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
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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
/