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Hara Y, Tsukiji J, Yabe A, Onishi Y, Hirose H, Yamamoto M, Kudo M, Kaneko T, Ebina T. Heme oxygenase-1 as an important predictor of the severity of COVID-19. PLoS One 2022; 17:e0273500. [PMID: 36001619 PMCID: PMC9401165 DOI: 10.1371/journal.pone.0273500] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 08/09/2022] [Indexed: 01/08/2023] Open
Abstract
Background and objective
A cytokine storm is caused by inflammatory cells, including pro-inflammatory macrophage phenotype (M1), and play a critical role in the pathogenesis of COVID-19, in which diffuse alveolar damage occurs in the lungs due to oxidative stress exposure. Heme oxygenase (HO)-1 is a stress-induced protein produced by the anti-inflammatory / anti-oxidative macrophage phenotype (M2), which also produces soluble CD163 (sCD163). In our study, we investigated and determined that serum HO-1 can be a predictive biomarker for assessing both the severity and the outcome of COVID-19 patients.
Method
The serum concentrations of HO-1 and sCD163 of COVID-19 patients were measured on admission. The relationship between these biomarkers and other clinical parameters and outcomes were evaluated.
Results
Sixty-four COVID-19 patients (11 mild, 38 moderate, and 15 severe cases) were assessed. The serum HO-1 tended to increase (11.0 ng/mL vs. 24.3 ng/mL vs. 59.6 ng/mL with severity). Serum HO-1 correlated with serum lactate dehydrogenase (R = 0.422), C-reactive protein (R = 0.463), and the ground glass opacity (GGO) and consolidation score (R = 0.625) of chest computed tomography. The serum HO-1 showed a better area under the curve (AUC) for predicting ICU admission than the serum sCD163 (HO-1; 0.816 and sCD163; 0.743). In addition, composite parameters including serum HO-1 and the GGO and consolidation score showed a higher AUC for predicting ICU admission than the AUC of a single parameter.
Conclusion
Clinically, serum HO-1, reflecting the activation of M2, could be a very useful marker for evaluating disease severity and predicting prognoses for COVID-19 patients. In addition, controlling activated M2 might be a preventative COVID-19 therapeutic target.
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Affiliation(s)
- Yu Hara
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Jun Tsukiji
- Department of Prevention and Infection Control, Kanagawa Cancer Center, Yokohama, Japan
- * E-mail:
| | - Aya Yabe
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yoshika Onishi
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, Yokohama, Japan
| | - Haruka Hirose
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, Yokohama, Japan
| | - Masaki Yamamoto
- Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Makoto Kudo
- Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Toshiaki Ebina
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, Yokohama, Japan
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Affiliation(s)
- Reiko Kunisaki
- Inflammatory Bowel Disease Centre, Yokohama City University Medical Centre, Yokohama, Japan,Corresponding author: Reiko Kunisaki, MD, PhD, Inflammatory Bowel Disease Centre, Yokohama City University Medical Centre, 4–57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan. Tel.: +81 45 2615 656; fax: +81 45 253 9954;
| | - Jun Tsukiji
- Department of Infection Prevention and Control, Yokohama City University Medical Centre, Yokohama, Japan
| | - Makoto Kudo
- Respiratory Disease Centre, Yokohama City University Medical Centre, Yokohama, Japan
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Kato H, Shimizu H, Shibue Y, Hosoda T, Iwabuchi K, Nagamine K, Saito H, Sawada R, Oishi T, Tsukiji J, Fujita H, Furuya R, Masuda M, Akasaka O, Ikeda Y, Sakamoto M, Sakai K, Uchiyama M, Watanabe H, Yamaguchi N, Higa R, Sasaki A, Tanaka K, Toyoda Y, Hamanaka S, Miyazawa N, Shimizu A, Fukase F, Iwai S, Komase Y, Kawasaki T, Nagata I, Nakayama Y, Takei T, Kimura K, Kunisaki R, Kudo M, Takeuchi I, Nakajima H. Clinical course of 2019 novel coronavirus disease (COVID-19) in individuals present during the outbreak on the Diamond Princess cruise ship. J Infect Chemother 2020; 26:865-869. [PMID: 32405245 PMCID: PMC7218347 DOI: 10.1016/j.jiac.2020.05.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 04/13/2020] [Revised: 05/02/2020] [Accepted: 05/07/2020] [Indexed: 01/08/2023]
Abstract
We investigated the clinical course of individuals with 2019 novel coronavirus disease (COVID-19) who were transferred from the Diamond Princess cruise ship to 12 local hospitals. The conditions and clinical courses of patients with pneumonia were compared with those of patients without pneumonia. Among 70 patients (median age: 67 years) analyzed, the major symptoms were fever (64.3%), cough (54.3%), and general fatigue (24.3%). Forty-three patients (61.4%) had pneumonia. Higher body temperature, heart rate, and respiratory rate as well as higher of lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and C-reactive protein (CRP) levels and lower serum albumin level and lymphocyte count were associated with the presence of pneumonia. Ground-glass opacity was found in 97.7% of the patients with pneumonia. Patients were administered neuraminidase inhibitors (20%), lopinavir/ritonavir (32.9%), and ciclesonide inhalation (11.4%). Mechanical ventilation and veno-venous extracorporeal membrane oxygenation was performed on 14 (20%) and 2 (2.9%) patients, respectively; two patients died. The median duration of intubation was 12 days. The patients with COVID-19 transferred to local hospitals during the outbreak had severe conditions and needed close monitoring. The severity of COVID-19 depends on the presence of pneumonia. High serum LDH, AST and CRP levels and low serum albumin level and lymphocyte count were found to be predictors of pneumonia. It was challenging for local hospitals to admit and treat these patients during the outbreak of COVID-19. Assessment of severity was crucial to manage a large number of patients.
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Affiliation(s)
- Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Japan; Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Japan.
| | - Hiroyuki Shimizu
- Department of Clinical Laboratory Medicine, Fujisawa City Hospital, Japan
| | - Yasushi Shibue
- Department of Infectious Diseases, Yokohama City Minato Red Cross Hospital, Japan
| | - Tomohiro Hosoda
- Department of Infectious Diseases, Kawasaki Municipal Kawasaki Hospital, Japan
| | - Keisuke Iwabuchi
- Department of General Medicine, Kanagawa Prefectural Ashigarakami Hospital, Japan
| | | | - Hiroki Saito
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Japan
| | - Reimin Sawada
- Department of Cardiology, Japanese Red Cross Hadano Hospital, Japan
| | - Takayuki Oishi
- Department of Infection Control and Prevention, Saiseikai Yokohamashi Tobu Hospital, Japan
| | - Jun Tsukiji
- Department of Prevention and Infection Control, Yokohama City University Medical Center, Japan
| | - Hiroyuki Fujita
- Infection Control Committee, Saiseikai Yokohama Nanbu Hospital, Japan
| | - Ryosuke Furuya
- Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Japan
| | - Makoto Masuda
- Department of Respiratory Medicine, Fujisawa City Hospital, Japan
| | - Osamu Akasaka
- Emergency Medical Center, Fujisawa City Hospital, Japan
| | - Yu Ikeda
- Emergency Medical Center, Fujisawa City Hospital, Japan
| | - Mitsuo Sakamoto
- Department of Infectious Diseases, Kawasaki Municipal Kawasaki Hospital, Japan
| | - Kazuya Sakai
- Department of Emergency Medicine, Yokohama City University School of Medicine, Japan
| | - Munehito Uchiyama
- Department of Emergency Medicine, Yokohama City University School of Medicine, Japan
| | - Hiroki Watanabe
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Japan
| | | | - Ryoko Higa
- Department of Prevention and Infection Control, Yokohama City University Medical Center, Japan
| | - Akiko Sasaki
- Nursing Department, Japanese Red Cross Hadano Hospital, Japan
| | - Katsuaki Tanaka
- Department of Gastroenterology, Japanese Red Cross Hadano Hospital, Japan
| | - Yukitoshi Toyoda
- Department of Emergency and Critical Care Medicine Major Trauma Center Trauma & Acute Care Surgery, Saiseikai Yokohamashi Tobu Hospital, Japan
| | - Shinsuke Hamanaka
- Department of Pulmonary Medicine, Saiseikai Yokohamashi Tobu Hospital, Japan
| | - Naoki Miyazawa
- Department of Respiratory Medicine, Saiseikai Yokohama Nanbu Hospital, Japan
| | - Atsuko Shimizu
- Infection Control Team, National Yokohama Medical Center, Japan
| | - Fumie Fukase
- Infection Control Team, National Yokohama Medical Center, Japan
| | - Shunsuke Iwai
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Japan
| | - Tsutomu Kawasaki
- Department of Respiratory Medicine, Yokohama City Minato Red Cross Hospital, Japan
| | - Isao Nagata
- Intensive Care Unit, Yokohama City Minato Red Cross Hospital, Japan
| | - Yusuke Nakayama
- Emergency Department, Yokohama City Minato Red Cross Hospital, Japan
| | - Tetsuhiro Takei
- Intensive Care Unit, Yokohama City Minato Red Cross Hospital, Japan
| | - Katsuo Kimura
- Department of Neurology, Yokohama City University Medical Center, Japan
| | - Reiko Kunisaki
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
| | - Makoto Kudo
- Respiratory Disease Center, Yokohama City University Medical Center, Japan
| | - Ichiro Takeuchi
- Kanagawa Disaster Medical Assistance Team, Japan; Advanced Emergency Medical Service Center, Yokohama City University Medical Center, Japan
| | - Hideaki Nakajima
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Japan
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Sugiyama S, Shimizu H, Hashimoto S, Tsukiji J. 202. The effectiveness of combination therapy of anti-methicillin-resistant Staphylococcus aureus agents and β-lactam agents in patients complicated with febrile neutropenia after bone marrow transplantation. Open Forum Infect Dis 2019. [PMCID: PMC6809729 DOI: 10.1093/ofid/ofz360.277] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Febrile neutropenia (FN) is one of the most frequent and serious complications of hematopoietic stem cell transplantation such as bone marrow transplantation (BMT). Anti-Pseudomonas agents should be initiated in all patients complicated with FN without delay, while anti–methicillin-resistant Staphylococcus aureus (MRSA) agents are exclusively recommended in the case of central venous (CV) line infection. Most BMT patients have the potential risk of catheter-related blood stream infection because of long-lasting catheterization including indwelling CV line. Therefore, the patients may also be received anti-MRSA agents empirically in addition to anti-Pseudomonas agents. So far, there are little reports that verify the effectiveness of the combination therapy under FN condition after BMT. The purpose of this study was to address the effectiveness.
Methods
BMT was performed at Yokohama City University Medical Center between April 2012 and March 2018, and 44 patients who developed FN after BMT were enrolled. We analyzed patient information retrospectively. We used the duration of fever to evaluate the additive effect of anti-MRSA agents to β-lactam anti-Pseudomonas agents. We classified the patients during FN period into two groups whether anti-MRSA agents were administered (Ad group; 34 patients) or not (non-Ad group; 10 patients). Fever is defined as a single axillary temperature measurement of over 37.5 Celsius degrees. The study design and protocol were approved by the ethics committee at the Review Board of our hospital (ID:D1602011).
Results
Baseline characteristics were similar between the two groups. Blood cultures were performed onset of FN in all cases, in which five showed positive (11.4%). Bacteria requiring administration of anti-MRSA drugs were detected in the four cases. Nonetheless, duration of fever was not significantly shorten (6.8 ± 4.0 vs. 5.2 ± 2.5, P = 0.171) and there was no difference in the hospitalization period. The renal dysfunction was significantly higher in Ad group and the cost of anti-MRSA agents totaled about $ 36,000.
Conclusion
Our study indicates that no use of empirical combination therapy of anti-MRSA agents in addition to anti-Pseudomonas agents under FN condition after BMT, even if CV line is inserted.
Disclosures
All authors: No reported disclosures.
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Affiliation(s)
- Soichiro Sugiyama
- Department of Infection Prevention and Control, Yokohama, Kanagawa, Japan
| | - Hiroyuki Shimizu
- Department of Clinical Laboratory Medicine, Fujisawa, Kanagawa, Japan
| | | | - Jun Tsukiji
- Department of Infection Prevention and Control, Yokohama, Kanagawa, Japan
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Yamamoto M, Ushio R, Watanabe H, Tachibana T, Tanaka M, Yokose T, Tsukiji J, Nakajima H, Kaneko T. Detection of Mycobacterium tuberculosis-derived DNA in circulating cell-free DNA from a patient with disseminated infection using digital PCR. Int J Infect Dis 2018; 66:80-82. [DOI: 10.1016/j.ijid.2017.11.018] [Citation(s) in RCA: 12] [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] [Received: 09/30/2017] [Revised: 11/06/2017] [Accepted: 11/08/2017] [Indexed: 12/12/2022] Open
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Tsukiji J, Cho SJ, Echevarria GC, Kwon S, Joseph P, Schenck EJ, Naveed B, Prezant DJ, Rom WN, Schmidt AM, Weiden MD, Nolan A. Lysophosphatidic acid and apolipoprotein A1 predict increased risk of developing World Trade Center-lung injury: a nested case-control study. Biomarkers 2014; 19:159-65. [PMID: 24548082 DOI: 10.3109/1354750x.2014.891047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
RATIONALE Metabolic syndrome, inflammatory and vascular injury markers measured in serum after World Trade Center (WTC) exposures predict abnormal FEV1. We hypothesized that elevated LPA levels predict FEV₁ < LLN. METHODS Nested case-control study of WTC-exposed firefighters. Cases had FEV₁ < LLN. Controls derived from the baseline cohort. Demographics, pulmonary function, serum lipids, LPA and ApoA1 were measured. RESULTS LPA and ApoA1 levels were higher in cases than controls and predictive of case status. LPA increased the odds by 13% while ApoA1 increased the odds by 29% of an FEV₁ < LLN in a multivariable model. CONCLUSIONS Elevated LPA and ApoA1 are predictive of a significantly increased risk of developing an FEV₁ < LLN.
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Affiliation(s)
- Jun Tsukiji
- Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University , New York, NY , USA
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Cho SJ, Echevarria GC, Lee YI, Kwon S, Park KY, Tsukiji J, Rom WN, Prezant DJ, Nolan A, Weiden MD. YKL-40 is a Protective Biomarker for Fatty Liver in World Trade Center Particulate Matter-Exposed Firefighters. ACTA ACUST UNITED AC 2014; 5. [PMID: 25717419 PMCID: PMC4337810 DOI: 10.4172/2155-9929.1000174] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Serum biomarkers of metabolic syndrome predict abnormal lung function in World Trade Center particulate matter (WTC-PM)-exposed Fire Department of New York (FDNY) rescue workers. In animal models, exposure to ambient PM induces non-alcoholic fatty liver disease (NAFLD), a well-known comorbidity of metabolic syndrome. YKL-40 is an inflammatory biomarker for both liver and lung disease. We tested if YKL-40 is a biomarker for NAFLD in this dust-exposed cohort. Methods Using a nested case-control design, we studied 131 FDNY personnel who had Computer Tomography performed within 5 years post 9/11. NAFLD was defined by a liver/spleen attenuation ratio of ≤1. Serum biomarkers, lipid panel and liver function were measured in serum that had been drawn within 6 months of September 11, 2001. YKL-40 and chitotriosidase were assayed by ELISA. We tested biomarker and NAFLD association using logistic regression adjusted for age, BMI, and post-911 lung function. Results NAFLD was present in 29/131 (22%) of the cohort. In a multivariable model increasing YKL-40 was protective while increasing triglyceride and alkaline phosphatase were risk factors for NAFLD. Conclusions Increased YKL-40 is a protective biomarker in non-alcoholic fatty liver disease. Further studies may reveal a link between PM-induced lung and liver diseases.
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Affiliation(s)
- Soo Jung Cho
- Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, USA
| | - Ghislaine C Echevarria
- Division of Anestesiology, School of Medicine, Pontifical Catholic University of Chile-Santiago, Chile ; Department of Anesthesiology, New York University School of Medicine, New York, USA
| | - Young Im Lee
- Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, USA
| | - Sophia Kwon
- Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, USA
| | - Kwan Yong Park
- Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, USA
| | - Jun Tsukiji
- Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, USA
| | - William N Rom
- Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, USA ; Department of Environmental Medicine, New York University, School of Medicine, NY, USA
| | - David J Prezant
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, NY, USA ; Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anna Nolan
- Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, USA ; Department of Environmental Medicine, New York University, School of Medicine, NY, USA ; Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, NY, USA
| | - Michael D Weiden
- Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, USA ; Department of Environmental Medicine, New York University, School of Medicine, NY, USA ; Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, NY, USA
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8
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Cho SJ, Nolan A, Echevarria GC, Kwon S, Naveed B, Schenck E, Tsukiji J, Prezant DJ, Rom WN, Weiden MD. Chitotriosidase is a biomarker for the resistance to World Trade Center lung injury in New York City firefighters. J Clin Immunol 2013; 33:1134-42. [PMID: 23744081 DOI: 10.1007/s10875-013-9913-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 05/30/2013] [Indexed: 12/29/2022]
Abstract
PURPOSE World Trade Center (WTC) exposure caused airflow obstruction years after exposure. Chitinases and IgE are innate and humoral mediators of obstructive airway disease. We investigated if serum expression of chitinases and IgE early after WTC exposure predicts subsequent obstruction. METHODS With a nested case-control design, 251 FDNY personnel had chitotriosidase, YKL-40 and IgE measured in serum drawn within months of 9/11/2001. The main outcome was subsequent Forced Expiratory Volume after 1 second/Forced Vital Capacity (FEV1/FVC) less than the lower limit of normal (LLN). Cases (N = 125) had abnormal FEV1/FVC whereas controls had normal FEV1/FVC (N = 126). In a secondary analysis, resistant cases (N = 66) had FEV1 (≥107%) one standard deviation above the mean. Logistic regression adjusted for age, BMI, exposure intensity and post-exposure FEV1/FVC modeled the association between early biomarkers and later lung function. RESULTS Cases and Controls initially lost lung function. Controls recovered to pre-9/11 FEV1 and FVC while cases continue to decline. Cases expressed lower serum chitotriosidase and higher IgE levels. Increase in IgE increased the odds of airflow obstruction and decreased the odds of above average FEV1. Alternately, increasing chitotriosidase decreased the odds of abnormal FEV1/FVC and increased the odds of FEV1 ≥ 107%. Serum YKL-40 was not associated with FEV1/FVC or FEV1 in this cohort. CONCLUSIONS Increased serum chitotriosidase reduces the odds of developing obstruction after WTC-particulate matter exposure and is associated with recovery of lung function. Alternately, elevated IgE is a risk factor for airflow obstruction and progressive lung function decline.
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Affiliation(s)
- Soo Jung Cho
- Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, NY 10016, USA
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9
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Horita N, Miyazawa N, Yoshiyama T, Tsukahara T, Takahashi R, Tsukiji J, Kato H, Kaneko T, Ishigatsubo Y. Decreased activities of daily living is a strong risk factor for liver injury by anti-tuberculosis drugs. Respirology 2013; 18:474-9. [DOI: 10.1111/resp.12008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 08/13/2012] [Accepted: 09/12/2012] [Indexed: 01/24/2023]
Affiliation(s)
- Nobuyuki Horita
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
| | - Naoki Miyazawa
- Department of Respiratory Medicine; Saiseikai Yokohamashi Nanbu Hospital; Yokohama; Japan
| | | | - Toshinori Tsukahara
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
| | - Ryohei Takahashi
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
| | - Jun Tsukiji
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
| | - Hideaki Kato
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
| | - Takeshi Kaneko
- Respiratory Disease Center; Yokohama City University Medical Center; Yokohama; Japan
| | - Yoshiaki Ishigatsubo
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
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10
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Weiden MD, Naveed B, Kwon S, Segal LN, Cho SJ, Tsukiji J, Kulkarni R, Comfort AL, Kasturiarachchi KJ, Prophete C, Cohen MD, Chen LC, Rom WN, Prezant DJ, Nolan A. Comparison of WTC dust size on macrophage inflammatory cytokine release in vivo and in vitro. PLoS One 2012; 7:e40016. [PMID: 22815721 PMCID: PMC3399845 DOI: 10.1371/journal.pone.0040016] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 05/30/2012] [Indexed: 11/18/2022] Open
Abstract
Background The WTC collapse exposed over 300,000 people to high concentrations of WTC-PM; particulates up to ∼50 mm were recovered from rescue workers’ lungs. Elevated MDC and GM-CSF independently predicted subsequent lung injury in WTC-PM-exposed workers. Our hypotheses are that components of WTC dust strongly induce GM-CSF and MDC in AM; and that these two risk factors are in separate inflammatory pathways. Methodology/Principal Findings Normal adherent AM from 15 subjects without WTC-exposure were incubated in media alone, LPS 40 ng/mL, or suspensions of WTC-PM10–53 or WTC-PM2.5 at concentrations of 10, 50 or 100 µg/mL for 24 hours; supernatants assayed for 39 chemokines/cytokines. In addition, sera from WTC-exposed subjects who developed lung injury were assayed for the same cytokines. In the in vitro studies, cytokines formed two clusters with GM-CSF and MDC as a result of PM10–53 and PM2.5. GM-CSF clustered with IL-6 and IL-12(p70) at baseline, after exposure to WTC-PM10–53 and in sera of WTC dust-exposed subjects (n = 70) with WTC lung injury. Similarly, MDC clustered with GRO and MCP-1. WTC-PM10–53 consistently induced more cytokine release than WTC-PM2.5 at 100 µg/mL. Individual baseline expression correlated with WTC-PM-induced GM-CSF and MDC. Conclusions WTC-PM10–53 induced a stronger inflammatory response by human AM than WTC-PM2.5. This large particle exposure may have contributed to the high incidence of lung injury in those exposed to particles at the WTC site. GM-CSF and MDC consistently cluster separately, suggesting a role for differential cytokine release in WTC-PM injury. Subject-specific response to WTC-PM may underlie individual susceptibility to lung injury after irritant dust exposure.
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Affiliation(s)
- Michael D. Weiden
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York, United States of America
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York, United States of America
| | - Bushra Naveed
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Sophia Kwon
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Leopoldo N. Segal
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Soo Jung Cho
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Jun Tsukiji
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Rohan Kulkarni
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Ashley L. Comfort
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Kusali J. Kasturiarachchi
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Colette Prophete
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York, United States of America
- Ruth L. and David S. Gottesman Institute for Stem and Regenerative Medicine Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Mitchell D. Cohen
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York, United States of America
| | - Lung-Chi Chen
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York, United States of America
| | - William N. Rom
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York, United States of America
| | - David J. Prezant
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York, United States of America
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Anna Nolan
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, New York, United States of America
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo Park, New York, United States of America
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York, United States of America
- * E-mail:
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Kato H, Ueda A, Tsukiji J, Sano K, Yamada M, Ishigatsubo Y. Salmonella enterica serovar Ohio septic arthritis and bone abscess in an immunocompetent patient: a case report. J Med Case Rep 2012; 6:204. [PMID: 22804866 PMCID: PMC3416725 DOI: 10.1186/1752-1947-6-204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 03/14/2012] [Accepted: 05/15/2012] [Indexed: 12/01/2022] Open
Abstract
Introduction Non-typhi Salmonella species cause severe extra-intestinal focal infection after occult bacteremia. Although the number of cases of non-typhi salmonellosis is increasing worldwide among patients with immunocompromising conditions such as human immunodeficiency virus infection, infection is uncommon in immunocompetent subjects. We report a case of septic arthritis and bone abscess due to a rare non-typhi Salmonella organism that developed after a prolonged asymptomatic period. Case presentation A 44-year-old Japanese immunocompetent man presented with acute-onset left knee pain and swelling. He had no history of food poisoning, and his most recent travel to an endemic area was 19 years ago. Salmonella enterica serovar Ohio was identified from samples of bone abscess and joint tissue. Arthrotomy and necrotic tissue debridement followed by intravenous ceftriaxone was successful. Conclusions Non-typhi Salmonella species only rarely cause extra-intestinal focal infections in immunocompetent patients. Our case suggests that non-typhi Salmonella species can cause severe focal infections many years after the occult bacteremia associated with food poisoning.
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Affiliation(s)
- Hideaki Kato
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9, Fuku'ura, Kanazawa, Yokohama City, 236-0004, Kanagawa, Japan.
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Shiobara Y, Goto H, Hoshino M, Tsukahara T, Yamaguchi N, Ito M, Nozawa A, Tsukiji J, Ishigatsubo Y, Kaneko T. [Two cases of juvenile-onset and adult-onset recurrent respiratory papillomatosis]. Nihon Kokyuki Gakkai Zasshi 2011; 49:667-673. [PMID: 22073613] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We recently experienced one each of 2 types of recurrent respiratory papillomatosis (RRP). Case 1 (juvenile-onset type): A 30-year-old woman presenting with bloody sputum and large tumors with cavities on her chest Xray film, was referred to our hospital. She had been diagnosed with laryngeal papillomatosis when she was three years old. According to our bronchoscopical examination biopsy, she was diagnosed with squamous cell carcinoma of the lung in addition to papillomatosis of the trachea and bronchus. Although chemotherapy was performed, she died 2 years after the diagnosis of lung cancer without any distinct treatment efficacy. Case 2 (adult-onset type): A 43 year-old woman presenting with fever and dry cough visited our hospital. Chest CT revealed that there was narrowing of bilateral main bronchi and hilar lymphadenopathy. Bronchoscopic examination revealed diffuse papilloma distributed extensively from the trachea to bilateral main bronchi. However, she recovered spontaneously in 6 months and has remained stable without recurrence. Both cases were diagnosed with RRP based on the separation of HPV in case 1 and pathological findings of koilocytosis in case 2. Case 1 was complicated with squamous cell carcinoma of the lung in the clinical course, presumably due to occurrence of malignant conversion of papillomatosis. Since RRP is a rare but refractory disease, novel effective treatment is necessary.
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Tsukiji J, Kaneko T, Inoue M, Tsukahara T, Shiobara Y, Ito M, Koizumi H, Nozawa A, Kobayashi M, Murakami S, Tomaru K, Oka H, Yamamoto M, Kobayashi N, Goto H, Kudo M, Inoue S, Miyazawa N, Watanuki Y, Ishigatsubo Y. [A case of lymphocytic interstitial pneumonia complicated with primary Sjögren's syndrome followed by chest CT scanning for thirteen years]. Nihon Kokyuki Gakkai Zasshi 2009; 47:151-157. [PMID: 19260540] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We encountered a rare case of lymphocytic interstitial pneumonia (LIP) complicated with primary Sjögren's syndrome (SjS), followed by chest CT scanning for a long period of time. A 54-year-old man with hemoptysis was admitted to our hospital in December, 2001. A diagnosis of SjS was made based on elevation of anti-SS-B/La antibody titer in serum in combination with diagnosis of keratoconjunctivitis sicca and xerostomia on a Schirmer test and a lip biopsy, respectively. Subsequent histopathological diagnosis by open lung biopsy showed LIP. Chest CT in September, 1995 at previous hospital revealed ground-glassed opacity (GGO), small nodules, thickened bronchovascular bundles and cyst formation in lungs. Chest CT was performed every year until 2008, when remarkable progression from thickened bronchovascular bundles accompanied by nodular opacities to an air-space consolidation in the right lower lobe was observed. Also, appearance of cyst formation in the right middle lobe, nodular lesions and GGO in the left lower lobe were noticed. Although the nodular opacities and GGO improved after an administration of corticosteroid (PSL 0.5 mg/kg/day), little improvement in the consolidations and cyst formation was demonstrated. In conclusion, it was suggested that differences among CT findings of LIP may be important for evaluating of efficacy of treatment by steroid agents for LIP associated with SjS.
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Affiliation(s)
- Jun Tsukiji
- Respiratory Center, Yokohama City University Medical Center
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Oka H, Ueda A, Watanuki Y, Tsukiji J, Kuroda H, Ishigatsubo Y, Akashi S, Hirai Y, Fuyuki T, Kaneko T. The efficacy of high-dose penicillin for community-acquired pneumonia diagnosed by pneumococcal urine antigen test. J Infect Chemother 2009; 15:108-12. [DOI: 10.1007/s10156-009-0672-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 01/30/2009] [Indexed: 10/20/2022]
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Inoue S, Oshiro H, Watanuki Y, Miyazawa N, Kudo M, Goto H, Tsukiji J, Kaneko T, Ishigatsubo Y. Metastatic brain mass caused by slow-growing small-cell lung cancer: differential vascular endothelial growth factor expression in primary and metastatic tumor. Clin Lung Cancer 2007; 8:436-8. [PMID: 17681098 DOI: 10.3816/clc.2007.n.029] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Brain metastasis is a critical complication of small-cell lung cancer (SCLC), resulting in rare long-time survival. We report a case of a 72-year-old man who displayed a very unique clinical appearance, with a large metastatic brain tumor that grew much faster than primary SCLC. The brain tumor expressed high levels of vascular endothelial growth factor (VEGF) that was negative in primary lung tumor. The patient, who underwent brain surgery and chemotherapy against SCLC, has survived for > 2 years with a good performance status since initial brain symptoms occurred. Weak expression of VEGF in primary tumor might be associated with good prognosis. However, VEGF upregulation could occur after metastasis, resulting in aggressive tumor growth.
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Affiliation(s)
- Satoshi Inoue
- Department of Internal Medicine and Clinical Immunology, Yokohama City University, School of Medicine, Kanazawa-ku, Yokohama, Japan.
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Tsukiji J, Sango K, Udaka N, Kageyama H, Ito T, Saito H, Horie H, Inoue S, Kitamura H, Hagiwara E, Ikeda H, Okubo T, Ishigatsubo Y. Long-term induction of beta-CGRP mRNA in rat lungs by allergic inflammation. Life Sci 2004; 76:163-77. [PMID: 15519362 DOI: 10.1016/j.lfs.2004.05.038] [Citation(s) in RCA: 8] [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: 01/09/2004] [Accepted: 05/14/2004] [Indexed: 11/25/2022]
Abstract
Calcitonin gene-related peptide (CGRP) is one of the major neuropeptides released from sensory nerve endings and neuroendocrine cells of the lung. Two CGRP isoforms, alpha-and beta-CGRP, have been identified in rats and humans, but no studies have attempted to reveal direct evidence of differences in action or location of these isoforms in allergic inflammation (AI). We investigated mRNA expressions of alpha-and beta-CGRP in lungs, nodose ganglia (NG), and dorsal root ganglia (DRG) of an animal model for AI of the airways, utilizing a model created by sensitizing Brown Norway (BN) rats with ovalbumin (OVA). By semiquantitative RT-PCR analysis, long-lasting enhanced expression of the beta-CGRP mRNA was shown in the lungs of the AI rats (14.5-fold enhancement at 6 hr, 8.1-fold at 24 hr, and 3.7-fold at 120 hr after OVA-challenge compared to the level in the lungs of phosphate-buffered saline (PBS)-challenged control rats). In contrast, the mRNA expression of the alpha-CGRP in AI lungs showed only a transient increase after OVA-challenge (2.7-fold at 6 hr) followed by a lower level of expression (0.5-fold at 48 hr and 0.6-fold at 120 hr). The mRNA expressions of both isoforms in NG, but not in DRG, were transiently up-regulated at 6 hr after antigen challenge. In situ RT-PCR in combination with immunohistochemical analysis revealed that beta-CGRP was expressed in neuroendocrine cells in clusters (termed neuroepithelial bodies [NEBs]) in AI lungs. These results indicate that the long-term induction of beta-CGRP in NEBs may play an important role in pulmonary AI such as bronchial asthma.
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Affiliation(s)
- Jun Tsukiji
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
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Tsukiji J, Kaneko T, Saito H, Kobayashi M, Kakemizu N, Komatsu S, Nishiyama H, Amano H, Miura K, Satoh T, Shinohara T, Mishima W, Yamakawa Y, Nishihira R, Miyashita A, Noda K, Ishigatsubo Y, Matsuse T. [A case of cT0N2M0 small cell lung cancer with Lambert-Eaton myasthenic syndrome]. Nihon Kokyuki Gakkai Zasshi 2004; 42:820-4. [PMID: 15500150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
We encountered a very rare case of cT0N2M0 small cell lung cancer (SCLC) with Lambert-Eaton myasthenic syndrome (LEMS). A 69-year-old man with a complaint of muscle weakness was admitted to our hospital. Although his chest radiograph on admission showed no abnormal findings, CT scanning detected a mediastinal lymphadenopathy. Also, 2-[18F]-2-fluorodeoxy-D-glucose position emission tomography (FDG-PET) revealed increased accumulation in the same portion in the mediastinum. A diagnosis of LEMS was made from the distinctive electromyogram (EMG) findings (waning and waxing phenomenon in response to low-and high-frequency repetitive stimulation, respectively) in combination with the increased serum level of a P/Q-type anti-voltage-gated calcium channel (VGCC) antibody. Subsequent histopathological diagnosis by mediastinoscopic resection of a paraaortic lymph node was small cell carcinoma. No distant metastasis was detected by MRI of the brain, abdominal CT scan or an FDG-PET. Eight courses of chemotherapy (carboplatin + etoposide) with radiotherapy of the mediastinum (for a total dose of 45 Gy) was performed. A decreased serum level of P/Q-type anti-VGCC antibody titers followed by marked improvement of neurological dysfunction (muscle weakness, gait disturbance and scanning speech) and of an EMG finding (a loss of waning phenomenon) was observed. A close relationship between reduction of the antibody titers and improvement of neurological symptoms after the therapy was noticed. It was suggested that monitoring the level of a P/Q-type anti-VGCC antibody titer in the serum is important for evaluating the efficacy of chemotherapy for LEMS associated with SCLC.
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Kakemizu N, Nishikawa M, Ueda S, Tsukiji J, Ikeda H, Suzuki S, Okubo T, Kitamura H. [Adenocarcinoma of the lung associated with acute promyelocytic leukemia and miliary tuberculosis]. Nihon Kyobu Shikkan Gakkai Zasshi 1997; 35:681-6. [PMID: 9294305] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 44-year-old man was admitted to the hospital because of acute promyelocytic leukemia. A nodular shadow (2.5 cm in diameter) was seen in the right upper lung field on a chest roentgenogram. During the administration of combination chemotherapy for the leukemia, diffuse granular shadow appeared in all lung fields. Transbronchial lung biopsy findings indicated tuberculosis. The patient was given streptomycin, isoniazid, rifampicin and ethambutol, but the nodular show enlarged and a pleural effusion appeared on the right side. Cytologic examination of the pleural effusion revealed adenocarcinoma. Similar findings were obtained from a second transbronchial lung biopsy. The frequency of association of lung cancer and other malignancy is about 4%. The incidences of primary lung cancer found during the course of active tuberculosis, active pulmonary tuberculosis found during the course of primary lung cancer, and tuberculosis found during the course of acute leukemia are 0.9 to 1.4%, 0.4 to 4.3%, and 2.4 to 4.5%, respectively. To our knowledge, this is the first case in Japan in which adenocarcinoma of the lung was associated with acute promyelocytic leukemia and tuberculosis.
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Affiliation(s)
- N Kakemizu
- First Department of Internal Medicine, Yokohama City University School of Medicine, Japan
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