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Jinno S, Onishi A, Hattori S, Dubreuil M, Ueda Y, Nishimura K, Okano T, Yamada H, Yamamoto W, Murata K, Onizawa H, Ebina K, Maeda Y, Son Y, Amuro H, Hara R, Hata K, Shiba H, Katayama M, Watanabe R, Hashimoto M, Saegusa J. Comparison of retention of biologics in Japanese patients with elderly-onset rheumatoid arthritis-the ANSWER cohort study. Rheumatology (Oxford) 2024:keae081. [PMID: 38317442 DOI: 10.1093/rheumatology/keae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVES This multicentre, retrospective study aimed to compare retention and reasons for discontinuation between Janus kinase inhibitors (JAKi) and biologic disease-modifying antirheumatic drugs in patients with elderly-onset rheumatoid arthritis (EORA). METHODS Patients with RA enrolled in a Japanese multicentre observational registry between 2015 and 2022 were included. EORA was defined as RA with onset at 60 or over. To adjust confounding factors by indication for initiation of tumor necrosis factor inhibitors (TNFi), interleukin-6 inhibitors (IL-6i), cytotoxic T-lymphocyte associated antigen 4 immunoglobulin (CTLA4-Ig) blockers, or JAKi, a propensity score based on baseline characteristics was used to compare drug retention. To assess the reasons for discontinuation, retention rates for ineffectiveness, adverse events, and remission were analyzed as secondary outcomes. RESULTS A total of 572 patients with 835 treatment courses were identified (314 TNFi, 175 IL-6i, 228 CTLA4-Ig, and 118 JAKi). After adjusting for differences in baseline characteristics, drug retention was significantly higher for IL-6i (HR = 0.38, 95%CI = 0.27-0.55, p< 0.01) as compared with TNFi. Discontinuation due to lack of effectiveness was lower with the JAKi (HR = 0.38, 95%CI = 0.22-0.66, p< 0.01) and the IL-6i (HR = 0.29, 95%CI = 0.19-0.46, p< 0.01) as compared with the TNFi although the CTLA4-Ig had a similar HR to TNFi. The adjusted incidence of discontinuation due to adverse event was higher in the JAKi (HR = 2.86, 95%CI = 1.46-5.59, p< 0.01) than the TNFi. CONCLUSIONS In EORA patients, IL-6i and JAKi had longer retention and less discontinuation due to ineffectiveness than TNFi. The potential risks of JAKi should be approached with an individualized perspective.
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Affiliation(s)
- Sadao Jinno
- Department of Medicine, University of Hawaii, Honolulu, HI, USA
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuhei Hattori
- University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA
| | - Maureen Dubreuil
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Yo Ueda
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keisuke Nishimura
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takaichi Okano
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotaka Yamada
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Okayama, Japan
| | - Koichi Murata
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hideo Onizawa
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kosuke Ebina
- Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, Osaka, Japan
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuichi Maeda
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yonsu Son
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Hideki Amuro
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Ryota Hara
- Rheumatology Clinic and Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Kenichiro Hata
- Department of Internal Medicine IV, Osaka Medical Pharmaceutical University, Osaka, Japan
| | - Hideyuki Shiba
- Department of Internal Medicine IV, Osaka Medical Pharmaceutical University, Osaka, Japan
| | - Masaki Katayama
- Department of Rheumatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Ryu Watanabe
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Jun Saegusa
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan
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Nakayama Y, Watanabe R, Yamamoto W, Ebina K, Hirano T, Kotani T, Shiba H, Katayama M, Son Y, Amuro H, Onishi A, Jinno S, Hara R, Murakami K, Murata K, Ito H, Tanaka M, Matsuda S, Morinobu A, Hashimoto M. IL-6 inhibitors and JAK inhibitors as favourable treatment options for patients with anaemia and rheumatoid arthritis: ANSWER cohort study. Rheumatology (Oxford) 2024; 63:349-357. [PMID: 37354495 DOI: 10.1093/rheumatology/kead299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/10/2023] [Accepted: 06/06/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVES Anaemia, a common comorbidity of RA, is related to high disease activity and poor prognosis. It is unknown which biologic/targeted synthetic (b/ts)-DMARDs are optimal for patients with anaemia and RA in regulating anaemia and controlling disease activity. METHODS We investigated the change in haemoglobin (Hb) levels, drug retention rates and disease activities after the administration of b/ts-DMARDs with different modes of action [TNF inhibitors (TNFis), immunoglobulin fused with cytotoxic T-lymphocyte antigen (CTLA-4-Ig), IL-6 receptor inhibitors (IL-6Ris) and Janus kinase inhibitors (JAKis)] in patients with RA stratified by baseline Hb levels using the multicentre observational registry for patients with RA in Japan (ANSWER cohort). RESULTS A total of 2093 patients with RA were classified into three groups based on tertiles of the baseline Hb levels (Hblow, anaemic; Hbint, intermediate; Hbhigh, non-anaemic). IL-6Ri increased Hb levels in all groups (the mean change at 12 months in Hblow was +1.5 g/dl, Hbint +0.7 g/dl and Hbhigh +0.1 g/dl). JAKis increased the Hb level in patients with anaemia and RA and retained or decreased the Hb level in non-anaemic patients (the mean change at 12 months in Hblow was +0.6 g/dl, Hbint 0 g/dl and Hbhigh -0.3 g/dl). In patients with anaemia and RA, overall adjusted 3-year drug retention rates were higher in JAKi followed by IL-6Ri, CTLA4-Ig and TNFi (78.6%, 67.9%, 61.8% and 50.8%, respectively). Change of disease activity at 12 months was not different among different b/ts-DMARDs treatments. CONCLUSION IL-6Ri and JAKi can effectively treat patients with anaemia and RA in a real-world setting.
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Affiliation(s)
- Yoichi Nakayama
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryu Watanabe
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Okayama, Japan
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kosuke Ebina
- Department of Musculoskeletal Regenerative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toru Hirano
- Division of Rheumatology, Nishinomiya Municipal Central Hospital, Hyogo, Japan
| | - Takuya Kotani
- Division of Rheumatology, Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Hideyuki Shiba
- Division of Rheumatology, Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Masaki Katayama
- Department of Rheumatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Yonsu Son
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Hideki Amuro
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sadao Jinno
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Ryota Hara
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Kosaku Murakami
- Center for Cancer Immunotherapy and Immunobiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koichi Murata
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Masao Tanaka
- Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Hata K, Kotani T, Matsuda S, Fujiki Y, Suzuka T, Kiboshi T, Wada Y, Shiba H, Shoda T, Kagitani M, Takeuchi T. Aggressive multi-combination therapy for anti-MDA5 antibody-positive dermatomyositis-rapidly progressive interstitial lung disease. Int J Rheum Dis 2024; 27:e14999. [PMID: 38063858 DOI: 10.1111/1756-185x.14999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/20/2023] [Accepted: 11/23/2023] [Indexed: 01/31/2024]
Abstract
OBJECTIVES To elucidate the efficacy and safety of aggressive multi-combination therapy with mycophenolate mofetil, rituximab, and plasma exchange or polymyxin B immobilized fiber column direct hemoperfusion followed by conventional therapy with corticosteroids, calcineurin inhibitors, and intravenous pulse cyclophosphamide in patients with rapidly progressive interstitial lung disease (RPILD) with anti-melanoma differentiation-associated gene 5 (MDA5)-antibody-positive dermatomyositis (DM). METHODS A total of 23 patients with anti-MDA5 antibody-positive DM-RPILD were enrolled, with nine patients in Group A (treated conventionally before March 2015) and 14 patients in Group B (received aggressive treatment after April 2015). RESULTS Pretreatment severity of interstitial lung disease (ILD) did not differ between the two groups. However, Group B exhibited a higher cumulative survival rate at 48 weeks than Group A (64.3% vs. 33.3%). The corticosteroid dose, divided by the initial dose at 3 months and 12 months, was significantly lower in Group B than in Group A (p = .046 and .026, respectively). Among the ILD-related deaths in Group B, there was a tendency toward a higher proportion of males and more severe ILD. The incidence of infection did not differ between the groups, but leukopenia was more common in Group B. CONCLUSION This aggressive multi-combination therapy may improve the survival outcome of patients with anti-MDA5 antibody-positive DM-RPILD. However, careful management of complications, such as opportunistic infections and leukopenia, is essential. Future refinement through longitudinal investigations tracking the long-term efficacy, safety, and cost-effectiveness of this treatment strategy is needed.
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Affiliation(s)
- Kenichiro Hata
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takuya Kotani
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Shogo Matsuda
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Youhei Fujiki
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takayasu Suzuka
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takao Kiboshi
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yumiko Wada
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Hideyuki Shiba
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takeshi Shoda
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Maki Kagitani
- Blood Purification Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan
| | - Tohru Takeuchi
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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Abe K, Hayato Y, Hiraide K, Ieki K, Ikeda M, Kameda J, Kanemura Y, Kaneshima R, Kashiwagi Y, Kataoka Y, Miki S, Mine S, Miura M, Moriyama S, Nakano Y, Nakahata M, Nakayama S, Noguchi Y, Okamoto K, Sato K, Sekiya H, Shiba H, Shimizu K, Shiozawa M, Sonoda Y, Suzuki Y, Takeda A, Takemoto Y, Takenaka A, Tanaka H, Watanabe S, Yano T, Han S, Kajita T, Okumura K, Tashiro T, Tomiya T, Wang X, Xia J, Yoshida S, Megias GD, Fernandez P, Labarga L, Ospina N, Zaldivar B, Pointon BW, Kearns E, Raaf JL, Wan L, Wester T, Bian J, Griskevich NJ, Kropp WR, Locke S, Smy MB, Sobel HW, Takhistov V, Yankelevich A, Hill J, Park RG, Bodur B, Scholberg K, Walter CW, Bernard L, Coffani A, Drapier O, El Hedri S, Giampaolo A, Mueller TA, Santos AD, Paganini P, Quilain B, Ishizuka T, Nakamura T, Jang JS, Learned JG, Choi K, Cao S, Anthony LHV, Martin D, Scott M, Sztuc AA, Uchida Y, Berardi V, Catanesi MG, Radicioni E, Calabria NF, Machado LN, De Rosa G, Collazuol G, Iacob F, Lamoureux M, Mattiazzi M, Ludovici L, Gonin M, Pronost G, Fujisawa C, Maekawa Y, Nishimura Y, Friend M, Hasegawa T, Ishida T, Kobayashi T, Jakkapu M, Matsubara T, Nakadaira T, Nakamura K, Oyama Y, Sakashita K, Sekiguchi T, Tsukamoto T, Boschi T, Di Lodovico F, Gao J, Goldsack A, Katori T, Migenda J, Taani M, Zsoldos S, Kotsar Y, Ozaki H, Suzuki AT, Takeuchi Y, Bronner C, Feng J, Kikawa T, Mori M, Nakaya T, Wendell RA, Yasutome K, Jenkins SJ, McCauley N, Mehta P, Tsui KM, Fukuda Y, Itow Y, Menjo H, Ninomiya K, Lagoda J, Lakshmi SM, Mandal M, Mijakowski P, Prabhu YS, Zalipska J, Jia M, Jiang J, Jung CK, Wilking MJ, Yanagisawa C, Harada M, Ishino H, Ito S, Kitagawa H, Koshio Y, Nakanishi F, Sakai S, Barr G, Barrow D, Cook L, Samani S, Wark D, Nova F, Yang JY, Malek M, McElwee JM, Stone O, Thiesse MD, Thompson LF, Okazawa H, Kim SB, Seo JW, Yu I, Ichikawa AK, Nakamura KD, Tairafune S, Nishijima K, Iwamoto K, Nakagiri K, Nakajima Y, Taniuchi N, Yokoyama M, Martens K, de Perio P, Vagins MR, Kuze M, Izumiyama S, Inomoto M, Ishitsuka M, Ito H, Kinoshita T, Matsumoto R, Ommura Y, Shigeta N, Shinoki M, Suganuma T, Yamauchi K, Martin JF, Tanaka HA, Towstego T, Akutsu R, Gousy-Leblanc V, Hartz M, Konaka A, Prouse NW, Chen S, Xu BD, Zhang B, Posiadala-Zezula M, Hadley D, Nicholson M, O'Flaherty M, Richards B, Ali A, Jamieson B, Marti L, Minamino A, Pintaudi G, Sano S, Suzuki S, Wada K. Erratum: Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande [Phys. Rev. Lett. 130, 031802 (2023)]. Phys Rev Lett 2023; 131:159903. [PMID: 37897794 DOI: 10.1103/physrevlett.131.159903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Indexed: 10/30/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.130.031802.
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Matsuda S, Oe K, Kotani T, Okazaki A, Kiboshi T, Suzuka T, Wada Y, Shiba H, Hata K, Shoda T, Takeuchi T. Serum Complement C4 Levels Are a Useful Biomarker for Predicting End-Stage Renal Disease in Microscopic Polyangiitis. Int J Mol Sci 2023; 24:14436. [PMID: 37833884 PMCID: PMC10572948 DOI: 10.3390/ijms241914436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
This study aimed to evaluate the risk factors for end-stage renal disease (ESRD) in microscopic polyangiitis (MPA). In total, 74 patients with MPA were enrolled, and we compared the baseline clinical characteristics and disease activity between MPA patients who have progressed to ESRD and those without ESRD to select predictive factors for ESRD. Out of 74 patients, 12 patients (16.2%) had ESRD during follow-up. Serum C4 levels were significantly higher in MPA patients who have progressed to ESRD than in those without ESRD (p = 0.009). Multivariate analyses revealed that high serum creatinine levels (odds ratio (OR) 4.4, 95% confidence interval (CI) 1.25-15.5) and high serum C4 levels (OR 1.24, 95% CI 1.03-1.49) were risk factors for ESRD. Using receiver operating characteristic analysis, the cut-off value for initial serum C4 levels and serum creatinine levels were 29.6 mg/dL and 3.54 mg/dL, respectively. Patients with MPA with a greater number of risk factors (serum C4 levels > 29.6 mg/dL and serum creatinine levels > 3.54 mg/dL) had a higher ESRD progression rate. Serum C4 levels were significantly positively correlated with serum creatinine levels and kidney Birmingham vasculitis activity score (p = 0.02 and 0.04, respectively). These results suggest that serum C4 levels are useful tools for assessing renal disease activity and prognosis in MPA.
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Affiliation(s)
| | | | - Takuya Kotani
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan; (S.M.); (T.S.); (T.T.)
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Makino H, Kotani T, Hata K, Nishioka D, Yamamoto W, Yoshikawa A, Wada Y, Hiramatsu Y, Shiba H, Nagai K, Katayama M, Son Y, Amuro H, Onishi A, Akashi K, Hara R, Hirano T, Hashimoto M, Takeuchi T. Prognostic factors affecting respiratory-related death in patients with rheumatoid arthritis complicated by interstitial lung disease: An ANSWER cohort study. Mod Rheumatol 2023; 33:928-935. [PMID: 36112486 DOI: 10.1093/mr/roac115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/11/2022] [Accepted: 09/13/2022] [Indexed: 08/27/2023]
Abstract
The aim of this multi-centre retrospective study was to clarify the prognostic factors for respiratory-related death in patients with interstitial lung disease (ILD) complicated rheumatoid arthritis (RA). Patient background data, treatment regimen, and disease activity indicators of RA and ILD at baseline, 6 months after the diagnosis of ILD, and at the last follow-up visit were extracted. A total of 312 patients with RA-ILD (17 patients who died from respiratory-related causes and 295 survivors) were included. Patients who died from respiratory-related causes had an older median age, a higher proportion of being male, and a higher anti-cyclic citrullinated peptide antibody positivity rate than survivors (p = .0001, .038, and .016, respectively); they also had significantly higher baseline serum levels of Krebs von den Lungen-6 (KL-6) than survivors (p = .013). Patients who died from respiratory-related causes showed significantly greater changes in serum KL-6 levels between the 6-month time point and the last visit [ΔKL-6 (6 months - last)] than survivors (p = .011). Multivariate analysis showed that the ΔKL-6 (6 months - last) corrected by disease duration was a predictor of respiratory-disease-related death in patients with RA-ILD (p < .0001). Long-term increase in serum KL-6 levels is associated with respiratory-disease related death in patients with RA-ILD.
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Affiliation(s)
- Hidehiko Makino
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takuya Kotani
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Kenichiro Hata
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Daisuke Nishioka
- Department of Medical Statistics, Research and Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Okayama, Japan
| | - Ayaka Yoshikawa
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yumiko Wada
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yuri Hiramatsu
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Hideyuki Shiba
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Koji Nagai
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Masaki Katayama
- Department of Rheumatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Yonsu Son
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Hideki Amuro
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kengo Akashi
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Ryota Hara
- Rheumatology Clinic and Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Toru Hirano
- Department of Rheumatology, Nishinomiya Municipal Central Hospital, Hyogo, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tohru Takeuchi
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
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Shiba H, Furukawa K, Tamaki S, Takahashi M. Triple-furrowed tongue in myasthenia gravis. QJM 2023; 116:534-535. [PMID: 36919764 DOI: 10.1093/qjmed/hcad035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Affiliation(s)
- H Shiba
- Department of Neurology, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan and Department of Internal Medicine, Suwa Central Hospital, 4300 Tamagawa,Chino-shi, Nagano-ken, 391-8503, Japan
| | - K Furukawa
- Department of Neurology, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - S Tamaki
- Department of Neurology, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - M Takahashi
- Department of Neurology, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
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Ebina K, Hirano T, Maeda Y, Okita Y, Etani Y, Hirao M, Yamamoto W, Hashimoto M, Murata K, Onishi A, Jinno S, Hara R, Son Y, Amuro H, Kotani T, Shiba H, Katayama M, Yamamoto K, Kumanogoh A, Okada S, Nakata K. Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study. Mod Rheumatol 2023; 33:690-699. [PMID: 35962543 DOI: 10.1093/mr/roac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/07/2022] [Accepted: 08/04/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES This multicenter, retrospective study evaluated the effectiveness of add-on methotrexate (MTX) or iguratimod (IGU) in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors (JAKis). METHODS Forty-five patients were treated with new additional MTX (n = 22) or IGU (n = 23) and followed for 6 months. Patients' background is as follows: age, 59.2 years; disease activity score of 28 joints with C-reactive protein (DAS28-CRP), 3.4; clinical disease activity index, 15.7; biological disease-modifying antirheumatic drug (DMARD)-switched cases, 77.8%; first JAKi cases, 95.6%; and JAKi treatment: tofacitinib (n = 25), baricitinib (n = 17), upadacitinib (n = 2), and peficitinib (n = 1) for 9.6 months. RESULTS Thirty-five patients continued the combination therapy for 6 months without a significant change in concomitant glucocorticoid or other conventional synthetic DMARDs. DAS28-CRP (MTX, 3.6 to 2.6, p < 0.05; IGU, 3.3 to 2.1, p < 0.001) and clinical disease activity index (MTX, 16.7 to 8.8, p < 0.05; IGU, 14.6 to 6.5, p < 0.01) improved significantly from baseline. Using the 2019 European League Against Rheumatism criteria, 45.4% (MTX) and 39.1% (IGU) achieved moderate or good response and 40.9% (MTX) and 39.1% (IGU) achieved American College of Rheumatology 20% improvement criteria. CONCLUSIONS Adding MTX or IGU to inadequate responders of JAKi can be considered as a complementary treatment.
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Affiliation(s)
- Kosuke Ebina
- Department of Musculoskeletal Regenerative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toru Hirano
- Department of Rheumatology, Nishinomiya Municipal Hospital, Hyogo, Japan
| | - Yuichi Maeda
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan
| | - Yasutaka Okita
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuki Etani
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Makoto Hirao
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Okayama, Japan
- Department of Advanced Medicine for Rheumatic diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motomu Hashimoto
- Department of Advanced Medicine for Rheumatic diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Koichi Murata
- Department of Advanced Medicine for Rheumatic diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sadao Jinno
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Ryota Hara
- Rheumatology Clinic and Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Yonsu Son
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Hideki Amuro
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Takuya Kotani
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Hideyuki Shiba
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Masaki Katayama
- Department of Rheumatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Keiichi Yamamoto
- Information Technology Center, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan
| | - Seiji Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ken Nakata
- Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
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9
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Shiba H, Kotani T, Nagai K, Hata K, Yamamoto W, Yoshikawa A, Wada Y, Hiramatsu Y, Makino H, Ueda Y, Onishi A, Murata K, Amuro H, Son Y, Hara R, Hirano T, Ebina K, Katayama M, Hashimoto M, Takeuchi T. Prognostic Factors Affecting Death in Patients with Rheumatoid Arthritis Complicated by Pneumocystis jirovecii Pneumonia and One-Year Clinical Course: The ANSWER Cohort Study. Int J Mol Sci 2023; 24:ijms24087399. [PMID: 37108561 PMCID: PMC10138913 DOI: 10.3390/ijms24087399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
This multicenter retrospective study aimed to clarify the prognostic factors for mortality and changes in treatment modalities and disease activities after the onset of Pneumocystis jirovecii pneumonia (PCP) in patients with rheumatoid arthritis (RA). Data regarding the clinical background, treatment modalities, and disease activity indicators of RA at the onset of PCP (baseline), and 6 months and 12 months after treatment were extracted. Of the 37 patients with RA-PCP (median age, 69 years; 73% female), chemical prophylaxis was administered to 8.1%. Six patients died during PCP treatment. The serum C-reactive protein (CRP) levels and the prednisolone (PDN) dose at baseline in the PCP death group were significantly higher than those in the survivor group. Multivariate analysis using a Cox regression model showed that PDN dose at baseline was a predictor of death from PCP in patients with RA. During the 12 months from baseline, the RA disease activity significantly decreased. A high dose of corticosteroids for RA may result in a poor prognosis when PCP is complicated. In the future, preventive administration techniques must be established for patients with RA who need PCP prevention.
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Affiliation(s)
- Hideyuki Shiba
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan
| | - Takuya Kotani
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan
| | - Koji Nagai
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan
| | - Kenichiro Hata
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Okayama 710-0016, Japan
| | - Ayaka Yoshikawa
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan
| | - Yumiko Wada
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan
| | - Yuri Hiramatsu
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan
| | - Hidehiko Makino
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan
| | - Yo Ueda
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Akira Onishi
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto 606-8303, Japan
| | - Koichi Murata
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto 606-8303, Japan
| | - Hideki Amuro
- First Department of Internal Medicine, Kansai Medical University, Osaka 573-1191, Japan
| | - Yonsu Son
- First Department of Internal Medicine, Kansai Medical University, Osaka 573-1191, Japan
| | - Ryota Hara
- Rheumatology Clinic and Department of Orthopaedic Surgery, Nara Medical University, Nara 634-8521, Japan
| | - Toru Hirano
- Department of Rheumatology, Nishinomiya Municipal Central Hospital, Nishinomiya 663-8014, Japan
| | - Kosuke Ebina
- Department of Musculoskeletal Regenerative Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Masaki Katayama
- Department of Rheumatology, Osaka Red Cross Hospital, Osaka 543-0027, Japan
| | - Motomu Hashimoto
- Department of Clinical Immunology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Tohru Takeuchi
- Department of Internal Medicine (IV), Division of Rheumatology, Osaka Medical and Pharmaceutical University, Osaka 569-8686, Japan
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10
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Matsuda S, Kotani T, Wakura R, Suzuka T, Kuwabara H, Kiboshi T, Wada Y, Shiba H, Hata K, Shoda T, Hirose Y, Takeuchi T. Examination of nailfold videocapillaroscopy findings in ANCA-associated vasculitis. Rheumatology (Oxford) 2023; 62:747-757. [PMID: 35816001 DOI: 10.1093/rheumatology/keac402] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The objective of this study was to evaluate nailfold videocapillaroscopy (NVC) as a useful tool for assessing the disease activity of ANCA-associated vasculitis (AAV). METHODS This study enrolled 51 patients with AAV and 21 healthy controls. We scored NVC findings semiquantitatively, and compared them between AAV patients and controls. We examined the association of NVC findings with disease activity indicators, histopathological findings of skin biopsies, and high-resolution CT (HRCT) scores in AAV. Additionally, we repeatedly rated the NVC findings 3 months after immunosuppressive therapy. RESULTS Of the 51 enrolled patients, 36 (70.6%) showed a microangiopathy pattern and 4 (7.8%) showed a scleroderma pattern in AAV. The scores for microhaemorrhage, capillary loss, neoangiogenesis, and tortuosity were significantly higher in the AAV group than in the control group. NVC abnormalities correlated with the severity of skin, lung and kidney involvement. The scores of giant capillaries significantly correlated with the total BVAS and the chest BVAS; the scores of capillary loss correlated with the chest BVAS and the renal BVAS. The scores of microhaemorrhage significantly correlated with perivascular inflammatory cell infiltrations in the upper dermis of the purpura and tended to correlate with the total ground-glass opacity and consolidation scores on HRCT. In addition, capillary loss scores had a significant positive correlation with serum creatinine levels. Additionally, the microhaemorrhage scores were significantly reduced after 3 months of immunosuppressive therapy. CONCLUSION In AAV patients, NVC abnormalities are significantly associated with disease severity. This result suggests that NVC is a useful tool for assessing the disease activity and treatment response in AAV.
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Affiliation(s)
- Shogo Matsuda
- Department of Internal Medicine IV, Division of Rheumatology
| | - Takuya Kotani
- Department of Internal Medicine IV, Division of Rheumatology
| | - Reiko Wakura
- Department of Internal Medicine IV, Division of Rheumatology
| | - Takayasu Suzuka
- Department of Internal Medicine IV, Division of Rheumatology
| | - Hiroko Kuwabara
- Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Takao Kiboshi
- Department of Internal Medicine IV, Division of Rheumatology
| | - Yumiko Wada
- Department of Internal Medicine IV, Division of Rheumatology
| | - Hideyuki Shiba
- Department of Internal Medicine IV, Division of Rheumatology
| | - Kenichiro Hata
- Department of Internal Medicine IV, Division of Rheumatology
| | - Takeshi Shoda
- Department of Internal Medicine IV, Division of Rheumatology
| | - Yoshinobu Hirose
- Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Tohru Takeuchi
- Department of Internal Medicine IV, Division of Rheumatology
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11
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Abe K, Hayato Y, Hiraide K, Ieki K, Ikeda M, Kameda J, Kanemura Y, Kaneshima R, Kashiwagi Y, Kataoka Y, Miki S, Mine S, Miura M, Moriyama S, Nakano Y, Nakahata M, Nakayama S, Noguchi Y, Okamoto K, Sato K, Sekiya H, Shiba H, Shimizu K, Shiozawa M, Sonoda Y, Suzuki Y, Takeda A, Takemoto Y, Takenaka A, Tanaka H, Watanabe S, Yano T, Han S, Kajita T, Okumura K, Tashiro T, Tomiya T, Wang X, Xia J, Yoshida S, Megias GD, Fernandez P, Labarga L, Ospina N, Zaldivar B, Pointon BW, Kearns E, Raaf JL, Wan L, Wester T, Bian J, Griskevich NJ, Kropp WR, Locke S, Smy MB, Sobel HW, Takhistov V, Yankelevich A, Hill J, Park RG, Bodur B, Scholberg K, Walter CW, Bernard L, Coffani A, Drapier O, El Hedri S, Giampaolo A, Mueller TA, Santos AD, Paganini P, Quilain B, Ishizuka T, Nakamura T, Jang JS, Learned JG, Choi K, Cao S, Anthony LHV, Martin D, Scott M, Sztuc AA, Uchida Y, Berardi V, Catanesi MG, Radicioni E, Calabria NF, Machado LN, De Rosa G, Collazuol G, Iacob F, Lamoureux M, Mattiazzi M, Ludovici L, Gonin M, Pronost G, Fujisawa C, Maekawa Y, Nishimura Y, Friend M, Hasegawa T, Ishida T, Kobayashi T, Jakkapu M, Matsubara T, Nakadaira T, Nakamura K, Oyama Y, Sakashita K, Sekiguchi T, Tsukamoto T, Boschi T, Di Lodovico F, Gao J, Goldsack A, Katori T, Migenda J, Taani M, Zsoldos S, Kotsar Y, Ozaki H, Suzuki AT, Takeuchi Y, Bronner C, Feng J, Kikawa T, Mori M, Nakaya T, Wendell RA, Yasutome K, Jenkins SJ, McCauley N, Mehta P, Tsui KM, Fukuda Y, Itow Y, Menjo H, Ninomiya K, Lagoda J, Lakshmi SM, Mandal M, Mijakowski P, Prabhu YS, Zalipska J, Jia M, Jiang J, Jung CK, Wilking MJ, Yanagisawa C, Harada M, Ishino H, Ito S, Kitagawa H, Koshio Y, Nakanishi F, Sakai S, Barr G, Barrow D, Cook L, Samani S, Wark D, Nova F, Yang JY, Malek M, McElwee JM, Stone O, Thiesse MD, Thompson LF, Okazawa H, Kim SB, Seo JW, Yu I, Ichikawa AK, Nakamura KD, Tairafune S, Nishijima K, Iwamoto K, Nakagiri K, Nakajima Y, Taniuchi N, Yokoyama M, Martens K, de Perio P, Vagins MR, Kuze M, Izumiyama S, Inomoto M, Ishitsuka M, Ito H, Kinoshita T, Matsumoto R, Ommura Y, Shigeta N, Shinoki M, Suganuma T, Yamauchi K, Martin JF, Tanaka HA, Towstego T, Akutsu R, Gousy-Leblanc V, Hartz M, Konaka A, Prouse NW, Chen S, Xu BD, Zhang B, Posiadala-Zezula M, Hadley D, Nicholson M, O'Flaherty M, Richards B, Ali A, Jamieson B, Marti L, Minamino A, Pintaudi G, Sano S, Suzuki S, Wada K. Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande. Phys Rev Lett 2023; 130:031802. [PMID: 36763398 DOI: 10.1103/physrevlett.130.031802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/30/2022] [Indexed: 06/18/2023]
Abstract
We report a search for cosmic-ray boosted dark matter with protons using the 0.37 megaton×years data collected at Super-Kamiokande experiment during the 1996-2018 period (SKI-IV phase). We searched for an excess of proton recoils above the atmospheric neutrino background from the vicinity of the Galactic Center. No such excess is observed, and limits are calculated for two reference models of dark matter with either a constant interaction cross section or through a scalar mediator. This is the first experimental search for boosted dark matter with hadrons using directional information. The results present the most stringent limits on cosmic-ray boosted dark matter and exclude the dark matter-nucleon elastic scattering cross section between 10^{-33}cm^{2} and 10^{-27}cm^{2} for dark matter mass from 1 MeV/c^{2} to 300 MeV/c^{2}.
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Affiliation(s)
- K Abe
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Hayato
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Hiraide
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Ieki
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Ikeda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - J Kameda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Kanemura
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - R Kaneshima
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - Y Kashiwagi
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - Y Kataoka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Miki
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - S Mine
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - M Miura
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Moriyama
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Nakano
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - M Nakahata
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Nakayama
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Noguchi
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - K Okamoto
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - K Sato
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - H Sekiya
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - H Shiba
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - K Shimizu
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - M Shiozawa
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Sonoda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - Y Suzuki
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - A Takeda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Takemoto
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - A Takenaka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - H Tanaka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Watanabe
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - T Yano
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - S Han
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - T Kajita
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Okumura
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - T Tashiro
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - T Tomiya
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - X Wang
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - J Xia
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - S Yoshida
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - G D Megias
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - P Fernandez
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - L Labarga
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - N Ospina
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - B Zaldivar
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - B W Pointon
- Department of Physics, British Columbia Institute of Technology, Burnaby, British Columbia V5G 3H2, Canada
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - E Kearns
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - J L Raaf
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - L Wan
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - T Wester
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - J Bian
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - N J Griskevich
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - W R Kropp
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - S Locke
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - M B Smy
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - H W Sobel
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - V Takhistov
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - A Yankelevich
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - J Hill
- Department of Physics, California State University, Dominguez Hills, Carson, California 90747, USA
| | - R G Park
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - B Bodur
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - K Scholberg
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - C W Walter
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - L Bernard
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - A Coffani
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - O Drapier
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - S El Hedri
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - A Giampaolo
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - Th A Mueller
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - A D Santos
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - P Paganini
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - B Quilain
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - T Ishizuka
- Junior College, Fukuoka Institute of Technology, Fukuoka, Fukuoka 811-0295, Japan
| | - T Nakamura
- Department of Physics, Gifu University, Gifu, Gifu 501-1193, Japan
| | - J S Jang
- GIST College, Gwangju Institute of Science and Technology, Gwangju 500-712, Korea
| | - J G Learned
- Department of Physics and Astronomy, University of Hawaii, Honolulu, Hawaii 96822, USA
| | - K Choi
- Institute for Basic Science (IBS), Daejeon 34126, Korea
| | - S Cao
- Institute For Interdisciplinary Research in Science and Education, ICISE, Quy Nhon 55121, Vietnam
| | - L H V Anthony
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - D Martin
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - M Scott
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - A A Sztuc
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - Y Uchida
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - V Berardi
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, I-70125 Bari, Italy
| | - M G Catanesi
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, I-70125 Bari, Italy
| | - E Radicioni
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, I-70125 Bari, Italy
| | - N F Calabria
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, I-80126 Napoli, Italy
| | - L N Machado
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, I-80126 Napoli, Italy
| | - G De Rosa
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, I-80126 Napoli, Italy
| | - G Collazuol
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - F Iacob
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - M Lamoureux
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - M Mattiazzi
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - L Ludovici
- INFN Sezione di Roma and Università di Roma "La Sapienza," I-00185, Roma, Italy
| | - M Gonin
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582, Japan
| | - G Pronost
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582, Japan
| | - C Fujisawa
- Department of Physics, Keio University, Yokohama, Kanagawa 223-8522, Japan
| | - Y Maekawa
- Department of Physics, Keio University, Yokohama, Kanagawa 223-8522, Japan
| | - Y Nishimura
- Department of Physics, Keio University, Yokohama, Kanagawa 223-8522, Japan
| | - M Friend
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Hasegawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Ishida
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Kobayashi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Jakkapu
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Matsubara
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Nakadaira
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - K Nakamura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Oyama
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - K Sakashita
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Sekiguchi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Tsukamoto
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Boschi
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - F Di Lodovico
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - J Gao
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - A Goldsack
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - T Katori
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - J Migenda
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - M Taani
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - S Zsoldos
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Kotsar
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - H Ozaki
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - A T Suzuki
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - Y Takeuchi
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - C Bronner
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - J Feng
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - T Kikawa
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - M Mori
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - T Nakaya
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - R A Wendell
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Yasutome
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - S J Jenkins
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - N McCauley
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - P Mehta
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - K M Tsui
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - Y Fukuda
- Department of Physics, Miyagi University of Education, Sendai, Miyagi 980-0845, Japan
| | - Y Itow
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Aichi 464-8602, Japan
- Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - H Menjo
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - K Ninomiya
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - J Lagoda
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - S M Lakshmi
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - M Mandal
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - P Mijakowski
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - Y S Prabhu
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - J Zalipska
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - M Jia
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - J Jiang
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - C K Jung
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - M J Wilking
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - C Yanagisawa
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - M Harada
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - H Ishino
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - S Ito
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - H Kitagawa
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - Y Koshio
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - F Nakanishi
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - S Sakai
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - G Barr
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
| | - D Barrow
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
| | - L Cook
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Samani
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
| | - D Wark
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington OX11 0QX, United Kingdom
| | - F Nova
- Rutherford Appleton Laboratory, Harwell, Oxford OX11 0QX, United Kingdom
| | - J Y Yang
- Department of Physics, Seoul National University, Seoul 151-742, Korea
| | - M Malek
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - J M McElwee
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - O Stone
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - M D Thiesse
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - L F Thompson
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - H Okazawa
- Department of Informatics in Social Welfare, Shizuoka University of Welfare, Yaizu, Shizuoka 425-8611, Japan
| | - S B Kim
- Department of Physics, Sungkyunkwan University, Suwon 440-746, Korea
| | - J W Seo
- Department of Physics, Sungkyunkwan University, Suwon 440-746, Korea
| | - I Yu
- Department of Physics, Sungkyunkwan University, Suwon 440-746, Korea
| | - A K Ichikawa
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - K D Nakamura
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - S Tairafune
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - K Nishijima
- Department of Physics, Tokai University, Hiratsuka, Kanagawa 259-1292, Japan
| | - K Iwamoto
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - K Nakagiri
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Nakajima
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - N Taniuchi
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - M Yokoyama
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Martens
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - P de Perio
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M R Vagins
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Kuze
- Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551, Japan
| | - S Izumiyama
- Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551, Japan
| | - M Inomoto
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - M Ishitsuka
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - H Ito
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - T Kinoshita
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - R Matsumoto
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - Y Ommura
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - N Shigeta
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - M Shinoki
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - T Suganuma
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - K Yamauchi
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - J F Martin
- Department of Physics, University of Toronto, Ontario M5S 1A7, Canada
| | - H A Tanaka
- Department of Physics, University of Toronto, Ontario M5S 1A7, Canada
| | - T Towstego
- Department of Physics, University of Toronto, Ontario M5S 1A7, Canada
| | - R Akutsu
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - V Gousy-Leblanc
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - M Hartz
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - A Konaka
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - N W Prouse
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - S Chen
- Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | - B D Xu
- Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | - B Zhang
- Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | | | - D Hadley
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - M Nicholson
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - M O'Flaherty
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - B Richards
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - A Ali
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
- Department of Physics, University of Winnipeg, Manitoba R3J 3L8, Canada
| | - B Jamieson
- Department of Physics, University of Winnipeg, Manitoba R3J 3L8, Canada
| | - Ll Marti
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - A Minamino
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - G Pintaudi
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - S Sano
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - S Suzuki
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - K Wada
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
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Matsuda S, Kotani T, Kuwabara H, Suzuka T, Kiboshi T, Wada Y, Ishida T, Fujiki Y, Shiba H, Hata K, Shoda T, Hirose Y, Takeuchi T. Association of M2 macrophages, Th2, and B cells with pathomechanism in microscopic polyangiitis complicated by interstitial lung disease. J Rheumatol 2022; 49:913-921. [DOI: 10.3899/jrheum.220123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 11/22/2022]
Abstract
Objective To address the pathomechanism of microscopic polyangiitis (MPA) complicated by interstitial lung disease (ILD) using serum biomarker profile and pulmonary histopathology. Methods Serum biomarkers from patients with MPA-ILD (n = 32), MPA without ILD (n = 17), and healthy controls (n =10) were examined. Based on the biomarker profiles, principal component analysis (PCA) and cluster analysis were performed to classify patients with MPA-ILD into subgroups. Clinical characteristics and prognosis were assessed for each subgroup. Two lung biopsies were examined following hematoxylineosin staining and immunostaining. Results T-cell and macrophage polarization was skewed toward the T helper (Th) 2 cells and M2 macrophages in MPA-ILD group relative to that in MPA without ILD group. The PCA allowed classification of the 19 biomarker profiles into three groups: (1) B cell- and neutrophil-related cytokines, vascular angiogenesis-related factors, extracellular matrix-producing factors, (2) Th1-driven cytokines, M1 macrophagedriven cytokines and Th2-driven cytokines, and (3) M2 macrophage -induced and - driven cytokines. The cluster analysis stratified the patients with MPA-ILD into clinically fibrotic dominant (CFD) and clinically inflammatory dominant (CID) groups. Notably, severe infections were significantly higher in the CFD group than in the CID group. Immunohistochemical staining demonstrated intense CXCL13 staining in B cells and Th2 cells in the interstitium of MPA-ILD lungs. Conclusion Activation of M2 macrophages, Th2 cells, and B cells plays a key role in the pathomechanism of MPA-ILD. Classification of MPA-ILD based on serum biomarker profile would be useful in predicting the disease activity and the complication of severe infection in MPA-ILD.
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Kiboshi T, Kotani T, Konma J, Makino H, Matsuda S, Suzuka T, Wada Y, Shiba H, Hata K, Shoda T, Takeuchi T. Comparison of therapeutic effects of combination therapy with prednisolone and tacrolimus or azathioprine on progressive interstitial pneumonia with systemic sclerosis. Mod Rheumatol 2022; 32:358-364. [PMID: 33896348 DOI: 10.1080/14397595.2021.1918864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We retrospectively compared the therapeutic effects of combination therapy with prednisolone (PSL) and oral tacrolimus (TAC) or azathioprine (AZA) on progressive interstitial pneumonia with systemic sclerosis (SSc-PIP). METHODS The effects of PSL (0.2-0.5 mg/kg/day) and TAC (3 mg/day) or AZA (1-2 mg/kg/day) therapies (n = 18) were evaluated for short (12 months) and long (36 months or more) periods. RESULTS In the short period, IP improved in 6 and 5 patients and was stable in 12 and 13 patients in the TAC and AZA groups, respectively. In the long period, 11 patients were followed up in the TAC group and 12 in the AZA group. IP improved in 4 and 2 patients and was stable in seven and nine in the TAC and AZA groups, respectively. The rates of evolution of total fibrosis score, and those corrected by disease duration for the long period, in the TAC group were significantly lower than those in the AZA group (p = .017 and .025, respectively). CONCLUSION The inhibitory effect of PSL and TAC combination therapy on the progression of fibrosis in SSc-PIP may be superior to that of PSL and AZA in the long period.
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Affiliation(s)
- Takao Kiboshi
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Takuya Kotani
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Junichi Konma
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Hidehiko Makino
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Shogo Matsuda
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Takayasu Suzuka
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Yumiko Wada
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Hideyuki Shiba
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Kenichiro Hata
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Takeshi Shoda
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
| | - Tohru Takeuchi
- Department of Internal Medicine IV, Division of Rheumatology, Osaka Medical College, Osaka, Japan
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Yuan H, Suzuki S, Terui H, Hirata-Tsuchiya S, Nemoto E, Yamasaki K, Saito M, Shiba H, Aiba S, Yamada S. Loss of IκBζ Drives Dentin Formation via Altered H3K4me3 Status. J Dent Res 2022; 101:951-961. [PMID: 35193410 DOI: 10.1177/00220345221075968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Enforced enrichment of the active promoter marks trimethylation of histone H3 lysine 4 (H3K4me3) and acetylation of histone H3 lysine 27 (H3K27ac) by inhibiting histone demethylases and deacetylases is positively associated with hard tissue formation through the induction of osteo/odontogenic differentiation. However, the key endogenous epigenetic modulator of odontoblasts to regulate the expression of genes coding dentin extracellular matrix (ECM) proteins has not been identified. We focused on nuclear factor (NF)-κB inhibitor ζ (IκBζ), which was originally identified as the transcriptional regulator of NF-κB and recently regarded as the NF-κB-independent epigenetic modulator, and found that IκBζ null mice exhibit a thicker dentin width and narrower pulp chamber, with aged mice having more marked phenotypes. At 6 mo of age, dentin fluorescent labeling revealed significantly accelerated dentin synthesis in the incisors of IκBζ null mice. In the molars of IκBζ null mice, marked tertiary dentin formation adjacent to the pulp horn was observed. Mechanistically, the expression of COL1A2 and COL1A1 collagen genes increased more in the odontoblast-rich fraction of IκBζ null mice than in wild type in vivo, similar to human odontoblast-like cells transfected with small interfering RNA for IκBζ compared with cells transfected with control siRNA in vitro. Furthermore, the direct binding of IκBζ to the COL1A2 promoter suppressed COL1A2 expression and the local active chromatin status marked by H3K4me3. Based on whole-genome identification of H3K4me3 enrichment, ECM and ECM organization-related gene loci were selectively activated by the knockdown of IκBζ, which consistently resulted in the upregulation of these genes. Collectively, this study suggested that IκBζ is the key negative regulator of dentin formation in odontoblasts by inhibiting dentin ECM- and ECM organization-related gene expression through an altered local chromatin status marked by H3K4me3. Therefore, IκBζ is a potential target for epigenetically improving the clinical outcomes of dentin regeneration therapies such as pulp capping.
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Affiliation(s)
- H Yuan
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - S Suzuki
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Terui
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Hirata-Tsuchiya
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - E Nemoto
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - K Yamasaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Saito
- Department of Restorative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Yamada
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Munakata K, Miyashita H, Nakahara T, Shiba H, Sugahara K, Katakura A, Nakagawa T. The use of SPECT/CT to assess resorptive activity in mandibular condyles. Int J Oral Maxillofac Surg 2021; 51:942-948. [PMID: 34937677 DOI: 10.1016/j.ijom.2021.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/30/2021] [Accepted: 11/26/2021] [Indexed: 12/20/2022]
Abstract
The aim of this study was to clarify the clinical significance of bone metabolism in the mandibular condyles in determining condylar resorptive changes. Twelve condyles of patients with idiopathic condylar resorption and degenerative joint disease were analysed using 99mTc HMDP SPECT/CT at baseline and subsequent computed tomography during the follow-up period. Twenty-two healthy condyles were enrolled as controls. After generating three-dimensional SPECT/CT images, two independent observers scored the degree of condylar uptake and measured the morphological changes in the condylar height and condylar volume. In the group with positive condylar uptake, the follow-up computed tomography showed significant decreases in condylar height (-1.69 ± 0.93 mm) and condylar volume (-12.51 ± 10.30%) when compared to healthy controls (condylar height, 0.09 ± 0.54 mm; condylar volume, -0.29 ± 4.22%) (P < 0.001). Moreover, the degree of uptake correlated with the changes in condylar height (observer 1, P = 0.012; observer 2, P = 0.039) and condylar volume (observer 1, P = 0.005; observer 2, P = 0.037). These results suggest that condylar bone metabolism is closely related to the resorptive activity. Thus, SPECT/CT would be useful in the prognostic evaluation or determination of treatment strategies for idiopathic condylar resorption and degenerative joint disease.
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Affiliation(s)
- K Munakata
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - H Miyashita
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - T Nakahara
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - H Shiba
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - K Sugahara
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - A Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - T Nakagawa
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
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Matsuda S, Kotani T, Kuwabara H, Suzuka T, Kiboshi T, Fukui K, Ishida T, Fujiki Y, Shiba H, Hata K, Shod T, Hirose Y, Takeuchi T. CCL2 Produced by CD68+/CD163+ Macrophages as a Promising Clinical Biomarker of Microscopic Polyanigiitis-Interstitial Lung Disease. Rheumatology (Oxford) 2021; 60:4643-4653. [PMID: 33493350 DOI: 10.1093/rheumatology/keab064] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/06/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Microscopic polyangiitis (MPA) is often complicated by interstitial lung disease (ILD); however, biomarkers that can be used to diagnose and predict the progression of MPA-ILD have not been identified. In this study we evaluated various serum biomarkers in MPA-ILD to assess their diagnostic and predictive performance. METHODS We enrolled 49 patients with anti-neutrophil cytoplasmic antibody (ANCA)+ MPA and 10 healthy controls, with 32 of the MPA patients also presented ILD. The presence of ILD was assessed by high-resolution computed tomography and evaluated by ground-glass opacity and fibrosis score. We compared 16 biomarker profiles among MPA-ILD patients, those without ILD, and healthy controls and extracted biomarkers with higher levels in MPA-ILD groups to determine correlations with disease activity and other biomarkers. Three lung biopsies were examined by hematoxylin-eosin staining and immunostaining. RESULTS Initial serum C-C motif chemokine ligand 2 (CCL2) levels were significantly higher in the MPA-ILD group than those of the MPA group, and were significantly higher in MPA-ILD patients 1 year after immunosuppressive therapy than those before treatment. Initial serum CCL2 levels positively correlated with an increased fibrosis score during the year after treatment and with initial serum platelet-derived growth factor levels. Immunohistochemical staining showed intense CCL2 signals in CD68+/CD163+ macrophages and metaplastic epithelial cells in MPA-ILD lungs. CONCLUSION CCL2 is associated with MPA-ILD pathogenesis and suggested its potential efficacy as a useful marker for diagnosing and predicting MPA-ILD progression. Therefore, targeting CCL2 in alveolar CD68+/CD163+ macrophages might represent a therapeutic intervention in ANCA+ MPA-ILD.
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Affiliation(s)
- Shogo Matsuda
- Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takuya Kotani
- Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Osaka, Japan
| | - Hiroko Kuwabara
- Department of Pathology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takayasu Suzuka
- Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takao Kiboshi
- Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Osaka, Japan
| | - Keisuke Fukui
- Graduate School of Advanced Science and Engineering, Hiroshima University, Higashi-Hiroshima City, Hiroshima, Japan.,Department of medical Statistics, Research and Development Center, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takaaki Ishida
- Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Osaka, Japan
| | - Youhei Fujiki
- Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Osaka, Japan
| | - Hideyuki Shiba
- Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Osaka, Japan
| | - Kenichiro Hata
- Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takeshi Shod
- Department of Rheumatology, Yodogawa Christian Hospital, Osaka, Japan
| | - Yoshinobu Hirose
- Department of Pathology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Tohru Takeuchi
- Department of Internal Medicine (IV), Osaka Medical College, Takatsuki, Osaka, Japan
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17
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Shintani T, Iwata T, Okada M, Nakaoka M, Yamasaki N, Fujii T, Shiba H. Clinical Outcomes of Post-exposure Prophylaxis following Occupational Exposure to Human Immunodeficiency Virus at Dental Departments of Hiroshima University Hospital. Curr HIV Res 2020; 18:475-479. [PMID: 32753017 PMCID: PMC8388063 DOI: 10.2174/1570162x18666200804151118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 11/22/2022]
Abstract
Background Dental professionals have so many opportunities to use injection needles and sharp instruments during dental treatment that they face an increased risk of needlestick injuries. This retrospective study reports the utilization and clinical outcomes of occupational post-exposure prophylaxis (PEP) with anti-retroviral agents after being potentially exposed to HIV at the dental departments of Hiroshima University Hospital. Objective This study reports the utilization and clinical outcomes of occupational post-exposure prophylaxis (PEP) with antiretroviral agents after being potentially exposed to HIV at dental departments of Hiroshima University Hospital. Methods Data on the clinical status of HIV-infected source patients and information on HIV-exposed dental professionals from 2007 to 2018 were collected. Results Five dentists with an average experience of 5.6 years (1-15 years) were exposed. The averaged CD4-positive cell number and HIV-RNA load were 1176 (768-1898) /μl and less than 20 copies/ml, respectively, in all the patients. Two of the five HIV exposed dentists received PEP. Three months after the exposures, all of their results were negative in HIV antibody/antigen tests. Conclusion These data might support the concept of “undetectable equals untransmittable”, although HIV exposure in this study was not through sexual transmission.
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Affiliation(s)
- T Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Japan
| | - T Iwata
- Department of Periodontal Medicine, Graduate School of Biomedical & Sciences, Hiroshima University, Japan
| | - M Okada
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Japan
| | - M Nakaoka
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Japan
| | - N Yamasaki
- Division of Blood Transfusion, Hiroshima University Hospital, Japan,AIDS Care Unit, Hiroshima University Hospital, Japan
| | - T Fujii
- Division of Blood Transfusion, Hiroshima University Hospital, Japan,AIDS Care Unit, Hiroshima University Hospital, Japan
| | - H Shiba
- Center of Oral Clinical Examination, Hiroshima University Hospital, Japan,Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
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18
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Ebina K, Hirano T, Maeda Y, Yamamoto W, Hashimoto M, Murata K, Takeuchi T, Shiba H, Son Y, Amuro H, Onishi A, Akashi K, Hara R, Katayama M, Yamamoto K, Kumanogoh A, Hirao M. Drug retention of 7 biologics and tofacitinib in biologics-naïve and biologics-switched patients with rheumatoid arthritis: the ANSWER cohort study. Arthritis Res Ther 2020; 22:142. [PMID: 32539813 PMCID: PMC7296929 DOI: 10.1186/s13075-020-02232-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/02/2020] [Indexed: 02/07/2023] Open
Abstract
Background This multi-center, retrospective study aimed to clarify retention rates and reasons for discontinuation of 7 biological disease-modifying antirheumatic drugs (bDMARDs) and tofacitinib (TOF), one of the janus kinase inhibitors, in bDMARDs-naïve and bDMARDs-switched patients with rheumatoid arthritis (RA). Methods This study assessed 3897 patients and 4415 treatment courses with bDMARDs and TOF from 2001 to 2019 (2737 bDMARDs-naïve courses and 1678 bDMARDs-switched courses [59.5% of switched courses were their second agent], female 82.3%, baseline age 57.4 years, disease duration 8.5 years; rheumatoid factor positivity 78.4%; Disease Activity Score in 28 joints using erythrocyte sedimentation rate 4.3; concomitant prednisolone [PSL] dose 6.1 mg/day [usage 42.4%], and methotrexate [MTX] dose 8.5 mg/week [usage 60.9%]). Treatment courses included abatacept (ABT; n = 663), adalimumab (ADA; n = 536), certolizumab pegol (CZP; n = 226), etanercept (ETN; n = 856), golimumab (GLM; n = 458), infliximab (IFX; n = 724), tocilizumab (TCZ; n = 851), and TOF (n = 101/only bDMARDs-switched cases). Drug discontinuation reasons (categorized into lack of effectiveness, toxic adverse events, non-toxic reasons, or remission) and rates were estimated at 36 months using Gray’s test and statistically evaluated after adjusted by potential clinical confounders (age, sex, disease duration, concomitant PSL and MTX usage, starting date, and number of switched bDMARDs) using the Fine-Gray model. Results Cumulative incidence of drug discontinuation for each reason was as follows: lack of effectiveness in the bDMARDs-naïve group (from 13.7% [ABT] to 26.9% [CZP]; P < 0.001 between agents) and the bDMARDs-switched group (from 18.9% [TCZ] to 46.1% [CZP]; P < 0.001 between agents); toxic adverse events in the bDMARDs-naïve group (from 4.6% [ABT] to 11.2% [ETN]; P < 0.001 between agents) and the bDMARDs-switched group (from 5.0% [ETN] to 15.7% [TOF]; P = 0.004 between agents); and remission in the bDMARDs-naïve group (from 2.9% [ETN] to 10.0% [IFX]; P < 0.001 between agents) and the bDMARDs-switched group (from 1.1% [CZP] to 3.3% [GLM]; P = 0.9 between agents). Conclusions Remarkable differences were observed in drug retention of 7 bDMARDs and TOF between bDMARDs-naïve and bDMARDs-switched cases.
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Affiliation(s)
- Kosuke Ebina
- Department of Musculoskeletal Regenerative Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Toru Hirano
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuichi Maeda
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Okayama, Japan.,Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motomu Hashimoto
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koichi Murata
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tohru Takeuchi
- Department of Internal Medicine (IV), Osaka Medical College, Osaka, Japan
| | - Hideyuki Shiba
- Department of Internal Medicine (IV), Osaka Medical College, Osaka, Japan
| | - Yonsu Son
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Hideki Amuro
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Akira Onishi
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Kengo Akashi
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Ryota Hara
- The Center for Rheumatic Diseases, Nara Medical University, Nara, Japan
| | - Masaki Katayama
- Department of Rheumatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Keiichi Yamamoto
- Department of Medical Informatics, Wakayama Medical University Hospital, Wakayama, Japan
| | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Makoto Hirao
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan
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Ebina K, Hirano T, Maeda Y, Yamamoto W, Hashimoto M, Murata K, Takeuchi T, Shiba H, Son Y, Amuro H, Onishi A, Akashi K, Hara R, Katayama M, Yamamoto K, Kumanogoh A, Hirao M. OP0025 DRUG RETENTION OF 7 BIOLOGICS AND TOFACITINIB IN BIOLOGICS-NAÏVE AND BIOLOGICS-SWITCHED PATIENTS WITH RHEUMATOID ARTHRITIS -THE ANSWER COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:EULAR recommendation announced that biological disease-modifying antirheumatic drugs (bDMARDs) and janus kinase inhibitors (JAKi) are considered as equivalent in the treatment of rheumatoid arthritis (RA). However, we still lack reliable evidence of direct comparison between these agents’ retention, which may reflect both effectiveness and safety.Objectives:The aim of this multi-center (7 university-related hospitals), retrospective study is to clarify retention rates and reasons for discontinuation of 7 bDMARDs and tofacitinib (TOF), one of the JAKi, in both bDMARDs-naïve and bDMARDs-switched cases.Methods:This study assessed 3,897 patients and 4,415 treatment courses of with bDMARDs and TOF from 2001 to 2019 (2,737 bDMARDs-naïve patients and 1,678 bDMARDs-switched patients [59.5% switched to their second agent], female 82.3%, baseline age 57.4 years, disease duration 8.5 years; rheumatoid factor positivity 78.4%; DAS28-ESR 4.3; concomitant prednisolone [PSL] 6.1 mg/day [42.4%] and methotrexate [MTX] 8.5 mg/week [60.9%]). Treatment courses included abatacept (ABT; n=663), adalimumab (ADA; n=536), certolizumab pegol (CZP; n=226), etanercept (ETN; n=856), golimumab (GLM; n=458), infliximab (IFX; n=724), tocilizumab (TCZ; n=851), and TOF (n=101/only bDMARDs-switched cases). Reasons for discontinuation were classified into four categories by each attending physician: 1) lack of effectiveness, 2) toxic adverse events, 3) non-toxic reasons, and 4) remission. Retention rates of each discontinuation reason were estimated at 36 months using the Kaplan-Meier method and adjusted for potential clinical confounders (age, sex, disease duration, concomitant PSL and MTX, starting date and number of switched bDMARDs) using Cox proportional hazards modeling.Results:Adjusted drug retention rates for each discontinuation reason were as follows: lack of effectiveness in the bDMARDs-naïve group (from 70.8% [CZP] to 85.1% [ABT]; P=0.001 between agents) and the bDMARDs-switched group (from 52.8% [CZP] to 78.7% [TCZ]; P<0.001 between agents). Toxic adverse events in the bDMARDs-naïve group (from 86.9% [IFX] to 96.3% [ABT]; P<0.001 between agents) and the bDMARDs-switched group (from 81.1% [ADA] to 95.4% [ETN]; P=0.01 between agents). Finally, overall retention rates excluding discontinuation for non-toxic reasons or remission ranged from 64.2% (IFX) to 82.0% (ABT) (P<0.001 between agents) in the bDMARDs-naïve group (figure a) and from 44.2% (ADA) to 66.8% (TCZ) (P<0.001 between agents) in the bDMARDs-switched group (figure b).Conclusion:Remarkable differences were observed in drug retention of 7 bDMARDs and TOF between bDMARDs-naïve and bDMARDs-switched cases.Disclosure of Interests:Kosuke Ebina Grant/research support from: KE has received research grants from Abbie, Asahi-Kasei, Astellas, Chugai, Eisai, Ono Pharmaceutical, and UCB Japan., Employee of: KE is affiliated with the Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, which is supported by Taisho., Speakers bureau: KE has received payments for lectures from Abbie, Asahi-Kasei, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Janssen, Mitsubishi-Tanabe, Ono Pharmaceutical, Sanofi, and UCB Japan., Toru Hirano Grant/research support from: TH received a research grant and/or speaker fee from Astellas, Chugai, Nippon Shinyaku, Abbvie, Eisai, and Ono Pharmaceutical, Speakers bureau: TH received a research grant and/or speaker fee from Astellas, Chugai, Nippon Shinyaku, Abbvie, Eisai, and Ono Pharmaceutical, Yuichi Maeda Grant/research support from: YM received a research grant and/or speaker fee from Eli Lilly, Chugai, Pfizer, Bristol-Myers Squibb, and Mitsubishi-Tanabe, Speakers bureau: YM received a research grant and/or speaker fee from Eli Lilly, Chugai, Pfizer, Bristol-Myers Squibb, and Mitsubishi-Tanabe, Wataru Yamamoto: None declared, Motomu Hashimoto Grant/research support from: Bristol-Myers Squibb, Eisai, and Eli Lilly and Company., Speakers bureau: Bristol-Myers Squibb and Mitsubishi Tanabe Pharma., Koichi Murata Grant/research support from: KMurata belong to a department that has been financially supported by four pharmaceutical companies (Mitsubishi-Tanabe, Chugai, AYUMI and UCB Japan)., Employee of: KMurata belong to a department that has been financially supported by four pharmaceutical companies (Mitsubishi-Tanabe, Chugai, AYUMI and UCB Japan)., Speakers bureau: KMurak has received speaking fees, and/or consulting fees from Eisai Co. Ltd, Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc, Bristol-Myers Squibb, Mitsubishi-Tanabe Pharma Corporation, UCB, Daiichi Sankyo Co. Ltd. and Astellas Pharma Inc., Tohru Takeuchi Grant/research support from: TT received a research grant from Chugai, CoverLetter and a speaker fee from Astellas, Chugai, Eisai, Mitsubishi-Tanabe, Abbvie, Bristol-Myers Squibb, Ayumi, Daiichi Sankyo, Eisai, Takeda, and Asahi-Kasei, Employee of: TT is affiliated with a department that is financially supported by six pharmaceutical companies (Mitsubishi-Tanabe, Chugai, Ayumi, Astellas, Eisai, and Takeda), Hideyuki Shiba: None declared, Yonsu Son: None declared, Hideki Amuro: None declared, Akira Onishi Speakers bureau: AO received a speaker fee from Chugai, Ono Pharmaceutical, Eli Lilly, Mitsubishi-Tanabe, Asahi-Kasei, and Takeda, Kengo Akashi: None declared, Ryota Hara Speakers bureau: RH received a speaker fee from AbbVie, Masaki Katayama: None declared, Keiichi Yamamoto: None declared, Atsushi Kumanogoh Grant/research support from: AK received a research grant and/or speaker fee from Mitsubishi-Tanabe, Chugai, Eisai, Asahi-Kasei, Astellas, Abbvie, Bristol-Myers Squibb, Ono Pharmaceutical, and Pfizer, Speakers bureau: AK received a research grant and/or speaker fee from Mitsubishi-Tanabe, Chugai, Eisai, Asahi-Kasei, Astellas, Abbvie, Bristol-Myers Squibb, Ono Pharmaceutical, and Pfizer, Makoto Hirao Speakers bureau: MHirao received a speaker fee from Astellas, Ono Pharmaceutical, Eli Lilly, Mitsubishi-Tanabe, Pfizer, Ayumi, and Takeda
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Shintani T, Fujii T, Yamasaki N, Kitagawa M, Iwata T, Saito S, Okada M, Ogawa I, Unei H, Hamamoto K, Nakaoka M, Kurihara H, Shiba H. Oral environment and taste function of Japanese HIV-infected patients treated with antiretroviral therapy. AIDS Care 2019; 32:829-834. [PMID: 31426660 DOI: 10.1080/09540121.2019.1656327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of the study was to evaluate the oral environment and the taste function of Japanese HIV-infected patients treated with antiretroviral therapy. Their median age of 73 patients taking anti-HIV drugs was 46 years. The median period of taking anti-HIV drugs was 30 months. The oral condition was evaluated by measurement of oral moisture, amount of saliva secretion, the number of oral bacteria, presence of oral candida, a taste test, and the number of missing teeth. The levels of oral moisture and secreted saliva were significantly lower in the HIV-infected group than in the healthy volunteer (control) group. The HIV-infected group showed a more robust decrease in taste sensation than the control group. The number of missing teeth was significantly higher in the HIV-infected group than in the control group. Furthermore, all of the evaluated oral conditions were worse in the HIV-infected patients whose CD4+ T lymphocyte counts were less than 500/mm3 than in the control group. It became clear that the patients taking anti-HIV drugs, especially the CD4+ count < 500/mm3 group, had a deteriorated oral environment and dysgeusia, suggesting that the management of oral hygiene is necessary to maintain oral health, which leads to systemic health.
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Affiliation(s)
- T Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - T Fujii
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima, Japan.,AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - N Yamasaki
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima, Japan.,AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - M Kitagawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - T Iwata
- Department of Periodontal Medicine, Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
| | - S Saito
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima, Japan.,AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - M Okada
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - I Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - H Unei
- Department of Pharmaceutical Services, Hiroshima University Hospital, Hiroshima, Japan
| | - K Hamamoto
- AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - M Nakaoka
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - H Kurihara
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan.,Department of Periodontal Medicine, Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
| | - H Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Sciences, Hiroshima, Japan
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Yoshida K, Suzuki S, Kawada-Matsuo M, Nakanishi J, Hirata-Tsuchiya S, Komatsuzawa H, Yamada S, Shiba H. Heparin-LL37 complexes are less cytotoxic for human dental pulp cells and have undiminished antimicrobial and LPS-neutralizing abilities. Int Endod J 2019; 52:1327-1343. [PMID: 31002379 DOI: 10.1111/iej.13130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 04/12/2019] [Indexed: 12/13/2022]
Abstract
AIM To investigate whether glycosaminoglycans (GAGs) binding to high-dose LL37 eliminates its cytotoxicity to dental pulp cells (hDPCs) whilst retaining undiminished antimicrobial and LPS-neutralizing abilities. METHODOLOGY hDPCs were stimulated with varying concentrations of LL37, and their cell viability was analysed by MTT. Then, high-dose LL37 (10 μmol L-1 ) was bound to varying concentrations of three GAGs, heparin, chondroitin sulphate and hyaluronic acid, and their cytotoxic effects on hDPCs and antimicrobial effects were evaluated and compared. Furthermore, the LPS-neutralizing ability of heparin (5 μg mL-1 )-LL37 (10 μmol L-1 ) complexes, which were found to be less cytotoxic for hDPCs with undiminished antimicrobial ability, was investigated. Statistical analysis was performed using one-way analysis of variance (anova), followed by Dunnett's test. P values below 0.05 were considered significant. RESULTS LL37 significantly reduced the cell viability of hDPCs in a dose-dependent manner (P < 0.01). LL37 (10 μmol L-1 ) binding to heparin within a limited concentration range (2~6 μg mL-1 ) eliminated the cytotoxicity for hDPCs (P < 0.01) whilst exerting potent antimicrobial effects against Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius, Aggegatibacter actinomycetemcomitans and Escherichia coli. LL37 (10 μmol L-1 ) binding to chondroitin sulphate exhibited similar functions (P < 0.01); however, the effective chondroitin sulphate concentration was highly restricted (3 μg mL-1 ). LL37 (10 μmol L-1 ) binding to hyaluronic acid was unable to abrogate the cytotoxicity of LL37 even at higher concentrations (10 and 100 μg mL-1 ). Moreover, exogenous addition of LPS dose-dependently reduced the amount of LL37 precipitated with the heparin-LL37 agarose beads (P < 0.01), and the released LL37 simultaneously neutralized the pro-inflammatory ability of LPS in macrophages (P < 0.01). CONCLUSIONS Heparin-LL37 complexes generated at suitable concentration ratios are easy to make, are less cytotoxic and are broad-range antimicrobial materials that can neutralize LPS by providing LL37 in accordance with the amount of free LPS. They may be a potential treatment to save dental pulp tissue from the acute inflammation exacerbated by invading bacteria and the LPS they release.
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Affiliation(s)
- K Yoshida
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Suzuki
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - M Kawada-Matsuo
- Department of Oral Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - J Nakanishi
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Hirata-Tsuchiya
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Komatsuzawa
- Department of Oral Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - S Yamada
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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22
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Ogawa M, Haruki K, Horiuchi A, Shiba H, Mitsuyama Y, Kusumoto M, Eto S, Ishiyama M, Hasegawa T, Yoshida K, Yanaga K. The evaluation of liver resection for colorectal cancer liver metastases. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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23
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Nakaseko Y, Shiba H, Yamanouchi E, Takano Y, Sakamoto T, Imazu H, Ashida H, Yanaga K. Successful Treatment of Stricture of Duct-to-Duct Biliary Anastomosis After Living-Donor Liver Transplantation of the Left Lobe: A Case Report. Transplant Proc 2018; 49:1644-1648. [PMID: 28838456 DOI: 10.1016/j.transproceed.2017.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 06/16/2017] [Indexed: 01/18/2023]
Abstract
Biliary complications, such as stricture or obstruction, after living-donor liver transplantation (LDLT) remain major problems to be solved. Magnetic compression anastomosis (MCA) is a minimally invasive method of biliary anastomosis without surgery in patients with biliary stricture or obstruction. A 66-year-old woman had undergone LDLT for end-stage liver disease for primary biliary cholangitis 20 months previously at another hospital. Computerized tomography showed dilation of the intrahepatic bile duct (B2). Because B2 was invisible with the use of endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage (PTBD) was performed for treatment of cholangitis. The rendezvous technique failed because a guidewire could not pass through the biliary stricture. Therefore, we decided to perform MCA. A parent magnet was endoscopically placed distally in the common bile duct of the stricture, and a daughter magnet attached to a guidewire was inserted proximally through the fistula tract of the PTBD. Both magnets were positioned across the stricture, and the 2 magnets were pulled to each other by magnetic power, to sandwich the stricture. By 14 days after MCA, a fistula between B2 and the common bile duct was created. At 28 days after MCA, the magnets were removed distally and a 16-French tube was placed across the fistula. At 7 months after MCA, that tube was removed. In conclusion, when a conventional endoscopic or percutaneous approach including the rendezvous technique fails, MCA is a good technique for biliary stricture after LDLT.
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MESH Headings
- Aged
- Anastomosis, Surgical/adverse effects
- Anastomosis, Surgical/methods
- Bile Ducts/diagnostic imaging
- Bile Ducts/pathology
- Bile Ducts/surgery
- Bile Ducts, Intrahepatic/diagnostic imaging
- Bile Ducts, Intrahepatic/surgery
- Biliary Tract Surgical Procedures/adverse effects
- Biliary Tract Surgical Procedures/methods
- Cholangiopancreatography, Endoscopic Retrograde/methods
- Cholangitis/etiology
- Cholangitis/pathology
- Cholangitis/surgery
- Constriction, Pathologic/etiology
- Constriction, Pathologic/surgery
- Drainage/adverse effects
- Drainage/methods
- End Stage Liver Disease/etiology
- End Stage Liver Disease/surgery
- Female
- Humans
- Liver Cirrhosis, Biliary/complications
- Liver Cirrhosis, Biliary/surgery
- Liver Transplantation/adverse effects
- Liver Transplantation/methods
- Living Donors
- Magnetics
- Postoperative Complications/etiology
- Postoperative Complications/pathology
- Postoperative Complications/surgery
- Tomography, X-Ray Computed
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Affiliation(s)
- Y Nakaseko
- Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
| | - H Shiba
- Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - E Yamanouchi
- Department of Radiology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Y Takano
- Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - T Sakamoto
- Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - H Imazu
- Department of Endoscopy, Jikei University School of Medicine, Tokyo, Japan
| | - H Ashida
- Department of Radiology, Jikei University School of Medicine, Tokyo, Japan
| | - K Yanaga
- Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
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24
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Kawabata S, Hiramatsu R, Matsushita Y, Futamura- G, Kanemitsu T, Shiba H, Takeuchi K, Nonoguchi N, Kuroiwa T, Tanaka H, Sakurai Y, Akita K, Suzuki M, Ono K, Miyatake S. Reactor-based Boron Neutron Capture Therapy (BNCT) for the patients with recurrent malignant glioma. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Wakiyama S, Takano Y, Shiba H, Gocho T, Sakamoto T, Ishida Y, Yanaga K. Significance of Portal Venous Velocity in Short-term Graft Function in Living Donor Liver Transplantation. Transplant Proc 2017; 49:1087-1091. [PMID: 28583533 DOI: 10.1016/j.transproceed.2017.03.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
BACKGROUND Graft regeneration and functional recovery after reperfusion of transplanted graft are very important for successful living donor liver transplantation (LDLT). The aim of this study was to evaluate the significance of postoperative portal venous velocity (PVV) in short-term recovery of graft function in LDLT. PATIENTS AND METHODS From February 2007 through December 2015, we performed 17 primary LDLTs, which were included in the present study. The patients ranged in age from 12 to 65 years (mean: 50 years), and 11 were female patients. Postoperatively, Doppler ultrasonography was performed daily to measure PVV (cm/s), and liver function parameters were measured daily. The change in PVV (ΔPVV) was defined as follows: ΔPVV = PVV on postoperative day (POD) 1 - PVV on POD 7. Maximal value of serum aspartate aminotransferase (ASTmax) and maximal value of serum alanine transaminase (ALTmax) at 24 hours after graft reperfusion were used as parameters of reperfusion injury. Correlation analyses were performed as follows: (1) correlation of ΔPVV and PVV on POD 1 (PVV-POD 1) with the values such as ASTmax, ALTmax, other liver function parameters on POD 7 and graft regeneration rate; (2) correlation of ASTmax and ALTmax with other liver function parameters on POD 7. RESULTS ΔPVV significantly correlated with the values of serum total bilirubin (P < .01), prothrombin time (P < .01), and platelet count (P < .05), and PVV-POD 1 significantly correlated with the values of serum total bilirubin (P < .05) and prothrombin time (P < .05). CONCLUSION ΔPVV and PVV-POD 1 may be useful parameters of short-term functional recovery of the transplant liver in LDLT.
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Affiliation(s)
- S Wakiyama
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Y Takano
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - H Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - T Gocho
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - T Sakamoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Y Ishida
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - K Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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26
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Uwagawa T, Sakamoto T, Nakaseko Y, Takano Y, Furukawa K, Kanehira M, Onda S, Gocho T, Shiba H, Arakawa Y, Aiba K, Yanaga K. P-117 Phase II study of combination chemotherapy of gemcitabine/S-1 with nafamostat mesilate for advanced unresectable pancreatic cancer. First report. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Zhu X, Shiba H, Zhu Y, Quintini C, Eghtesad B, Miller C, Fung J, Kelly D. Adenosine Increases Hepatic Artery Flow in Liver Transplant Recipients: A Pilot Study. Transplant Proc 2016; 48:116-9. [DOI: 10.1016/j.transproceed.2016.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Accepted: 01/05/2016] [Indexed: 02/07/2023]
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28
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Miyashita H, Shiba H, Kawana H, Nakahara T. Clinical utility of three-dimensional SPECT/CT imaging as a guide for the resection of medication-related osteonecrosis of the jaw. Int J Oral Maxillofac Surg 2015; 44:1106-9. [PMID: 26008732 DOI: 10.1016/j.ijom.2015.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/01/2015] [Indexed: 11/16/2022]
Abstract
In recent years, proactive surgical treatment has been reported to be effective for medication-related osteonecrosis of the jaw (MRONJ). However, an uncertain resection entails the risk of recurrence, whereas an extensive surgical procedure may lead to a marked reduction in quality of life as a result of reduced masticatory function and poor cosmesis. Therefore, radiological assessment can be helpful to accurately localize MRONJ before surgery. The integrated single-photon emission computed tomography and computed tomography system (SPECT/CT) allows oral and maxillofacial surgeons to identify an area of MRONJ, especially when three-dimensional (3D) SPECT and CT fusion images are offered. A patient for whom 3D SPECT and CT image fusion (as developed in the radiology department of the study institution) contributed to determining the extent of the lesion, thereby leading to a favourable patient prognosis, is reported herein. There was exact correlation between the histological and radiological results.
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Affiliation(s)
- H Miyashita
- Division of Oral and Maxillofacial Surgery, Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - H Shiba
- Division of Oral and Maxillofacial Surgery, Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - H Kawana
- Division of Oral and Maxillofacial Surgery, Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - T Nakahara
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
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Ouhara K, Iwasaki Y, Kajiya M, Savitri IJ, Kitagawa M, Tokunaga N, Shintani T, Ogawa I, Hino T, Fujita T, Shiba H, Kurihara H. The differential expression of mgl mRNA by Porphyromonas gingivalis affects the production of methyl mercaptan. Oral Dis 2015; 21:626-33. [PMID: 25703825 DOI: 10.1111/odi.12326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 02/03/2015] [Accepted: 02/03/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE A large number of individuals have halitosis. The total amount of volatile sulfur compounds, which are the main cause of halitosis, has been correlated with periodontitis following bacterial infection. In this study, Porphyromonas gingivalis (Pg), a major periodontopathogenic bacterium, was isolated from patients with halitosis by the amplification of 16S rRNA, and the ability of isolated Pg to produce methyl mercaptan (CH3 SH) was determined to clarify the relationship between halitosis and Pg infection. MATERIALS AND METHODS CH3 SH concentrations were measured in patients using Oral Chroma. The production of CH3 SH by Pg standard and clinical strains was also measured in vitro. Real-time PCR was performed to compare the expression of mgl mRNA (which encoded l-methionine-a-deamino-g-mercaptomethane-lyase) among the Pg strains. The production of CH3 SH and the expression of mgl mRNA were also determined to assess the effects of oriental medicine. RESULTS The production of CH3 SH and the expression of mgl mRNA strongly correlated with each other in the presence of l-methionine. The expression of mgl mRNA by Pg W83 was strongly inhibited by magnoliaceae. CONCLUSION The production of CH3 SH was correlated with the expression of mgl. Furthermore, the oriental medicine, magnoliaceae, may represent a potential treatment for halitosis.
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Affiliation(s)
- K Ouhara
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Iwasaki
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Kajiya
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - I J Savitri
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Kitagawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - N Tokunaga
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - I Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - T Hino
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Fujita
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Shiba
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Kurihara
- Division of Applied Life Sciences, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.,Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
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30
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Fujita T, Yoshimoto T, Matsuda S, Kajiya M, Kittaka M, Imai H, Iwata T, Uchida Y, Shiba H, Kurihara H. Interleukin-8 induces DNA synthesis, migration and down-regulation of cleaved caspase-3 in cultured human gingival epithelial cells. J Periodontal Res 2014; 50:479-85. [PMID: 25244101 DOI: 10.1111/jre.12230] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND OBJECTIVE Migration of the junctional epithelium occurs in association with the formation of a periodontal pocket. Although the migration of junctional epithelium is known to be related to the proliferation and migration of gingival junctional epithelial cells, the mechanism has not been clarified. In patients with periodontitis, the levels of interleukin-8 (IL-8) in both gingival tissue and gingival crevicular fluid are dramatically increased. IL-8 has broad bioactive functions. In this study, we examined the role of IL-8 in DNA synthesis, migration and protection against apoptosis in cultured human gingival epithelial cells (HGEC). MATERIAL AND METHODS DNA synthesis was estimated by measuring the incorporation of bromodeoxyuridine. The migration of gingival epithelial cells was assessed in a wound-healing assay. The expression of integrin beta-1 was analyzed using immunofluorescence confocal microscopy and western blotting. Cleaved caspase-3 was detected using western blotting and a Caspase-Glo assay kit. RESULTS IL-8 increased the synthesis of DNA in HGEC, and the maximal effect was seen at 25 or 50 ng/mL of IL-8. In addition, 50 ng/mL of IL-8 induced cell migration, and a neutralizing antibody of integrin beta-1 inhibited the migration. IL-8 also activated expression of integrin beta-1. Furthermore, IL-8 reduced the Aggregatibacter actinomycetemcomitans-induced increase in caspase-3 expression in HGEC. CONCLUSION IL-8 may facilitate the migration of gingival junctional epithelium by enhancing DNA synthesis, migration and preventing apoptosis of gingival epithelial cells.
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Affiliation(s)
- T Fujita
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Yoshimoto
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Matsuda
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Kajiya
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Kittaka
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Imai
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Iwata
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Uchida
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Shiba
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Kurihara
- Division of Applied Life Science, Department of Periodontal Medicine, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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31
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Savitri IJ, Ouhara K, Fujita T, Kajiya M, Miyagawa T, Kittaka M, Yamakawa M, Shiba H, Kurihara H. Irsogladine maleate inhibits Porphyromonas gingivalis-mediated expression of toll-like receptor 2 and interleukin-8 in human gingival epithelial cells. J Periodontal Res 2014; 50:486-93. [PMID: 25244303 DOI: 10.1111/jre.12231] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis is an infectious disease caused by an interaction between the host and periodontopathogenic bacteria. Regulating the immune response in human gingival epithelial cells (HGEC) may contribute to the prevention of periodontitis. Irsogladine maleate (IM) has previously been shown to regulate inflammation and the cell-cell junctional barrier in HGEC. In addition to these functions, control of bacterial recognition is important for preventing inflammation in periodontal tissue. Innate immunity in gingival epithelium is the first line of defense and plays a crucial role against bacterial challenge. Therefore, the effect of IM on regulating toll-like receptor 2 (TLR2), which is part of the innate immunity, was determined in this study. MATERIAL AND METHODS OBA-9, an immortalized human gingival epithelial cell line, and primary cultured HGEC were used in this study. Real-time PCR and western blotting were performed in OBA-9 or HGEC stimulated with whole cells of Porphyromonas gingivalis or with lipopolysaccharide (LPS) derived from P. gingivalis (PgLPS) in the presence or absence of IM to determine expression of TLR2 mRNA and production of TLR2 protein. Small interfering RNA (siRNA) against TLR2 was transfected into OBA-9 to clarify the association between the induction of TLR2 and interleukin-8 (IL-8) production. RESULTS The addition of IM into P. gingivalis or PgLPS-induced OBA-9 suppressed IL-8 production (p < 0.01). The addition of IM also abolished the induction of TLR2 by P. gingivalis or PgLPS in OBA-9 and primary cultured HGEC (p < 0.01). The suppressive effect of IM on the induction of TLR2 was also confirmed by immunohistostaining. Stimulation with peptidoglycan, a specific ligand for TLR2, suppressed the expression of toll-like receptor 4 (TLR4) mRNA in the presence of IM (p < 0.01). However, LPS derived from Escherichia coli, a ligand for TLR4, did not induce the expression of TLR2 mRNA. The PgLPS-induced expression of TLR4 mRNA was abolished by IM. Knockdown of TLR2 by siRNA transfection resulted in a weaker response of induction of IL8 mRNA in P. gingivalis or PgLPS-stimulated OBA-9. CONCLUSION These results suggest that IM suppresses the induction of IL-8 production by regulating increased levels of TLR2.
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Affiliation(s)
- I J Savitri
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - K Ouhara
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Fujita
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Kajiya
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Miyagawa
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Kittaka
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Yamakawa
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Shiba
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Kurihara
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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32
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Khung R, Shiba H, Kajiya M, Kittaka M, Ouhara K, Takeda K, Mizuno N, Fujita T, Komatsuzawa H, Kurihara H. LL37 induces VEGF expression in dental pulp cells through ERK signalling. Int Endod J 2014; 48:673-9. [DOI: 10.1111/iej.12365] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/31/2014] [Indexed: 01/09/2023]
Affiliation(s)
- R. Khung
- Department of Periodontal Medicine, Applied Life Sciences; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - H. Shiba
- Department of Periodontal Medicine, Applied Life Sciences; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - M. Kajiya
- Department of Periodontal Medicine, Applied Life Sciences; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - M. Kittaka
- Department of Periodontal Medicine, Applied Life Sciences; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - K. Ouhara
- Department of Periodontal Medicine, Applied Life Sciences; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - K. Takeda
- Department of Periodontal Medicine, Applied Life Sciences; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - N. Mizuno
- Department of Periodontal Medicine, Applied Life Sciences; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - T. Fujita
- Department of Periodontal Medicine, Applied Life Sciences; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - H. Komatsuzawa
- Department of Oral Microbiology; Kagoshima University Graduate School of Medical and Dental Sciences; Kagoshima Japan
| | - H. Kurihara
- Department of Periodontal Medicine, Applied Life Sciences; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
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Matsuda S, Fujita T, Kajiya M, Kashiwai K, Takeda K, Shiba H, Kurihara H. Brain-derived neurotrophic factor prevents the endothelial barrier dysfunction induced by interleukin-1β and tumor necrosis factor-α. J Periodontal Res 2014; 50:444-51. [DOI: 10.1111/jre.12226] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2014] [Indexed: 11/29/2022]
Affiliation(s)
- S. Matsuda
- Department of Periodontal Medicine; Division of Applied Life Sciences; Institute of Biomedical & Health Sciences; Hiroshima University; Hiroshima Japan
| | - T. Fujita
- Department of Periodontal Medicine; Division of Applied Life Sciences; Institute of Biomedical & Health Sciences; Hiroshima University; Hiroshima Japan
| | - M. Kajiya
- Department of Periodontal Medicine; Division of Applied Life Sciences; Institute of Biomedical & Health Sciences; Hiroshima University; Hiroshima Japan
| | - K. Kashiwai
- Department of Periodontal Medicine; Division of Applied Life Sciences; Institute of Biomedical & Health Sciences; Hiroshima University; Hiroshima Japan
| | - K. Takeda
- Department of Periodontal Medicine; Division of Applied Life Sciences; Institute of Biomedical & Health Sciences; Hiroshima University; Hiroshima Japan
| | - H. Shiba
- Department of Periodontal Medicine; Division of Applied Life Sciences; Institute of Biomedical & Health Sciences; Hiroshima University; Hiroshima Japan
| | - H. Kurihara
- Department of Periodontal Medicine; Division of Applied Life Sciences; Institute of Biomedical & Health Sciences; Hiroshima University; Hiroshima Japan
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Yoshimoto T, Fujita T, Ouhara K, Kajiya M, Imai H, Shiba H, Kurihara H. Smad2 is involved in Aggregatibacter actinomycetemcomitans-induced apoptosis. J Dent Res 2014; 93:1148-54. [PMID: 25192897 DOI: 10.1177/0022034514550041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Apoptosis is thought to contribute to the progression of periodontitis. It has been suggested that the apoptosis of epithelial cells may contribute to the loss of epithelial barrier function. Smad2, a downstream signaling molecule of TGF-β receptors (TGF-βRs), is critically involved in apoptosis in several cell types. However, the relationship between smad2 and bacteria-induced apoptosis has not yet been elucidated. It is possible that the regulation of apoptosis induced by periodontopathic bacteria may lead to novel preventive therapies for periodontitis. Therefore, in the present study, we investigated the involvement of smad2 phosphorylation in apoptosis of human gingival epithelial cells induced by Aggregatibacter actinomycetemcomitans (Aa). Aa apparently induced the phosphorylation of smad2 in primary human gingival epithelial cells (HGECs) or the human gingival epithelial cell line, OBA9 cells. In addition, Aa induced phosphorylation of the serine residue of the TGF-β type I receptor (TGF-βRI) in OBA9 cells. SB431542 (a TGF-βRI inhibitor) and siRNA transfection for TGF-βRI, which reduced both TGF-βRI mRNA and protein levels, markedly attenuated the Aa-induced phosphorylation of smad2. Furthermore, the disruption of TGF-βRI signaling cascade by SB431542 and siRNA transfection for TGF-βRI abrogated the activation of cleaved caspase-3 expression and repressed apoptosis in OBA9 cells treated with Aa. Thus, Aa induced apoptosis in gingival epithelial cells by activating the TGF-βRI-smad2-caspase-3 signaling pathway. The results of the present study may suggest that the periodontopathic bacteria, Aa, activates the TGF-βR/smad2 signaling pathway in human gingival epithelial cells and induces apoptosis in epithelial cells, which may lead to new therapeutic strategies that modulate the initiation of periodontitis.
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Affiliation(s)
- T Yoshimoto
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Fujita
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - K Ouhara
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Kajiya
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Imai
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Shiba
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Kurihara
- Department of Periodontal Medicine, Division of Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Yabu T, Shiba H, Shibasaki Y, Nakanishi T, Imamura S, Touhata K, Yamashita M. Stress-induced ceramide generation and apoptosis via the phosphorylation and activation of nSMase1 by JNK signaling. Cell Death Differ 2014; 22:258-73. [PMID: 25168245 PMCID: PMC4291487 DOI: 10.1038/cdd.2014.128] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 07/14/2014] [Accepted: 07/15/2014] [Indexed: 12/20/2022] Open
Abstract
Neutral sphingomyelinase (nSMase) activation in response to environmental stress or inflammatory cytokine stimuli generates the second messenger ceramide, which mediates the stress-induced apoptosis. However, the signaling pathways and activation mechanism underlying this process have yet to be elucidated. Here we show that the phosphorylation of nSMase1 (sphingomyelin phosphodiesterase 2, SMPD2) by c-Jun N-terminal kinase (JNK) signaling stimulates ceramide generation and apoptosis and provide evidence for a signaling mechanism that integrates stress- and cytokine-activated apoptosis in vertebrate cells. An nSMase1 was identified as a JNK substrate, and the phosphorylation site responsible for its effects on stress and cytokine induction was Ser-270. In zebrafish cells, the substitution of Ser-270 for alanine blocked the phosphorylation and activation of nSMase1, whereas the substitution of Ser-270 for negatively charged glutamic acid mimicked the effect of phosphorylation. The JNK inhibitor SP600125 blocked the phosphorylation and activation of nSMase1, which in turn blocked ceramide signaling and apoptosis. A variety of stress conditions, including heat shock, UV exposure, hydrogen peroxide treatment, and anti-Fas antibody stimulation, led to the phosphorylation of nSMase1, activated nSMase1, and induced ceramide generation and apoptosis in zebrafish embryonic ZE and human Jurkat T cells. In addition, the depletion of MAPK8/9 or SMPD2 by RNAi knockdown decreased ceramide generation and stress- and cytokine-induced apoptosis in Jurkat cells. Therefore the phosphorylation of nSMase1 is a pivotal step in JNK signaling, which leads to ceramide generation and apoptosis under stress conditions and in response to cytokine stimulation. nSMase1 has a common central role in ceramide signaling during the stress and cytokine responses and apoptosis.
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Affiliation(s)
- T Yabu
- Nihon University, College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - H Shiba
- Nihon University, College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Y Shibasaki
- Nihon University, College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - T Nakanishi
- Nihon University, College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - S Imamura
- Food Safety Assessment Research Group, National Research Institute of Fisheries Science, 12-4 Fukuura 2, Kanazawa-ku, Yokohama, Kanagawa 236-8648, Japan
| | - K Touhata
- Food Safety Assessment Research Group, National Research Institute of Fisheries Science, 12-4 Fukuura 2, Kanazawa-ku, Yokohama, Kanagawa 236-8648, Japan
| | - M Yamashita
- Food Safety Assessment Research Group, National Research Institute of Fisheries Science, 12-4 Fukuura 2, Kanazawa-ku, Yokohama, Kanagawa 236-8648, Japan
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Shirai Y, Shiba H, Uwagawa T, Iwase R, Haruki K, Fujiwara Y, Furukawa K, Iida T, Futagawa Y, Misawa T, Ohashi T, Yanaga K. Inhibitor of Nuclear Factor κB Activation Enhances the Antitumor Effect of Radiation Therapy for Pancreatic Cancer. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nagai K, Takeuchi T, Kotani T, Hata K, Yoshida S, Isoda K, Fujiki Y, Shiba H, Makino S, Hanafusa T. Therapeutic drug monitoring of cyclosporine microemulsion in interstitial pneumonia with dermatomyositis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-010-0342-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ooi Y, Shiba H, Nagai K, Higashiyama T, Nakanishi T, Nakano T, Ukimura A, Gonoi T. Lung Nocardia elegans infection diagnosed on matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Intern Med 2014; 53:2111-3. [PMID: 25224198 DOI: 10.2169/internalmedicine.53.2387] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 73-year-old man with adultonset Still's disease developed a high fever, coughing, dyspnea and bloody sputum and was therefore admitted to our hospital. Thoracic X-ray and CT scans revealed oval lesions in the bilateral lungs. A bacterial isolate from the sputum was identified to be Nocardia elegans (N. elegans) on comparative 16S rRNA gene sequencing and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS). The patient recovered following treatment with imipenem/cilastatin and amikacin. To the best of our knowledge, this is the first case of nocardiosis caused by N. elegans identified on MALDI-TOF MS.
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Affiliation(s)
- Yukimasa Ooi
- Infection Control Office, Osaka Medical College Hospital, Japan
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Kawamoto K, Kawamoto T, Shiba H, Hosono K. A histochemical study of the posterior silk glands ofBombyx moriduring metamorphosis from larvae to pupae using frozen sections. Biotech Histochem 2013; 89:145-52. [DOI: 10.3109/10520295.2013.830777] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Futagawa Y, Wakiyama S, Matsumoto M, Shiba H, Gocho T, Ishida Y, Yanaga K. Living-related liver transplantation in Diego blood group disparity: a case report. Transplant Proc 2013; 45:814-6. [PMID: 23498825 DOI: 10.1016/j.transproceed.2012.07.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Accepted: 07/27/2012] [Indexed: 11/29/2022]
Abstract
To date, only limited cases of Diego blood group disparity in liver transplantation have been reported, and no cases with a long-term clinical course have been documented. Herein, we report a case of Diego blood group disparity in liver transplantation with details of long-term follow-up. The recipient was a 47-year-old woman with primary biliary cirrhosis; her 18-year-old daughter was the donor. Both recipient and donor were of blood type O according to the ABO blood group system. Preoperative serological tests showed the presence of antibodies against the Di(a) antigen only in the recipient, and not in the donor. Thus, the Diego phenotype was Di(a+) in the donor and Di(a-) in the recipient. Living-related liver transplantation was performed in July 2009. Immediate graft function was obtained, and no signs of humoral or cellular rejection were observed during the postoperative period. Further, anti-Di(a) antibodies were not detected throughout the postoperative course. The patient is alive and shows no signs of humoral rejection 34 months after liver transplantation. Liver transplantation has been performed successfully in cases of Diego blood group disparity.
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Affiliation(s)
- Y Futagawa
- Department of Hepato-biliary-pancreas Surgery, Jikei University School of Medicine, Tokyo, Japan
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41
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Kittaka M, Shiba H, Kajiya M, Ouhara K, Takeda K, Kanbara K, Fujita T, Kawaguchi H, Komatsuzawa H, Kurihara H. Antimicrobial peptide LL37 promotes vascular endothelial growth factor-A expression in human periodontal ligament cells. J Periodontal Res 2012; 48:228-34. [PMID: 22943069 DOI: 10.1111/j.1600-0765.2012.01524.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2012] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVE LL37, originally found in the innate immune system, is a robust antimicrobial peptide. LL37 exhibits multiple bio-functions in various cell types, such as migration, cytokine production, apoptosis, and angiogenesis besides its antimicrobial activity Periodontal ligament (PL) cells play a pivotal role in periodontal tissue regeneration. Based on these findings, we hypothesized that LL37 can regulate PL cell function to promote regeneration of periodontal tissue. To prove this hypothesis, we investigated the effect of LL37 on the potent angiogenic inducer vascular endothelial growth factor (VEGF) expression in cultures of human PL (HPL) cells because neovascularization is indispensable for the progress of tissue regeneration. Moreover, we investigated the signaling cascade associated with LL37-induced VEGF expression. MATERIAL AND METHOD HPL cells were treated with synthesized LL37 in the presence or absence of PD98059, a MEK-ERK inhibitor, or PDTC, an NF-κB inhibitor. VEGF expression levels were assessed by real-time polymerase chain reaction analysis and an enzyme-linked immunoassay. Phosphorylation levels of ERK1/2 or NF-κB p65 were determined by Western blotting. RESULTS LL37 upregulated VEGF-A expression at the mRNA and protein levels in HPL cells, while VEGF-B mRNA expression was not affected. Both ERK and NF-κB inhibitors clearly abrogated the increase in VEGF-A levels induced by LL37 in HPL cells. Importantly, LL37 increased phosphorylated levels of ERK1/2 and NF-κB p65 in HPL cells. CONCLUSION LL37 induces VEGF-A production in HPL cells via ERK and NF-κB signaling cascades, which may result in angiogenesis, thereby contributing to periodontal regeneration.
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Affiliation(s)
- M Kittaka
- Department of Periodontal Medicine, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Yamamoto N, Fukuda Y, Shiba H, Ozaki T, Hayashi S, Sonoda K, Yoshida M, Saeki A, Ohsawa N, Sugino M. Noninvasive Positive Pressure Ventilation Improved Refractory Behavioral and Psychological Symptoms of Dementia in an Elderly Adult with Type 2 Respiratory Failure. J Am Geriatr Soc 2012; 60:1576-8. [DOI: 10.1111/j.1532-5415.2012.04072.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | | | | | - Kaoru Sonoda
- Department of Gerontology; Aino Hospital; Osaka; Japan
| | | | - Akio Saeki
- Department of Internal Medicine; Osaka; Japan
| | - Nakaaki Ohsawa
- Department of Aino Institute for Aging Research; Osaka; Japan
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Fujita T, Yumoto H, Shiba H, Ouhara K, Miyagawa T, Nagahara T, Matsuda S, Kawaguchi H, Matsuo T, Murakami S, Kurihara H. Irsogladine maleate regulates epithelial barrier function in tumor necrosis factor-α-stimulated human gingival epithelial cells. J Periodontal Res 2011; 47:55-61. [DOI: 10.1111/j.1600-0765.2011.01404.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nagai K, Takeuchi T, Kotani T, Hata K, Yoshida S, Isoda K, Fujiki Y, Shiba H, Makino S, Hanafusa T. Therapeutic drug monitoring of cyclosporine microemulsion in interstitial pneumonia with dermatomyositis. Mod Rheumatol 2010; 21:32-6. [PMID: 20680374 DOI: 10.1007/s10165-010-0342-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 07/06/2010] [Indexed: 11/26/2022]
Abstract
The prognosis of dermatomyositis (DM)-associated progressive interstitial pneumonia (IP) has recently been improved by steroids/cyclosporine-A (CSA) combination therapy, but treatment outcomes varied. One reason for this variation is thought to be differences in CSA regimen. There is marked interpatient variability in CSA absorption. However, the pharmacokinetics of CSA has rarely been studied. In this study, we calculated the area under the blood concentration-time curve (AUC) of CSA microemulsion in 15 patients with progressive IP complicating DM, and analyzed its correlation with CSA levels at blood sampling time points to investigate the optimum monitoring and dosing regimen. The highest correlation between AUC(0-6) and blood level of CSA was observed 2 h (C2) after drug administration (R = 0.910). The trough level (C0) was not correlated with AUC(0-6) (R = 0.052). There were no differences in blood levels (AUC(0-6), C2, and C6) between postprandial administration in a divided dose (CSA given twice daily) and preprandial administration once daily in a single dose, while C0 was significantly lower (P = 0.020) when the drug was administered once daily before breakfast. These findings suggest that measurement of CSA blood level, especially C2 and C0, is useful to monitor clinical and adverse effects of CSA during combination therapy. It is also suggested that preprandial, once daily administration of CSA is beneficial in DM patients with progressive IP.
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Affiliation(s)
- Koji Nagai
- First Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan
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Fujita T, Hayashida K, Shiba H, Kishimoto A, Matsuda S, Takeda K, Kawaguchi H, Kurihara H. The expressions of claudin-1 and E-cadherin in junctional epithelium. J Periodontal Res 2010; 45:579-82. [PMID: 20337884 DOI: 10.1111/j.1600-0765.2009.01258.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE The epithelium provides an important barrier against microbial invasion. Tight junction structural proteins called claudins are known to contribute to the epithelial cell barrier. Junctional epithelium is located at a strategically important interface between gingival sulcus and is interconnected by desmosomes and gap junctions, but not by tight junctions. Although claudins are tight junction-associated proteins, they are also expressed in the epithelium despite its lack of tight junctions in invertebrates. Therefore, claudins may play an important role in junctional epithelium without tight junctions. E-cadherin is a key molecule in the formation of adherence junctions and desmosomes. In the present study, we aimed to investigate the expressions of claudin-1,claudin-3, claudin-7 and E-cadherin in the junctional epithelium of Fischer 344 rats. MATERIAL AND METHODS Gingival tissues from Fischer 344 rats were analyzed by immunohistochemical staining for claudin-1, claudin-3, claudin-7, and E-cadherin. RESULTS Intense staining for claudin-1 and E-cadherin were observed in the junctional epithelium. In contrast to claudin-1, claudin-3 was mainly expressed in oral gingival epithelium and claudin-7 could not be detected on immunohistochemical analysis of the rat gingiva. CONCLUSION These data suggest that claudin-1 and E-cadherin exist in the junctional epithelium and may play an important role in epithelial barrier function.
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Affiliation(s)
- T Fujita
- Department of Periodontal Medicine, Division of Frontier Medical Science, Hiroshima University Graduate School of Biomedical Sciences, Kasumi, Minami-ku, Hiroshima, Japan.
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Kunieda E, Oku Y, Fukada J, Kawaguchi O, Shiba H, Takeda A, Kubo A. The reproducibility of a HeadFix relocatable fixation system: analysis using the stereotactic coordinates of bilateral incus and the top of the crista galli obtained from a serial CT scan. Phys Med Biol 2009; 54:N197-204. [PMID: 19420419 DOI: 10.1088/0031-9155/54/10/n03] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We analysed the repositioning accuracy of bite-plate fixations from serial QA-CT (quality-assurance CT) taken during the course of stereotactic radiotherapy. A total of 72 series of CT examinations from 15 consecutive patients, who underwent stereotactic radiotherapy for various intracranial tumours, were examined. Three or four CT scans were obtained for the purpose of QA for the right and left incus, as well as the crista galli. The stereotactic coordinates of the centres of the incus and the top of the crista galli were semi-automatically obtained for each QA-CT scan. Positional displacements for these anatomical reference points and the centre of the points were obtained. The mean displacements for these points in the 3D directions ranged from -0.10 to 0.08 mm (standard deviations: 0.44-0.94). The absolute positional displacement ranged from 0.93 to 1.09 mm (standard deviations: 0.52-0.88 mm). The rotations of the head were 0.49+/-0.36 degrees. Our 3D measurement technique using anatomical landmarks revealed excellent stability of the mouthpiece fixation system in terms of translational and rotational displacements. This technique can also be used as a QA method for other fixation devices.
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Affiliation(s)
- Etsuo Kunieda
- Department of Radiology, Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
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Yago K, Kizu H, Miyashita H, Shiba H, Kasazaki Y, Asanami S. Bisphosphonate-related osteonecrosis of the jaw for which a surgical procedure was performed. Int J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.ijom.2009.03.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Iida T, Shiba H, Misawa T, Ohashi T, Eto Y, Yanaga K. QS142. Immuno Gene Therapy for Liver Metastasis by Subcutaneous Injection of Adenovirus Vector Expressing CD40 Ligand in Rats. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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49
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Uwagawa T, Misawa T, Sakamoto T, Ito R, Gocho T, Shiba H, Wakiyama S, Hirohara S, Sadaoka S, Yanaga K. A phase I study of full-dose gemcitabine and regional arterial infusion of nafamostat mesilate for advanced pancreatic cancer. Ann Oncol 2008; 20:239-43. [PMID: 18836085 DOI: 10.1093/annonc/mdn640] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The primary end points of this study were to determine the dose-limiting toxic effects (DLTs), maximum tolerated dose, and a recommended phase II dose of a synthetic serine protease inhibitor, nafamostat mesilate, in combination with full-dose gemcitabine in patients with unresectable locally advanced or metastatic pancreatic cancer. The secondary end point was to assess therapeutic response. PATIENTS AND METHODS Patients with previously untreated pancreatic cancer received gemcitabine (1 000 mg/m(2) i.v. for 30 min) on days 1, 8, and 15, with nafamostat mesilate (continuous regional arterial infusion for 24 h through a port-catheter system) on days 1, 8, and 15; this regimen was repeated at 28-day intervals. The initial dose of nafamostat mesilate was 2.4 mg/kg and was escalated in increments of 1.2 mg/kg until a dose of 4.8 mg/kg was achieved. A standard '3+3' phase I dose-escalation design was used. Therapeutic response and clinical benefit response were assessed. RESULTS Twelve patients were enrolled in this study. None of the patients experienced DLTs, and nafamostat mesilate was well tolerated at doses up to 4.8 mg/kg in combination with full-dose gemcitabine. This combination chemotherapy yielded a reduction of a high serum level of the tumor marker CA19-9. Pain was reduced in three of seven patients without oral morphine sulfate. Overall survival was 7.1 months for all patients. CONCLUSION This phase I study was carried out safely. This combination chemotherapy showed beneficial improvement in health-related quality of life. The recommended phase II dose of nafamostat mesilate in combination with full-dose gemcitabine is 4.8 mg/kg.
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Affiliation(s)
- T Uwagawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
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50
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Kishimoto A, Fujita T, Shiba H, Komatsuzawa H, Takeda K, Kajiya M, Hayashida K, Kawaguchi H, Kurihara H. Irsogladine maleate abolishes the increase in interleukin-8 levels caused by outer membrane protein 29 fromAggregatibacter(Actinobacillus)actinomycetemcomitansthrough the ERK pathway in human gingival epithelial cells. J Periodontal Res 2008; 43:508-13. [DOI: 10.1111/j.1600-0765.2007.01059.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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