알레르기 질환의 증가 요인  기관지천식  알레르기성 비염  아토피 피부염  약물 알레르기  두드러기  식품 알레르기  직업성 알레르기  아나필락시스  집먼지진드기  `  스트레스  대기오염  담배  음식    비염-매우 흔한 질환   미국 (알레르기 비염)  영국  한국  5 만명 (’97), 40세까지 42%에서 경험  소요비용 : 31조2천억  알레르기 비염 : 인구의 16%  
알레르기 비염 : 인구의 소아 15%, 성인 19.3% (5명 중 1명)
                    ig e mediated disease  by antigen  develop symptom on nose and neighboring organ  associated with co-morbid disease  influence qol  characteristics of ar    알레르기 행진과 알레르기 비염  
-전신 질환으로 이해
food  sensitivity  eczema  gi  distress  recurent  otitis  media  allergic  rhinitis  asthma  inhalant  sensitivity  time(~years)    천식과 비염의 밀접한 관련성  기관지 천식   알레르기 비염  천식 40~50%  비염 70~90%  기관지 천식  부비동염 25~70%    
epidemiologic links between allergic rhinitis and asthma
most patients with asthma have allergic rhinitis
approximately 80% of asthmatics have   allergic rhinitis  slide 4  sga 2001-w-6472-ss  

adapted from the workshop expert panel. management of allergic rhinitis and its impact on asthma (aria) pocket guide

a pocket guide for physicians and nurses. 2001; bousquet j and the aria workshop group j allergy clin immunol xxxx

xx. xx(5):s147-s334; sibbald b, rink e thorax xxxx

xx. xxxxx-xxx; leynaert b et al am j respir crit
care med 2 ;xxxx.xx.xx-1396.
asthma  alone  allergic rhinitis  alone  allergic  rhinitis     asthma  *  slide 4  

allergic rhinitis and asthma frequently coexist. most patients with asthma have allergic rhinitis (up to 80%)

xxx-xxx among participants from two french centers in the european community respiratory health survey (ecrhs), 79% (77/98) of patients with asthma had concurrent rhinitis, and 20% (xxxx. xx

xx) with allergic rhinitis had concurrent asthma. asthma was defined as one or more asthma attacks in the preceding 12 months or positive response to metachloline challenge

patients were considered to have allergic rhinitis if they responded positively to one or two questions regarding rhinitis symptoms. 18
epidemiologic studies support the suggestion that allergic rhinitis should be suspected as a comorbid condition in most patients with asthma.
  알레르기 비염의 특징적 증상  맑은 콧물  재채기  코막힘  코가려움    코, 눈 알레르기 증상  코가 가렵다  콧물/재채기  코막힘  눈이 가렵다  충혈  귀가 가렵다  열감  몸살 기운  기운이 없다  찬공기, 온도변화, 먼지,   자극성 냄새, 담배 냄새    *  
meatus : turbinate(concha)와 lat.wall 사이의 공간
  activation of t cell and ige production  macrophage  allergen  mhc molecula  antigen peptide  t cell receptor  helper t cell  mast cell  b cell  eosinophil  antigen producing cell  increased ige production  cd80/86  cd28  il-4, il-13  il-3, gm-csf  il-5  il-3, gm-csf  ige  *     (이하 생략)