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Ueda K, Ikeda K. Cellular carcinogenesis in preleukemic conditions:drivers and defenses. Fukushima J Med Sci 2024; 70:11-24. [PMID: 37952978 PMCID: PMC10867434 DOI: 10.5387/fms.2023-17] [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: 04/18/2023] [Accepted: 09/26/2023] [Indexed: 11/14/2023] Open
Abstract
Acute myeloid leukemia (AML) arises from preleukemic conditions. We have investigated the pathogenesis of typical preleukemia, myeloproliferative neoplasms, and clonal hematopoiesis. Hematopoietic stem cells in both preleukemic conditions harbor recurrent driver mutations; additional mutation provokes further malignant transformation, leading to AML onset. Although genetic alterations are defined as the main cause of malignant transformation, non-genetic factors are also involved in disease progression. In this review, we focus on a non-histone chromatin protein, high mobility group AT-hook2 (HMGA2), and a physiological p53 inhibitor, murine double minute X (MDMX). HMGA2 is mainly overexpressed by dysregulation of microRNAs or mutations in polycomb components, and provokes expansion of preleukemic clones through stem cell signature disruption. MDMX is overexpressed by altered splicing balance in myeloid malignancies. MDMX induces leukemic transformation from preleukemia via suppression of p53 and p53-independent activation of WNT/β-catenin signaling. We also discuss how these non-genetic factors can be targeted for leukemia prevention therapy.
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Affiliation(s)
- Koki Ueda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University
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2
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Ikeda K, Nollet KE. FIT for surgery: fractures, iron, and tranexamic acid. Lancet Haematol 2023; 10:e699-e700. [PMID: 37524102 DOI: 10.1016/s2352-3026(23)00214-4] [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] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Affiliation(s)
- Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan.
| | - Kenneth E Nollet
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
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3
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Sano T, Ueda K, Minakawa K, Mori T, Hashimoto Y, Koseki H, Takeishi Y, Ikeda K, Ikezoe T. Impaired Repopulating Ability of Uhrf2-/- Hematopoietic Progenitor Cells in Mice. Genes (Basel) 2023; 14:1531. [PMID: 37628583 PMCID: PMC10454722 DOI: 10.3390/genes14081531] [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: 06/17/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
UHRF proteins catalyze the ubiquitination of target proteins and are involved in regulating gene expression. Some studies reported a reduced expression of UHRF2 in acute leukemia cells, but the role of UHRF2 in hematopoiesis remains unknown. Here, we generated Uhrf2-/- mice to clarify the role of UHRF2 deletion in hematopoiesis. Compared to Uhrf2+/+ mice, Uhrf2-/- mice showed no differences in complete blood counts, as well as bone marrow (BM) findings and spleen weights. Proportions of cells in progenitor fractions in BM were comparable between Uhrf2+/+ mice and Uhrf2-/- mice. However, in competitive repopulation assays with BM transplants (BMT), the proportions of Uhrf2-/- cells were decreased relative to Uhrf2+/+ cells in all lineages. After the second BMT, Uhrf2-/- neutrophils were few, while 20-30% of Uhrf2-/- T cells and B cells were still detected. RNA sequencing showed downregulation of some genes associated with stem-cell function in Uhrf2-/- hematopoietic stem/progenitor cells (HSPCs). Interestingly, trimethylated histone H3 lysine 9 was increased in Uhrf2-/- HSPCs in a cleavage under targets and tagmentation assay. While UHRF2 deletion did not cause hematologic malignancy or confer a growth advantage of HSPCs, our results suggest that UHRF2 may play a role in the regulation of hematopoiesis.
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Affiliation(s)
- Takahiro Sano
- Department of Hematology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Koki Ueda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Keiji Minakawa
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Tsutomu Mori
- Department of Human Life Sciences; Fukushima Medical University School of Nursing, Fukushima 960-1295, Japan
| | - Yuko Hashimoto
- Department of Diagnostic Pathology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Haruhiko Koseki
- Laboratory for Developmental Genetics, RIKEN Center for Integrative Medical Sciences, Wako 351-0198, Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Takayuki Ikezoe
- Department of Hematology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
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Takahashi N, Mochizuki K, Kobayashi S, Ohara Y, Kudo S, Saito Y, Ikeda K, Ohto H, Kikuta A, Sano H. T-Cell-Replete Haploidentical Hematopoietic Stem Cell Transplantation for a Patient With Tcf3-Hlf-Positive Acute Lymphoblastic Leukemia Extramedullary Relapse After Unrelated Bone Marrow Transplantation. J Pediatr Hematol Oncol 2023; 45:e419-e422. [PMID: 36162014 DOI: 10.1097/mph.0000000000002555] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
Abstract
TCF3-HLF-positive B-cell precursor acute lymphoblastic leukemia (BCP-ALL) has an extremely poor prognosis. A 2-year-old boy with TCF3-HLF-positive BCP-ALL had an isolated extramedullary relapse in multiple bones after allogeneic hematopoietic stem cells transplantation (HSCT) from a human leukocyte antigen-matched unrelated donor. In this study, he received a T-cell-replete haploidentical HSCT (TCR-haplo-HSCT) from his father when in nonremission state, which resulted in a sustained complete remission for over 3 years. Immune therapies for patients with an extramedullary relapse of TCF3-HLF-positive BCP-ALL have been attempted; however, long-term efficacies of these therapies remain unknown. Our TCR-haplo-HSCT may be an effective therapeutic option for such patients.
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Affiliation(s)
| | | | | | | | | | - Yuya Saito
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Kazuhiko Ikeda
- Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima
| | - Hitoshi Ohto
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
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Contreras-Sanz A, Reike M, Negri G, Htoo Z, Spencer Miko S, Nielsen K, Roberts M, Scurll J, Ikeda K, Wang G, Seiler R, Morin G, Black P. Proteomic profiling of muscle invasive bladder cancer treated with neoadjuvant chemotherapy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01201-0] [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: 02/12/2023]
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Contreras-Sanz A, Reike M, Negri G, Oo H, Spencer Miko S, Nielsen K, Roberts M, Scurll J, Ikeda K, Wang G, Seiler R, Morin G, Black P. Proteomic profiling of muscle invasive bladder cancer treated with neoadjuvant chemotherapy. EUR UROL SUPPL 2023. [DOI: 10.1016/s2666-1683(23)00035-6] [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: 02/02/2023] Open
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Affiliation(s)
- Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan.
| | - Koki Ueda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
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Misaka T, Kimishima Y, Yokokawa T, Ikeda K, Takeishi Y. Clonal hematopoiesis and cardiovascular diseases: role of JAK2V617F. J Cardiol 2023; 81:3-9. [PMID: 35165011 DOI: 10.1016/j.jjcc.2022.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
Abstract
Bone marrow-derived hematopoietic and immune cells play important roles in the onset and progression of cardiovascular diseases. Recent genetic analyses have discovered that clonal expansion of bone marrow hematopoietic stem/progenitor cells carrying somatic gene mutations is common and is increasing with age in healthy individuals who do not show any hematologic disorders, termed as clonal hematopoiesis. It is emergingly recognized that clonal hematopoiesis is a significant risk factor for cardiovascular diseases rather than a cumulative incidence risk of blood cancers. JAK2V617F, a gain-of-function mutation, has been identified as one of the most important mutations in clonal hematopoiesis as well as the most frequent driver mutation in myeloproliferative neoplasms. Hematopoietic cell clones harboring JAK2V617F are causally associated with the pathogenesis of cardiovascular diseases. Here, we will review the key of JAK2V617F-mediated clonal hematopoiesis including identification, prevalence, and biological impacts, linking to cardiovascular diseases and the related mechanisms. Clonal hematopoiesis with JAK2V617F may be a novel therapeutic target for cardiovascular diseases, connected to precision medicines by detecting its presence.
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Affiliation(s)
- Tomofumi Misaka
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
| | - Yusuke Kimishima
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Tetsuro Yokokawa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
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Ikeda K, Miyamori D, Hirabayashi R, Ito M. Pachydermoperiostosis. QJM 2022; 115:611-612. [PMID: 35731213 DOI: 10.1093/qjmed/hcac147] [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: 06/12/2022] [Revised: 06/14/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Ikeda
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan;
| | - D Miyamori
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
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Ohba S, Fujimaki M, Kojima M, Suzuki Y, Ikeda K, Matsumoto F. A novel procedure for transoral resection for retropharyngeal lymph node metastasis in head and neck cancer recurrence. Oral and Maxillofacial Surgery Cases 2022. [DOI: 10.1016/j.omsc.2022.100274] [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: 11/28/2022] Open
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Yamashita S, Arai H, Yokote K, Araki E, Hounslow N, Ikeda K, Nojima T, Suganami H, Ishibashi S. Response of lipoproteins to a meal tolerance test in patients with type 2 diabetes and hypertriglyceridemia. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.429] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tamai H, Ikeda K, Miyamoto T, Taguchi H, Kuo CF, Shin K, Hirata S, Okano Y, Sato S, Yasuoka H, Choi IA, Park SH, Weng MY, Kuwana M, Lee YJ, Ishii T, Kim J, Kameda H, Kojima T, Baek HJ, Hsu PN, Huang CM, Cheng TT, Sung WY, Taninaga T, Mori M, Miyagishi H, Sato Y, Takeuchi T, Kaneko Y. OP0062 EFFICACY AND SAFETY OF ADALIMUMAB WITH LOW AND HIGH DOSE-METHOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH INADEQUATE RESPONSE TO METHOTREXATE: THE RANDOMISED CONTROLLED MIRACLE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4] [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
BackgroundRheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes not only joint pain but also bone destruction resulting in impairment of quality of life. Tumor necrosis factor inhibitors have improved prognosis of patients with rheumatoid arthritis dramatically, especially in combination with methotrexate, however, the optimal dose of the concomitant methotrexate is unclear.ObjectivesTo evaluate the efficacy and safety of adalimumab in combination with reduced dose of methotrexate in patients with early RA with inadequate response to methotrexate.MethodsThe MIRACLE study was a multinational, randomized, open-label study in patients with RA with inadequate response to methotrexate conducted in Asia. It compared low dose and high dose methotrexate upon starting adalimumab. Methotrexate-naive patients with RA with a disease duration of less than two years started methotrexate at 6 to 8 mg/week and increased it to the maximum tolerable dose by week 12. Patients who have not achieved remission according to simplified disease activity index (SDAI) despite methotrexate ≥ 10 mg/week at week 24 were randomised to the maximum tolerable dose of methotrexate group (10 to 25 mg/week) or the reduced dose group (6 to 8 mg/week) and started to receive subcutaneous adalimumab 40 mg every other week. The primary endpoint was non-inferiority in the achievement of SDAI remission at week 48 in the reduced dose group compared with the maximum tolerable dose group with a non-inferiority margin of -15% based on two-sided 90% confidence interval. (NCT03505008)ResultsA total of 300 patients were enrolled in the study. Among them, 291 started methotrexate and were included in the analysis. The mean age was 57.7±15.2 years, female was 74.6%, and the mean disease duration from the diagnosis of RA was 21.1±56.2 days. Anti-CCP antibody was positive in 211 (73.0%) and the mean SDAI at study enrollment was 26.5±12.4. At week 24, with the mean dose of methotrexate of 12.6±2.9 mg/week, 108 patients (37.1%) achieved remission according to SDAI and continued MTX monotherapy. 134 patients (46.0%) were randomised and started adalimumab with 68 patients in the maximum tolerable dose group and 66 patients in the reduced dose group. At week 48, the remission achievement rates were 38.4 % and 44.8 %, respectively, with the adjusted risk difference of the reduced dose group to the maximum tolerable dose group of 6.4% (-7.0% to 19.8%, 90% CI), which met the criterion for noninferiority. No significant difference was found in health assessment questionnaire disability index ≤0.5 (59.1% vs 62.0%, respectively, p=0.72) and in radiological remission rates (Δmodified total Sharp score ≤0.5, 66.3% vs 62.0 %, respectively, p=0.59). Adverse drug reactions tended to be more frequent in the maximum tolerable dose group than in the reduced dose group (22.1% vs 9.1%, respectively, p=0.06).ConclusionThe MIRACLE randomised study demonstrated that, in patients with inadequate response to methotrexate, the efficacy of adalimumab with reduced dose of concomitant methotrexate was not inferior to that with maximum tolerable dose of methotrexate with better safety profile.Disclosure of InterestsHiroya Tamai Speakers bureau: Eisai, Grant/research support from: Eisai, Kei Ikeda Speakers bureau: AbbVie, Eisai, Eli Lilly, Novartis, Gilead, Asahi-Kasei, Grant/research support from: Mitsubishi-Tanabe, Toshiaki Miyamoto: None declared, Hiroaki Taguchi: None declared, Chang-Fu Kuo: None declared, Kichul Shin: None declared, Shintaro Hirata Speakers bureau: AbbVie, Asahi-Kasei, Astellas, Ayumi, Bristol Myers Squibb, Celgene, Chugai, Eisai, Eli Lilly, Gilead, Glaxo SmithKline, Janssen, Kyorin, Novartis, Pfizer, Sanofi, Tanabe-Mitsubishi, UCB, Paid instructor for: AbbVie, Mitsubishi-Tanabe, Consultant of: AbbVie, Astellas, Bristol Myers Squibb, Eisai, Gilead, Ily Lilly, Grant/research support from: AbbVie, Asahi-Kasei, Eisai, Otsuka, Sanofi, Shionogi, Chugai, Pfizer, Tanabe-Mitsubishi, Eli Lilly, UCB, yutaka okano: None declared, Shinji Sato Speakers bureau: AbbVie, Eisai, Grant/research support from: AbbVie, Eisai, Hidekata Yasuoka Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas, Daiichi-Sankyo, Eisai, Kissei, Takeda, Mitsubishi-Tanabe, Chugai, Novartis, Eli Lilly, Pfizer, Janssen, Sanofi, Teijin, Boehringer-Ingelheim, Bayer, Glaxo Smith Kline, Paid instructor for: AbbVie, Consultant of: AbbVie, Asahi Kasei, Grant/research support from: Mitsubishi-Tanabe, Takeda, Daiichi-Sankyo, Chugai, Bristol-Myers, MSD, Astellas, In Ah Choi Speakers bureau: Abbvie, Eisai, Sung-Hwan Park: None declared, Meng-Yu Weng Paid instructor for: Novartis, Eli Lilly, ChuGai, Abbvie, Consultant of: Abbvie, Masataka Kuwana Speakers bureau: Astellas, Asahi Kasei Pharma, Boehringer-Ingelheim, Chugai, Eisai, Janssen, Mochida, Nippon Shinyaku, Ono Pharmaceuticals, Pfizer, Mitsubishi-Tanabe, Consultant of: Boehringer-Ingelheim, Kissei, Mochida, Grant/research support from: AbbVie, Asahi Kasei Pharma, Boehringer-Ingelheim, Chugai, Eisai, MBL, Nippon Shinyaku, Ono Pharmaceuticals, Mitsubishi-Tanabe, Yun Jong Lee Grant/research support from: Yuhan, Tomonori Ishii Speakers bureau: Chugai, Mitsubishi-Tanabe, Glaxo Smith Kline, Pfizer, Eli Lilly, Janssen, AbbVie, Eisai, Astellas, Jinhyun Kim: None declared, Hideto Kameda Speakers bureau: AbbVie, Pfizer, Consultant of: AbbVie, Grant/research support from: AbbVie, Eisai, Toshihisa Kojima Speakers bureau: AbbVie, Pfizer, Eisai, Grant/research support from: AbbVie, Han Joo Baek: None declared, Ping-Ning Hsu: None declared, Chun-Ming Huang Paid instructor for: Abbvie, Pfizer, Tien-Tsai Cheng Paid instructor for: Abbvie, Grant/research support from: Abbvie, Wan-Yu Sung: None declared, Takehiro Taninaga Shareholder of: Eisai.co.,Ltd., Employee of: Eisai.co.,Ltd., Masahiko Mori Shareholder of: Eisai.co.,Ltd., Employee of: Eisai.co.,Ltd., Hideaki Miyagishi Shareholder of: Eisai.co.,Ltd., Employee of: Eisai.co.,Ltd., Yasunori Sato Speakers bureau: Eisai Co., Ltd. Kowa Company, Ltd., Consultant of: MOCHIDA PHARMACEUTICAL CO., LTD, Tsutomu Takeuchi Speakers bureau: Astellas, AbbVie, Ayumi, Bristol Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Glaxo Smith Kline, Janssen, Mitsubishi-Tanabe, Nippon-kayaku, Novartis, Pfizer, Sanofi, UCB, Grant/research support from: Asahi Kasei, AbbVie, Ayumi, Boehringer-Ingelheim, Chugai, Eisai, Eli Lilly, Mitsubishi-Tanabe, Sanofi, UCB, Yuko Kaneko Speakers bureau: Asahi Kasei, Astellas, Ayumi, Bristol Myers Squibb, Chugai, Eisai, Elli Lilly, Mitsubishi-Tanabe, Novartis, UCB, Grant/research support from: AbbVie, Chugai, Eisai, Mitsubishi-Tanabe, UCB.
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Hasegawa H, Tsukada Y, Wakabayashi M, Nomura S, Sasaki T, Nishizawa Y, Ikeda K, Takeshita N, Teramura K, Ito M. Impact of near-infrared fluorescence imaging with indocyanine green on structural sequelae of anastomotic leakage after laparoscopic intersphincteric resection of malignant rectal tumors. Tech Coloproctol 2022; 26:561-570. [DOI: 10.1007/s10151-022-02631-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 05/02/2022] [Indexed: 12/16/2022]
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Ikeda K, Minakawa K, Yamahara K, Yamada-Fujiwara M, Okuyama Y, Fujiwara SI, Yamazaki R, Kanamori H, Iseki T, Nagamura-Inoue T, Kameda K, Nagai K, Fujii N, Ashida T, Hirose A, Takahashi T, Ohto H, Ueda K, Tanosaki R. Comparison of cryoprotectants in hematopoietic cell infusion-related adverse events. Transfusion 2022; 62:1280-1288. [PMID: 35396716 DOI: 10.1111/trf.16877] [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: 12/16/2021] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The standard cryoprotectant for human cellular products is dimethyl sulfoxide (DMSO), which is associated with hematopoietic cell infusion-related adverse events (HCI-AEs) in hematopoietic stem cell transplantation including peripheral blood stem cell (PBSC) transplantation (PBSCT). DMSO is often used with hydroxyethyl starch (HES), which reduces DMSO concentration while maintaining the postthaw cell recovery. The cryoprotectant medium CP-1 (Kyokuto Pharmaceutical Industrial) is widely used in Japan. After mixture of a product with CP-1, DMSO and HES concentrations are 5% and 6%, respectively. However, the safety profile of CP-1 in association with HCI-AEs has not been investigated. STUDY DESIGN AND METHODS To compare CP-1 with other cryoprotectants, we conducted a subgroup analysis of PBSCT recipients in a prospective surveillance study for HCI-AEs. Moreover, we validated the toxicity of CP-1 in 90 rats following various dose administration. RESULTS The PBSC products cryopreserved with CP-1 (CP-1 group) and those with other cryoprotectants, mainly 10% DMSO (non-CP-1 group), were infused into 418 and 58 recipients, respectively. The rate of ≥grade 2 HCI-AEs was higher in the CP-1 group, but that of overall or ≥grade 3 HCI-AEs was not significantly different, compared to the non-CP-1 group. Similarly, after propensity score matching, ≥grade 2 HCI-AEs were more frequent in the CP-1 group, but the ≥grade 3 HCI-AE rate did not differ significantly between the groups. No significant toxicity was detected regardless of the CP-1 dose in the 90 rats. CONCLUSIONS Infusion of a CP-1-containing PBSC product is feasible with the respect of HCI-AEs.
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Affiliation(s)
- Kazuhiko Ikeda
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Keiji Minakawa
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenichi Yamahara
- Laboratory of Medical Innovation, Institute for Advanced Medical Sciences, Hyogo College of Medicine, Nishinomiya, Japan
| | - Minami Yamada-Fujiwara
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Division of Blood Transfusion and Cell Therapy, Tohoku University Hospital, Sendai, Japan
| | - Yoshiki Okuyama
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Division of Transfusion and Cell Therapy, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Shin-Ichiro Fujiwara
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Rie Yamazaki
- Center for Transfusion Medicine and Cell Therapy, Keio University School of Medicine, Tokyo, Japan
| | - Heiwa Kanamori
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Tohru Iseki
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Department of Transfusion Medicine and Cell Therapy, Chiba University Hospital, Chiba, Japan
| | - Tokiko Nagamura-Inoue
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Institution of Medical Science, University of Tokyo, Tokyo, Japan
| | - Kazuaki Kameda
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Kazuhiro Nagai
- Transfusion and Cell Therapy Unit, Nagasaki University Hospital, Nagasaki, Japan
| | - Nobuharu Fujii
- Department of Transfusion Medicine, Okayama University Hospital, Okayama, Japan
| | - Takashi Ashida
- Center for Transfusion and Cell Therapy, Kindai University Hospital, Osakasayama, Japan
| | - Asao Hirose
- Department of Hematology, Osaka City University, Osaka, Japan
| | - Tsutomu Takahashi
- Department of Oncology/Hematology, Shimane University Hospital, Shimane, Japan
| | - Hitoshi Ohto
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Koki Ueda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ryuji Tanosaki
- Cell Therapy Committee, Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.,Center for Transfusion Medicine and Cell Therapy, Keio University School of Medicine, Tokyo, Japan
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Ikeda K. [Myeloproliferative neoplasms and vascular diseases]. Rinsho Ketsueki 2022; 63:1107-1114. [PMID: 36198536 DOI: 10.11406/rinketsu.63.1107] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Vascular diseases are a feature of myeloproliferative neoplasms (MPNs) with a driver mutation, such as JAK2V617F. There is growing evidence that clonal hematopoiesis with JAK2V617F (JAK2V617F-CH) is often complicated with vascular diseases, even in the absence of MPN onset. Such vascular diseases associated with the MPN driver mutation include arterial/venous thrombosis, atherosclerotic coronary artery disease and aortic aneurysm, and pulmonary hypertension. Murine studies have recently revealed mechanisms by which hematopoietic cells activated by the MPN driver mutation may promote thrombosis and vascular remodeling in deep vein stenosis, atherosclerosis, and pulmonary hypertension models. Furthermore, MPN driver mutations mediate various downstream molecules of JAK-STAT activation in neutrophils and macrophages, such as inflammatory cytokines, which may be candidates for preventing and treating vascular diseases in MPNs and JAK2V617F-CH.
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Affiliation(s)
- Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine
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16
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Takeichi T, Ikeda K, Muro Y, Ogi T, Morizane S, Akiyama M. Epithelioid cell granuloma formation in CARD14-associated papulosquamous eruptions. J Eur Acad Dermatol Venereol 2021; 36:e369-e371. [PMID: 34927775 DOI: 10.1111/jdv.17890] [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] [Indexed: 11/28/2022]
Affiliation(s)
- T Takeichi
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - K Ikeda
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Y Muro
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Ogi
- Department of Genetics, Research Institute of Environmental Medicine (RIeM), Nagoya University, Nagoya, Japan.,Department of Human Genetics and Molecular Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Morizane
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - M Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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17
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Kobayashi S, Sano H, Mochizuki K, Ohara Y, Takahashi N, Kudo S, Ikeda K, Ohto H, Kikuta A. Effects of second transplantation with T-cell-replete haploidentical graft using low-dose anti-thymocyte globulin on long-term overall survival in pediatric patients with relapse of leukemia after first allogeneic transplantation. Int J Hematol 2021; 115:414-423. [PMID: 34822127 DOI: 10.1007/s12185-021-03266-9] [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: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the preferred treatment for children with high-risk hematologic malignancies, but post-allo-HSCT relapse has a poor prognosis and limited treatment options. We evaluated the feasibility, outcome, and risk factors influencing survival after T-cell-replete haploidentical HSCT with low-dose anti-thymocyte globulin (ATG) in 30 patients with post-allo-HSCT relapse of acute lymphoblastic leukemia and acute myeloid leukemia. Overall, 50% of the patients had complete remission (CR) before the second transplant and the overall survival (OS) rate was 52%. In surviving patients (median follow-up 614 days), Kaplan-Meier analysis revealed estimated 2-year leukemia-free survival and OS rates of 48.1% and 61.1%, respectively. Cumulative incidences of 2-year non-relapse mortality and relapse were 24.7% and 36.3%, respectively. Achieving CR before the second allo-HSCT was a predominant independent prognostic factor identified in the multivariate analysis, with a significantly improved 2-year OS rate of 86.7%. T-cell-replete haplo-HSCT with low-dose ATG for second allo-HSCT may benefit a selected patient population.
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Affiliation(s)
- Shogo Kobayashi
- Department of Pediatric Oncology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
| | - Hideki Sano
- Department of Pediatric Oncology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
| | - Kazuhiro Mochizuki
- Department of Pediatric Oncology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
| | - Yoshihiro Ohara
- Department of Pediatric Oncology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
| | - Nobuhisa Takahashi
- Department of Pediatric Oncology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
| | - Shingo Kudo
- Department of Pediatric Oncology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
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Haryono A, Ikeda K, Nugroho DB, Kitagawa H, Igarashi M, Hirata K, Emoto N. Chondroitin sulfate n-acetylgalactosaminyltransferase-2 (ChGn-2) plays a significant role in cardiac remodeling and heart failure following pressure overload. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3297] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac extracellular matrix (ECM) is critically involved in cardiac homeostasis by providing mechanical support as well as modulating growth factor signaling. Cardiac ECM dysregulation has been shown in heart failure pathogenesis, and accumulation of chondroitin sulfate glycosaminoglycans (CS-GAGs) was previously shown to exacerbate heart failure by augmenting inflammation and fibrosis at the chronic phase. However, it remains unclear whether and the mechanism by which CS-GAGs cause cardiac dysfunction, especially at the acute phase.
Purpose
The purpose of this study is to elucidate the role of CS-GAGs in heart failure.
Methods
In this study, we analyzed the role of CS-GAGs in heart failure using mice with target deletion of chondroitin sulfate N-acetylgalactosaminyltransferase (ChGn)-2 that elongates CS chains of GAGs. Heart failure was induced by transverse aortic constriction (TAC) in mice. Since cardiac fibroblasts (CFs) are the primary cells for ECM production in the heart, we explored the role of CF-derived ECM in cardiomyocyte apoptosis. CFs were given stretch stimuli that mimic pressure overload conditions.
Results
Significant CS-GAGs accumulation was detected in the heart of WT mice after TAC, which was substantially reduced in the heart of ChGn2−/− mice. Unexpectedly, loss of ChGn-2 deteriorated left ventricular systolic dysfunction accompanied by augmented cardiac hypertrophy and increased cardiomyocyte apoptosis. Stretch stimuli increased ChGn-2 expression and enhanced GAG production in CFs. Interestingly, only conditioned medium (CM) derived from stretched CFs showed protective effects on cardiomyocyte death induced by doxorubicin. Degradation of CS-GAGs in CFs-derived CM by using Chondroitinase ABC abolished its cardioprotective effect. Further experiments revealed that this cardioprotective effect is at least partially through CS-GAGs-derived PI3K/AKT pathway activation via CD44.
Conclusion
Our data revealed that CF-derived GAGs protect cardiomyocytes from death in the acute phase of heart failure due to pressure overload; thus, insufficient GAGs production caused by loss of ChGn-2 exacerbated heart failure.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Haryono
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Ikeda
- Kyoto Prefectural University of Medicine, Department of Epidemiology for Longevity and Regional Health, Kyoto, Japan
| | - D B Nugroho
- Gadjah Mada University, Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Yogyakarta, Indonesia
| | - H Kitagawa
- Kobe Pharmaceutical University, Laboratory of Biochemistry, Kobe, Japan
| | - M Igarashi
- Niigata University Graduate School of Medical and Dental Sciences, Department of Neurochemistry and Molecular Cell Biology, Niigata, Japan
| | - K Hirata
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe, Japan
| | - N Emoto
- Kobe Pharmaceutical University, Laboratory of Clinical Pharmaceutical Science, Kobe, Japan
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Ramadhiani R, Ikeda K, Miyagawa K, Ryanto GRT, Tamada N, Suzuki Y, Hirata K, Emoto N. Senescent endothelial cells exacerbate pulmonary hypertension through notch-mediated juxtacrine interaction with pulmonary artery smooth muscle cells. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite recently developed clinical therapies, vascular remodelling in pulmonary arterial hypertension (PAH) progressively worsen. Hemodynamic unloading has been proposed to normalize the remodelled pulmonary vascular structures in the lungs. Recently, it has been reported that cellular senescence was associated with the irreversibility of pulmonary vascular structures after hemodynamic unloading.
Purpose
This study aims to elucidate the role of senescent endothelial cells (ECs) in the pathogenesis of PAH.
Methods
We generated EC-specific progeroid mice in which ECs undergo premature senescence by overexpressing the dominant-negative form of telomere repeat-binding factor 2 under the control of the VE-cadherin promoter. Following three weeks of hypoxia exposure, the PH phenotypes were assessed by RVSP, lung histology, and RT-qPCR. The interaction of human pulmonary artery ECs (hPAECs) and human pulmonary artery smooth muscle cells (hPASMCs) was indirectly and directly explored through the co-culture system. Gamma-secretase inhibitor (DAPT) was administrated to inhibit Notch signalling both in the in-vitro and in-vivo study.
Results
EC-specific progeroid mice showed exacerbated pulmonary hypertension after chronic hypoxia exposure, accompanied by the enhanced medial SMCs proliferation in the distal pulmonary arteries. Contact-mediated interaction with senescent hPAECs increased proliferation and migration capacities in hPASMCs, while no such effects were detected in the absence of ECs-SMCs contact. Consistently, senescent ECs highly expressed Notch ligands, thus activated Notch signalling in hPASMCs, leading to increased Notch target genes in hPASMCs. Pharmacological inhibition of Notch signalling attenuated the enhanced SMCs proliferation and migration induced by senescent hPAECs, as well as the worsened PH phenotypes in EC-specific progeroid mice.
Conclusions
Our data established a crucial role of senescent ECs in the PAH pathogenesis through the dysregulated SMC functions via juxtacrine signaling. Senescent ECs are attracting targets for further pathological-targeted therapy to cure PAH completely.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Ramadhiani
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Ikeda
- Kyoto Prefectural University of Medicine, Department of Epidemiology for Longevity and Regional Health, Kyoto, Japan
| | - K Miyagawa
- Kobe Pharmaceutical University, Laboratory of Clinical Pharmaceutical Science, Kobe, Japan
| | - G R T Ryanto
- Kobe Pharmaceutical University, Laboratory of Clinical Pharmaceutical Science, Kobe, Japan
| | - N Tamada
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe, Japan
| | - Y Suzuki
- Kobe Pharmaceutical University, Laboratory of Clinical Pharmaceutical Science, Kobe, Japan
| | - K Hirata
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe, Japan
| | - N Emoto
- Kobe Pharmaceutical University, Laboratory of Clinical Pharmaceutical Science, Kobe, Japan
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Takahashi N, Mochizuki K, Sano H, Kobayashi S, Ohara Y, Ikeda K, Ohto H, Kikuta A. Decline of serum albumin precedes severe acute GVHD after haploidentical HSCT. Pediatr Int 2021; 63:1048-1054. [PMID: 33253440 DOI: 10.1111/ped.14564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/26/2020] [Accepted: 11/25/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Haploidentical hematopoietic stem cell transplantation (HSCT) is a useful therapy for relapsed/refractory acute leukemia or lymphoma because of the strong graft-vs-leukemia (GVL) effect. However, it is often accompanied by severe acute graft-versus-host disease (aGVHD), which is the most serious complication after haploidentical HSCT. Thus, it is important to control the severity of aGVHD while maintaining the GVL effect. In our experience of pediatric haploidentical HSCT, it takes several days for aGVHD to become severe after the appearance of initial symptoms, mostly skin rashes. In this study, we aimed to identify useful biomarkers at the onset of aGVHD that predict subsequent development of severe aGVHD. METHODS Forty-five consecutive children with relapsed/refractory acute leukemia or lymphoma who developed aGVHD after haploidentical HSCT were enrolled. We analyzed possible biomarkers from samples collected at the onset of acute GVHD. RESULTS Nineteen patients developed grade 1-2 aGVHD, and 26 patients developed grade 3-4 aGVHD. There was no significant difference in patient characteristics between the two groups. Transplant-related mortality occurred only in the grade 3-4 aGVHD group (34.5%). Multivariate analysis revealed that serum albumin was an independent biomarker for predicting the severity of aGVHD (P = 0.009). The area under the receiver operating characteristic curve of serum albumin was 0.864. CONCLUSIONS The serum albumin level at the onset of aGvHD could be a useful biomarker for the development of subsequent severe aGVHD in pediatric patients after haploidentical HSCT.
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Affiliation(s)
- Nobuhisa Takahashi
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima City, Japan
| | - Kazuhiro Mochizuki
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima City, Japan
| | - Hideki Sano
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima City, Japan
| | - Shogo Kobayashi
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima City, Japan
| | - Yoshihiro Ohara
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima City, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University Hospital, Fukushima City, Japan
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University Hospital, Fukushima City, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima City, Japan
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21
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Sano H, Mochizuki K, Kobayashi S, Ohara Y, Takahashi N, Kudo S, Ikeda K, Ohto H, Kikuta A. T-cell replete haploidentical stem cell transplantation with low dose anti-thymocyte globulin for relapsed/refractory Ewing sarcoma family tumors. Cancer Rep (Hoboken) 2021; 5:e1519. [PMID: 34291886 PMCID: PMC9327660 DOI: 10.1002/cnr2.1519] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/02/2022] Open
Abstract
Background Despite intensive multimodal therapies, the prognosis of relapsed/ refractory Ewing sarcoma family tumors (RR‐ESFTs) is dismal. Some case reports using allogeneic stem cell transplantation (allo SCT) for RR‐ESFTs have been reported, however, the efficacy of allo SCT is yet to be established. Aim The purpose of this study was to evaluate the response and toxicity of T‐cell replete haploidentical SCT (TCR‐haplo‐SCT) in RR‐ESFTs. Methods and results In this study, we retrospectively analyzed six patients with RR‐ESFTs who received TCR‐haplo‐SCT. Four patients had relapsed and two patients had refractory Ewing sarcoma. Before the TCR‐haplo‐SCT, all patients received a reduced intensity‐conditioning regimen containing fludarabine, melphalan, and low‐dose rabbit anti‐thymocyte globulin (2.5 mg/kg), as well as graft‐versus‐host disease (GVHD) prophylaxis, which consisted of tacrolimus, methotrexate, and prednisolone. Primary neutrophil engraftment was achieved in all the patients. Four patients developed acute GVHD (aGVHD) (grade I, 1; grade II, 1; grade III, 2), and two patients developed chronic GVHD (cGVHD). Among the four that developed aGVHD, three survived for 14, 116, and 129 months without relapse, while one died due to a transplant‐related complication. In contrast, the two patients who did not develop aGVHD experienced relapse early after TCR‐haplo‐SCT. Conclusions In this study, three of the six patients with RR‐ESFTs survived for more than one year without relapse, and the treatment toxicity was considered acceptable even for patients who underwent high‐intensity pretreatment. TCR‐haplo‐SCT could be a potential therapeutic option for patients with RR‐ESFTs.
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Affiliation(s)
- Hideki Sano
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Kazuhiro Mochizuki
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Shogo Kobayashi
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Yoshihiro Ohara
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Nobuhisa Takahashi
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Shingo Kudo
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
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Yokokawa T, Misaka T, Kimishima Y, Wada K, Minakawa K, Sugimoto K, Ishida T, Morishita S, Komatsu N, Ikeda K, Takeishi Y. Crucial role of hematopoietic JAK2 V617F in the development of aortic aneurysms. Haematologica 2021; 106:1910-1922. [PMID: 33567809 PMCID: PMC8252954 DOI: 10.3324/haematol.2020.264085] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Received: 06/24/2020] [Indexed: 12/11/2022] Open
Abstract
JAK2 V617F is the most frequent driver mutation in myeloproliferative neoplasms (MPN) and is associated with vascular complications. However, the impact of hematopoietic JAK2 V617F on aortic aneurysms (AA) remains unknown. Our cross-sectional study indicated that nine (23%) of 39 MPN patients with JAK2 V617F exhibited the presence of AA. In order to clarify whether the hematopoietic JAK2 V617F contributes to the AA, we applied bone marrow transplantation (BMT) with the donor cells from Jak2 V617F transgenic (JAK2V617F) mice or control wild-type (WT) mice into lethally irradiated apolipoprotein E-deficient mice. Five weeks after BMT, the JAK2V617F-BMT mice and WT-BMT mice were subjected to continuous angiotensin II infusion to induce AA formation. Four weeks after angiotensin II infusion, the abdominal aorta diameter in the JAK2V617F-BMT mice was significantly enlarged compared to that in the WT-BMT mice. Additionally, the abdominal AA-free survival rate was significantly lower in the JAK2V617F-BMT mice. Hematopoietic JAK2 V617F accelerated aortic elastic lamina degradation as well as activation of matrix metalloproteinase (MMP)-2 and MMP-9 in the abdominal aorta. The numbers of infiltrated macrophages were significantly upregulated in the abdominal aorta of the JAK2V617F-BMT mice accompanied by STAT3 phosphorylation. The accumulation of BM-derived hematopoietic cells carrying JAK2 V617F in the abdominal aorta was confirmed by use of the reporter green fluorescent proteintransgene. BM-derived macrophages carrying JAK2 V617F showed increases in mRNA expression levels of Mmp2, Mmp9, and Mmp13. Ruxolitinib decreased the abdominal aorta diameter and the incidence of abdominal AA in the JAK2V617F-BMT mice. Our findings provide a novel feature of vascular complications of AA in MPN with JAK2 V617F.
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Affiliation(s)
- Tetsuro Yokokawa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan; Department of Pulmonary Hypertension, Fukushima Medical University, Fukushima
| | - Tomofumi Misaka
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan; Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima.
| | - Yusuke Kimishima
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima
| | - Kento Wada
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima
| | - Keiji Minakawa
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima
| | - Koichi Sugimoto
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan; Department of Pulmonary Hypertension, Fukushima Medical University, Fukushima
| | - Takafumi Ishida
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima
| | - Soji Morishita
- Department of Transfusion Medicine and Stem Cell Regulation, Juntendo University Graduate School of Medicine, Tokyo
| | - Norio Komatsu
- Department of Hematology, Juntendo University Graduate School of Medicine, Tokyo
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima.
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima
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Tamai H, Kaneko Y, Kameda H, Kuwana M, Okano Y, Ishii T, Ikeda K, Taguchi H, Sato S, Miyamoto T, Hirata S, Yasuoka H, Kojima T, Park SH, Shin K, Baek HJ, Lee YJ, Choi IA, Kim J, Hsu PN, Kuo CF, Huang CM, Weng MY, Sung WY, Tsai WC, Cheng TT, Taninaga T, Mori M, Miyagishi H, Sato Y, Takeuchi T. AB0253 COMPARISON OF PHARMACODYNAMICS OF METHOTREXATE AS METHOTREXATE-POLYGLUTAMATES CONCENTRATIONS IN RHEUMATOID ARTHRITIS; INTERIM DATA EVALUATION OF MIRACLE STUDY CONDUCTED IN JAPAN, KOREA AND TAIWAN. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.762] [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: 11/04/2022]
Abstract
Background:Methotrexate (MTX) is the first-line therapy for rheumatoid arthritis (RA). The concentrations of MTX-polyglutamates (PG) in erythrocytes, an active form of MTX, are useful markers for the optimal usage of MTX in patients with RA. The concentrations of MTX-PG have been reported to be different between Japanese and Caucasians. However, the difference among Asian ethnicity remains unclear.Objectives:To examine MTX-PG concentrations in association with MTX dose during the first 24 weeks after the initiation of MTX for newly diagnosed RA patients in Japan, Korea and Taiwan.Methods:MIRACLE study is a multicenter, open-label, randomized, 48 weeks interventional study conducted in Japan, Korea and Taiwan to evaluate non-inferiority of low dose to high dose of MTX as an add-on therapy to adalimumab in 300 patients with RA who do not achieve remission after 24 weeks MTX monotherapy in stipulated dosage. In the first 24 weeks, MTX was started at 6 to 8 mg/week for newly diagnosed RA patients, and promptly escalated to the maximum tolerable dose in 12 weeks in principle. This interim data evaluation was intended to investigate the differences among countries in the relationship between MTX dose, safety and MTX-PG concentrations in erythrocytes during the first 24 weeks. The efficacy of the treatment is not included at this point.Results:A total of 166 patients (106 in Japan, 35 in Korea, 25 in Taiwan) were included in this interim data. The age at treatment initiation was 57.2 years old on average and female was 79.5%. The time course changes in total and individual MTX-PG levels differed in the three countries. At 24 weeks, whereas the mean total MTX-PG concentrations were comparable (112.9 nmol/L in Japan, 104.4 nmol/L in Korea, and 115.7 nmol/L in Taiwan) with a dose of MTX of 12.3 mg/week, 14.1 mg/week, and 12.2 mg/week, respectively, the individual MTX-PG concentrations were different. The MTX-PG1 and MTX-PG2 concentrations were lower in Korea than Japan and Taiwan whereas MTX-PG3, MTX-PG4 and MTX-PG5 concentrations were the highest in Korea.Conclusion:The distribution of short-chain and long-chain MTX-PG concentrations were various among Asian countries despite similar dose of MTX administration: NCT03505008.Disclosure of Interests:Hiroya Tamai: None declared, Yuko Kaneko Speakers bureau: AbbVie, Astellas, Ayumi, Bristol–Myers Squibb, Chugai, Eisai, Eli Lilly, Hisamitsu, Jansen, Kissei, Kirin, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, and UCB., Grant/research support from: Sanofi, Hideto Kameda Speakers bureau: AbbVie, Pfizer, Consultant of: AbbVie, Grant/research support from: AbbVie, Eisai, Masataka Kuwana Speakers bureau: Astellas, Asahi Kasei Pharma, Boehringer- Ingelheim, Chugai, Eisai, Janssen, Mochida, Nippon Shinyaku, Ono Pharmaceuticals, Pfizer, Mitsubishi-Tanabe, Consultant of: Corbus, Grant/research support from: AbbVie, Asahi Kasei Pharma, Boehringer- Ingelheim, Chugai, Eisai, MBL, Nippon Shinyaku, Ono Pharmaceuticals, Mitsubishi-Tanabe, Yutaka Okano: None declared, Tomonori Ishii Speakers bureau: Chugai, Mitsubishi- Tanabe, Glaxo Smith Kline, Pfizer, Eli Lilly, Janssen, AbbVie, Eisai, Astellas, Kei Ikeda Speakers bureau: AbbVie, Eli Lilly, Novartis, Mitsubishi-Tanabe, Eisai, BMS, Grant/research support from: Mitsubishi-Tanabe, Hiroaki Taguchi: None declared, Shinji Sato: None declared, Toshiaki Miyamoto: None declared, Shintaro Hirata Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas, Ayumi, Bristol Myers Squibb, Chugai, Eisai, Eli Lilly, Janssen, Glaxo Smith Kline, Kissei, Pfizer, Sanofi, Mitsubishi- Tanabe, UCB, Paid instructor for: AbbVie, Mitsubishi- Tanabe, Consultant of: AbbVie, Eisai, Gilead, Grant/research support from: AbbVie, Chugai, Mitsubishi-Tanabe, UCB, Hidekata Yasuoka Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas, Daiichi- Sankyo, Eisai, Kissei, Takeda, Mitsubishi- Tanabe, Chugai, Novartis, Eli Lilly, Pfizer, Janssen, Sanofi, Teijin, Boehringer- Ingelheim, Bayer, Glaxo Smith Kline, Paid instructor for: AbbVie, Consultant of: AbbVie, Asahi Kasei, Grant/research support from: Mitsubishi-Tanabe, Takeda, Daiichi-Sankyo, Chugai, Bristol-Myers, MSD, Astellas, Toshihisa Kojima Speakers bureau: AbbVie, Pfizer, Eisai, Grant/research support from: AbbVie, Sung-Hwan Park: None declared, Kichul Shin: None declared, Han Joo Baek: None declared, Yun Jong Lee Grant/research support from: research fund, In Ah Choi Speakers bureau: Abbvie, Eizai, Grant/research support from: Abbvie, Eizai, Jinhyun Kim: None declared, Ping-Ning Hsu: None declared, Chang-Fu Kuo: None declared, Chun-Ming Huang Paid instructor for: AbbVie, Pfizer, Meng-Yu Weng Consultant of: AbbVie, Wan-Yu Sung: None declared, Wen-Chan Tsai: None declared, Tien-Tsai Cheng Paid instructor for: AbbVie, Grant/research support from: AbbVie, Takehiro Taninaga Shareholder of: Eisai Co., Ltd., Employee of: Eisai Co., Ltd., Masahiko Mori Shareholder of: Eisai Co., Ltd., Employee of: Eisai Co., Ltd., Hideaki Miyagishi Employee of: Eisai Co., Ltd., Yasunori Sato: None declared, Tsutomu Takeuchi Speakers bureau: Astellas, Abbvie, Daiichi Sankyo, Ayumi, Eisai, GlaxoSmithKline, Mitsubishi Tanabe, Chugai, Novartis, Eli Lilly, Pfizer, Bristol Myers Squibb, Janssen, UCB, TaishoToyama, Sanofi–Aventis, Nipponkayaku, Taiho, Gilead, Boehringer Ingelheim, Grant/research support from: Asahikasei, Astellas, Abbvie, Daiichi Sankyo, Ayumi, Eisai, Takeda, Mitsubishi Tanabe, Chugai, Eli Lilly, UCB, Sanofi–Aventis, Nipponkayaku, Boehringer Ingelheim
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Matsumoto T, Chen Y, Contreras-Sanz A, Ikeda K, Sano T, Roberts M, Moskalev I, Black P. FBXW7 loss identifies a subgroup of bladder cancer patients with poor prognosis who benefit from neoadjuvant chemotherapy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00838-1] [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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Taylor PC, Blanco R, Ikeda K, Jia B, Chen YF, Walls C, Haladyj E, Fautrel B. POS0649 BARICITINIB PROVIDES GREATER IMPROVEMENTS IN PATIENT-REPORTED OUTCOMES ACROSS ALL DISEASE ACTIVITY LEVELS COMPARED TO PLACEBO AND ADALIMUMAB IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.182] [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: 11/04/2022]
Abstract
Background:Baricitinib (BARI) is a JAK1/JAK2 inhibitor which provides improvements to clinical signs, symptoms, and patient-reported outcomes (PROs) in patients with rheumatoid arthritis [1, 2].Objectives:The effect of BARI on the relationship between disease activity and pain has been explored previously [3]. The purpose of this post hoc analysis was to determine the association between additional PROs (physical function, fatigue, and duration of morning joint stiffness) and disease activity status after 12 weeks of treatment and to evaluate whether patients with an inadequate response to methotrexate treated with BARI 4 mg experienced greater PRO improvement than patients treated with either placebo (PBO) or adalimumab (ADA) across all levels of disease activity.Methods:Data for these analyses were derived from the Phase 3 study RA-BEAM (N=1305; NCT01710358). Pain was evaluated using a 0-100 mm visual analog scale, physical function was assessed using the Health Assessment Questionnaire-Disability Index (HAQ-DI), fatigue was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, and duration of morning joint stiffness (MJS, minutes) was reported by the patient. Disease activity was measured using the Clinical Disease Activity Index (CDAI) and categorized as remission (REM, ≤2.8), low disease activity (LDA, >2.8 to ≤10), moderate disease activity (MDA, >10 to ≤22), or high disease activity (HDA, >22). Linear regression was used to model the relationship between change in PROs at Week 12 (response) and CDAI values at Week 12 (primary explanatory variable) to evaluate the extent of improvement in PROs with BARI relative to PBO and ADA across a spectrum of disease activity levels. Last observation carried forward was used to impute missing values.Results:At baseline, 91% of patients were classified as having HDA and 9% as having MDA by CDAI across all treatment groups. After 12 weeks of treatment, 2%, 7%, and 9% of patients achieved REM; 16%, 27%, and 33% of patients achieved LDA; and 33%, 40%, and 38% of patients achieved MDA with PBO, ADA, and BARI, respectively [3].At Week 12, the estimated changes in measures of pain and physical function, as well as duration of MJS, for BARI 4 mg were greater than both PBO and ADA at all disease activity level threshold values of CDAI (Table 1). The estimated change in fatigue for BARI 4 mg was similar to that of ADA, and greater than PBO, at all disease activity level threshold values (Table 1).Table 1.Estimate of PRO Improvement by Disease Activity Threshold Level (CDAI) at Week 12PROCDAI=2.8CDAI=10CDAI=22PBOADABARI4 mgPBOADABARI 4 mgPBOADABARI 4 mgPain VASa(mm)-28.4-37.9-40.9-24.5-32.6-36.1-18.0-23.7-28.1HAQ-DIb-0.6-0.7-0.9-0.5-0.7-0.7-0.4-0.5-0.6FACIT-Fc9.811.811.18.810.610.27.08.78.7Duration of MJS (min)-6.9-37.8-64.9-6.3-35.3-55.7-5.3-31.3-40.2aPain VAS scores range from 0 (no pain) to 100 (worst pain).bHAQ-DI scores range from 0 (no disability) to 3 (completely disabled).cFACIT-F scores range from 0 (worst fatigue) to 52 (no fatigue).Abbreviations: ADA, adalimumab; BARI, baricitinib; CDAI, Clinical Disease Activity Index; FACIT-F, Functional Assessment of Chronic Illness Therapy-Fatigue; HAQ-DI, Health Assessment Questionnaire-Disability Index; MJS, morning joint stiffness; PBO, placebo; PRO, patient-reported outcomes; VAS, visual analog scale.Conclusion:Estimates of treatment differences suggest that patients treated with BARI 4 mg may experience greater improvements in pain, physical function, and MJS duration than patients treated with PBO or ADA regardless of their disease activity status reached after 12 weeks of treatment. Using this approach, improvements in fatigue with BARI 4 mg may be greater than with PBO and similar to ADA after 12 weeks.References:[1]Taylor, P.C., et al., N Engl J Med, 2017. 376(7): p. 652-662.[2]Keystone, E.C., et al., Ann Rheum Dis, 2017. 76(11): p. 1853-1861.[3]Taylor, P., et al., Arthritis Rheumatol, 2019. 71(S10): p. 2455-2457.Acknowledgements:The authors would like to acknowledge Catherine Lynch, with Eli Lilly and Company, for medical writing and project management support.Disclosure of Interests:Peter C. Taylor Consultant of: AbbVie, Biogen, Galapagos, Gilead, GlaxoSmithKline, Janssen, Eli Lilly, BMS, Pfizer, Roche, Celltrion, Sanofi, Nordic Pharma, Fresenius and UCB, Grant/research support from: Celgene, Galapagos, Gilead, Eli Lilly, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, BMS, Janssen, Eli Lilly and MSD, Consultant of: Abbvie, Pfizer, Roche, BMS, Janssen, Eli Lilly and MSD, Grant/research support from: Abbvie, MSD, and Roche, Kei Ikeda Speakers bureau: Eli Lilly, Abbvie, Mitsubishi-Tanabe, Novartis, Paid instructor for: Abbvie, Grant/research support from: Mitsubishi-Tanabe, Bochao Jia Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Yun-Fei Chen Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Chad Walls Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Ewa Haladyj Employee of: Eli Lilly and Company, Bruno Fautrel Speakers bureau: Eli Lilly, Consultant of: AbbVie, Biogen, Bristol-Myers Squibb, Celgene, Janssen Pharmaceuticals, Eli Lilly and Company, Medac, MSD, NORDIC Pharma, Novartis, Pfizer Inc., Roche, Sanofi-Aventis, SOBI, UCB, Grant/research support from: AbbVie, Eli Lilly and Company, MSD, Pfizer Inc
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Hayashi T, Ikeda K, Taniyama D, Hsi R, Inoue S, Teishima J, Akabane S, Sentani K, Yasui W, Yamamoto H, Kuraoka K, Hinoi T. Clinicopathological characteristics of upper tract urothelial cancer with loss of immunohistochemical expression of mismatch repair proteins. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01155-6] [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: 11/24/2022]
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Itoh K, Yamada R, Saida J, Ikeda K, Otomo T. Atomic-level characterization of free volume in the structure of Cu 67Zr 33amorphous alloy. J Phys Condens Matter 2021; 33:274001. [PMID: 33906162 DOI: 10.1088/1361-648x/abfc12] [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] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/27/2021] [Indexed: 06/12/2023]
Abstract
The structure of Cu67Zr33amorphous alloy was investigated in terms of packing density and free volume by using neutron, x-ray diffraction and reverse Monte Carlo (RMC) modelling. The RMC model was analysed by a method of decomposing the three-dimensional atomic configuration into fundamental polyhedral units (termed as 'holes' referencing the Bernal's works) of which faces are all triangles consisting of chemical bonds. Not only tetrahedral and octahedral holes but also other larger holes were identified. Moreover, the atomic packing fractions and free volumes in the respective polyhedral holes were evaluated with reference to those for the corresponding crystal structures. The results show that the distribution of free volumes for the larger holes can be described by the exponential function assuming that there are no energetic interactions between each other. On the other hand, the local structural fluctuations due to densely and loosely packed tetrahedral holes were observed, leading to the negative free volume spaces.
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Affiliation(s)
- K Itoh
- Graduate School of Education, Okayama University, 3-1-1 Tsushima-Naka, kita-ku, Okayama 700-8530, Japan
| | - R Yamada
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai 980-8578, Japan
| | - J Saida
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai 980-8578, Japan
| | - K Ikeda
- Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Otomo
- Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
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Minakawa K, Yokokawa T, Ueda K, Nakajima O, Misaka T, Kimishima Y, Wada K, Tomita Y, Miura S, Sato Y, Mimura K, Sugimoto K, Nakazato K, Nollet KE, Ogawa K, Ikezoe T, Hashimoto Y, Takeishi Y, Ikeda K. Myeloproliferative neoplasm-driving Calr frameshift promotes the development of pulmonary hypertension in mice. J Hematol Oncol 2021; 14:52. [PMID: 33785036 PMCID: PMC8011226 DOI: 10.1186/s13045-021-01064-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/23/2020] [Accepted: 03/15/2021] [Indexed: 04/08/2023] Open
Abstract
Frameshifts in the Calreticulin (CALR) exon 9 provide a recurrent driver mutation of essential thrombocythemia (ET) and primary myelofibrosis among myeloproliferative neoplasms (MPNs). Here, we generated knock-in mice with murine Calr exon 9 mimicking the human CALR mutations, using the CRISPR-Cas9 method. Knock-in mice with del10 [Calrdel10/WT (wild−type) mice] exhibited an ET phenotype with increases of peripheral blood (PB) platelets and leukocytes, and accumulation of megakaryocytes in bone marrow (BM), while those with ins2 (Calrins2/WT mice) showed a slight splenic enlargement. Phosphorylated STAT3 (pSTAT3) was upregulated in BM cells of both knock-in mice. In BM transplantation (BMT) recipients from Calrdel10/WT mice, although PB cell counts were not different from those in BMT recipients from CalrWT/WT mice, Calrdel10/WT BM-derived macrophages exhibited elevations of pSTAT3 and Endothelin-1 levels. Strikingly, BMT recipients from Calrdel10/WT mice developed more severe pulmonary hypertension (PH)—which often arises as a comorbidity in patients with MPNs—than BMT recipients from CalrWT/WT mice, with pulmonary arterial remodeling accompanied by an accumulation of donor-derived macrophages in response to chronic hypoxia. In conclusion, our murine model with the frameshifted murine Calr presented an ET phenotype analogous to human MPNs in molecular mechanisms and cardiovascular complications such as PH.
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Affiliation(s)
- Keiji Minakawa
- Department of Blood Transfusion and Transplantation Immunology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Tetsuro Yokokawa
- Department of Cardiovascular Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Koki Ueda
- Department of Blood Transfusion and Transplantation Immunology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Osamu Nakajima
- Center for Molecular Genetics, Yamagata University, Yamagata, Japan
| | - Tomofumi Misaka
- Department of Cardiovascular Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yusuke Kimishima
- Department of Cardiovascular Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kento Wada
- Department of Cardiovascular Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yusuke Tomita
- Department of Cardiovascular Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Saori Miura
- Department of Blood Transfusion and Transplantation Immunology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Yuka Sato
- Department of Blood Transfusion and Transplantation Immunology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Kosaku Mimura
- Department of Blood Transfusion and Transplantation Immunology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Koichi Sugimoto
- Department of Cardiovascular Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan.,Department of Pulmonary Hypertension, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kazuhiko Nakazato
- Department of Cardiovascular Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kenneth E Nollet
- Department of Blood Transfusion and Transplantation Immunology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Kazuei Ogawa
- Department of Hematology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takayuki Ikezoe
- Department of Hematology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yuko Hashimoto
- Department of Diagnostic Pathology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
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Li Q, Ho CP, Tang H, Okano M, Ikeda K, Takagi S, Takenaka M. Si racetrack optical modulator based on the III-V/Si hybrid MOS capacitor. Opt Express 2021; 29:6824-6833. [PMID: 33726194 DOI: 10.1364/oe.418108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
We have fabricated a Si racetrack optical modulator based on a III-V/Si hybrid metal-oxide-semiconductor (MOS) capacitor. The III-V/Si hybrid MOS optical phase shifter was integrated to a Si racetrack resonator with a coupling length of 200 µm and a coupling gap of 700 nm. The fabricated Si racetrack resonator demonstrated a small VπL of 0.059 Vcm. For 10-dB optical intensity modulation, the Si racetrack resonator showed a 60% smaller driving voltage than a Mach-Zehnder interferometer modulator with the same phase shifter, leading to a better balance between high energy efficiency and large modulation bandwidth.
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Shima E, Go H, Maeda H, Ogasawara K, Imamura T, Sasaki M, Koh Y, Nollet KE, Ikeda K, Ohto H, Hosoya M. Down syndrome with neonatal alloimmune thrombocytopenia due to anti-HLA A31 and B61 antibodies. Int J Hematol 2021; 113:945-949. [PMID: 33569741 DOI: 10.1007/s12185-021-03092-z] [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: 09/15/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
Neonatal alloimmune thrombocytopenia (NAIT) arises from fetomaternal platelet incompatibility that results in transplacental passage of maternal antibodies mostly against fetal human platelet antigens (HPA), whereas NAIT due to anti-human leukocyte antigen (HLA) antibodies is extremely rare. Here, we report a case of Down syndrome (DS) with NAIT that was attributed to HLA antibodies. A boy with DS was delivered at 36 weeks' gestation. His platelet count declined to 13.0 × 109/L, suggestive of NAIT rather than other conditions, including transient abnormal myelopoiesis. Random platelet concentrates and intravenous immunoglobulin administration resolved the thrombocytopenia without clinical complications. Immunoserological investigations detected anti-HLA, but no anti-HPA antibodies in samples from the patient and the mother. HLA typing and cross-matching indicated that anti-HLA antibodies to paternal HLA A31 and B61, which had probably been induced during a prior pregnancy, led to NAIT in this case. Although it is a rare condition, healthcare providers should consider NAIT due to HLA antibodies and be vigilant for subsequent cases in DS.
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Affiliation(s)
- Eriko Shima
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Hayato Go
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Hajime Maeda
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.
| | - Kei Ogasawara
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Takashi Imamura
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.,Department of Pediatrics, Ohta Nishinouchi Hospital, Koriyama, Japan
| | - Mutsumi Sasaki
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yangsook Koh
- Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | - Kenneth E Nollet
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
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Tanaka A, Yokohama A, Fujiwara SI, Fujii Y, Kaneko M, Ueda Y, Abe T, Kato Y, Hasegawa Y, Ikeda K, Fujino K, Matsumoto M, Makino S, Kino S, Takeshita A, Muroi K. Transfusion-associated circulatory overload and high blood pressure: A multicentre retrospective study in Japan. Vox Sang 2021; 116:785-792. [PMID: 33529383 DOI: 10.1111/vox.13063] [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: 05/04/2020] [Revised: 11/23/2020] [Accepted: 12/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Transfusion-associated circulatory overload (TACO) is an adverse reaction associated with a high risk of mortality. The actual incidence of TACO and hypertension associated with transfusion in Japan is unknown. METHODS A multicentre retrospective observational study was conducted across 23 institutions during the 1-year period of 2016. Patients were included if they developed TACO or their blood pressure (either systolic or diastolic) increased by at least 30 mmHg during the transfusion. TACO was confirmed by the primary physicians and transfusion medicine teams and recorded in the data on passive surveillance, and additional data were extracted from electronic medical records. RESULTS In our patient cohort of 31 384 patients who underwent transfusion, the incidence of TACO and hypertension was 0·03% and 0·2%, respectively. However, 43% of the participating institutions didn't report any cases. When comparing risk factors between the TACO and hypertension groups, there were significant differences in comorbidities, such as abnormal findings on chest x-ray. Significant differences between the two groups were observed post-transfusion pulse rate, body temperature and oxygen saturation (P < 0·01). In the group of patients with hypertension, the level of BNP increased significantly after transfusion in 45% (5/11) of the patients. We identified 4 patients in the hypertension group who met the new ISBT's TACO criteria. CONCLUSION Our study suggests that more attention should be given to TACO in Japan, particularly in terms of improving surveillance systems. For the early diagnosis of TACO, it is crucial to carefully monitor vital signs including blood pressure.
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Affiliation(s)
- Asashi Tanaka
- Department of Clinical Laboratory Medicine and Department of Transfusion Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Akihiko Yokohama
- Division of Blood Transfusion Service, Gunma University Hospital, Gunma, Japan
| | - Shin-Ichiro Fujiwara
- Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital, Tochigi, Japan
| | - Yasuhiko Fujii
- Department of Transfusion Medicine, Yamaguchi University Hospital, Yamaguchi, Japan
| | - Makoto Kaneko
- Division of Cell Transplantation and Transfusion, University of Yamanashi Hospital, Yamanashi, Japan
| | - Yasunori Ueda
- Department of Hematology and Oncology, Kurashiki Central Hospital, Okayama, Japan
| | - Takashi Abe
- Department of Hematology, Niigata City General Hospital, Niigata, Japan
| | - Yoko Kato
- Division of Transfusion and Cell Therapy, The Jikei University Hospital, Tokyo, Japan
| | - Yuichi Hasegawa
- Department of Transfusion Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Keizo Fujino
- Department of Transfusion Medicine, Osaka City University Hospital, Osaka, Japan
| | | | - Shigeyoshi Makino
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Shuichi Kino
- Hokkaido Block Blood Center Japanese Red Cross, Hokkaido, Japan
| | - Akihiro Takeshita
- Transfusion and Cell Therapy, Hamamatsu University School of Medicine, Shizuokoa, Japan
| | - Kazuo Muroi
- Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital, Tochigi, Japan
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Sano H, Mochizuki K, Kobayashi S, Ohara Y, Takahashi N, Kudo S, Waragai T, Ikeda K, Ohto H, Kikuta A. Effectiveness of T-Cell Replete Haploidentical Hematopoietic Stem Cell Transplantation for Refractory/Relapsed B Cell Acute Lymphoblastic Leukemia in Children and Adolescents. Front Pediatr 2021; 9:743294. [PMID: 34722423 PMCID: PMC8549544 DOI: 10.3389/fped.2021.743294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 09/17/2021] [Indexed: 12/19/2022] Open
Abstract
Background: The prognosis of refractory/relapsed B-cell precursor acute lymphoblastic leukemia (BCP-ALL) remains dismal owing to acquired resistance to chemotherapeutic agents. This study aimed to evaluate the efficacy of T-cell replete HLA haploidentical hematopoietic stem cell transplantation (TCR-haplo-HSCT) for pediatric refractory/relapsed BCP-ALL (RR-BCP-ALL). Methods: Nineteen pediatric patients with RR-BCP-ALL underwent TCR-haplo-HSCT between 2010 and 2019 at the Fukushima Medical University Hospital. The disease status at TCR-haplo-HSCT included complete remission (CR) in eight patients and non-CR with active disease in 11 patients. Total body irradiation-based, busulfan-based, and reduced-intensity conditioning regimens were employed in 11, 6, and 2 patients, respectively. Low-dose anti-thymocyte globulin (thymoglobulin, 2.5 mg/kg) was used in all patients. Graft-vs.-host disease (GVHD) prophylaxis was administered with tacrolimus, methotrexate, and prednisolone. Results: All patients received peripheral blood stem cells as the stem cell source. The HLA disparities in graft vs. host directions were 2/8 in one, 3/8 in five, and 4/8 in 13 patients. Among 18 patients who achieved primary engraftment, acute GVHD occurred in all 18 evaluable patients (grade II, 9; grade III, 8; grade IV, 1), and chronic GVHD was observed in 10 out of 15 evaluable patients. Three patients died because of transplant-related mortality. The 3-year overall survival (OS) and leukemia-free survival rates were 57.4 and 42.1%, respectively. Compared to patients older than 10 years in age (N = 10), those younger than 10 years in age (N = 9) showed an excellent OS rate (3-year OS rate: patients < 10 years old, 100%; patients > 10 years old, 20% [95% confidence interval, 3.1-47.5]; p = 0.002). Conclusions: We suggest that TCR haplo-HSCT with low-dose ATG conditioning has the potential to improve the transplantation outcomes in patients with RR-BCP.
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Affiliation(s)
- Hideki Sano
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Kazuhiro Mochizuki
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Shogo Kobayashi
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Yoshihiro Ohara
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Nobuhisa Takahashi
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Shingo Kudo
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Tomoko Waragai
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
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Hayashi T, Ikeda K, Sakamoto N, Sentani K, Hsi RS, Sekino Y, Kitano H, Goto K, Inoue S, Yasui W, Black PC, Teishima J. Transition of ANXA10 expression is a useful diagnostic and prognostic marker in upper tract urothelial carcinoma. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.047] [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: 10/22/2022]
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Matumoto T, Chen Y, Contreras-Sanz A, Ikeda K, Schulz G, Gao J, Zarni Oo H, Roberts M, da Costa JB, Nykopp TK, Kumar G, Sano T, Black PC. FBXW7 loss of function contributes to worse overall survival and is associated with accumulation of MYC in muscle invasive bladder cancer. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.048] [Citation(s) in RCA: 1] [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] [Indexed: 10/22/2022]
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35
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Ramadhiani R, Ikeda K, Miyagawa K, Ryanto G, Tamada N, Suzuki Y, Hirata K, Emoto N. Endothelial cell premature senescence exacerbates pulmonary arterial hypertension through contact-mediated interaction with vascular smooth muscle cells. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2234] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Pulmonary arterial hypertension (PAH) is characterized by remodelling and stenosis of the pulmonary arteries, ultimately leading to the right heart failure and death. Endothelial cell (EC) dysfunction is thought to play a central role in the pathogenesis of PAH by mediating the structural changes in pulmonary vasculatures. Various stresses promote premature senescence in EC, which may modify vascular disorders; however, the role of EC senescence in the development of PAH remains poorly understood.
Purpose
We aimed at investigating the potential role of EC premature senescence in the development of PAH.
Methods
We recently generated EC-specific progeroid mice in which ECs specifically undergo premature senescence by overexpressing the dominant-negative form of telomere repeat-binding factor 2 (published in Nat Commun 2020). These EC-specific progeroid mice were exposed to hypoxia (10% O2 for three weeks) to induce pulmonary hypertension. Also, we prepared premature senescent ECs using human pulmonary artery ECs (hPAECs) and explored their interaction with human pulmonary artery smooth muscle cells (hPASMCs) in two different conditions; direct and indirect interactions. For indirect coculture, hPASMCs were seeded onto the culture insert, while hPAECs were plated on the culture plate, and they were cocultured in the same well and medium so that secreted factors derived from senescent ECs could access to SMCs through the insert pores. For direct coculture, hPAECs were seeded onto the bottom side of the insert, while hPASMCs were cultured on the top side of the same insert, so that cell-to-cell contact could be made through the pores.
Results
After chronic hypoxia exposure, the EC-specific progeroid mice showed higher right ventricular systolic pressure and increased right ventricular mass as compared to wild-type (WT) mice, indicating exacerbated pulmonary hypertension. Histological analysis of the lung revealed a significantly enhanced muscularization in the small pulmonary arteries in EC-specific progeroid mice compared to WT mice. Mechanistically, we identified that direct coculture with premature senescent hPAECs enhanced proliferation and migration in hPASMCs, while no such effects were detected in indirect coculture condition.
Conclusion
To our knowledge, this is the first report that reveals a crucial role of EC premature senescence in the development of PAH. Our in vitro studies suggest that contact-mediated interaction between premature senescent ECs and SMCs is critically involved in its underlying mechanism. Therefore, EC premature senescence is a novel attractive pharmacotherapeutic target for the treatment of PAH.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Ramadhiani
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Ikeda
- Kobe Pharmaceutical University, Laboratory of Clinical Pharmaceutical Science, Kobe, Japan
| | - K Miyagawa
- Kobe Pharmaceutical University, Laboratory of Clinical Pharmaceutical Science, Kobe, Japan
| | - G.R.T Ryanto
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe, Japan
| | - N Tamada
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe, Japan
| | - Y Suzuki
- Kobe Pharmaceutical University, Laboratory of Clinical Pharmaceutical Science, Kobe, Japan
| | - K Hirata
- Kobe University Graduate School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe, Japan
| | - N Emoto
- Kobe Pharmaceutical University, Laboratory of Clinical Pharmaceutical Science, Kobe, Japan
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Yokohama A, Okuyama Y, Ueda Y, Itoh M, Fujiwara SI, Hasegawa Y, Nagai K, Arakawa K, Miyazaki K, Makita M, Watanabe M, Ikeda K, Tanaka A, Fujino K, Matsumoto M, Makino S, Kino S, Takeshita A, Muroi K. Differences among hemoglobin thresholds for red blood cell transfusions in patients with hematological diseases in teaching hospitals: a real world data in Japan. Int J Hematol 2020; 112:535-543. [PMID: 32683598 DOI: 10.1007/s12185-020-02937-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/07/2020] [Revised: 06/08/2020] [Accepted: 06/23/2020] [Indexed: 01/28/2023]
Abstract
A hemoglobin (Hb) threshold level of 7 g/dL has been proposed for red blood cell (RBC) transfusion in patients with chronic anemia in the Japanese guideline since 2005. However, Hb thresholds for hematological diseases in clinical practice and factors responsible for higher Hb thresholds remain unclear. Hb thresholds were collected for patients with hematological diseases from 32 Japanese teaching hospitals. Uni- and multivariate analyses were used to analyze relationships between Hb threshold level and various patient and hospital factors. In total, 4996 units of RBC were transfused to 1054 patients with hematological diseases in 2421 transfusions. Median age was 68 years. Myelodysplastic syndrome was the most frequent diagnosis. Overall median Hb threshold level was 6.9 g/dL. Multivariate linear regression analysis detected the following variables associated with Hb threshold level: hospital; cardiovascular disease; symptomatic anemia; and hematopoietic stem cell transplantation. Hospital was the most significant factor. Collectively, median Hb threshold level in clinical practice in Japan was similar to the guidelines. Higher Hb threshold level depended on the hospitals at which the transfusions were performed as well as patient condition. Educational approaches directed toward hospitals may be useful to promote transfusion guidelines.
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Affiliation(s)
- Akihiko Yokohama
- Division of Blood Transfusion Service, Gunma University Hospital, Gunma University School of Medicine , 3-39-15 Showa, Maebashi, Gunma, 371-8511, Japan.
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan.
| | - Yoshiki Okuyama
- Division of Transfusion and Cell Therapy, Tokyo Metropolitan Komagome Hospital, Bunkyo, Tokyo, Japan
| | - Yasunori Ueda
- Department of Hematology and Oncology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Masumi Itoh
- Clinical Laboratory, Narita Red Cross Hospital, Narita, Chiba, Japan
| | - Shin-Ichiro Fujiwara
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan
- Division of Hematology, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan
| | - Yuichi Hasegawa
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan
- Department of Transfusion Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Kazuhiro Nagai
- Transfusion and Cell Therapy Unit, Nagasaki University Hospital, Nagasaki, Japan
| | - Kimika Arakawa
- Division of Clinical Laboratory, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Koji Miyazaki
- Department of Transfusion and Cell Transplantation, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Masanori Makita
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Mai Watanabe
- Department of Hematology, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan
| | - Asashi Tanaka
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan
- Transfusion Medicine, Hachioji Medical Center of Tokyo Medical University, Hachioji, Tokyo, Japan
| | - Keizo Fujino
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan
- Department of Transfusion Medicine, Osaka City University Hospital, Osaka, Japan
| | - Mayumi Matsumoto
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan
- Department of Nursing, Shinko Hospital, Kobe, Hyogo, Japan
| | - Shigeyoshi Makino
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Minato, Japan
| | - Shuichi Kino
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan
- Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Hokkaido, Japan
| | - Akihiro Takeshita
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan
- Department of Transfusion and Cell Therapy, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kazuo Muroi
- Clinical Study Supporting Committee, The Japan Society of Transfusion Medicine and Cell Therapy, Tokyo, Japan
- Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan
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Kobatake K, Ikeda K, Nakata Y, Yamasaki N, Hayashi T, Sentani K, Yasui W, Kaminuma O, Horie S, Black P, Matsubara A, Honda H. Kdm6a deficiency activates inflammatory pathways, promotes M2 macrophage polarization and causes bladder cancer with p53 dysfunction. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32616-1] [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: 10/23/2022] Open
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38
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Inoue S, Hayashi T, Hieda K, Miyamoto S, Fujii S, Sekino Y, Kitano H, Ikeda K, Goto K, Teishima J, Matsubara A. Longitudinal analysis of conventional laparoscopic, posterior retroperitoneoscopic, and laparoendoscopic single-site adrenalectomy regarding cosmesis and satisfaction outcomes. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33186-4] [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: 11/16/2022] Open
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39
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Kimura S, Ohkawara H, Minakawa K, Fukatsu M, Mori H, Takahashi H, Harada-Shirado K, Ohara Y, Takahashi N, Mochizuki K, Sano H, Nollet KE, Ogawa K, Ohto H, Kikuta A, Ikeda K, Ikezoe T. Optimal timing of apheresis for the efficient mobilization of peripheral blood progenitor cells recruited by high-dose granulocyte colony-stimulating factor in healthy donors. Transfus Apher Sci 2020; 59:102737. [DOI: 10.1016/j.transci.2020.102737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
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40
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Ikeda K, Yagi T, Chiba S. 0903 Screening Of Pediatric Obstructive Sleep Apnea Using Video Monitoring. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.899] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
In Japan, the many of the patients are not able to access the specialized sleep medical facilities for overnight polysomnography(PSG) due to less availability and cost issues. Purpose of the study is to examine whether combination of video monitoring and other clinical examinations can reliably predict the severity of pediatric OSA compared with PSG.
Methods
Between April 1, 2012 and March 31, 2019, total of 175 children (3-12 years of age, boy 122, girl 53) with SDB were enrolled in this individual prospective-cohort study. In-laboratory based PSG were performed for all patients and sleep stages and respiratory events were manually scored. Video monitoring was performed during PSG. Modified video-recording test scoring system (based on Sivan et al 1996), were scored by laboratory technicians. Other clinical examinations were extracted from each PSG with ENT examinations, cephalogram, and rhinomanometry for all patient
Results
Multiple linear regression analyses was performed with a forward stepwise approach in which independent predictors that were significantly related to severity of OSA (AHI: 5/hr and 10/hr). Applying the multiple logistic regression analysis, the independent predictors for AHI 5/hr were ODI 3% >3/hr, rhinomanometry (NR>0.5 Pa/cm3/sec), enlargement of tonsils (Brodsky classification more than 2), two video monitoring items and total score, with an accuracy of predictive statistic model was 88.0% (sensitivity 78.3%, and specificity 93.0%). For the severity above AHI 10/hr, the independent predictors were Cephalogram parameter (Fx>84°), Oximetry (ODI 3% >5/hr) and BMI<15 with the video monitoring parameters of whole night inspiratory noise (loud) and chest retraction contribute to predict with the sensitivity 91.5%, the specificity 82.6% and the accuracy 88.0%.
Conclusion
Video monitor scoring parameters contributed to predict both AHI 5/hr and 10/hr with good overall sensitivity, specificity and overall accuracy compare with the combination of objective results alone. Instead of PSG, the combination of video scoring system and multiple clinical examinations could potentially provide reliable diagnostic approach for pediatric OSA with high accuracy. These results will support to establish more efficient diagnostic strategy for both patients and physicians
Support
N/A
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Affiliation(s)
- K Ikeda
- Jikei University School of Medicine Daisan Hospital, Tokyo, JAPAN
| | - T Yagi
- Ota Memorial Sleep Center, Kanagawa, JAPAN
| | - S Chiba
- Ota Memorial Sleep Center, Kanagawa, JAPAN
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41
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Oba A, Ito S, Okada H, Anzai T, Kikuchi K, Ikeda K. Early and noninvasive diagnosis using serological antigen biomarkers in chronic invasive fungal rhinosinusitis. RHINOL 2020. [DOI: 10.4193/rhinol/20.041] [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: 11/08/2022] Open
Abstract
Background: Chronic invasive form of fungal rhinosinusitis (FRS) is characterized by the invasion of fungal organisms into the sinonasal mucosa in the background of diabetes mellitus and corticosteroid treatment. Although the histopathology has traditionally been used to make a proven diagnosis of invasive fungal infections, the dependence on tissue samples and the slow turnaround time hamper the early confirmation of such infections. Methodology: This is a retrospective case series conducted over 6 years. All patients with a chronic course and immunosuppressive background of FRS diagnosed by radiologic imaging and treated with endoscopic sinus surgery were eligible for inclusion. Data were collected through medical records, including basic characteristics, symptoms and signs, imaging findings, laboratory investigations, pathology, treatment, and outcomes. Results: Fifteen patients with chronic course and immunosuppressive background of FRS diagnosed by radiologic imaging were identified. High values of 1,3-b-D-glucan (BDG) assay were recognized in 5 patients, whereas the other 10 patients with negative findings in the BDG assay showed sinus mycetomas. All the 5 patients showing significant elevations of serum BDG showed positive findings in the polymerase chain reaction (PCR), but only 2 patients were positive in the histopathology. The findings of the BDG assay were consistent with those of the PCR method, which was superior in sensitivity to the histopathology. Conclusion: We first applied BDG assay as a diagnostic tool for chronic invasive FRS. The BDG assay may be useful to distinguish chronic invasive FRS, including its early stage, from noninvasive mycetoma, contributing to timely treatment.
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Ikeda K, Ohto H, Yamada‐Fujiwara M, Okuyama Y, Fujiwara S, Muroi K, Mori T, Kasama K, Kanamori H, Iseki T, Nagamura‐Inoue T, Kameda K, Kanda J, Nagai K, Fujii N, Ashida T, Hirose A, Takahashi T, Minakawa K, Tanosaki R. Hematopoietic cell infusion‐related adverse events in pediatric/small recipients in a prospective/multicenter study. Transfusion 2020; 60:1015-1023. [DOI: 10.1111/trf.15786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/02/2020] [Accepted: 03/03/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Kazuhiko Ikeda
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
- Department of Blood Transfusion and Transplantation ImmunologyFukushima Medical University Fukushima Japan
| | - Hitoshi Ohto
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
- Department of Blood Transfusion and Transplantation ImmunologyFukushima Medical University Fukushima Japan
| | - Minami Yamada‐Fujiwara
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
- Division of Blood Transfusion and Cell TherapyTohoku University Hospital Sendai Japan
| | - Yoshiki Okuyama
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
- Division of Transfusion and Cell TherapyTokyo Metropolitan Komagome Hospital Tokyo Japan
| | - Shin‐ichiro Fujiwara
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
- Division of Hematology, Department of MedicineJichi Medical University Shimotsuke Japan
| | - Kazuo Muroi
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
- Cell Transplantation and TransfusionJichi Medical University Tochigi Japan
| | - Takehiko Mori
- Division of Hematology, Department of MedicineKeio University School of Medicine Tokyo Japan
| | - Kinuyo Kasama
- Department of Transfusion MedicineTokyo Jikei University Hospital Tokyo Japan
| | - Heiwa Kanamori
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
- Department of HematologyKanagawa Cancer Center Yokohama Japan
| | - Tohru Iseki
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
- Department of Transfusion Medicine and Cell TherapyChiba University Hospital Chiba Japan
| | - Tokiko Nagamura‐Inoue
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
- Institution of Medical ScienceUniversity of Tokyo Tokyo Japan
| | - Kazuaki Kameda
- Division of Hematology, Saitama Medical CenterJichi Medical University Saitama Japan
| | - Junya Kanda
- Department of Hematology and OncologyGraduate School of Medicine, Kyoto University Kyoto Japan
| | - Kazuhiro Nagai
- Transfusion and Cell Therapy UnitNagasaki University Hospital Nagasaki Japan
| | - Nobuharu Fujii
- Department of Transfusion MedicineOkayama University Hospital Okayama‐shi Japan
| | - Takashi Ashida
- Center for Transfusion and Cell TherapyKindai University Hospital Osakasayama Japan
| | - Asao Hirose
- Department of HematologyOsaka City University Osaka Japan
| | - Tsutomu Takahashi
- Department of Oncology/HematologyShimane University Hospital Shimane Japan
| | - Keiji Minakawa
- Department of Blood Transfusion and Transplantation ImmunologyFukushima Medical University Fukushima Japan
| | - Ryuji Tanosaki
- Cell Therapy CommitteeJapan Society of Transfusion Medicine and Cell Therapy Tokyo Japan
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Omisade A, O'Grady C, Sadler RM, Ikeda K. Functional MRI for language lateralization in individuals with intellectual and cognitive dysfunction: Two clinical case examples. Clin Neuropsychol 2020; 35:1471-1484. [PMID: 32167409 DOI: 10.1080/13854046.2020.1736163] [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] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Task-based functional MRI (fMRI) is a common non-invasive method of confirming hemispheric language dominance prior to neurosurgery in epilepsy. However, the use of this method is not recommended for individuals with cognitive dysfunction and in those with IQ below 70 due to concerns about accuracy of task performance in the scanner. This manuscript describes successful use of task-based functional MRI to lateralize language dominance in two individuals with cognitive dysfunction and intellectual disability. METHODS Two patients completed a pre-surgical epilepsy work-up at the QEII Health Sciences Centre in Halifax, Nova Scotia, which included comprehensive neuropsychological assessment. They also completed an fMRI paradigm that involved semantic category fluency, sentence completion, naming to description and passage listening tasks with stimuli delivered both visually and auditorily. RESULTS In both cases, fMRI maps were successful in lateralizing language dominance in relation to other clinical data, including intraoperative cortical mapping in one of the cases. CONCLUSIONS This manuscript is the first to demonstrate that task-based fMRI can be used successfully to lateralize language in adult patients with cognitive and intellectual disabilities, and is the first to propose a specific paradigm for this purpose.
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Affiliation(s)
- A Omisade
- Acquired Brain Injury (Epilepsy Program), Nova Scotia Health Authority, Halifax, Canada.,Department of Psychology & Neuroscience, Dalhousie University, Halifax, Canada
| | - C O'Grady
- Department of Medicine, Nova Scotia Health Authority, Halifax, Canada
| | - R M Sadler
- Department of Medicine, Division of Neurology, Dalhousie University, Halifax, Canada
| | - K Ikeda
- Department of Medicine, Division of Neurology, Dalhousie University, Halifax, Canada
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Tiwari T, Randall CL, Cohen L, Holtzmann J, Webster-Cyriaque J, Ajiboye S, Schou L, Wandera M, Ikeda K, Fidela de Lima Navarro M, Feres M, Abdellatif H, Al-Madi E, Tubert-Jeannin S, Fox CH, Ioannidou E, D'Souza RN. Gender Inequalities in the Dental Workforce: Global Perspectives. Adv Dent Res 2020; 30:60-68. [PMID: 31746651 DOI: 10.1177/0022034519877398] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this review is to investigate the growth of diversity and inclusion in global academic dental research with a focus on gender equality. A diverse range of research methodologies were used to conduct this review, including an extensive review of the literature, engagement of key informants in dental academic leadership positions around the world, and review of current data from a variety of national and international organizations. Results provide evidence of gender inequalities that currently persist in dental academics and research. Although the gender gap among graduating dental students in North America and the two most populous countries in Europe (the United Kingdom and France) has been narrowed, women make up 30% to 40% of registered dentists in countries throughout Europe, Oceania, Asia, and Africa. In academic dentistry around the globe, greater gender inequality was found to correlate with higher ranking academic and leadership positions in the United States, United Kingdom, several countries in European Union, Japan, and Saudi Arabia. Further disparities are noted in the dental research sector, where women make up 33% of dental researchers in the European Union, 35% in North America, 55% in Brazil, and 25% in Japan. Family and societal pressures, limited access to research funding, and lack of mentoring and leadership training opportunities are reported as also contributing to gender inequalities. To continue advancing gender equality in dental academia and research, efforts should be geared toward the collection and public dissemination of data on gender-specific distributions. Such evidence-driven information will guide the selection of future strategies and best practices for promoting gender equity in the dental workforce, which provides a major pipeline of researchers and scholars for the dental profession.
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Affiliation(s)
- T Tiwari
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - C L Randall
- School of Dentistry, University of Washington, Seattle, WA, USA
| | - L Cohen
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - J Holtzmann
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - S Ajiboye
- International Association for Dental Research, Alexandria, VA, USA
| | - L Schou
- National University Health System, Singapore, Singapore
| | - M Wandera
- Uganda Dental Association, Kampala, Uganda
| | - K Ikeda
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - M Feres
- Guarulhos University, Guarulhos, Brazil
| | - H Abdellatif
- Princess Nourah bint AbdulRahman University, Riyadh, Saudi Arabia
| | - E Al-Madi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - C H Fox
- International Association for Dental Research, Alexandria, VA, USA
| | - E Ioannidou
- School of Dental Medicine, UConn Health, Farmington, CT, USA
| | - R N D'Souza
- University of Utah Health Sciences, Salt Lake City, UT, USA
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Kisaki M, Nakano H, Tsumori K, Ikeda K, Masaki S, Haba Y, Fujiwara Y, Nagaoak K, Osakabe M. Study of correlation between plasma parameter and beam optics. Rev Sci Instrum 2020; 91:023503. [PMID: 32113389 DOI: 10.1063/1.5131102] [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] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
Simultaneous measurement of negative ion source plasma and extracted beam is carried out in order to clarify a key plasma parameter governing the meniscus formation in negative ion sources for fusion. The plasma discharge is performed with various discharge powers at different bias voltages in order to vary the plasma parameters. It is shown that the beam width changes along the same curve with respect to the negative ion density at any bias voltage while it varies along different curves with other plasma parameters depending on the bias voltage. This implies that the mechanism of meniscus formation in negative ion sources could be described along the similar manner as positive ion sources.
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Affiliation(s)
- M Kisaki
- National Institute for Fusion Science, Toki, Gifu 509-5292, Japan
| | - H Nakano
- National Institute for Fusion Science, Toki, Gifu 509-5292, Japan
| | - K Tsumori
- National Institute for Fusion Science, Toki, Gifu 509-5292, Japan
| | - K Ikeda
- National Institute for Fusion Science, Toki, Gifu 509-5292, Japan
| | - S Masaki
- The Graduate University for Advanced Studies, SOKENDAI, Toki, Gifu 509-5292, Japan
| | - Y Haba
- Graduate School of Science, Nagoya University, Nagoya 464-8601, Japan
| | - Y Fujiwara
- National Institute for Fusion Science, Toki, Gifu 509-5292, Japan
| | - K Nagaoak
- National Institute for Fusion Science, Toki, Gifu 509-5292, Japan
| | - M Osakabe
- National Institute for Fusion Science, Toki, Gifu 509-5292, Japan
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Kimura S, Imagawa J, Murai K, Hino M, Kitawaki T, Okada M, Tanaka H, Shindo M, Kumagai T, Ikezoe T, Uoshima N, Sato T, Watanabe R, Kowata S, Hayakawa M, Hosoki T, Ikeda K, Kobayashi T, Kakinoki Y, Nishimoto T, Takezako N, Shibayama H, Takaori-Kondo A, Nakamae H, Kawaguchi A, Ureshino H, Sakamoto J, Ishida Y. Treatment-free remission after first-line dasatinib discontinuation in patients with chronic myeloid leukaemia (first-line DADI trial): a single-arm, multicentre, phase 2 trial. Lancet Haematol 2020; 7:e218-e225. [PMID: 31978329 DOI: 10.1016/s2352-3026(19)30235-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND A previous dasatinib discontinuation (DADI) trial showed that 31 (49%) of 63 patients with chronic-phase chronic myeloid leukaemia who were treated with second-line or subsequent dasatinib could discontinue the drug safely. However, the safety and efficacy of discontinuing first-line dasatinib remains unclear. In this trial (the first-line DADI trial) we aimed to assess molecular relapse-free survival at 6 months after discontinuation of dasatinib in patients with chronic myeloid leukaemia who had been treated with first-line dasatinib and had maintained deep molecular response for at least 1 year. METHODS The first-line DADI trial was a single-arm, multicentre, phase 2 trial done at 23 hospitals in Japan. Patients with newly diagnosed chronic-phase chronic myeloid leukaemia without hepatosplenomegaly and extramedullary mass, who received at least 24-month dasatinib treatment and had a sustained deep molecular response (defined as BCR-ABL1/ABL1 international scale ≤0·0069% in at least four successive samples spanning a 12 month period) were enrolled. Other eligibility criteria were an age of 15 years or older, an Eastern Cooperative Oncology Group performance status score of 0-2, and no primary organ dysfunction. The primary outcome was molecular relapse-free survival (also known as treatment-free remission) after discontinuation of dasatinib at 6 months and was analysed in all patients who completed the 12-month consolidation phase. Safety was assessed in all patients who received treatment. This study closed early due to accrual and is registered with the UMIN Clinical Trials Registry (UMIN000011099). FINDINGS Between Sept 20, 2013 and July 12, 2016, 68 patients who had a deep molecular response after receiving first-line dasatinib for at least 24 months were enrolled and assigned to the consolidation phase. Nine patients were excluded during the consolidation phase and one patient was excluded after study completion because of meeting exclusion criteria. 58 patients discontinued dasatinib and were assessed. 32 (55%) of 58 patients had treatment-free remission at 6 months after dasatinib discontinuation, and median follow-up was 23·3 months (IQR 11·7-31·0). Treatment-free remission at 6 months was 55·2% (95% CI 43·7-69·6). No non-haematological adverse events worse than grade 2 occurred before dasatinib discontinuation. The most common haematological adverse event was anaemia (14 [21%] of 68 treated patients); three (4%) of 68 treated patients had grade 3 neutropenia and one (1%) had grade 4 lymphopenia. INTERPRETATION Our findings suggest that dasatinib could be safely discontinued after first-line treatment in patients with chronic myeloid leukaemia who had received at least 36 months of therapy and sustained deep molecular response; however, further confirmation in larger trials is needed. FUNDING Epidemiological and Clinical Research Information Network.
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Affiliation(s)
- Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
| | - Jun Imagawa
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Kazunori Murai
- Department of Hematology, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Masayuki Hino
- Department of Hematology, Osaka City University Hospital, Osaka, Japan
| | - Toshio Kitawaki
- Department of Hematology and Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masaya Okada
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Hideo Tanaka
- Department of Hematology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Motohiro Shindo
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Takashi Kumagai
- Department of Hematology, Ome Municipal General Hospital, Ome, Japan
| | - Takayuki Ikezoe
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan; Department of Hematology, Fukushima Medical School, Fukushima, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Matsushita Memorial Hospital, Osaka, Japan
| | - Tsutomu Sato
- Department of Medical Oncology and Hematology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Reiko Watanabe
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Shugo Kowata
- Department of Hematology, Iwate Prefecture Ofunato Hospital, Iwate, Japan
| | - Masaya Hayakawa
- Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Takaaki Hosoki
- Department of Hematology and Oncology, Asahikawa Kosei Hospital, Asahikawa, Japan
| | - Kazuhiko Ikeda
- Department of Hematology, Fukushima Medical School, Fukushima, Japan
| | - Tsutomu Kobayashi
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Tetsuo Nishimoto
- Department of Hematology, Ashiya Municipal Hospital, Ashiya, Japan
| | - Naoki Takezako
- Division of Hematology, National Hospital Organization Disaster Medical Center, Tachikawa, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akifumi Takaori-Kondo
- Department of Hematology and Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Osaka City University Hospital, Osaka, Japan
| | - Atsushi Kawaguchi
- Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hiroshi Ureshino
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Junichi Sakamoto
- Epidemiological and Clinical Research Information Network, Okazaki, Japan
| | - Yoji Ishida
- Department of Hematology and Oncology, Iwate Medical University, Morioka, Japan
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Masaki S, Nakano H, Kisaki M, Haba Y, Nagaoka K, Ikeda K, Fujiwara Y, Osakabe M, Tsumori K. Spatial distribution of negative ion density near the plasma grid. Rev Sci Instrum 2020; 91:013512. [PMID: 32012531 DOI: 10.1063/1.5129705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/28/2019] [Indexed: 06/10/2023]
Abstract
Density distributions of negative hydrogen (H-) ions and negative deuterium (D-) ions were measured with the laser photodetachment method in the extraction region of the negative ion source. The distribution of H- ion density peaks at the center of the ion source, while that of the D- ion shows a flatter profile in the direction parallel to the plasma grid. The positive ion densities of hydrogen and deuterium estimated from the positive saturation current indicate similar profiles with different amounts close to the grid. The difference in the H- ion and D- ion distributions can be explained by the difference in the negative ion yield and the survival probability of the ions due to the isotope effect.
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Affiliation(s)
- S Masaki
- Department of Fusion Science, The Graduate University for Advanced Studies, SOKENDAI, Toki, Gifu 509-5292, Japan
| | - H Nakano
- Department of Fusion Science, The Graduate University for Advanced Studies, SOKENDAI, Toki, Gifu 509-5292, Japan
| | - M Kisaki
- Department of Fusion Science, The Graduate University for Advanced Studies, SOKENDAI, Toki, Gifu 509-5292, Japan
| | - Y Haba
- Graduate School of Science, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - K Nagaoka
- National Institute for Fusion Science, National Institutes of Natural Science, Toki, Gifu 509-5292, Japan
| | - K Ikeda
- National Institute for Fusion Science, National Institutes of Natural Science, Toki, Gifu 509-5292, Japan
| | - Y Fujiwara
- National Institute for Fusion Science, National Institutes of Natural Science, Toki, Gifu 509-5292, Japan
| | - M Osakabe
- Department of Fusion Science, The Graduate University for Advanced Studies, SOKENDAI, Toki, Gifu 509-5292, Japan
| | - K Tsumori
- Department of Fusion Science, The Graduate University for Advanced Studies, SOKENDAI, Toki, Gifu 509-5292, Japan
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48
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Ikeda K, Yagi T, Chiba S. Screening of pediatric OSA using video monitoring. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.458] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Inoshita A, Kasai T, Matsuoka R, Sata N, Shiroshita N, Kawana F, Kato M, Ikeda K. Age-stratified sex differences in polysomnographic findings and pharyngeal morphology among children with obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.463] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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Kitaguchi D, Nishizawa Y, Sasaki T, Tsukada Y, Ikeda K, Ito M. Recurrence of rectal anastomotic leakage following stoma closure: assessment of risk factors. Colorectal Dis 2019; 21:1304-1311. [PMID: 31199545 DOI: 10.1111/codi.14728] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/12/2019] [Indexed: 02/08/2023]
Abstract
AIM In patients with a previous history of rectal anastomotic leakage (AL), the surgical indications and timing for closure of a diverting stoma have to be carefully judged. Even if AL has apparently healed before stoma closure, re-leakage may occur after closure. The aim of this study was to determine the incidence and risk factors for recurrent AL following stoma closure. We also examined the treatment strategies aiming to minimize the risk of recurrent AL. METHODS From January 2009 to December 2016, 1008 patients underwent sphincter-saving surgery [low anterior resection, all-sphincter-preserving rectal resection with hand-sewn coloanal anastomosis (CAA) and intersphincteric resection (ISR)] for primary rectal cancer with curative intent at our hospital. A total of 69 patients with AL with a Clavien-Dindo Grade III or more who subsequently underwent closure of a diverting stoma were retrospectively reviewed for this study. RESULTS The incidence of recurrent leakage after stoma closure in this series was 13% overall with an incidence of 25% in the CAA/ISR group and 5% in the low anterior resection group. Significant risk factors included hand-sewn anastomosis (P = 0.0257) compared to stapled anastomosis, ischaemia at the anastomotic site as the cause of initial AL (P < 0.001) and a shorter interval between confirmation of healing and stoma closure (P = 0.00952). CONCLUSION Ischaemia at the anastomotic site was the main risk factor for recurrent leakage, particularly after CAA/ISR. Additional treatment options before stoma closure should be considered to avoid re-leakage in such cases.
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Affiliation(s)
- D Kitaguchi
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Y Nishizawa
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan
| | - T Sasaki
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan
| | - Y Tsukada
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan
| | - K Ikeda
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan
| | - M Ito
- Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan
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