Papers by Jing-long Huang
Journal of Microbiology, Immunology and Infection, 2019
RATIONALE: Atopic eczema and food allergy are common during the first 2 years of life. The relati... more RATIONALE: Atopic eczema and food allergy are common during the first 2 years of life. The relationship between eczema onset after infancy and allergen sensitizationand atopic diseases was investigated. METHODS: We investigated 186 children followed up regularly for 4 years in a birth cohort study. Early-onset eczema was defined to occur symptoms before age of 2. Specific IgE antibodies against food (egg white, milk, and wheat) and inhalant allergens (mite) were measured at 6 months as well as 1, 1.5, 2, 3 and 4 years of age. The associations between onsets of eczema and atopic indices were assessed. RESULTS: A significantly higher prevalence of sensitization to food, especially milk was found in children with early-onset eczema compared to children without eczema at age 1, 1.5, 2, 3 and 4. A significantly higher number of eosinophils was found in children with early or late-onset eczema compared to children without eczema at age of 1.5 years. Both early and late-onset eczema were not only significantly associated with higher prevalence of allergic rhinitis at 2, 3, and 4 years of age, but also asthma at age 2. Furthermore, early-onset eczema appeared to show a significantly increased risk of allergic rhinitis [odds ratio (OR), 3.71; 95% confidence interval (CI), 1.37-10.02; P 5 0.010] and asthma (OR, 3.80; 95% CI, 1.12-12.85; P 5 0.032) at an age of 4 years. CONCLUSIONS: Early-onset eczema appears not only to be associated with an increase in the prevalence of milk sensitization but also the risk of rhinitis and asthma in early childhood.
Clinical & Experimental Allergy
BackgroundEczema (atopic dermatitis) is a major global public health issue with high prevalence a... more BackgroundEczema (atopic dermatitis) is a major global public health issue with high prevalence and morbidity. Our goal was to evaluate eczema prevalence over time, using standardized methodology.MethodsThe Global Asthma Network (GAN) Phase I study is an international collaborative study arising from the International Study of Asthma and Allergies in Children (ISAAC). Using surveys, we assessed eczema prevalence, severity, and lifetime prevalence, in global centres participating in GAN Phase I (2015–2020) and one/ both of ISAAC Phase I (1993–1995) and Phase III (2001–2003). We fitted linear mixed models to estimate 10‐yearly prevalence trends, by age group, income, and region.ResultsWe analysed GAN Phase I data from 27 centres in 14 countries involving 74,361 adolescents aged 13–14 and 47,907 children aged 6–7 (response rate 90%, 79%). A median of 6% of children and adolescents had symptoms of current eczema, with 1.1% and 0.6% in adolescents and children, respectively, reporting sy...
Nutrients
Vitamin D has been implicated in the pathogenesis of skeletal disorders and various autoimmune di... more Vitamin D has been implicated in the pathogenesis of skeletal disorders and various autoimmune disorders. Vitamin D can be consumed from the diet or synthesized in the skin upon ultraviolet exposure and hydroxylation in the liver and kidneys. In its bioactive form, vitamin D exerts a potent immunomodulatory effect and is important for bone health. Juvenile idiopathic arthritis (JIA) is a collection of inflammatory joint diseases in children that share the manifestation of inflamed synovium, which can result in growth arrest, articular deformity, bone density loss, and disability. To evaluate the potential effect of vitamin D on JIA disease manifestations and outcomes, we review the role of vitamin D in bone metabolism, discuss the mechanism of vitamin D in modulating the innate and adaptive immune systems, evaluate the clinical significance of vitamin D in patients with JIA, and summarize the supplementation studies.
Infection, 2003
Ocular herpes simplex virus (HSV) infection is generally accepted to be a unilateral disease and ... more Ocular herpes simplex virus (HSV) infection is generally accepted to be a unilateral disease and simultaneous bilateral recurrent ocular HSV disease is uncommon. Recurrent ocular herpes was generally thought to be characterized by corneal involvement. We here report an 11-year-old boy with monthly bilateral recurrent HSV type 1 blepharitis for more than 10 years. He had a general normal immunological examination. Only supportive or topical acyclovir ointment treatment proved adequate for controlling the monthly recurrent disease without corneal involvement or other sequelae to date. The case highlights the unusual presentation, general normal immune function, clinical course and treatment opinion for recurrent HSV blepharitis.
Clinical Microbiology and Infection, 2017
Objectives: The study aimed to determine the long-term Staphylococcus aureus colonization pattern... more Objectives: The study aimed to determine the long-term Staphylococcus aureus colonization patterns and strain relatedness, and the association between maternal and infant colonization in infancy. Methods: A birth cohort study was conducted from January 2012 to November 2014. Nasopharyngeal swabs for S. aureus detection were collected from infants at the age of 1, 2, 4, 6 and 12 months and from mothers when their children were 1-month-old. Results: In total, 254 samples were collected at each planned visit during the first 12-month study. The prevalence of S. aureus colonization decreased in the first year of life, ranging from 61.0% (155/254) at the age of 1 month to 12.2% (31/254) at 12 months. Persistent colonization, defined as a positive culture on four or five occasions, was detected in only 13.8% (35/254) of carriers. Most of the persistent carriers were colonized with methicillin-resistant S. aureus (MRSA) only, and among persistent MRSA carriers, 61.1% (11/18) had indistinguishable genotypes. Of the mothers with MRSA colonization, 77.1% (27/35) had infants who were concomitantly colonized at the age of 1 month; 70.4% (19/27) of the infantemother paired isolates belonged to indistinguishable or related subtypes, which suggests that surrounding carriers, probably their mothers, may be the possible source for MRSA acquisition in early infancy. Conclusions: Staphylococcus aureus colonization including MRSA was commonly observed in our cohort. Strains of persistent MRSA among infantemother pairs were usually of indistinguishable genotypes. Therefore, horizontal spread within households is possibly an important factor related to infant MRSA colonization.
Chang Gung medical journal
Hypertensive encephalopathy is an uncommon neurological syndrome in children, usually with revers... more Hypertensive encephalopathy is an uncommon neurological syndrome in children, usually with reversible clinical and neuroimaging findings. Little is known about the precipitating factors, clinical presentations, neuroimaging findings and outcomes of childhood hypertensive encephalopathy in Taiwan. To characterize this syndrome, we retrospectively analyzed 12 children with hypertensive encephalopathy in a tertiary institution from 1998 through 2005. We investigated the precipitating factors, clinical findings, courses, neuroimaging characteristics and outcomes. Twelve patients (10 boys and 2 girls) with hypertensive encephalopathy were identified. Post-streptococcal glomerulonephritis was the most common precipitating underlying disease. Common clinical presentations included mental change (100%), seizure (91.6%), headache (66.6%), nausea or vomiting (75%), and blurred vision (41.6%). Brain imaging studies showed vasogenic edema over the bilateral parietal, occipital and parasagittal ...
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2014
The association between vitamin D status at birth and allergen sensitizations is uncertain. The a... more The association between vitamin D status at birth and allergen sensitizations is uncertain. The aim of this study was to investigate the relationship between cord blood vitamin D status with allergen sensitizations and the development of atopic diseases in early childhood. Children aged 0 through 4 yr from a birth cohort in the Prediction of Allergies in Taiwanese Children (PATCH) study were enrolled. Serum levels of 25-hydroxyvitamin D (25(OH)D) in cord blood were measured by a new automated electrochemiluminescence-based assay. Specific IgE antibodies against food and inhalant allergens were measured at 6 months, and 1, 1.5, 2, 3, and 4 yr of age. A total of 186 children were regular followed up at clinics for a 4-yr follow-up period. The mean level of cord blood 25(OH)D was 23.8 ± 9.5 ng/ml with a high prevalence of low vitamin D status (<20 ng/ml) at birth (42%). There was a tendency of low cord blood 25(OH)D levels being associated with higher risk of food sensitization thro...
Pediatrics & Neonatology, 2014
Background: Headache is a common complaint in children and is one of the most common reasons for ... more Background: Headache is a common complaint in children and is one of the most common reasons for presentation at a pediatric emergency department (PED). This study described the etiologies of patients with headache seen in the PED and determined predictors of intracranial pathology (ICP) requiring urgent intervention. A secondary objective was to develop rapid, practical tools for screening headache in the PED. Methods: We conducted a retrospective chart review of children who presented with a chief complaint of headache at the PED during 2008. First, we identified possible red flags in the patients' history or physical examination and neurological examination findings. Then, we recorded the brain computed tomography results. Results: During the study period, 43,913 visits were made to the PED; in 409 (0.9%) patients, the chief complaint was headache. Acute viral, respiratory, and febrile illnesses comprised the most frequent cause of headache (59.9%). Six children (1.5%) had life-threatening ICP findings. In comparison with the group without ICP, the group with ICP had a significantly higher percentage of blurred vision (p Z 0.008) and ataxia (p Z 0.002). Conclusion: Blurred vision and ataxia are the best clinical parameters to predict ICP findings.
PLoS ONE, 2013
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening, virus-triggered immune disease. H... more Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening, virus-triggered immune disease. Hypersensitivity to mosquito bite (HMB), a presentation of Chronic Active Epstein-Barr Virus infection (CAEBV), may progress to HLH. This study aimed to investigate the immunologic difference between the HMB episodes and the HLH episodes associated with EBV infection. Immunologic changes of immunoglobulins, lymphocyte subsets, cytotoxicity, intracellular perforin and granzyme expressions, EBV virus load and known candidate genes for hereditary HLH were evaluated and compared. In 12 HLH episodes (12 patients) and 14 HMB episodes (4 patients), there were both decreased percentages of CD4+ and CD8+ and increased memory CD4+ and activated (CD2+HLADR+) lymphocytes. In contrast to HMB episodes that had higher IgE levels and EBV virus load predominantly in NK cells, those HLH episodes with virus load predominantly in CD3+ lymphocyte had decreased perforin expression and cytotoxicity that were recovered in the convalescence period. However, there was neither significant difference of total virus load in these episodes nor candidate genetic mutations responsible for hereditary HLH. In conclusion, decreased perforin expression in the HLH episodes with predominant-CD3+ EBV virus load is distinct from those HMB episodes with predominant-NK EBV virus load. Whether the presence of non-elevated memory CD4+ cells or activated lymphocytes (CD2+HLADR+) increases the mortality rate in the HLH episodes remains to be further warranted through larger-scale studies.
Lupus, 2013
ObjectivesImpaired function of polymorphonuclear cells (PMNs) in systemic lupus erythematosus (SL... more ObjectivesImpaired function of polymorphonuclear cells (PMNs) in systemic lupus erythematosus (SLE) leads to severe gram-positive and gram-negative bacterial infection, and to major morbidity and mortality. Few studies have focused on the association of impaired function of PMNs and SLE patients’ susceptibility to infection. This study aimed to analyze function of PMNs in peroxidase production, chemotaxis, and phagocytosis in pediatric-onset SLE with severe infection.MethodsThis study compared function of PMNs among pediatric-onset SLE patients with and without histories of severe infection and in normal control subjects. Human peripheral blood PMNs were isolated from patients and controls. Function of PMNs was measured by analyzing peroxidase, chemotaxis, and phagocytic activities. Different disease activity and severity, and drug use in newly diagnosed SLE patients were also compared.ResultsIn total, 34 SLE patients (12 patients with severe infection, 22 patients without infection...
Journal of Asthma, 2004
Background. It is often difficult to predict the timing and frequency of asthma attacks. In addit... more Background. It is often difficult to predict the timing and frequency of asthma attacks. In addition to interrupting the daily life of both the affected child and his/her family, asthma can also pose sudden danger to a child. Based on clinical observations, many asthma-affected children and their parents must constantly adjust themselves to the uncertainty of the disease, which leads to increased stress on the family. The use of care maps has demonstrated increased efficiency and effectiveness in the care of asthma patients from a variety of settings. Objective. We designed this study to construct and evaluate a care map for asthmatic children in Taiwan. Specific attention was placed on comparing the study and control subjects by parental knowledge of asthma, medication used for asthma, hospital readmission, and health care resource usage. Subjects and Methods. The care map was constructed by in-depth interviews with eight sets of parents of children with asthma. Forty-four parents of 42 asthma children were randomized into two groups in the Allergic Clinic of the Chang Gung Children's Hospital. The experimental group of 22 parents received individual instruction and training sessions in addition to the regular care provided to the control group of 22 parents. Results. Forty-two children with asthma were surveyed in this study. To examine the reliability and validity of a care map for children with asthma, a quantitative survey was conducted with 42 outpatient parents with asthmatic children.
The Lancet, 2021
Background Asthma is the most common chronic disease in children globally. The Global Asthma Netw... more Background Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing. Methods This updated cross-sectional study used the same methods as the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993-95), ISAAC Phase III (2001-03), or both. We included individuals from two age groups (children aged 6-7 years and adolescents aged 13-14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders. Findings Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993-2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (-0•37, 95% CI-0•69 to-0•04) and an increase in ever having asthma (1•25, 0•67 to 1•83) and night cough (4•25, 3•06 to 5•44), which was also found in children (3•21, 1•80 to 4•62). The prevalence of current wheeze decreased in low-income countries (-1•37,-2•47 to-0•27), in children and-1•67,-2•70 to-0•64, in adolescents) and increased in lower-middle-income countries (1•99, 0•33 to 3•66, in children and 1•69, 0•13 to 3•25, in adolescents), but it was stable in upper-middleincome and high-income countries. Interpretation Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.
Pediatric Infectious Disease Journal, 2015
Pathogenesis and host ResPonse Background: For acute respiratory diseases caused by bacteria, col... more Pathogenesis and host ResPonse Background: For acute respiratory diseases caused by bacteria, colonization in the respiratory tracts is often the first sign, although nasopharynx is the major source of secretions containing pathogens. To understand the pathogenesis of respiratory tract diseases, it is important to analyze the establishment of nasopharyngeal bacterial colonization. Methods: Infants with nasopharyngeal swabs were examined at the age of 1, 2, 4, 6 and 12 months for the detection of pathogens, including Streptococcus pneumoniae, Hemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes and Staphylococcus aureus. The methods used for detection were bacterial culture and multiplex polymerase chain reaction. Results: From January 2012 to August 2013, a total of 320 neonates were enrolled, and 120 of them completed the first 12-month study. Staphylococcus aureus was the most common pathogen at all 5 time points while the rates declined; in contrast, the other 4 increased during the first year of life. Of our series, the multiplex polymerase chain reaction detection rates were higher than those of bacterial culture. More than 50% of Staphylococcus aureus was methicillin-resistant, and the trend decreased in the same period. In the analysis of factors associated with the development of infant wheeze, infants with maternal atopy [odds ratio (OR): 3.26; 95% confidence interval (CI): 1.20-8.88; P = 0.02] and pneumococcal colonization (OR: 15.64; 95% CI: 3.25-75.35; P = 0.001) had higher rates of wheeze. Conclusions: Bacterial interactions may result in differing pathogen prevalence in the first year of life. In addition, nasopharyngeal pneumococcal colonization may have an effect on the risk of infant wheeze. The result could help clinicians to clarify the relation between bacterial colonization and respiratory illnesses in infancy.
Computer Physics Communications, 2011
A reversible ratchet by which Brownian particles can be transported might be attained through the... more A reversible ratchet by which Brownian particles can be transported might be attained through the periodic change of a potential in space and time. Since the integrated flow of particles in the ratchet along a certain process can be expressed as a contour integral in the space of potential parameters, it is possible, therefore, to investigate what kind of process has a better net flow of particles in a reversible ratchet system. In a certain process, we study the behavior of the particle flow in two potential parameters and then find that structures exist in the net flow of particles in different potentials or processes. Our findings can be useful in the design of Brownian motors.
Scientific reports, Jan 16, 2018
Few studies have addressed the mother-to-child transmission of Th2 immunity and the impact on the... more Few studies have addressed the mother-to-child transmission of Th2 immunity and the impact on the development of atopic diseases in early childhood. We investigated 186 children who were followed-up regularly for 4 years in a birth cohort study. The levels of Th2 related chemokine (C-C motif) ligand 17 (CCL17) and CCL22 were quantified in cord blood and at 1.5 years-of-age using multiplex Luminex kits. The levels of 125 pairs of CCL17 and CCL22 chemokines from birth to 1.5 years were recorded in this study. Using K-means clustering, only the declining trend of CCL22 levels was separately clustered (cluster A, n = 51; cluster B, n = 46; cluster C, n = 28). Mothers of children with higher CCL22 chemokine levels at birth were significantly more likely to display Dermatophagoides pteronyssinus sensitization. A lower CCL22 level at birth with a slight rise during infancy was associated with higher prevalence of mite sensitization and a higher risk of asthma at 3 years-of-age (P = 0.014)....
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, Jan 21, 2018
Several metabolites and altered metabolic pathways have been reported to be associated with asthm... more Several metabolites and altered metabolic pathways have been reported to be associated with asthma. However, longitudinal analysis of the dynamics of metabolites contributing to the development of asthma has not yet been fully clarified. We sought to identify the metabolic mechanisms underlying asthma development in early childhood. Thirty children with asthma and paired healthy controls from a prospective birth cohort were enrolled. Time-series analysis of urinary metabolites collected at ages 1, 2, 3, and 4 years were assessed using H-nuclear magnetic resonance (NMR) spectroscopy coupled with partial least-squares discriminant analysis (PLS-DA). Metabolites identified were studied in relation to changes over time in a linear mixed model for repeated measures. A total of 172 urine samples collected from the enrolled children were analyzed. Urinary metabolomics identified four metabolites significantly associated with childhood asthma development, with longitudinal analysis. Among t...
Scientific reports, Jan 10, 2017
The functional study of different mutations on vitamin D receptor (VDR) gene causing hereditary v... more The functional study of different mutations on vitamin D receptor (VDR) gene causing hereditary vitamin D-resistant rickets (HVDRR) remains limited. This study was to determine the VDR mutation and the mechanisms of this mutation-causing phenotype in a family with HVDRR and alopecia. Phenotype was analyzed, and in vitro functional studies were performed. The proband and his affected sister exhibited typical HVDRR with alopecia, and their biochemical and radiographic abnormalities but not alopecia responded to supraphysiological doses of active vitamin D3. A novel homozygous missense R343H mutation in the exon 9 of VDR residing in the retinoid X receptor (RXR)-binding domain was identified. The expression level and C-terminal conformation of R343H mutant are not different from the wild-type VDR. This mutant had no effect on the nuclear localization of VDR, VDR-RXR heterodimerization, but it impaired CYP24A1 promoter activity in the presence of 1,25 (OH)2 vitamin D3, at least in part,...
Pediatric Research
BACKGROUND: In this study, we aimed to determine whether introducing various allergenic foods dur... more BACKGROUND: In this study, we aimed to determine whether introducing various allergenic foods during infancy is associated with IgE sensitization at 12 months of age. METHODS: Detailed information on feeding practices regarding six possible allergenic foods (fruits, egg white, egg yolk, fish, shellfish, and peanuts) was obtained by administering age-specific questionnaires to parents of infants at ages 6 and 12 months. Fecal secretory IgA (sIgA), fecal eosinophil cationic protein (ECP), and serum levels of total IgE and IgE specific to 20 foods, and IgE specific to 20 inhalant allergens were also quantified at 12 months of age. RESULTS: At 12 months of age, infants with IgE sensitization had been introduced to fewer allergenic food items during infancy (3.2 ± 1.4 vs. 3.7 ± 1.3 items). Compared with infants who were given 0-2 allergenic food items, infants introduced to 3-4 or ≥ 5 allergenic food items showed a significantly lower risk of IgE sensitization (odds ratios (ORs) 0.62 and 0.61, respectively) and lower total IgE levels. In addition, nonintroduction of egg white or egg yolk was significantly related to IgE sensitization (ORs 1.41 and 1.26, respectively). CONCLUSION: Increasing the diversity of allergenic foods in infancy, including fruits, egg white, egg yolk, fish, shellfish, and peanuts, may protect infants from IgE sensitization at 12 months of age.
PloS one, 2017
The aim of this study was to investigate changes in plasma fatty acids proportions and estimated ... more The aim of this study was to investigate changes in plasma fatty acids proportions and estimated desaturase activities for variable grading of liver steatosis in children. In total, 111 schoolchildren (aged 8-18 years) were included in the analysis from March 2015 to August 2016. Anthropometric evaluation, liver ultrasound examination and scoring for nonalcoholic fatty liver disease (NAFLD score = 0-6), and biochemical and plasma fatty acids analysis were performed. We compared the composition ratio of fatty acids between children with high-grade liver steatosis (NAFLD score = 4-6), low-grade liver steatosis (NAFLD score = 1-3), and healthy controls (NAFLD score = 0). In addition, correlation coefficients (r) between NAFLD score, metabolic variables, and estimated activity of desaturase indices (stearoyl-coenzyme A desaturase-1 (SCD1), delta-5 and delta-6 desaturase) were calculated. Compared with healthy controls, children with liver steatosis showed a higher proportion of monounsa...
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Papers by Jing-long Huang