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논문 기본 정보

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학술저널
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대한소아알레르기호흡기학회 Allergy Asthma & Respiratory Diseases Allergy Asthma & Respiratory Diseases 제1권 제1호
발행연도
2013.1
수록면
11 - 19 (9page)

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Asthma is a heterogeneous disorder with a variable course, characterized by episodes of cough, wheezing and shortness of breath, reversible airflow limitation, and bronchial hyperresponsiveness (BHR). It begins early in life in many subjects, and it is well recognized that over 50% of asthmatic children go into long-term clinical remission, defined as the complete absence of asthmatic symptoms and no asthma medication for at least 24 months, during adolescence. Several studies have shown spirometric abnormalities and BHR during clinical remission. It is unknown whether these functional abnormalities, which are supposed to be indicative of asthma severity with respect to symptomatic asthma, reflect persistent airway inflammation or merely indicate residual airway damage or are related to another mechanism such as a familial predisposition. It is likely that the nature of BHR in asthma remission is not same as that in symptomatic asthma. We have shown that the former condition is associated with lower levels of blood eosinophils and eosinophilic cationic protein, a lower degree of bronchial responsiveness to exercise, and a more common formation of plateau on the dose-response curve to high-dose inhaled methacholine (i.e., limited maximal airway narrowing), compared to the latter condition. It is still controversial whether BHR in adolescents with asthma remission is reduced by inhaled corticosteroids. Better understanding of the mechanisms that lead to asthma remission, especially that seen during adolescence, is likely to lead to significant advances in our understanding of asthma pathogenesis, and should provide insights into how remission might be induced with therapy. We still have minimal understanding of the mechanism underlying BHR in adolescents with asthma remission. Elucidation of this mechanism would be an important step towards new perspectives that see remission as the next therapeutic frontier in asthma.
#Adolescence #Asthma #Bronchial hyperresponsiveness #Clinical remission

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참고문헌 (37)

참고문헌 신청
Koh YY / 2001 / Effect of inhaled budesonide on bronchial hyperresponsiveness in adolescents with clinical remission of asthma / Chest 120:1140~1146 google schola Koh YY / 2003 / Bronchial hyperresponsiveness in adolescents with long-term asthma remission: importance of a family history of bronchial hyperresponsiveness / Chest 124:819~825 google schola Koh YY / 2003 / Absence of association of peripheral blood eosinophilia or increased eosinophil cationic protein with bronchial hyperresponsiveness during asthma remission / Ann Allergy Asthma Immunol 91:297~302 google schola Tatar M / 2005 / Induced sputum eosinophils, bronchial reactivity, and cough sensitivity in subjects with allergic rhinitis / J Physiol Pharmacol 56:227~236 google schola Koh YY / 2002 / Maximal airway response in adolescents with long-term asthma remission and persisting airway hypersensitivity: its profile and the effect of inhaled corticosteroids / Chest 122:1214~1221 google schola

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