Vol.9 No.1 March, 2008

(

) ............................ 2 ............................................................... 3

(Are probiotics & prebotics good bacteria?) ... 5 New agents show promise in the management of atopic dermatitis ....................... 8 ................................ 10

A. 1.

97

3 23 3 30 4 13 Updated Information Relate with Pediatric Asthma Management 2. 4 13 3.

4

26

27

............................................................... 13 ................................................................. 14 ................................ 15

100 6 5 19081661 T e l (02) 2311-4670 Fax (02) 2311-4732 http://www.air.org.tw

508

19391392 T e l (02) 2311-4670 Fax (02) 2311-4732 http://www.asthma.org.tw ( 1000-1500

---)

4. 16

00

97 9

5

18

(

)14

00

B. 1. 22 nd European Immunogenetics and Histocompatibility Conference, April 02, 2008 - April 05, 2008.Toulouse France E-mail: [email protected] 2. Allergy and Clinical Immunology, April 04, 2008 - April 04, 2008. Minneapolis United States E-mail: [email protected] 3. The 7th Annual Conference of The Egyptian Society of Asthma and COPD, April 16, 2008 - April 17, 2008. Cairo Egypt E-mail: [email protected] 4. Immunopharmacology 2008, April 19, 2008 - April 22, 2008. Varadero Beach Cuba E-mail: [email protected] 5. The 5th International Congress on Familial Mediterranean Fever and Systemic Autoinflammatory Diseases. April 04, 2008 April 08, 2008. Rome Italy. E-mail: [email protected] 6. 3-rd National Congress of Immunology, May 08, 2008 - May 10, 2008. Varna Bulgaria. E-mail: [email protected] 7. Cytokines 2008, May 10, 2008 - May 15, 2008. Kololi Gambia. E-mail: [email protected] Vol.9 No.1 March 2008

1

8. 25 Years of HIV, May 19, 2008 - May 21, 2008. Paris France. E-mail: [email protected] 9. 3rd Tutzing Autoimmunity Conference, May 20, 2008 - May 23, 2008. Tutzing Germany. E-mail: daria. [email protected] 10. Discovery Strategies: Modeling Human Autoimmune Diseases in the Laboratory Mouse, May 27, 2008 - May 29, 2008. San Francisco United States. E-mail: [email protected]

(

)

8

bcl-2 c -kit

3

-6 (IL-6)

GOT:66 IU/L

GPT:

144IU/L Giemsa stain ( )

H2

(

darier

) 75

2

Vol.9 No.1 March 2008

( ) darier

Giemsa stain

toluidine

blue stain

(H1

H2

)

cromoglycate

Epidermolysis Bullosa

X

15

X

Strachan

Th1

Th2 Th1

Th2 innate

IL-13

adaptive

Th2

Th1 B

Th2 class switch

IL-4 IgE

Th2 (Genotype/ Phenotype)

(

Crohn's disease, Th2

)

Innate Th1

Th2 Th1

Vol.9 No.1 March 2008

Th2 3

Th1

Th2

T

IgG (3)

innate immunity

IFNTreg

IL-10

(1) (4)

(Muramic acid)

80%

(5)

(2)

(2)

(

) Probiotics (6)

CpG A A A EBV

CMV

IgE

4

Vol.9 No.1 March 2008

(?)

(?)

A EBV

(

References 1. Schaub B, Lauener R, von Mutius E. The many faces of the hygiene hypothesis. J Allergy Clin Immunol 117 969-77, 2006 2. Wassall HJ, Devenny AM, Daud Khan S, Ninan TK, Russell G. A comparison of virus-associated and multi-trigger wheeze in school children. J Asthma 42 737-44, 2005 3. Lemanske RF, Jackson DJ, Gangnon RE, et al. Rhinovirus illnesses during infancy predict subsequent childhood wheezing. J Allergy Clin Immunol 116 571-7, 2005 4. Matricardi PM, Rosmini F, Riondino S, et al. Exposure to foodborne and orofecal microbes versus

)

airborne viruses in relation to atopy and allergic asthma: epidemiological study. Bmj 320 412-7. 2000 5. Yazdanbakhsh MP, M., Kremsner PG, van Ree R. Allergy, parasites, and the hygiene hypothesis. Science 296 490-4, 2002 6. Schram-Bijkerk D, Doekes G, Douwes J, et al. Bacterial and fungal agents in house dust and wheeze in children: the PARSIFAL study. Clin Exp Allergy 35 1272-8, 2005 7. Kalliomaki M, Salminen S, Poussa T, Arvilommi H, Isolauri E. Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebocontrolled trial. Lancet 361 1869-71, 2003

(Are probiotics & prebotics good bacteria?) 1

1

2 1

2

2

(probiotics) Probiotic

pro biotic

Vol.9 No.1 March 2008

for life 5

Klebsiella, Citrobacter, Enterobactor

Candida

albincans Clostridium difficile Bifidobacterium (Clostridium) (necrotizing enterocolitis) (3)

(75%

carbamazepine, phenytoin (3) (4) (

1956

) (CD95-fas ligand)

Lyell Toxic epidermal necrolysis (

TEN) Erythema Multiforme( )

Nikolsky sign

Steven-Johnson syndrome(

SJS) . SJS (

10%)

TEN(

(1~3

30%). 0.4~1.2

( 10

)

(1~3

(1) Vol.9 No.1 March 2008

) )

3~4 (1) ( )

(2) (3)

(4) (5)

. 30%

BUN (

SCORTEN (toxic epidermal

)

necrolysis - specific severity-of-illness score) (1) (2) (

)

necrolysis in children. Milton H Nirken, MD.

( )

(

www.Uptodate.com, 2008

) (

2. Long-term follow-up of patients treated for toxic

)

epidermal necrolysis. J Burn Care Res 27

( )

1. Steven-Johnson syndrome and toxic epidermal

(

26-33,

2006 3. Chronic pulmonary complications associated with toxic epidermal necrolysis: report of a severe case

)

with anti-Ro/SS-A and a review of the published work. Journal of Dermatology 33

616-22, 2006

4. Pulmonary complications in toxic epidermal necrolysis: a prospective clinical study. Intensive 3~4

Care Med 23

1237-44, 1997

5. Clinical characteristics of childhood erythema multiforme, Steven-Johnson syndrome and toxic epidermal necrolysis in Taiwanese children. J Microbiol Immunol Infect 37 Vol.9 No.1 March 2008

366-70, 2004 11

---

21 (Staphylococcus aureus) (1) Job Syndrome(Hyper IgE syndrome)

(2) (pneumocuccal vaccine)

(

)

Job Syndrome B-

(3) 1918 2

(

) 5000

(evidence based medicine) DPT polio X

Vol.9 No.1 March 2008

13

Th1 3. (

) (

)

4.

Reese

2007

Nature Th2

----

IL-4

chitotriosidase I (CHIT1)

IL-13

AMC

acidic mammalian chitinase (AMC)

chitinase-3- like proteins 3 and 4

AMC /

A.

[5] 2

B. 2004

6

Science

Th2

AMC 1.

AMC BALF( )

Th1

[1] Science[2]

Th2

9 2.

[3]

1. 2. AMC

(polymorphism) 1. Zhou Z,et al. Science 304

[4]

2. Couzin J. Science 304

1678-82, 2004

1577, 2004

3. Willis-Karp M, Caprt CL. New Eng J Med 351 1455-7, 2004 1.

AMC mRNA

2. 14

4. Bierbaum S, et al.Am J Respir Crit Care Med 172 (12)

1505-9, 2005 Dec 15

5. Reese TA,et al. Nature 447(7140) Vol.9 No.1 March 2008

92-6, 2007

SLE

PP)

AT

PP 8

(plasmapheresis, PP)

(

(double filtration, DF)

1

2)

2

10

(iv) (PP PP 2

3)

2

3 3

IVMP

PP

(platelet count: 12000/mm3) 3

(

5 5

1

18

(

)

(plasmapheresis, PP) 6

4

)

DF(

)

5

15 (platelet count: 8000/ (Therapeutic plasma

mm3) (plasmapheresis, PP) 3

4

exchange)

PP 3

12

SLE

1 (hemoglobin

1.5

40ml/kg

7.4gm/dl)

1.

Therapeutic Plasmapheresis:

Plasma exchange. 2. Double filtration

(iv)

plasmapheresis. 3.Plasma perfusion

(plasmapheresis, PP) 6 DFPP(

)4

Plasmapharesis (PP)

PP PP

, 1.

(autoimmune thrombocytopenia, AT) . 2.

. 3.

AT (IVMP) 3

7

IVMP

Double filtration(DF) DF(

AT

)

(plasmapheresis, Vol.9 No.1 March 2008

15

B2

(M.G) (AIDP) (TTP/ HUS)

[

]

1. Antibodies: Anti-GBM Ab disease; MG 2. Immune complex: SLE

(Goodpasture)

3. Cryoglobulin: Cryoglobulinemia

(RPGN)

4. Myeloma protein: Myeloma nephropathy

CIDP, Hepatic failure, Familial

5. Endotoxin,cytokine: Sepsis

hypercholesterolemia, etc

6. Cholesterol, LDL-c: Familial hypercholesterolemia 1.

Citrate

: Anti-thrombotic or fibrinolytic factor: HUS/TTP

2.

hypocalcemia ,

(Immunomodulation):

, CMV, HTLV-III)

Removal of complement products: SLE

anaphylaxis

Effect of immune regulation: Transplantation

fibrinolytic cascade, 1.

(

2. Plasma exchange 60kg

5% =3000cc

/

Citrate

) (

24U FFP

)

3. Double filtration plasmapheresis 10% = 300cc Albumin 25% 50cc 1 bottle N/S 250cc

(autoimmune-induced thrombocytopenia, AT)

(

1. DF

2.

chloroquine

3.

16

IVIG

,

) PP

5

1-2

IVIG

1-2 PP

Vol.9 No.1 March 2008

/