Publications by authors named "Young-Il Koh"

Nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity reactions are commonly reported but often overestimated due to reliance on clinical history alone. Accurate diagnosis and identification of safe alternative medications are essential for appropriate management. This retrospective study aimed to evaluate the clinical manifestations of NSAID hypersensitivity, assess the diagnostic value and safety of aspirin oral provocation testing, and investigate the tolerability of alternative medications, including acetaminophen, meloxicam, and celecoxib.

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The anergic period is defined as a period of around 3-6 weeks following a systemic allergic reaction when skin test results are negative. Therefore, most guidelines recommend that physicians should conduct skin test 6 weeks after an immediate hypersensitivity reaction. However, in vitro tests, including serum-specific immunoglobulin E (IgE) measurement, are generally deemed unaffected by the anergic period.

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Mepolizumab, an interleukin-5 antagonist, is globally recognized for its efficacy in randomized controlled trials for the treatment of severe eosinophilic asthma. The present study explored its real-world effectiveness and safety in a Korean cohort, filling a critical gap in current research. This multi-center retrospective study used data from the Korean Severe Asthma Registry, involving 67 patients treated with mepolizumab for uncontrolled severe asthma between September 2017 and July 2022.

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Background: Drug hypersensitivity reaction (DHR) poses significant challenges in clinical practice, with some patients experiencing more severe reactions upon re-exposure. Understanding the factors contributing to escalation into more severe reactions is crucial for improving patient safety. This study aimed to investigate the clinical characteristics and risk factors associated with the progression from non-severe DHR to anaphylaxis.

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This study aimed to identify recent changes of AIT treatment behaviors in real-world clinical practice using a questionnaire survey in Korea. The questionnaire on AIT prescriptions and practical experiences was distributed to all members of the Korean Academy of Asthma Allergy and Clinical Immunology in June 2022. The responses were analyzed and compared with the results from 2009 and 2017.

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Background: The frequency of cefaclor-induced immediate hypersensitivity reactions has increased in Korea. Skin prick tests (SPTs) and intradermal tests (IDTs) using cephalosporins are not as well validated as those using penicillin. Limited data are available regarding the diagnostic value of SPTs and IDTs for cefaclor-induced immediate hypersensitivity reactions.

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Background: Clonal hematopoiesis of indeterminate potential (CHIP) is associated with cardiovascular diseases and other disorders, possibly via inflammation. Recent research suggests a connection of CHIP with neurodegenerative disorders.

Objective: We aimed to investigate the association between multiple system atrophy (MSA) and CHIP.

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Article Synopsis
  • Patients with severe asthma often face lung function decline (LFD), but reliable biomarkers to predict this decline are still being identified.
  • A study analyzed CT images from 102 severe asthma patients to find links between imaging features and past instances of LFD, focusing on airway structure and lung health metrics.
  • The findings showed that lower airway wall thickness (WT) and higher levels of fractional exhaled nitric oxide (FeNO) were associated with worse LFD, suggesting these factors could guide better management strategies for these patients.*
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This study aimed to determine the effects of indoor environment (IE) and outdoor air pollutants (OAPs) in residential areas on acute exacerbation (AE) in patients with severe asthma. A total of 115 participants were recruited. To characterize IE, we used structured questionnaires and estimated OAP concentrations using a land-use regression model.

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Purpose: Few studies have compared the clinical characteristics of severe asthma (SA) in elderly patients compared to that in nonelderly patients.

Methods: We analyzed data from the Korean SA Registry, a nationwide, real-world observational study of SA in Korea. The baseline clinical characteristics, disease control status, and medication use of the patients were compared between elderly (≥ 65 years) and nonelderly groups.

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Purpose: Severe asthma is associated with high morbidity and healthcare utilization; however, treatment options for these patients are limited. This study aimed to determine the therapeutic effects of biologics in clinical practice.

Methods: This multicenter, retrospective cohort study included 136 patients who received biologics for at least 4 months between September 2017 and July 2022 at 25 medical centers affiliated with the Korean Severe Asthma Registry (KoSAR).

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Article Synopsis
  • Exposure to allergens at work can worsen asthma and impact patients' quality of life (QoL).
  • In a study of 364 adults with severe asthma, 17.9% were found to have work-related asthma (WRA), highlighting its prevalence.
  • Those with WRA faced higher levels of anxiety and depression and reported a lower QoL compared to their counterparts without WRA, despite similar asthma control and lung function.
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Background: Symptom perception and quality of life (QOL) are important domains for properly managing severe asthma. This study aimed to assess the relationship between airway structural and parenchymal variables measured using chest computed tomography (CT) and subjective symptom perception and QOL in patients with severe asthma enrolled in the Korean Severe Asthma Registry.

Methods: This study used CT-based objective measurements, including airway wall thickness (WT), hydraulic diameter, functional small airway disease (fSAD), and emphysematous lung (Emph), to assess their association with subjective symptom (cough, dyspnea, wheezing, and sputum) perception measured using the visual analog scale, and QOL measured by the Severe Asthma Questionnaire (SAQ).

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Healthcare workers are known to be at a higher risk of experiencing occupational contact dermatitis and attention should be paid to new materials that cause contact dermatitis. Sodium tetradecyl sulfate is widely used in the treatment of small varicose veins of the legs and venous malformations. We report the case of a 42-year-old woman, a healthcare worker, who presented with contact dermatitis caused by sodium tetradecyl sulfate.

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Purpose: The role of allogeneic stem cell transplantation (alloSCT) in multiple myeloma (MM) treatment remains controversial. We conducted a retrospective, multicenter, nationwide study in Korea to evaluate the outcomes of alloSCT in Asian patients with MM.

Materials And Methods: Overall, 109 patients with MM who underwent alloSCT between 2003 and 2020 were included in this study.

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Allergen immunotherapy is regarded as the only disease-modifying treatment option for various allergic conditions, including allergic rhinitis and asthma. Among the routes of administration of allergens, sublingual immunotherapy (SLIT) has gained clinical interest recently, and the prescription of SLIT is increasing among patients with allergies. After 30 years of SLIT use, numerous pieces of evidence supporting its efficacy, safety, and mechanism allows SLIT to be considered as an alternative option to subcutaneous immunotherapy.

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Allergen immunotherapy (AIT) is a causative treatment for various allergic diseases such as allergic rhinitis, allergic asthma, and bee venom allergy that induces tolerance to offending allergens. The need for uniform practice guidelines in AIT is continuously growing because of the increasing discovery of potential candidates for AIT and evolving interest in new therapeutic approaches. This guideline is an updated version of the Korean Academy of Asthma Allergy and Clinical Immunology recommendations for AIT published in 2010.

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Background: Iodinated contrast media (ICM) are a common cause of drug-induced immediate hypersensitivity reaction (IHR). Repeated use of ICM is often necessary; therefore, a standardized protocol to prevent recurrence of IHR is required.

Objective: We aimed to propose an intradermal skin test (IDT)-guided strategy for previous reactors to prevent recurrence of IHR.

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Background: Clonal haematopoiesis of indeterminate potential (CHIP) is a predisposition to haematological malignancy whose relationship with chronic inflammatory diseases, such as cardiovascular diseases, has been highlighted. Here, we aimed to investigate the CHIP emergence rate and its association with inflammatory markers in Behçet's disease (BD).

Methods: We performed targeted next-generation sequencing to detect the presence of CHIP using peripheral blood cells from 117 BD patients and 5004 healthy controls between March 2009 and September 2021 and analysed the association between CHIP and inflammatory markers.

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Background: Although beta-lactams are 1 of the major causative agents of severe cutaneous adverse reactions (SCAR), their epidemiology and clinical aspects have been poorly studied. This study aimed to investigate the characteristics of SCAR caused by beta-lactams in the Korean SCAR registry.

Methods: We retrospectively analyzed beta-lactam-induced SCAR cases collected from 28 tertiary university hospitals in Korea between 2010 and 2015.

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Background/aims: Chronic spontaneous urticaria (CSU) poses a considerable burden both on the quality of life (QoL) of individual patients and on healthcare systems. Real‑world data evaluating the disease burden of CSU are limited in this country. This study evaluated the disease burden and healthcare resource utilization (HRU) among symptomatic CSU patients.

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Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, potentially life-threatening, delayed, drug-induced hypersensitivity reaction. Immediate withdrawal of the culprit drug and administration of systemic corticosteroids is the most widely accepted treatment. However, it is difficult to manage patients with DRESS syndrome who are not responsive to systemic steroids.

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Article Synopsis
  • Multiple drug hypersensitivity syndrome (MDHS) can lead to significant treatment delays and severe reactions, particularly in response to first-line anti-tuberculosis medications, with limited clinical data available.
  • A study of 27 patients revealed that 48% diagnosed with MDHS had reactions to combinations of drugs, with ethambutol and rifampin being the most frequent culprits.
  • All patients with MDHS were successfully treated with alternative drugs, highlighting the importance of assessing allergic reactions to these drugs even in cases of non-severe hypersensitivity.
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Cutaneous T-cell lymphomas (CTCLs) are a group of T-cell lymphomas with low incidence. Due to their indolent characteristics, treatment strategies have not yet been established for advanced CTCLs. In this study, relative incidence of CTCLs in Asia was estimated and the therapeutic outcomes presented based on various treatments currently used in clinics for advanced CTCLs.

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The Working Group on Severe Asthma of the Korean Academy of Allergy and Clinical Immunology recently published an expert opinion paper on the management of severe asthma in Korea. When developing a consensus, the working group encountered several diagnostic and treatment issues and decided to perform a questionnaire survey of Korean specialists with regard to severe asthma. An e-mail with a uniform resource locator link to the questionnaire was sent to 121 asthma specialists, of whom 44.

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