기 농도를 측정하고 ELISA로 Der p 1, Der f 1, 제2군 집먼지진드기 알레르겐을 측정한 뒤 비교 분석하였다. 결과:제품 AcarexⓇ와 Rapid test for Mite AllergenⓇ를 제외한 제품들 사이에 상관관계가 있는 것으로 나타났다. ELISA로 측정한 Der f 1 농도와 SD CHECK Quick Mite TestⓇ, Mitey checkerⓇ, Rapid test for Mite AllergenⓇ 사이에 상관성을 나타냈고, AcarexⓇ의 결과와는 관련이 없었다. 제2군 알레르겐의 농도는 SD CHECK Quick Mite TestⓇ, Rapid test for Mite AllergenⓇ의 결과와 상관관계가 있었으나, AcarexⓇ, Mitey checkerⓇ의 결과와는 관련이 없었다. 결론:국내에서 판매되고 있는 반정량적 집먼지진드기 농도 측정 시약들 간의 상관성이 확인되었으나 민감도와 특이도의 경우 제품별로 차이가 있어 이에 대한 대책 마련이 필요할 것으로 판단된다.

Analysis of positive rates for standard allergens of patch test in Korea with literature review

( Bo Ram Kwon ),( Min Young Lee ),( Ji Yeon Byun ),( You Won Choi ),( Hae Young Choi ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Korean standard series (KSS) have no change for 20 years. Moreover, the Korea Food and Drug Administration has suspended import licensing of Cosmetic series(ChemotechiniqueⓇ) Objectives: To analyze trends in the positive rates of allergens in KSS and to compare the results to those using European baseline series(EBS) and North American Contact Dermatitis Group(NACDG) screening series through literature review. Methods: Positive rate of KSS allergens were analyzed from the contact dermatitis patients who visit the department of dermatology in Ewha Womans University Mokdong Hospital from 1998 to 2018. Literature reviews were conducted via comparison with the results of 2015-2016 NACDG, 2013-2014 ESSCA, and standard antigens in K-camp. Results: The positive rates for KSS allergens from patients in 2018 were compared to those from 1998 to 2007. The top 3 allergens in two study periods are all metal allergens. The positive rates for balsam of Peru and paraben mix increased from 7.1% to 17.46% and from 2.73% to 7.94%, respectively. As compared with the results of NACDG standard series and EBS, KSS lacked fragrance and cosmetic series of allergens, especially fragrance mix II, methyldibromo glutaronitrile, and methylisothiazolinone. Conclusion: Our results, especially increasing trends of balsam of Peru and paraben mix, would be proven by multicenter study. Also, in the sight of increase of fragrance and preservative allergens, KSS could need the addition of the related allergens.