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Sonomoto K, Tanaka H, Nguyen TM, Yoshinari H, Nakano K, Nakayamada S, Tanaka Y. Prophylaxis against pneumocystis pneumonia in rheumatoid arthritis patients treated with b/tsDMARDs: insights from 3787 cases in the FIRST registry. Rheumatology (Oxford) 2022; 61:1831-1840. [PMID: 34382090 PMCID: PMC9071566 DOI: 10.1093/rheumatology/keab647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/08/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The use of biologic and targeted synthetic (b/ts) DMARDs in the treatment of RA is increasing. Therefore, prevention of b/tsDMARDs-induced infection is important. Here we describe a prophylaxis protocol for preventing pneumocystis pneumonia (PCP) in RA patients treated with b/tsDMARDs. METHODS The study subjects were 3787 RA patients from the FIRST registry. They were divided into cohort 1 (n = 807, requiring prophylaxis against PCP based on physicians' assessment at the point of new treatment with or switch to b/tsDMARDs) and cohort 2 (n = 2980, receiving strategic PCP prophylaxis). The incidence and risk factors for PCP were investigated. RESULTS Twenty-six PCP cases were observed throughout the study. After the introduction of strategic PCP prophylaxis, PCP incidence diminished from 0.51/100 person-years (PYs) to 0.21/100 PYs (risk ratio = 0.42). Sulfamethoxazole and trimethoprim in combination (SMX-TMP) showed greater efficacy in the prevention of PCP than pentamidine inhalation (P <0.0001). The prophylaxis rate increased chronologically despite the falls in the average SMX-TMP dose and in the incidence of PCP. Subanalysis of the data for 929 patients from both groups who did not receive prophylaxis showed that old age, high BMI, coexisting lung diseases, low lymphocyte count, and low serum IgG levels increased the risk of PCP development. Development of PCP could be predicted (using an equation based on these variables) in patients not treated with glucocorticoids [area under the curve (AUC) = 0.910)], but less accurately in those on glucocorticoids (AUC = 0.746). CONCLUSIONS Our study clarified the risk factors for PCP in RA patients on b/tsDMARDs treatment and highlighted and defined the criteria for effective prophylaxis against PCP.
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Affiliation(s)
- Koshiro Sonomoto
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu
| | - Hiroaki Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu
| | - Tuan Manh Nguyen
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu
| | - Hiroko Yoshinari
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu
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Kitanaga Y, Yamajuku D, Kubo S, Nakamura K, Maeda M, Seki M, Kaneko Y, Kinugasa F, Morokata T, Kondo Y, Yoshinari H, Nakayamada S, Sumida T, Tanaka Y. Discovery of a novel Igβ and FcγRIIB cross-linking antibody, ASP2713, and its potential application in the treatment of systemic lupus erythematosus. Int Immunopharmacol 2021; 101:108343. [PMID: 34781122 DOI: 10.1016/j.intimp.2021.108343] [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: 09/06/2021] [Revised: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022]
Abstract
B cell-targeted therapies have evolved as established therapies for systemic lupus erythematosus (SLE); however, existing approaches still do not thoroughly satisfy clinical requirements due to limited efficacy against memory B cells, autoantibody-producing plasmablasts and disease heterogeneity. To provide a new treatment option for SLE, we created a novel anti-Igβ antibody with enhanced affinity for Fc gamma receptor (FcγR) IIB called ASP2713. ASP2713 cross-reacted with both human and cynomolgus monkey Igβ and showed increased binding affinity for human and monkey FcγRIIB compared to native human IgG1. This binding property allows dominant B cell binding and induction of intrinsic negative feedback signals. In human B cells, ASP2713 significantly and concentration-dependently induced FcγRIIB ITIM phosphorylation, while suppressing proliferation under B cell receptor stimulation. This pharmacological effect was also confirmed in in vitro B cell proliferation and antibody production assays using peripheral B cells isolated from patients with SLE. In a cynomolgus monkey tetanus toxoid-induced antibody production model, ASP2713 almost completely inhibited the increase in antigen-specific antibodies with superior efficacy to rituximab. Additionally, ASP2713 significantly suppressed recall antibody production in response to secondary tetanus toxoid immunization, indicating the memory B cell- and plasmablast-targeting potential of ASP2713. Our results suggest that ASP2713 may have therapeutic potential as a treatment for SLE, where B cells play a pathogenic role.
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Affiliation(s)
- Yukihiro Kitanaga
- Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan; First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Fukuoka, Japan.
| | - Daisuke Yamajuku
- Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan
| | - Satoshi Kubo
- Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan
| | - Koji Nakamura
- Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan
| | - Masashi Maeda
- Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan
| | - Mutsumi Seki
- Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan
| | - Yoko Kaneko
- Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan
| | - Fumitaka Kinugasa
- Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan
| | - Tatsuaki Morokata
- Drug Discovery Research, Astellas Pharma Inc., Tsukuba, Ibaraki, Japan
| | - Yuya Kondo
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroko Yoshinari
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - Shingo Nakayamada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - Takayuki Sumida
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
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Tanaka Y, Sato-Kanda Y, Yoshinari H, Nakano K, Shimajiri S, Satoh M. Lung transplantation resulted in marked improvement of autoimmunity and scleroderma in diffuse cutaneous systemic sclerosis: a case report. Rheumatology (Oxford) 2021; 60:e129-e131. [PMID: 33188699 DOI: 10.1093/rheumatology/keaa736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/04/2020] [Accepted: 10/13/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yoshiya Tanaka
- First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Yurie Sato-Kanda
- First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Hiroko Yoshinari
- First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuhisa Nakano
- First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Shohei Shimajiri
- Department of Pathology, University of Occupational and Environmental Health, Japan
| | - Minoru Satoh
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Japan
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Lee S, Nakayamada S, Kubo S, Yamagata K, Yoshinari H, Tanaka Y. Interleukin-23 drives expansion of Thelper 17 cells through epigenetic regulation by signal transducer and activators of transcription 3 in lupus patients. Rheumatology (Oxford) 2020; 59:3058-3069. [DOI: 10.1093/rheumatology/keaa176] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Abstract
Objectives
To elucidate the molecular mechanisms underlying pathogenic Th17 cells, we investigated the modulation of epigenetic modifications and its association with SLE.
Methods
Naive CD4+ T cells were cultured in Th17 polarizing conditions for 5 days and then treated with various cytokines, including IL-23. Expression of Th17 cell–related markers and phosphorylation of signal transducers and activators of transcription (pSTATs) were analysed using flow cytometry and quantitative PCR. Histone modifications were assessed using chromatin immunoprecipitation PCR. T cell phenotypes and pSTATs were analysed in blood samples of patients with SLE (n = 28). Finally, the effects of baricitinib on memory Th17 cells were investigated in SLE patients (n = 12).
Results
Stimulation of resting Th17 cells with IL-23 promoted maturation of these cells (P < 0.0001). IL-23 induced pSTAT3, but not pSTAT4, during Th17 cell maturation (P < 0.05). IL-23-induced STAT3 directly bound the RORγT gene locus. This was accompanied by induction of the H3H4me3 permissive mark and reduction of the H3K27me3 repressive mark, leading to enhanced RORγT gene expression. IL-23-induced expansion of Th17 cells and pSTAT3 were suppressed by the addition of baricitinib in a concentration-dependent manner (P < 0.05). In memory Th17 cells from SLE patients, pSTAT3 was hypersensitized by IL-23 stimulation and inhibited by baricitinib (P < 0.05).
Conclusion
The results of this study indicate that IL-23/STAT3 signalling plays a fundamental role in Th17 cell maturation through transcriptional and epigenetic modifications in patients with SLE. This mechanism may underlie pathogenic Th17 cell expansion and may lead to identification of novel therapeutic targets for SLE.
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Affiliation(s)
- Seunghyun Lee
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu Japan
| | - Kaoru Yamagata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu Japan
| | - Hiroko Yoshinari
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu Japan
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Kubo S, Nakayamada S, Miyazaki Y, Yoshikawa M, Yoshinari H, Satoh Y, Todoroki Y, Nakano K, Satoh M, Smith V, Cutolo M, Tanaka Y. Distinctive association of peripheral immune cell phenotypes with capillaroscopic microvascular patterns in systemic sclerosis. Rheumatology (Oxford) 2020; 58:2273-2283. [PMID: 31230071 DOI: 10.1093/rheumatology/kez244] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 05/09/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The pathological changes in SSc include immune system dysregulation and microvascular damage. However, the association of immune cell phenotype heterogeneity and microvascular abnormalities is unclear. The aim of this study is to elucidate this association in SSc. METHODS Peripheral blood mononuclear cells obtained from 150 SSc patients were used for comprehensive flow cytometric analysis based on the Human Immunology Project. Hierarchical cluster analysis was used to classify SSc patients into subgroups and their association with microvascular abnormalities, as assessed by nailfold videocapillaroscopy (i.e. 'early', 'active' and 'late' patterns), was analysed. RESULTS The proportions of activated CD4+ T cells, T cells re-expressing CD45RA, activated Th1 and Th17 cells and IgD-CD27- B cells were higher in SSc patients than in healthy individuals. Hierarchical cluster analysis stratified SSc patients into three groups: patients with few immune abnormalities (fewer abnormalities group), patients with high proportions of activated T and Treg cells (Treg-dominant group) and patients with high proportions of Tfh and plasmablasts (Tfh-dominant group). Age and disease duration were comparable among the groups. On the other hand, microvascular abnormalities, especially the 'late' nailfold videocapillaroscopy pattern, correlated with internal organ involvement. Among the groups stratified according to immune cell phenotype, the progression to the 'late' nailfold videocapillaroscopy pattern was more frequent in the Tfh-dominant group. CONCLUSION Our study confirmed the presence of immunophenotypic abnormalities in SSc. Immunological abnormalities were not uniform but rather limited to subpopulations, particularly the Tfh-dominant group, where they were highly associated with microvascular abnormalities and organ involvement.
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Affiliation(s)
- Satoshi Kubo
- First Department of Internal Medicine, Japan, Kitakyushu, Japan
| | | | - Yusuke Miyazaki
- First Department of Internal Medicine, Japan, Kitakyushu, Japan
| | - Maiko Yoshikawa
- First Department of Internal Medicine, Japan, Kitakyushu, Japan
| | | | - Yurie Satoh
- First Department of Internal Medicine, Japan, Kitakyushu, Japan
| | | | - Kazuhisa Nakano
- First Department of Internal Medicine, Japan, Kitakyushu, Japan
| | - Minoru Satoh
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Vanessa Smith
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Maurizio Cutolo
- Research Laboratories and Academic Division of Rheumatology, Department of Internal Medicine, University of Genova, San Martino Polyclinic Hospital, Genova, Italy
| | - Yoshiya Tanaka
- First Department of Internal Medicine, Japan, Kitakyushu, Japan
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Miyagawa I, Nakayamada S, Nakano K, Kubo S, Iwata S, Miyazaki Y, Yoshikawa M, Yoshinari H, Tanaka Y. Precision medicine using different biological DMARDs based on characteristic phenotypes of peripheral T helper cells in psoriatic arthritis. Rheumatology (Oxford) 2019; 58:336-344. [PMID: 29618121 DOI: 10.1093/rheumatology/key069] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives We sought to investigate the selection of specific biological DMARDs (bDMARDs) based on characteristic lymphocyte phenotypes for treating PsA. Methods Of 64 patients with PsA resistant to MTX, 26 underwent bDMARDs therapy selected according to phenotypic differences in peripheral helper T cells on 8-colour flow cytometry. The efficacies of this strategic treatment and the standard treatment administered to the other 38 patients were evaluated at 6 months. Results The 26 patients with PsA in the strategic treatment group were classified into the following four types based on peripheral blood analysis: (i) CXCR3+CCR6-CD38+HLA-DR+ activated Th1 cell-predominant type, (ii) CXCR3-CCR6+ CD38+HLA-DR+ activated Th17 cell-predominant type, (iii) Th1/Th17-high type and (iv) Th1/Th17-low type. Accordingly, ustekinumab was administered to the activated Th1 cell-predominant patients, secukinumab to the activated Th17 cell-predominant patients, secukinumab or TNF inhibitor to the Th1/Th17-high patients, and TNF inhibitor to the Th1/Th17-low patients. After 6 months of strategic treatment, there was a significant decrease in simplified disease activity index (SDAI) (from 16.2 to 3.52), DAS28 (ESR) (from 4.13 to 2.27) and psoriasis area and severity index (from 8.36 to 2.40). Low disease activity by SDAI was achieved in 24 (92.3%) of the 26 patients. The rate of low disease activity achievement according to SDAI at 6 months was significantly higher in the strategic bDMARDs treatment group compared with that of the standard bDMARDs treatment group. Conclusion Strategic treatment in which different bDMARDs were selected according to phenotypic differences in helper T cells showed significantly higher efficacy than standard bDMARD therapy, indicating the value of precision medicine.
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Affiliation(s)
- Ippei Miyagawa
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yusuke Miyazaki
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Maiko Yoshikawa
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroko Yoshinari
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Ueno M, Nakano K, Yoshinari H, Nakayamada S, Iwata S, Kubo S, Miyagawa I, Tanaka Y. An Autopsy Case with Cerebral Hemorrhaging due to disseminated Aspergillosis During Glucocorticoid Therapy for Overlap Syndrome of Systemic Lupus Erythematosus and Systemic Sclerosis. Intern Med 2019; 58:1023-1027. [PMID: 30568120 PMCID: PMC6478969 DOI: 10.2169/internalmedicine.1226-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We encountered a 60-year-old female patient who died of cerebral hemorrhage caused by disseminated aspergillosis during massive steroid therapy for overlap syndrome of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) and performed autopsy. Histologically, necrotizing vasculitis accompanied by Aspergillus hyphae was noted in the arterial wall of the region with cerebral hemorrhage and an abscess containing Aspergillus clumps was present in the lung, therefor we considered the cerebral hemorrhage caused by disseminated aspergillosis. For immunocompromised patients, it is desirable to perform treatment taking the possibility of deep mycosis into consideration, and when it is suspected, early therapeutic intervention may be useful.
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Affiliation(s)
- Masanobu Ueno
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Hiroko Yoshinari
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Shingo Nakayamada
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Shigeru Iwata
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Ippei Miyagawa
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan
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Iwata S, Saito K, Hirata S, Ohkubo N, Nakayamada S, Nakano K, Hanami K, Kubo S, Miyagawa I, Yoshikawa M, Miyazaki Y, Yoshinari H, Tanaka Y. Efficacy and safety of anti-CD20 antibody rituximab for patients with refractory systemic lupus erythematosus. Lupus 2018; 27:802-811. [DOI: 10.1177/0961203317749047] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Objective We examined the efficacy and safety of rituximab in patients with refractory systemic lupus erythematosus (SLE). Methods The study enrolled 63 SLE patients who were treated with rituximab between 2002 and 2015. The participants underwent a battery of tests before treatment and at one year. Treatment ranged from two to four times at 500 or 1000 mg. Results Baseline characteristics were males:females = 6:57, age 33.9 years, and disease duration 87.2 months. The primary endpoint: The rate of major clinical response (MCR) was 60% while the partial clinical response (PCR) was 25%. Thirty of 36 (83%) patients with lupus nephritis (WHO II: 2, III: 5, IV: 22, V: 4, IV+V: 2, not assessed: 1) and 22 of 24 patients (92%) with neuropsychiatric SLE, who could be followed at one year, showed changes from BILAG A or B score to C or D score at one year. Multivariate analysis identified high anti-dsDNA antibody and shorter disease duration as significant determinants of MCR at one year. Repeat examination was conducted at five years. Primary failure was recorded in 8.8% and secondary failure in 32.4% (time to relapse: 24.4 months). Rituximab was well tolerated although 65 adverse events, mostly infections, were recorded within one year. Conclusion Rituximab is potentially efficacious for the treatment of patients with refractory SLE.
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Affiliation(s)
- S Iwata
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - K Saito
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - S Hirata
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - N Ohkubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - S Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - K Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - K Hanami
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - S Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - I Miyagawa
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - M Yoshikawa
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - Y Miyazaki
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - H Yoshinari
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
| | - Y Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational & Environmental Health, Japan, Kitakyushu, Fukuoka, Japan
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Satoh Y, Nakano K, Yoshinari H, Nakayamada S, Iwata S, Kubo S, Miyagawa I, Yoshikawa M, Miyazaki Y, Saito K, Tanaka Y. A case of refractory lupus nephritis complicated by psoriasis vulgaris that was controlled with secukinumab. Lupus 2018. [PMID: 29523055 DOI: 10.1177/0961203318762598] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 12/22/2022]
Abstract
It has been reported that T helper 17 cells are involved in the pathogenesis of systemic lupus erythematosus, but there is no report on interleukin-17-targeted therapy. We report a case of a 62-year-old female who presented with psoriasis vulgaris and refractory lupus nephritis. Because her conditions were resistant to conventional treatment, and flow cytometry confirmed the proliferation of activated T helper 17 cells in peripheral blood, and examination of a renal biopsy tissue sample confirmed infiltration of numerous interleukin-17-positive lymphocytes to the renal interstitium, administration of the anti-interleukin-17A antibody secukinumab was initiated. After starting secukinumab the clinical and biological features were improved.
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Affiliation(s)
- Y Satoh
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - K Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - H Yoshinari
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - S Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - S Iwata
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - S Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - I Miyagawa
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - M Yoshikawa
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Y Miyazaki
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - K Saito
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Y Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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Sasaki H, Hoshiba T, Asamoto A, Hirabuki S, Ishikawa H, Yoshinari H, Saitoh R. 281. J Minim Invasive Gynecol 2005. [DOI: 10.1016/j.jmig.2005.07.242] [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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Ikeda K, Terashima M, Kawamura H, Takiyama I, Koeda K, Takagane A, Sato N, Ishida K, Iwaya T, Maesawa C, Yoshinari H, Saito K. Pharmacokinetics of cisplatin in combined cisplatin and 5-fluorouracil therapy: a comparative study of three different schedules of cisplatin administration. Jpn J Clin Oncol 1998; 28:168-75. [PMID: 9614438 DOI: 10.1093/jjco/28.3.168] [Citation(s) in RCA: 39] [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] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cisplatin is widely used in combination chemotherapy against a variety of tumors; however, the optimal administration schedule of cisplatin is still controversial. To clarify the pharmacokinetic differences according to the administration schedules of cisplatin, we compared three different administration schedules of cisplatin such as single short-term infusion, daily short-term infusion and daily continuous infusion in combination with 5-fluorouracil. Preliminary clinical responses and toxicities were also investigated. METHODS A total of 12 courses in combination of cisplatin and 5-fluorouracil therapy was studied. The schedules of cisplatin tested were as follows: single short-term infusion (80 mg/m2, day 1,2 h div., n = 4), daily short-term infusion (20 mg/m2, days 1 to 5, 2 h div., n = 4), daily continuous infusion (100 mg/m2, 120 h, n = 4). In all schedules, 5-fluorouracil was continuously administered at a dose of 800 mg/m2/day on days 1 to 5. The area under the time-concentration curve (AUC) and the maximum concentration (Cmax) of total and free Pt were investigated. RESULTS The highest AUC of total and free Pt and the lowest Cmax of free Pt were observed in the daily continuous infusion (total AUC; 162.53 +/- 18.39 micrograms h/ml, free AUC; 5.50 +/- 0.9 micrograms h/ml, free Cmax; 0.07 +/- 0.01 microgram/ml, mean +/- SEM). Two patients in the single short-term infusion and one patient in the daily continuous infusion indicated partial responses clinically. No nephrotoxicity or ototoxicity was observed. All toxicities were mild and tolerable in all regimens; however, the incidence of GI toxicity in daily continuous infusion seemed to be relatively higher. CONCLUSIONS Daily continuous infusion of cisplatin gave the best pharmacokinetic results and to evaluate the clinical advantage of this schedule a prospective randomized trial should be conducted with sufficient numbers of patients.
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Affiliation(s)
- K Ikeda
- Department of Surgery 1, Iwate Medical University, Morioka, Japan
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12
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Tachikawa E, Yoshinari H, Takahashi S, Kashimoto T, Mizuma K, Takahashi E. Cisplatin, an antineoplastic drug, inhibits catecholamine secretion from bovine adrenal chromaffin cells. Eur J Pharmacol 1993; 236:355-61. [PMID: 8359195 DOI: 10.1016/0014-2999(93)90471-s] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Long-term pretreatment (12-120 h) of cultured bovine adrenal chromaffin cells with cis-diamminedichloroplatinum (cisplatin, Pt(NH3)2Cl2) (33 microM), an antineoplastic drug, resulted in a decrease in the secretion of catecholamines from the cells stimulated by acetylcholine. Acetylcholine-induced 45Ca2+ influx into the cells was also reduced in the cells pretreated with cisplatin for 48 h. The concentration-response curves (3-66 microM) for cisplatin inhibition of the secretion and 45Ca2+ influx were quite similar. Pretreatment of cells with 33 microM Pt4+ or carboplatin, an analog of cisplatin, for 48 h also led to a decrease in acetylcholine-evoked secretion, but not with 33 microM Pt2+ or other metals (Au+, Au3+, Ni2+, Os3+, Pd2+, Ir3+, and Ir4+) that have properties similar to Pt4+. These results strongly suggest that in bovine adrenal chromaffin cells, cisplatin (3-66 microM) inhibits catecholamine secretion by the suppression of the Ca2+ influx into the cells evoked by acetylcholine and that the inhibitory effect of cisplatin is attributable to the tetravalent platinum ion in its molecule.
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Affiliation(s)
- E Tachikawa
- Department of Pharmacology, School of Medicine, Iwate Medical University, Morioka, Japan
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13
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Terashima M, Ikeda K, Kawamura H, Maesawa C, Takiyama I, Yoshinari H, Koeda K, Sato N, Ishida K, Saito K. [Experimental study of biochemical modulation of 5-fluorouracil with l-leucovorin against human esophageal cancer]. Gan To Kagaku Ryoho 1992; 19:1999-2004. [PMID: 1417007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Potentiation of cytotoxic effects of 5-fluorouracil (5-FU) were investigated by simultaneous or sequential combination of l-leucovorin (LV) against human esophageal cancer cell line (TE-1, TE-2) and 23 human clinical cancer samples in vitro. LV enhanced the cytotoxic effects of 5-FU on human esophageal cancer cell line as a dose dependent manner, and increased the cytotoxic effect of 5-FU about 1.5-fold with 10 microM and about 2-fold with 100 microM. The incubation time did not affect the effects. The potentiation with LV was also demonstrated against human clinical cancer samples, and the cytotoxic effects of 5-FU increased 7.6% in esophageal cancer, 20.9% in gastric cancer and 25.5% in colorectal cancer. As a result, the potentiating effects of LV against 5-FU seemed to be limited on human esophageal cancer.
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Affiliation(s)
- M Terashima
- Dept. of Surgery 1, Iwate Medical University School of Medicine
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14
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Orii S, Sugai T, Nakano O, Yoshinari H, Sato S. Acute promyelocytic leukemia in Crohn's disease. Case report and review of the literature. J Clin Gastroenterol 1991; 13:325-7. [PMID: 2066549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
A 19-year-old man with a documented 2-year history of Crohn's disease abruptly developed leukopenia and thrombocytopenia. A diagnosis of acute promyelocytic leukemia was established by bone marrow cytology. Chromosomal analysis of bone marrow aspirate revealed aberrations of no. 8 trisomy and translocation between no. 15 and no. 17 [46,XY,t(15q+,17q-)/47,XY,+8,t(15q+,17q-)]. Nine cases of Crohn's disease complicated by leukemia have been reported, including the present one; once again, a relationship between Crohn's disease and leukemia is suggested.
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MESH Headings
- Adult
- Chromosome Aberrations
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 8
- Crohn Disease/complications
- Crohn Disease/genetics
- Humans
- Leukemia, Promyelocytic, Acute/complications
- Leukemia, Promyelocytic, Acute/genetics
- Male
- Translocation, Genetic
- Trisomy
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Affiliation(s)
- S Orii
- First Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
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15
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Yokobori AT, Yoshinari H, Kowata I. Mechanical test methods of biomedical membranes such as used for otolaryngology. Biomed Mater Eng 1991; 1:137-42. [PMID: 1364632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Biomedical membranes, such as artificial tympanic membranes, are subject to noncontact internal air pressure. To estimate mechanical characteristics of such membranes, it is necessary to carry out the noncontact pressure test and membranous contact test, in addition to the usual monotonic tensile test, by using a rectangular specimen cut from the membranes. In this paper, these mechanical test methods and results on such biomedical membranes were studied. Some of the authors have already presented the mechanical test methods of cellophane membrane for hemodialysis under applied water pressure. Herein, we are concerned with the mechanical test methods of biomedical membranes such as tympanic membrane, in which gaseous pressure was applied.
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Affiliation(s)
- A T Yokobori
- Department of Mechanical Engineering II, Tohoku University, Sendai, Japan
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16
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Yokobori, Jr. AT, Ohkuma T, Yoshinari H, Yokobori T, Ohuchi H, Mori S. Acoustical Imaging and Processing of Blood Vessel and the Related Materials Using Ultrasound Doppler Effect. Biomed Mater Eng 1991. [DOI: 10.3233/bme-1991-1205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - T. Ohkuma
- Department of Second Surgery, Tohoku University, Sendai, Japan
| | - H. Yoshinari
- Department of Science and Technology, Teikyo University, Nagaokamachi Utsunomiya, Japan
| | - T. Yokobori
- Department of Science and Technology, Teikyo University, Nagaokamachi Utsunomiya, Japan
| | - H. Ohuchi
- Sendai Railways Hospital, Sendai, Japan
| | - S. Mori
- Department of Second Surgery, Tohoku University, Sendai, Japan
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17
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Yokobori AT, Ohkuma T, Yoshinari H, Yokobori T, Ohuchi H, Mori S. Acoustical imaging and processing of blood vessel and the related materials using ultrasound Doppler effect. Biomed Mater Eng 1991; 1:127-36. [PMID: 1364631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
In the present paper a method is proposed to measure the degree of the degradation of the elasticity in natural blood vessel and the related materials by using ultrasound Doppler effect. It was found that the deformation rate and its acceleration in the radial direction of the blood vessel can be detected by acoustical imaging and processing using this method. These results were proven to correspond to the degree of the degradation of the elasticity, that is, the degree of viscoelasticity in the blood vessel from the wave versus time pattern detected and its simple analysis. This method was applied to predicting the arteriosclerosis of blood vessels of humans by acoustical imaging and processing uninvadedly, as the characteristics of viscoelasticity in blood vessels.
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Affiliation(s)
- A T Yokobori
- Department of Mechanical Engineering II, Tohoku University, Sendai, Japan
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