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Kanemitsu Y, Matsumoto H, Oguma T, Nagasaki T, Ito I, Izuhara Y, Tajiri T, Iwata T, Mishima M, Niimi A. Independent Factors Contributing to Daytime and Nighttime Asthmatic Cough Refractory to Inhaled Corticosteroids. J Investig Allergol Clin Immunol 2018; 29:30-39. [PMID: 29956665 DOI: 10.18176/jiaci.0281] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Cough is a common feature of asthma, which is often resistant to inhaled corticosteroids (ICSs). The pathophysiology of this refractoriness may differ between daytime and nighttime asthmatic cough. We sought to identify factors contributing to ICS-refractory daytime and nighttime asthmatic cough. METHODS Sixty-seven patients with asthma presenting solely or predominantly with chronic cough were prospectively enrolled from April 2012 to December 2014. At baseline and 12 weeks after ICS treatment, the capsaicin cough threshold (C2, C5) and methacholine airway sensitivity and reactivity were examined. A visual analog scale (VAS) and numeric scores were used to evaluate daytime and nighttime cough symptoms separately. The Japanese version of the Leicester Cough Questionnaire was also completed. When either the VAS or numeric scores showed an improvement of ≥50% or ≥2 points, patients were considered responders to ICS treatment. RESULTS Fifty-five patients were eligible for evaluation. Subjective cough indices improved significantly at 12 weeks after ICS treatment (P<.001). Multivariate analysis revealed that lower C2 significantly contributed to residual daytime cough (P=.04). Meanwhile, methacholine hyperreactivity and lower IgE levels were predictors of the nighttime residual cough (P=.002 and P=.03, respectively). CONCLUSIONS Heightened cough reflex sensitivity is an independent factor of daytime asthmatic cough that is refractory to ICSs. In contrast, airway hyperreactivity and less atopic status contribute to ICS-refractory nighttime cough.
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Affiliation(s)
- Y Kanemitsu
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Respiratory Medicine, Allergy and Clinical Immunology, Graduate School of Medical Sciences, Nagoya City University, Aichi, Japan
| | - H Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Oguma
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Nagasaki
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - I Ito
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Izuhara
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Tajiri
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Iwata
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - M Mishima
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - A Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Graduate School of Medical Sciences, Nagoya City University, Aichi, Japan
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Sunadome H, Matsumoto H, Petrova G, Kanemitsu Y, Tohda Y, Horiguchi T, Kita H, Kuwabara K, Tomii K, Otsuka K, Fujimura M, Ohkura N, Tomita K, Yokoyama A, Ohnishi H, Nakano Y, Oguma T, Hozawa S, Nagasaki T, Ito I, Oguma T, Inoue H, Tajiri T, Iwata T, Izuhara Y, Ono J, Ohta S, Hirota T, Tamari M, Yokoyama T, Niimi A, Izuhara K, Mishima M. Cover Image. Clin Exp Allergy 2017. [DOI: 10.1111/cea.12985] [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]
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3
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Sunadome H, Matsumoto H, Petrova G, Kanemitsu Y, Tohda Y, Horiguchi T, Kita H, Kuwabara K, Tomii K, Otsuka K, Fujimura M, Ohkura N, Tomita K, Yokoyama A, Ohnishi H, Nakano Y, Oguma T, Hozawa S, Nagasaki T, Ito I, Oguma T, Inoue H, Tajiri T, Iwata T, Izuhara Y, Ono J, Ohta S, Hirota T, Tamari M, Yokoyama T, Niimi A, Izuhara K, Mishima M. IL4Rα and ADAM33 as genetic markers in asthma exacerbations and type-2 inflammatory endotype. Clin Exp Allergy 2017; 47:998-1006. [PMID: 28326636 DOI: 10.1111/cea.12927] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 03/02/2017] [Accepted: 03/08/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Genetic markers of susceptibility to asthma exacerbations in adults remain unclear. OBJECTIVE To identify genetic markers of asthma exacerbations, particularly in patients with type-2 inflammatory endotype. METHODS In this observational study of patients enrolled in the Kinki Hokuriku Airway disease Conference multicenter study, frequency of exacerbations requiring systemic corticosteroids during 2 years after enrolment and associated risk factors was determined. For genetic marker analysis, interleukin-4 receptor α (IL4RA) rs8832 and a disintegrin and metalloprotease 33 (ADAM33) S_2 (rs528557), T_1 (rs2280091), T_2 (rs2280090), and V_4 (rs2787094) variants were included. Elevated serum periostin levels at enrolment (≥95 ng/mL, defined as type-2 inflammatory endotype) were considered in the analysis. RESULTS Among 217 patients who were successfully followed up for 2 years after enrolment, 60 patients showed at least one asthma exacerbation during the 2 years. Airflow limitation (%FEV1 <80%) and recent exacerbations but not genetic variants were identified as risk markers of exacerbations. A total of 27 patients showed type-2 inflammatory endotype (serum periostin ≥95 ng/mL at enrolment) and subsequent exacerbations; risk factors in these patients were airflow limitation (odds ratio, 6.51; 95% confidence interval (CI): 2.37-18.6; P=.0003), GG genotype of IL4RA rs8832 (odds ratio, 4.01; 95% CI: 1.47-11.0; P=.007), and A allele of ADAM33 T_2 (odds ratio, 2.81; 95% CI: 1.05-7.67; P=.04) by multivariate analysis. In addition, GG genotype of IL4RA rs8832 was associated with type-2 endotype, whereas A allele of ADAM33 T_2 was associated with mixed type of eosinophilic/type-2 and neutrophilic inflammations. CONCLUSIONS AND CLINICAL RELEVANCE IL4RA and ADAM33 variants may be risk markers of asthma exacerbations in type-2 inflammatory endotype. Precise endotyping may facilitate the identification of genetic risk markers of asthma exacerbations.
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Affiliation(s)
- H Sunadome
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan
| | - H Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan
| | - G Petrova
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Kanemitsu
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan
| | - Y Tohda
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Respiratory Medicine and Allergology, Faculty of Medicine, Kinki University, Sayama, Japan
| | - T Horiguchi
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Respiratory Internal Medicine, Fujita Health University Second Educational Hospital, Nagoya, Japan
| | - H Kita
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Respiratory Medicine, Takatsuki Red Cross Hospital, Takatsuki, Japan
| | - K Kuwabara
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Respiratory Internal Medicine, Fujita Health University Second Educational Hospital, Nagoya, Japan
| | - K Tomii
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Otsuka
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - M Fujimura
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - N Ohkura
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - K Tomita
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Respiratory Medicine and Allergology, Faculty of Medicine, Kinki University, Sayama, Japan
| | - A Yokoyama
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Hematology and Respiratory Medicine, Kochi University, Kochi, Japan
| | - H Ohnishi
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Department of Hematology and Respiratory Medicine, Kochi University, Kochi, Japan
| | - Y Nakano
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan
| | - T Oguma
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan
| | - S Hozawa
- Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Hiroshima Allergy and Respiratory Clinic, Hiroshima, Japan
| | - T Nagasaki
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - I Ito
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Oguma
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - H Inoue
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Tajiri
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Iwata
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Izuhara
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - J Ono
- Shino-Test Corporation, Sagamihara, Japan
| | - S Ohta
- Department of Laboratory Medicine, Saga Medical School, Saga, Japan
| | - T Hirota
- Laboratory for Respiratory and Allergic Diseases, Core for Genomic Medicine, Center for Integrative Medical Sciences, Institute of Physical and Chemical Research (RIKEN), Yokohama, Japan
| | - M Tamari
- Laboratory for Respiratory and Allergic Diseases, Core for Genomic Medicine, Center for Integrative Medical Sciences, Institute of Physical and Chemical Research (RIKEN), Yokohama, Japan
| | - T Yokoyama
- Department of Health Promotion, National Institute of Public Health, Wako, Japan
| | - A Niimi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan.,Division of Respiratory Medicine, Department of Medical Oncology and Immunology, Nagoya City University School of Medical Sciences, Nagoya, Japan
| | - K Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - M Mishima
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Kinki Hokuriku Airway disease Conference (KiHAC), Sayama, Japan
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Mishima M. Preparation of centralspindlin as an active heterotetramer of kinesin and GTPase activating protein subunits for in vitro structural and functional assays. Methods Cell Biol 2017; 137:371-385. [DOI: 10.1016/bs.mcb.2016.04.005] [Citation(s) in RCA: 2] [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: 02/03/2023]
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Ajimizu H, Ozasa H, Sato S, Sakamori Y, Funazo T, Yasuda Y, Nomizo T, Tsuji T, Yoshida H, Yagi Y, Nagai H, Sato A, Tsuchiya M, Muro S, Nagasaka Y, Mishima M, Kim Y. Survival impact of treatment for chronic obstructive pulmonary disease in patients with advanced non-small cell lung cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw384.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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6
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Tajiri T, Matsumoto H, Gon Y, Ito R, Hashimoto S, Izuhara K, Suzukawa M, Ohta K, Ono J, Ohta S, Ito I, Oguma T, Inoue H, Iwata T, Kanemitsu Y, Nagasaki T, Niimi A, Mishima M. Utility of serum periostin and free IgE levels in evaluating responsiveness to omalizumab in patients with severe asthma. Allergy 2016; 71:1472-9. [PMID: 27113353 DOI: 10.1111/all.12922] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND Omalizumab, a humanized anti-IgE monoclonal antibody, has demonstrated efficacy in patients with severe allergic asthma. However, treatment responses vary widely among individuals. Despite a lack of data, free serum IgE levels following omalizumab treatment have been proposed as a marker of treatment responsiveness. METHODS In this prospective, observational study, we assessed the utility of biomarkers of type 2 inflammation in predicting omalizumab treatment responses, as determined by the absence of asthma exacerbation during the first year of treatment. Free serum IgE levels were monitored for 2 years to examine their association with baseline biomarker levels and the number of exacerbations. RESULTS We enrolled thirty patients who had been treated with omalizumab for at least 1 year, of whom 27 were treated for 2 years. Baseline serum periostin levels and blood eosinophil counts were significantly higher in patients without exacerbations during the first year of treatment than in patients with exacerbations. Baseline serum periostin levels, but not eosinophil counts, were negatively associated with free serum IgE levels after 16 or 32 weeks of treatment. Reduced free serum IgE levels during treatment from those at baseline were associated with reduced exacerbation numbers at 2 years. In 14 patients who continued to have exacerbations during the first year of treatment, exacerbation numbers gradually and significantly decreased over the 2-year study period, with concurrent significant reductions in free serum IgE levels. CONCLUSION Baseline serum periostin levels and serum free IgE levels during treatment follow-up may be useful in evaluating responses to omalizumab treatment.
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Affiliation(s)
- T. Tajiri
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
| | - H. Matsumoto
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
| | - Y. Gon
- Division of Respiratory Medicine Department of Internal Medicine Nihon University School of Medicine Tokyo Japan
| | - R. Ito
- Division of Respiratory Medicine Department of Internal Medicine Nihon University School of Medicine Tokyo Japan
| | - S. Hashimoto
- Division of Respiratory Medicine Department of Internal Medicine Nihon University School of Medicine Tokyo Japan
| | - K. Izuhara
- Division of Medical Biochemistry Department of Biomolecular Sciences Saga Medical School Saga Japan
| | - M. Suzukawa
- Respiratory Center National Hospital Organization Tokyo National Hospital Tokyo Japan
| | - K. Ohta
- Respiratory Center National Hospital Organization Tokyo National Hospital Tokyo Japan
| | - J. Ono
- Shino‐Test Corporation Kanagawa Japan
| | - S. Ohta
- Department of Laboratory Medicine Saga Medical School Saga Japan
| | - I. Ito
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
| | - T. Oguma
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
| | - H. Inoue
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
| | - T. Iwata
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
| | - Y. Kanemitsu
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
| | - T. Nagasaki
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
| | - A. Niimi
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
- Division of Respiratory Medicine Department of Medical Oncology and Immunology Nagoya City University School of Medical Sciences Aichi Japan
| | - M. Mishima
- Department of Respiratory Medicine Graduate School of Medicine Kyoto University Kyoto Japan
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7
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Izuhara Y, Matsumoto H, Nagasaki T, Kanemitsu Y, Murase K, Ito I, Oguma T, Muro S, Asai K, Tabara Y, Takahashi K, Bessho K, Sekine A, Kosugi S, Yamada R, Nakayama T, Matsuda F, Niimi A, Chin K, Mishima M. Mouth breathing, another risk factor for asthma: the Nagahama Study. Allergy 2016; 71:1031-6. [PMID: 26991116 DOI: 10.1111/all.12885] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Allergic rhinitis, a known risk factor for asthma onset, often accompanies mouth breathing. Mouth breathing may bypass the protective function of the nose and is anecdotally considered to increase asthma morbidity. However, there is no epidemiological evidence that mouth breathing is independently associated with asthma morbidity and sensitization to allergens. In this study, we aimed to clarify the association between mouth breathing and asthma morbidity and allergic/eosinophilic inflammation, while considering the effect of allergic rhinitis. METHODS This community-based cohort study, the Nagahama Study, contained a self-reporting questionnaire on mouth breathing and medical history, blood tests, and pulmonary function testing. We enrolled 9804 general citizens of Nagahama City in the Shiga Prefecture, Japan. RESULTS Mouth breathing was reported by 17% of the population and was independently associated with asthma morbidity. The odds ratio for asthma morbidity was 1.85 (95% CI, 1.27-2.62) and 2.20 (95% CI, 1.72-2.80) in subjects with mouth breathing alone and allergic rhinitis alone, which additively increased to 4.09 (95% CI, 3.01-5.52) when mouth breathing and allergic rhinitis coexisted. Mouth breathing in nonasthmatics was a risk for house dust mite sensitization, higher blood eosinophil counts, and lower pulmonary function after adjusting for allergic rhinitis. CONCLUSION Mouth breathing may increase asthma morbidity, potentially through increased sensitization to inhaled allergens, which highlights the risk of mouth-bypass breathing in the 'one airway, one disease' concept. The risk of mouth breathing should be well recognized in subjects with allergic rhinitis and in the general population.
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Affiliation(s)
- Y. Izuhara
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - H. Matsumoto
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - T. Nagasaki
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Y. Kanemitsu
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - K. Murase
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - I. Ito
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - T. Oguma
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - S. Muro
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - K. Asai
- Department of Oral and Maxillofacial Surgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Y. Tabara
- Center for Genomic Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - K. Takahashi
- Department of Oral and Maxillofacial Surgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - K. Bessho
- Department of Oral and Maxillofacial Surgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - A. Sekine
- Pharmacogenomics Project; Kyoto University Graduate School of Medicine; Kyoto Japan
- Center for Preventive Medical Science; Chiba University; Chiba Japan
| | - S. Kosugi
- Department of Medical Ethics and Medical Genetics; Kyoto University School of Public Health; Kyoto Japan
| | - R. Yamada
- Center for Genomic Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - T. Nakayama
- Department of Health Informatics; Kyoto University School of Public Health; Kyoto Japan
| | - F. Matsuda
- Center for Genomic Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - A. Niimi
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
- Department of Respiratory Medicine Allergy and Clinical Immunology; Nagoya City University School of Medical Sciences; Aichi Japan
| | - K. Chin
- Department of Respiratory Care and Sleep Control Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - M. Mishima
- Department of Respiratory Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
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8
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Mishima M, Hamada T, Maharani N, Ikeda N, Onohara T, Notsu T, Ninomiya H, Miyazaki S, Mizuta E, Sugihara S, Kato M, Ogino K, Kuwabara M, Hirota Y, Yoshida A, Otani N, Anzai N, Hisatome I. Effects of Uric Acid on the NO Production of HUVECs and its Restoration by Urate Lowering Agents. Drug Res (Stuttg) 2016; 66:270-4. [DOI: 10.1055/s-0035-1569405] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- M. Mishima
- Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Yonago, Japan
| | - T. Hamada
- Department of Regional Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - N. Maharani
- Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Yonago, Japan
| | - N. Ikeda
- Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Yonago, Japan
| | - T. Onohara
- Division of Organ Regeneration Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - T. Notsu
- Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Yonago, Japan
| | - H. Ninomiya
- Department of Biological Regulation, Tottori University Faculty of Medicine, Yonago, Japan
| | - S. Miyazaki
- Division of Cardiovascular Medicine, Fujii Masao Memorial Hospital, Kurayoshi, Japan
| | - E. Mizuta
- Department of Cardiovascular Medicine, Sanin Rosai Hospital, Yonago, Japan
| | - S. Sugihara
- Division of Cardiovascular Medicine Department of Molecular Medicine and Therapeutics, Tottori University Faculty of Medicine, Yonago, Japan
| | - M. Kato
- Division of Cardiovascular Medicine Department of Molecular Medicine and Therapeutics, Tottori University Faculty of Medicine, Yonago, Japan
| | - K. Ogino
- Department of Clinical Laboratory, Tottori University Hospital, Yonago, Japan
| | - M. Kuwabara
- Department of Cardiology, Toranomon Hospital, Tokyo, Japan
| | - Y. Hirota
- Department of Surgery, Tomimasu Surgical and Primary Care Clinic, Yonago, Japan
| | - A. Yoshida
- Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Yonago, Japan
| | - N. Otani
- Department of Pharmacology, Dokkyo Medical College, Tochigi, Japan
| | - N. Anzai
- Department of Pharmacology, Dokkyo Medical College, Tochigi, Japan
| | - I. Hisatome
- Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Yonago, Japan
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9
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Okabe M, Toh U, Iwakuma N, Mishima M, Kawahara A, Kage M, Itoh K, Akagi Y. Abstract P5-08-16: Local immunologic environment related with tumor infiltrating lymphocytes (TIL) and PD-1/PD-L1 expression in early stage breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-08-16] [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: 11/16/2022]
Abstract
Abstract
Purpose:
Recent studies have shown that local immune environment revealed with programmed death 1(PD-1)/programmed death ligand 1(PD-L1) and tumor infiltrating lymphocytes(TIL) affects the tumor-growth and prognosis. In this study, we evaluated the tumor local immune environments using immunohistological staining for analysis of PD-1/PD-L1 expression and TIL of tumor local in operable early-stage breast cancer.
Method:
A total of 100 surgical specimens of stageI-III invasive breast carcinoma paraffinembedded between 1995 and 2005 were analyzed. Immunohistological staining for PD-1, PD-L1, PTEN, CD3, CD8, and CD163 were performed by the conventional PAP method. In addition, intratumoral and intrastromal TILs and macrophages were simultaneously stained by anti-CD3, CD8, CD163 antibodies and measured by 'Win ROOF' computer software (version 5.7, Mitani Corporation, Japan).
Results:
Intratumoral PD-1 expressed significantly higher in triple negative breast cancer (TNBC) compared to other subtype BC (p=0.0094), intratumoral and intrastromal CD3+ lymphocytes and CD163+ macrophages were also significantly higher in TNBC, respectively (CD3: p=0.0002; 0.0139 and CD163: p=0.0043; 0.0270). PTEN loss was also more frequently observed in TNBC (p=0.0475). In addition, after a median 5-year follow-up, patients of luminal A subtype with lower PD-L1 and PTEN expression showed better disease free survival (DFS) with a significant difference (p=0.0148, p=0.0475).
Conclusion:
Local expression of PD-1/PD-L1 antigens on tumor cells, CD3+ lymphocytes, CD163+ macrophages infiltration singnificantly increased in early-stage TNBC. PTEN expression on tumor local might be associated with DFS in patients with early-stage BC.
Citation Format: Okabe M, Toh U, Iwakuma N, Mishima M, Kawahara A, Kage M, Itoh K, Akagi Y. Local immunologic environment related with tumor infiltrating lymphocytes (TIL) and PD-1/PD-L1 expression in early stage breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-08-16.
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Affiliation(s)
- M Okabe
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - U Toh
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - N Iwakuma
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - M Mishima
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - A Kawahara
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - M Kage
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - K Itoh
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - Y Akagi
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
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10
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Toh U, Okabe M, Iwakuma N, Mishima M, Shichijo S, Yamada A, Noguchi M, Itoh K, Akagi Y. Abstract P2-11-04: Serum IgG response against prostate-related antigen revealed by personalized peptide vaccination in patients with metastatic recurrent breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-11-04] [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: 11/16/2022]
Abstract
Abstract
Purpose: We have indicated that IgG and CTL boosting response could be a potential prognostic factor for overall survival (OS) and progression free survival (PFS) in metastatic recurrent breast cancer (mrBC) patients, who had received personalized selected peptide vaccine (PPV) therapy in our previously reported clinical phase II study. The aim of this study is to identify the prognostic role of serum value of IgG antibody against prostate related-antigen (PRA), including prostate-specific antigen (PSA), prostate specific membrane antigen (PSMA) and prostate acid phosphatase (PAP) in mrBC patients
Methods: Peripheral blood samples of 77 patients with mrBC were analyzed for serum anti-PRA IgG levels before and after 6th and 12th PPV therapy prospectively. Most of the peptides using for PPV are derived from cancer associated antigens expressing in various types of advanced cancers, but the peptides derived from PRAs were not used in this study.
Results: After PPV therapy, total serum levels of anti-PRA IgG were significantly increased in 31 mrBC patients (Group 1) whereas in remaining 46 rmBC patients (Group 2). Either serum anti-PSA, anti-PAP and/or anti-PMSA IgGs showed a significant increase in patients of Group 1 after 6th (p=0.045) and 12th PPV treatment (p < 0.001), irrespective of their intrinsic subtypes. The median PFS and median OS of Group 1 patients were 8.1 and 14.3 months, while those of Group 2 patients were 5.1 and 10.8 months, respectively. Anti-PRA IgG levels were significantly associated with PFS (p=0.0073; HR: 0.37) and OS (p=0.025; HR: 0.43) between these two groups, whereas no significant relation was found with age, clinical response rate and recurrent metastatic status.
Conclusions: The Group 1 patients with elevated anti-PRA IgG may have better prognosis compared to Group 2 patients who showed no IgG elevation after PPV treatment for rmBC. These results indicated a clinical significance between pre-and post- treatment measurement of serum anti-PRA IgGs in mrBC patients receiving PPV therapy, and may be a useful prognostic marker for monitoring the outcome to PPV treatment of breast cancer.
Citation Format: Toh U, Okabe M, Iwakuma N, Mishima M, Shichijo S, Yamada A, Noguchi M, Itoh K, Akagi Y. Serum IgG response against prostate-related antigen revealed by personalized peptide vaccination in patients with metastatic recurrent breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-11-04.
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Affiliation(s)
- U Toh
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - M Okabe
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - N Iwakuma
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - M Mishima
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - S Shichijo
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - A Yamada
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - M Noguchi
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - K Itoh
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
| | - Y Akagi
- Kurume University School of Medicine, Kurume, Fukuoka, Japan; Kurume University Cancer Vaccine Center, Kurume, Fukuoka, Japan
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Toh U, Iwakuma N, Mishima M, Furukawa M, Fujii T, Ogo E, Nakagawa S, Tanaka M, Akagi Y. P008 S-1 in combination with CPT-11 plus trastuzumab for pretreated HER2+ metastatic breast cancer. Breast 2015. [DOI: 10.1016/s0960-9776(15)70059-7] [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: 11/30/2022] Open
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12
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Toh U, Iwakuma N, Mishima M, Furukawa M, Akagi Y. P223 Image-guided sentinel lymph node detection using near-infrared fluorescence in breast cancer. Breast 2015. [DOI: 10.1016/s0960-9776(15)70255-9] [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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13
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Ikezoe K, Handa T, Tanizawa K, Kubo T, Ito I, Sokai A, Nakatsuka Y, Nagai S, Izumi T, Mishima M. A toll-like receptor 3 single nucleotide polymorphism in Japanese patients with sarcoidosis. ACTA ACUST UNITED AC 2015; 85:204-8. [DOI: 10.1111/tan.12535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 01/18/2015] [Accepted: 02/02/2015] [Indexed: 12/26/2022]
Affiliation(s)
- K. Ikezoe
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - T. Handa
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - K. Tanizawa
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - T. Kubo
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - I. Ito
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - A. Sokai
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Y. Nakatsuka
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - S. Nagai
- Kyoto Central Clinic; Clinical Research Center; Kyoto Japan
| | - T. Izumi
- Kyoto Central Clinic; Clinical Research Center; Kyoto Japan
| | - M. Mishima
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
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14
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Izuhara Y, Matsumoto H, Kanemitsu Y, Izuhara K, Tohda Y, Horiguchi T, Kita H, Kuwabara K, Tomii K, Otsuka K, Fujimura M, Ohkura N, Tomita K, Yokoyama A, Ohnishi H, Nakano Y, Oguma T, Hozawa S, Nagasaki T, Ito I, Oguma T, Inoue H, Tajiri T, Iwata T, Ono J, Ohta S, Tamari M, Hirota T, Yokoyama T, Niimi A, Mishima M. GLCCI1 variant accelerates pulmonary function decline in patients with asthma receiving inhaled corticosteroids. Allergy 2014; 69:668-73. [PMID: 24673601 DOI: 10.1111/all.12400] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND In steroid-naive patients with asthma, several gene variants are associated with a short-term response to inhaled corticosteroid (ICS) treatment; this has mostly been observed in Caucasians. However, not many studies have been conducted for other ethnicities. Here, we aimed to determine the relationship between the annual decline in forced expiratory flow volume in one second (FEV1 ) and the variant of the glucocorticoid-induced transcript 1 gene (GLCCI1) in Japanese patients with asthma receiving long-term ICS treatment, taking into account the effect of high serum periostin levels, a known association factor of pulmonary function decline and a marker of refractory eosinophilic/Th2 inflammation. METHODS In this study, 224 patients with asthma receiving ICS treatment for at least 4 years were enrolled. The effects of single-nucleotide polymorphisms (SNPs) in GLCCI1, stress-induced phosphoprotein 1 (STIP1), and T gene on the decline in FEV1 of 30 ml/year or greater were determined. RESULTS Besides the known contributing factors, that is, the most intensive treatment step, ex-smoking, and high serum periostin levels (≥95 ng/ml), the GG genotype of GLCCI1 rs37973, and not other SNPs, was independently associated with a decline in FEV1 of 30 ml/year or greater. When patients were stratified according to their serum periostin levels, the GG genotype of rs37973 was significantly associated with blood eosinophilia (≥250/μl) in the high serum periostin group. CONCLUSIONS A GLCCI1 variant is a risk factor of pulmonary function decline in Japanese patients with asthma receiving long-term ICS treatment. Thus, GLCCI1 may be associated with response to ICS across ethnicities.
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15
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Oga T, Chin K, Mishima M. Towards the next stage of novel biomarker discussion in COPD: Tekizai-Tekisho. Eur Respir J 2014; 43:322-4. [DOI: 10.1183/09031936.00146013] [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: 11/05/2022]
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16
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Nagasaki T, Matsumoto H, Nakaji H, Niimi A, Ito I, Oguma T, Muro S, Inoue H, Iwata T, Tajiri T, Kanemitsu Y, Mishima M. Smoking attenuates the age-related decrease in IgE levels and maintains eosinophilic inflammation. Clin Exp Allergy 2014; 43:608-15. [PMID: 23711122 DOI: 10.1111/cea.12073] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 11/08/2012] [Accepted: 11/27/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Epidemiological studies have shown that smoking increases the propensity for atopy and asthma. However, the effects of smoking on atopy and eosinophilic inflammation in asthmatics, including the elderly, remain unknown. OBJECTIVE To determine the effects of smoking on serum immunoglobulin E (IgE) levels and eosinophilic inflammation in asthmatics of all ages. METHODS The associations of serum IgE levels, blood eosinophil counts and fractional exhaled nitric oxide (FeNO) levels with smoking and age in steroid-naive asthmatics were cross-sectionally assessed (n = 307). Levels of sputum eosinophil and thymic stromal lymphopoietin (TSLP) that promotes Th2 inflammation were also analysed. Current smokers were excluded when analysing contributing factors of FeNO. RESULTS Levels of serum IgE, blood eosinophil and FeNO decreased with increasing age in never-smokers, whereas decrease in serum IgE levels with increasing age was not observed in current smokers. In addition, current smoking was associated with higher blood eosinophil counts. In atopic asthmatics, age-related declines in serum IgE levels were less steep in ex-smokers than in never-smokers, and atopic ex-smokers with asthma showed higher blood eosinophil counts and higher FeNO irrespective of age. Lastly, sputum TSLP levels were associated with sputum eosinophil proportions and pack-years. Current and ex-smokers had higher TSLP levels than never-smokers. CONCLUSIONS AND CLINICAL RELEVANCE In steroid-naive asthmatics, smoking may attenuate the age-related decrease in IgE levels and maintain eosinophilic inflammation, in which TSLP may be involved.
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Affiliation(s)
- T Nagasaki
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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17
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Toh U, Iwakuma N, Mishima M, Takenaka M, Takahashi R, Koura K, Fujii T, Nakagawa S, Ogo E, Tanaka M, Sasada T, Itoh K, Shirouzu K. Abstract P5-01-05: Personalized peptide vaccines in combination with conventional chemo- or endocrine therapy for metastatic breast cancer: A single-arm phase II study. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p5-01-05] [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: 11/16/2022]
Abstract
Abstract
Background: Immunotherapy using multiple personalized peptide vaccines (PPV) has been reported to be effective for boosting anticancer immunity in patients (pts) with advanced prostate cancer and glioblastoma. The PPVs binding HLA-A2, A24, A3 family and A26 molecules were selected from 31 candidate peptides derived from various tumor associated antigens. Currently, we performed a phase II trial to evaluate the benefit of the PPVs in combination with conventional chemo-or endocrine therapy for pretreated metastatic breast cancer (MBC). Methods: Seventy-one pretreated pts had histologically confirmed measurable MBC and their HLA A molecules matched each of HLA-A2, A24, A26 and A3 family. Pre-vaccination plasma was measured for their IgG levels reactive to each of 31 peptides followed by administration subcutaneously of the four peptides at maximum showing higher levels of IgG in order with schedule of every 1-2 week. The concurrent conventional chemotherapy or endocrine therapy was available for the combination of PPVs. The primary endpoint was anti-tumor immunologic effect and safety, and the secondary endpoints were clinical responses and survival. Levels of IgG reactive to each of the 31 peptides in the pre- and post-treatment plasma at every 6 times of vaccination were measured using LUMNEX system. The CTL responses were simultaneously evaluated using ELISPOT method. Clinical response was evaluated by RECIST criteria. Results: Between May 2009 and December 2012, a total of 71 pts (Luminal-Her2- cases: 39; Her2+cases: 18; Triple negative(TN) cases:14) were enrolled in this study. The median duration of follow-up was 20.7 months. Concurrent chemotherapies (capecitabine, gemcitabine, eribulin, vinorelbine etc.) and endocrine therapies (aromatase inhibitor, toremifen or fulvestrant) were administered to 36 and 24 pts, respectively. Trastuzumab, Laptinib or Bevacizumab was simultaneously used for 13 pts. After 6th vaccination, the IgG reaction and CTL response were identified in 53 of 71 (74.6%) pts and 33 of 63 (52.3%) pts. There were no significant differences between TN cases and the other cases of MBC with regard to immunological humoral and/or cellular responses. No vaccine-related severe adverse events were observed. Clinical response rate of assessable 61 pts was 14.8% (CR 3, PR 6, SD 24, PD 28). The median PFS and OS were 7.6 m and 20.7 m, respectively. In contrast, the PFS and OS of luminal type, Her2 type or TN type were 12, 4.6 or 8.3 m and 24, 15 or 12 m. Conclusions: The phase II PPVs study for MBC demonstrated the promising response and safety, and further studies are essential to identify the clinical benefits of this novel therapy. Clinical trial information: UMIN000001482.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-01-05.
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Affiliation(s)
- U Toh
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - N Iwakuma
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - M Mishima
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - M Takenaka
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - R Takahashi
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - K Koura
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - T Fujii
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - S Nakagawa
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - E Ogo
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - M Tanaka
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - T Sasada
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - K Itoh
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
| | - K Shirouzu
- Kurume University School of Medicine, Kurume, Japan; Social Insurance Kurume Daiichi Hospital, Kurume, Japan
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Chen F, Oga T, Sakai H, Matsumoto I, Yamada T, Sato M, Aoyama A, Bando T, Mishima M, Chin K, Date H. A prospective study analyzing one-year multidimensional outcomes in living lung transplant donors. Am J Transplant 2013; 13:3003-9. [PMID: 24102773 DOI: 10.1111/ajt.12476] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 08/16/2013] [Accepted: 08/16/2013] [Indexed: 01/25/2023]
Abstract
The success of living-donor lobar lung transplantation (LDLLT) largely depends on donor outcome; but to date, no authors have studied health-related quality of life (HRQOL) of donors. We prospectively evaluated multidimensional outcomes before and 1 year after donor lobectomies. Patient-reported HRQOL, dyspnea, psychological status and sleep quality, and physiological pulmonary function were determined. All donors were alive without any limitations in their activities of daily living after 1 year. Postoperative pulmonary function was better than the estimated preoperative values; but, with respect to HRQOL, four of the eight subscales of the Medical Outcomes Study 36-item short form (SF-36) deteriorated significantly after donation. In addition, dyspnea assessed by the modified Medical Research Council scale also worsened significantly. In contrast, postoperative anxiety assessed by the Hospital Anxiety and Depression Scale significantly improved from baseline. The donors whose recipients died reported lower SF-36 scores with worsening sleep quality measured by Pittsburgh Sleep Quality Index. Thus, although postoperative pulmonary functions in donors were preserved, their HRQOL and dyspnea deteriorated postoperatively. Moreover, HRQOL and sleep quality were impaired in recipients who experienced poor outcomes. To capture the comprehensive outcomes in LDLLT donors after donation, patient-reported outcomes should be analyzed separately from physiological outcomes.
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Affiliation(s)
- F Chen
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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19
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Sakamori Y, Kim Y, Yoshioka H, Hirabayashi M, Onaru K, Fukui M, Hirata T, Nagai H, Ozasa H, Mishima M. Circulating Tumor Cells as a Prognostic Marker in Metastatic Non-Small-Cell Lung Cancer Patients Receiving Chemotherapy. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Fujita K, Ito Y, Hirai T, Maekawa K, Imai S, Tatsumi S, Niimi A, Iinuma Y, Ichiyama S, Mishima M. Genetic relatedness of Mycobacterium avium-intracellulare complex isolates from patients with pulmonary MAC disease and their residential soils. Clin Microbiol Infect 2013; 19:537-41. [DOI: 10.1111/j.1469-0691.2012.03929.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Maekawa K, Ito Y, Oga T, Hirai T, Kubo T, Fujita K, Imai S, Niimi A, Chin K, Ichiyama S, Togashi K, Mishima M. High-resolution computed tomography and health-related quality of life in Mycobacterium avium complex disease. Int J Tuberc Lung Dis 2013; 17:829-35. [DOI: 10.5588/ijtld.12.0672] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K. Maekawa
- Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
| | - Y. Ito
- Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
| | - T. Oga
- Department of Respiratory Care and Sleep Control Medicine, Kyoto University, Kyoto, Japan
| | - T. Hirai
- Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
| | - T. Kubo
- Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University, Kyoto, Japan
| | - K. Fujita
- Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
| | - S. Imai
- Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
| | - A. Niimi
- Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - K. Chin
- Department of Respiratory Care and Sleep Control Medicine, Kyoto University, Kyoto, Japan
| | - S. Ichiyama
- Department of Clinical Laboratory Medicine, Kyoto University, Kyoto, Japan
| | - K. Togashi
- Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University, Kyoto, Japan
| | - M. Mishima
- Department of Respiratory Medicine, Kyoto University, Kyoto, Japan
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22
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Mizuta E, Utami SB, Ohtahara A, Endo S, Mishima M, Hasegawa A, Yamada K, Kato M, Yamamoto K, Ogino K, Ninomiya H, Miyazaki S, Hamada T, Taniguchi SI, Cheng J, Hisatome I. A vasodilating β1 blocker celiprolol inhibits muscular release of uric acid precursor in patients with essential hypertension. Horm Metab Res 2013; 45:69-73. [PMID: 22893261 DOI: 10.1055/s-0032-1321872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Although nonvasodilating β1 blockers increase the levels of uric acid in serum, it is not known whether vasodilating β1 blockers have a similar effect. In the present study, we evaluated the effect of celiprolol on the release of hypoxanthine, a uric acid precursor, from muscles after an exercise. We used the semi-ischemic forearm test to examine the release of lactate (ΔLAC), ammonia (ΔAmm), and hypoxanthine (ΔHX) before and 4, 10, and 60 min after an exercise in 18 hypertensive patients as well as 4 normotensive subjects. Before celiprolol treatment, all the levels of ΔHX and ΔAmm, and ΔLAC were increased by semi-ischemic exercise in hypertensive patients, and the increases were remarkably larger than those in normotensive subjects. Celiprolol decreased both systolic and diastolic pressure. It also decreased the levels of ΔHX and ΔAmm without changes in ΔLAC after an exercise. These findings also were confirmed by summation of each metabolite (ΣΔMetabolites). Celiprolol caused a marginal decrease of serum uric acid, but the difference was not statistically significant. On the other hand, nonvasodilating β1 blockers did not suppress the levels of ΔHX and ΔAmm, whereas they significantly increased ΔLAC after an exercise. Celiprolol improved energy metabolism in skeletal muscles. It suppressed HX production and consequently did not adversely affect serum uric acid levels.
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Affiliation(s)
- E Mizuta
- Division of Molecular Medicine and Therapeutics, Tottori University Faculty of Medicine, Yonago, Japan
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Kim Y, Hirabayashi M, Kosaka S, Nikaidoh J, Yamamoto Y, Shimada M, Toyazaki T, Nagai H, Mishima M. Phase II Study of Pemetrexed in Elderly (≥75) Non-Squamous Non-Small-Cell Lung Cancer: Kyoto Thoracic Oncology Research Group Trial 0901. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33819-9] [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] Open
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24
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Tanizawa K, Handa T, Nagai S, Ito I, Kubo T, Ito Y, Watanabe K, Aihara K, Mishima M, Izumi T. A CD40 single-nucleotide polymorphism affects the lymphocyte profiles in the bronchoalveolar lavage of Japanese patients with sarcoidosis. ACTA ACUST UNITED AC 2012; 78:442-5. [PMID: 22077624 DOI: 10.1111/j.1399-0039.2011.01783.x] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
CD40 plays a critical role in adaptive immunity, and alveolar macrophages in patients with sarcoidosis express higher levels of CD40. This study investigated the association of rs1883832, a functional single-nucleotide polymorphism in the CD40 gene with susceptibility to sarcoidosis and phenotypes of sarcoidosis. Genotyping of rs1883832 in 175 Japanese patients with sarcoidosis and 150 age- and sex-matched controls revealed no significant difference between the genotypes of the patient and control groups (CC/CT/TT, 32.8/52.0/14.7% in the patients; 37.3/48.0/14.7% in the controls, P = 0.66; allele C, 59.1% in the patients, 61.3% in the controls, P = 0.57). T-cell and CD4+ cell counts in the bronchoalveolar lavage fluid were significantly higher in the TT genotype group than in the CC and CT genotype group.
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Affiliation(s)
- K Tanizawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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25
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Ito Y, Hirai T, Maekawa K, Fujita K, Imai S, Tatsumi S, Handa T, Matsumoto H, Muro S, Niimi A, Mishima M. Predictors of 5-year mortality in pulmonary Mycobacterium avium-intracellulare complex disease. Int J Tuberc Lung Dis 2012; 16:408-14. [PMID: 22230733 DOI: 10.5588/ijtld.11.0148] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Kyoto, Japan. OBJECTIVE To determine predictors of 5-year mortality in pulmonary Mycobacterium avium-intracellulare complex (MAC) disease. DESIGN Retrospective study of 164 patients diagnosed with pulmonary MAC disease between 1999 and 2005 and followed for 5 years. RESULTS Overall 5-year mortality was 28.0%. Among 117 patients with microbiological outcomes, 54 were treated (treated MAC patients) and 24 were not treated and did not experience sputum culture conversion during follow-up (untreated chronic MAC patients); 39 patients were not treated and experienced sputum culture conversion. Five-year all-cause overall mortality among the 78 patients with definite MAC disease (including treated and untreated chronic MAC patients) was 25.6%. The mortality rate was 33.3% for untreated chronic MAC patients only vs. 22.2% for treated MAC patients (P = 0.30). After adjustment for clinical, microbiological and radiological confounders, independent factors for 5-year mortality were a high Charlson comorbidity index in cases with definite MAC disease (hazard ratio [HR] 1.76) and untreated chronic MAC (HR 3.08), and presence of cavitary lesions in cases with definite MAC disease (HR 1.82) and treated MAC patients (HR 3.91). CONCLUSION Patients with cavitary lesions require immediate treatment for sputum culture conversion and to improve their chances of survival.
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Affiliation(s)
- Y Ito
- Department of Respiratory Medicine, Kyoto University, Kyoto, Japan.
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Imai S, Ito Y, Hirai T, Imai H, Ito I, Maekawa K, Chin K, Ichiyama S, Uemoto S, Mishima M. Clinical features and risk factors of tuberculosis in living-donor liver transplant recipients. Transpl Infect Dis 2011; 14:9-16. [DOI: 10.1111/j.1399-3062.2011.00680.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 06/16/2011] [Accepted: 08/04/2011] [Indexed: 12/27/2022]
Affiliation(s)
- S. Imai
- Department of Respiratory Medicine; Kyoto University; Kyoto; Japan
| | - Y. Ito
- Department of Respiratory Medicine; Kyoto University; Kyoto; Japan
| | - T. Hirai
- Department of Respiratory Medicine; Kyoto University; Kyoto; Japan
| | - H. Imai
- Departments of Hepato-Biliary-Pancreatic and Transplant Surgery; Kyoto University; Kyoto; Japan
| | - I. Ito
- Department of Respiratory Medicine; Kyoto University; Kyoto; Japan
| | - K. Maekawa
- Department of Respiratory Medicine; Kyoto University; Kyoto; Japan
| | - K. Chin
- Departments of Respiratory Care and Sleep Control Medicine; Kyoto University; Kyoto; Japan
| | - S. Ichiyama
- Department of Clinical Laboratory Medicine; Kyoto University; Kyoto; Japan
| | - S. Uemoto
- Departments of Hepato-Biliary-Pancreatic and Transplant Surgery; Kyoto University; Kyoto; Japan
| | - M. Mishima
- Department of Respiratory Medicine; Kyoto University; Kyoto; Japan
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Kim Y, Sumiyoshi S, Hashimoto S, Masago K, Togashi Y, Sakamori Y, Okuda C, Mio T, Mishima M. 9143 POSTER Expressions of IGF-1R and IGFBP3 in Advanced Non-small Cell Lung Cancer (NSCLC). Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72455-8] [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: 10/17/2022]
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Imai S, Ito Y, Ishida T, Hirai T, Ito I, Yoshimura K, Maekawa K, Takakura S, Niimi A, Iinuma Y, Ichiyama S, Mishima M. Distribution and clonal relationship of cell surface virulence genes among Streptococcus pneumoniae isolates in Japan. Clin Microbiol Infect 2011; 17:1409-14. [DOI: 10.1111/j.1469-0691.2010.03446.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Murase K, Tomii K, Chin K, Niimi A, Ishihara K, Mishima M. Non-invasive ventilation in severe asthma attack, its possibilities and problems. Panminerva Med 2011; 53:87-96. [PMID: 21659974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Asthma attack is characterized by episodic attacks of cough, dyspnea and wheeze occurring due to bronchoconstriction, airway hyperresponsiveness and mucous hypersecretion. Although nationwide clinical guidelines have been published to establish the standard care of asthma, choices in the treatment of fatal asthma attacks remain of clinical significance. Especially, in a severe asthma attack, despite the application of conventional medical treatment, respiratory management is critical. Even though non-invasive ventilation (NIV) has been shown to be effective in a wide variety of clinical settings, reports of NIV in asthmatic patients are scarce. According to a few prospective clinical trials reporting promising results in favour of the use of NIV in a severe asthma attack, a trial of NIV prior to invasive mechanical ventilation seems acceptable and may benefit patients by decreasing the need for intubation and by supporting pharmaceutical treatments. Although selecting the appropriate patients for NIV use is a key factor in successful NIV application, how to distinguish such patients is quite controversial. Larger high quality clinical trails are urgently required to confirm the benefits of NIV to patients with severe asthma attack. In this article, we focus on the body of evidence supporting the use of NIV in asthma attacks and discuss its advantages as well its problems.
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Affiliation(s)
- K Murase
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Nagai H, Yasuda H, Kanai M, Nishimura T, Kitano T, Matsumoto S, Mori Y, Ishiguro H, Kakudo Y, Sato H, Yamaguchi T, Takashima S, Nakata K, Kobayashi M, Terada T, Sasaki T, Mio T, Mishima M, Yanagihara K, Fukushima M. A double-blind, randomized, multicenter study regarding the effects of solution for gemcitabine on frequency and degree of vascular pain in patients with cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Fukudo M, Ikemi Y, Togashi Y, Masago K, Kim YH, Mio T, Mishima M, Inui K, Katsura T. Population pharmacokinetics and pharmacogenomics of erlotinib: Effect of drug exposure on treatment outcomes in Japanese patients with non-small cell lung cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yamauchi Y, Kimura K, Agawa T, Tsukahara R, Mishima M, Yamakawa N, Goto H. Correlation between high-resolution optical coherence tomography (OCT) images and histopathology in an N-methyl-N-nitrosourea-induced retinal degeneration rat model. Br J Ophthalmol 2011; 95:1161-5. [DOI: 10.1136/bjo.2010.198317] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Togashi Y, Kim YH, Masago K, Sakamori Y, Okuda C, Mio T, Mishima M. Long-term Survival in a Patient with Small-cell Lung Cancer Undergoing Hemodialysis Who Received Multiple Courses of Chemotherapy. Jpn J Clin Oncol 2011; 41:582-5. [DOI: 10.1093/jjco/hyq244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Matsumoto H, Niimi A, Takemura M, Ueda T, Yamaguchi M, Matsuoka H, Jinnai M, Takeda T, Otsuka K, Oguma T, Handa T, Hirai T, Chin K, Mishima M. Long-term changes in airway-wall thickness on computed tomography in asthmatic patients. J Investig Allergol Clin Immunol 2011; 21:113-119. [PMID: 21462801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Effects of long-term treatment with inhaled corticosteroids (ICSs) on airway-wall thickness in patients with asthma remain unknown. OBJECTIVES To determine whether airway-wall thickness consistently decreases after long-term ICS treatment, and to analyze factors contributing to long-term airway-wall changes in asthmatics. METHODS A retrospective analysis of long-term changes in airway-wall thickness using computed tomography was performed in 14 patients with asthma. Wall area corrected by body surface area (WA/BSA) was examined at baseline, 12 weeks after the commencement of ICSs (second measurement), and at least 2 years (mean +/- SEM. 4.2 +/- 0.5) after the second measurement (third measurement). Mean +/- SEM changes in WA/BSA from the second to the third measurements were analyzed. RESULTS The mean change in WA/BSA was not significant between the second and the third measurements (-0.27 +/- 0.59 mm2/m2/y). Overall, the changes were significantly associated with disease duration but not with other clinical indices. When the 14 patients were divided into 2 groups using a cutoff value of 0.32 mm2/m2/y for the mean change in WA/BSA, for the 5 patients whose WA/BSA exceeded this cutoff, daily ICS doses were not reduced and both forced expiratory volume in the first second (FEV1) and forced vital capacity decreased significantly. For the remaining 9 patients, daily ICS doses were reduced and long-term FEV1 values did not change. CONCLUSIONS Despite long-term treatment with ICSs, airway-wall thickness did not consistently decrease. One possible mechanism underlying poor response to long-term treatment may be long-standing asthma.
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Affiliation(s)
- H Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Tanizawda K, Handa T, Naga S, Ito EY, Watanabe K, Aihara K, Izumi T, Mishima M. CD24 gene exon 2 dimorphism does not affect disease susceptibility in Japanese sarcoidosis patients. Sarcoidosis Vasc Diffuse Lung Dis 2010; 27:64-69. [PMID: 21086907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND CD24 proteins are expressed on several inflammatory cells, and play an important role for the T-cell activation. OBJECTIVES The aim of this study is to investigate the relationship of a CD24 gene polymorphism to disease susceptibility or clinical findings including bronchoalveolar lavage (BAL) cell profiles in Japanese sarcoidosis patients. METHODS A previously reported functional single nucleotide polymorphism (SNP) of CD24 gene exon 2 was examined in 186 Japanese sarcoidosis patients and 146 sex and age-matched healthy controls using restriction fragment length polymorphism method. The distribution of genotypes was compared between the two groups. The association between genotypes or alleles and clinical features or BAL cell profiles was also examined. RESULTS There were no significant differences in the distribution of genotypes or allele frequencies between sarcoidosis and controls. There were also no significant differences in clinical features or BAL cell profiles among patients with different genotypes of CD24. CONCLUSIONS There was no relationship between a CD24 exon 2 SNP and disease susceptibility or clinical findings in Japanese sarcoidosis patients.
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Affiliation(s)
- K Tanizawda
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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36
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Handa T, Nagai S, Ueda S, Chin K, Ito Y, Watanabe K, Tanizawa K, Tamaya M, Mishima M, Izumi T. Significance of plasma NT-proBNP levels as a biomarker in the assessment of cardiac involvement and pulmonary hypertension in patients with sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2010; 27:27-35. [PMID: 21086902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Cardiac involvement and pulmonary hypertension (PH) are life-threatening complications in sarcoidosis. OBJECTIVE This study aimed to investigate the utility of plasma NT-proBNP in the assessment of these conditions in sarcoidosis patients. STUDY DESIGN AND METHODS A prospective, observational study was performed on 150 consecutive Japanese sarcoidosis patients. Doppler echocardiography was performed in all subjects, and those who were successfully evaluated for PH status were included in the analysis. Cardiac sarcoidosis was diagnosed based on Japanese guidelines, and PH was defined as estimated systolic pulmonary artery pressure (sPAP) > or = 35 mmHg. The diagnostic accuracy of NT-proBNP according to the presence of cardiac sarcoidosis and PH was assessed based on receiver-operator characteristic (ROC) curves. RESULTS 130 subjects were successfully evaluated for PH status. Of these, 29 met the diagnostic criteria of cardiac sarcoidosis, and 21 were diagnosed with PH. Plasma NT-proBNP levels were significantly higher in patients with cardiac sarcoidosis (p < 0.0001). Stepwise regression analysis showed that presence of cardiac sarcoidosis, decreased ejection fraction and increased sPAP were all independently associated with higher plasma NT-proBNP levels. Plasma NT-proBNP showed good accuracy in identifying patients with cardiac sarcoidosis (area under the ROC curve; AURC = 0.913). However, even when patients with cardiac sarcoidosis were excluded, plasma NT-proBNP levels could not be used reliably to identify patients with PH (AURC = 0.681). CONCLUSION In patients with sarcoidosis, plasma NT-proBNP levels are a useful biomarker to identify cardiac involvement, but not to identify PH.
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Affiliation(s)
- T Handa
- Department of Rehabilitation Medicine, Kyoto University Hospital, Kyoto, Japan.
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Kim Y, Mio T, Masago K, Irisa K, Sakamori Y, Mishima M. Retrospective analysis of Japanese patients with relapse or refractory small-cell lung cancer (SCLC) treated with amrubicin hydrochloride. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e18088] [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: 11/20/2022] Open
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38
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Imai S, Ito Y, Ishida T, Hirai T, Ito I, Maekawa K, Takakura S, Iinuma Y, Ichiyama S, Mishima M. High prevalence of multidrug-resistant Pneumococcal molecular epidemiology network clones among Streptococcus pneumoniae isolates from adult patients with community-acquired pneumonia in Japan. Clin Microbiol Infect 2009; 15:1039-45. [DOI: 10.1111/j.1469-0691.2009.02935.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Fujita S, Masago K, Kaji R, Hata A, Nanjo S, Otsuka K, Mio T, Mishima M, Katakami N. 9028 Genetic polymorphisms of the endothelial nitric oxide synthase gene correlate with overall survival in advanced non-small-cell lung cancer treated with platinum-based doublet chemotherapy. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71741-0] [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: 11/28/2022] Open
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40
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Handa T, Nagai S, Kitaichi M, Chin K, Ito Y, Oga T, Takahashi K, Watanabe K, Mishima M, Izumi T. Long-term complications and prognosis of chronic beryllium disease. Sarcoidosis Vasc Diffuse Lung Dis 2009; 26:24-31. [PMID: 19960785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Chronic beryllium disease (CBD) is a rare disease, and there are no previous reports that have followed CBD patients over several decades. Thus, the long-term complications and prognosis of this illness still remain unclear. OBJECTIVE The aim of this study was to investigate long-term complications and prognosis of CBD patients. STUDY DESIGN AND METHODS This was a retrospective study based on the medical records of all CBD patients diagnosed at Kyoto University Hospital between the period 1973 to the present day. Ultimately, ten patients whose diagnoses had been made during the period 1973 to 1977 were included. Long-term physiological and radiological change, complications and prognosis of these patients were investigated. RESULTS Three patients completely remitted, and one died of cor-pulmonale. Among the remaining six patients, four have been followed up for more than thirty years in our institute. The majority developed mixed patterns of lung function impairment, cavity lesions of the lung, pneumothorax, and respiratory infections. CONCLUSIONS Long-term prognosis of CBD was poor with several complications due to chronic parenchymal and airway lesions.
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Affiliation(s)
- T Handa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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41
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Terada K, Muro S, Sato S, Ohara T, Haruna A, Marumo S, Kinose D, Ogawa E, Hoshino Y, Niimi A, Terada T, Mishima M. Impact of gastro-oesophageal reflux disease symptoms on COPD exacerbation. Thorax 2008; 63:951-5. [DOI: 10.1136/thx.2007.092858] [Citation(s) in RCA: 141] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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42
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Ogawa E, Nakano Y, Ohara T, Muro S, Hirai T, Sato S, Sakai H, Tsukino M, Kinose D, Nishioka M, Niimi A, Chin K, Paré PD, Mishima M. Body mass index in male patients with COPD: correlation with low attenuation areas on CT. Thorax 2008; 64:20-5. [PMID: 18852156 DOI: 10.1136/thx.2008.097543] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is characterised by the presence of airflow limitation caused by loss of lung elasticity and/or airway narrowing. The pathological hallmark of loss of lung elasticity is emphysema, and airway wall remodelling contributes to the airway narrowing. Using CT, these lesions can be assessed by measuring low attenuation areas (LAA) and airway wall thickness/luminal area, respectively. As previously reported, COPD can be divided into airway dominant, emphysema dominant and mixed phenotypes using CT. In this study, it is postulated that a patient's physique may be associated with the relative contribution of these lesions to airflow obstruction. METHODS CT was used to evaluate emphysema and airway dimensions in 201 patients with COPD. Emphysema was evaluated using percentage of LAA voxels (LAA%) and airway lesion was estimated by percentage wall area (WA%). Patients were divided into four phenotypes using LAA% and WA%. RESULTS Body mass index (BMI) was significantly lower in the higher LAA% phenotype (ie, emphysema dominant and mixed phenotypes). BMI correlated with LAA% (rho = -0.557, p<0.0001) but not with WA%. BMI was significantly lower in the emphysema dominant phenotype than in the airway dominant phenotype, while there was no difference in forced expiratory volume in 1 s %predicted between the two. CONCLUSION A low BMI is associated with the presence of emphysema, but not with airway wall thickening, in male smokers who have COPD. These results support the concept of different COPD phenotypes and suggest that there may be different systemic manifestations of these phenotypes.
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Affiliation(s)
- E Ogawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan.
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Toh U, Fujii T, Seki N, Nakagawa S, Mishima M, Fukunaga M, Ogo E, Yahara T, Yamana H, Shirouzu K. Strategy to augment the efficacy of immunotherapy for refractory breast cancer using trastuzumab combined adoptive cell therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.3062] [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: 11/20/2022] Open
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44
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Yamaguchi M, Niimi A, Matsumoto H, Ueda T, Takemura M, Matsuoka H, Jinnai M, Otsuka K, Oguma T, Takeda T, Ito I, Chin K, Mishima M. Sputum levels of transforming growth factor-beta1 in asthma: relation to clinical and computed tomography findings. J Investig Allergol Clin Immunol 2008; 18:202-206. [PMID: 18564632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Transforming growth factor (TGF) beta1 is considered to play central roles in the pathogenesis of airway remodeling in asthma. This notion is based primarily on the results of experimental studies; clinical evidence is limited. OBJECTIVES To ascertain the involvement of TGF-beta1 in asthma. METHODS We studied 27 patients with moderate-to-severe, but stable, asthma treated with inhaled corticosteroids and 8 healthy controls. Helical computed tomography scans were acquired at full inspiration. Airway wall thickness (WT) was assessed on the basis of wall area corrected for body surface area (WA/BSA) and absolute WT corrected for BSA (WT/square root of BSA) according to a validated method. Induced sputum concentrations of TGF-beta1 were measured by enzyme-linked immunosorbent assay. Pulmonary function was evaluated. RESULTS Indices of expiratory airflow were significantly lower in the asthmatic patients than in the controls. WA/BSA, WT/square root of square root of BSA, and sputum concentrations of TGF-beta1 were significantly higher in the asthmatic patients. Sputum TGF-beta1 concentrations correlated positively with WA/BSA and WT/square root of BSA and negatively with forced expiratory volume in 1 second in both asthmatic and control subjects. CONCLUSIONS Levels of TGF-beta1 in induced sputum are elevated in asthmatic patients despite treatment with inhaled corticosteroids and are associated with airflow obstruction and airway wall thickening. TGF-beta1 is involved in the pathogenesis of airway remodeling and resultant functional impairment and it may be a target for specific medical treatment.
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Affiliation(s)
- M Yamaguchi
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Takemura M, Niimi A, Matsumoto H, Ueda T, Yamaguchi M, Matsuoka H, Jinnai M, Chin K, Mishima M. Atopic features of cough variant asthma and classic asthma with wheezing. Clin Exp Allergy 2007; 37:1833-9. [PMID: 17941915 DOI: 10.1111/j.1365-2222.2007.02848.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cough variant asthma is a phenotype of asthma solely presenting with coughing. It involves airway inflammation and remodelling as does classic asthma with wheezing, and a subset of patients may progress to classic asthma. The atopic features of cough variant asthma remain unclear. OBJECTIVE To compare atopic features between patients with cough variant asthma and those with classic asthma, and to examine the possible correlation of these features with the future development of wheezing in the former group. METHODS Total and specific IgE levels of seven common aeroallergens [house dust mite (HDM), Gramineae/Japanese cedar/weed pollens, moulds, cat/dog dander] were examined in 74 cough variant asthma patients and in 115 classic asthma patients of varying severity. Forty of the former patients were prospectively observed for 2 years to determine whether cough variant asthma progressed to classic asthma despite inhaled corticosteroid treatment. RESULTS Patients with classic asthma had higher total IgE (P<0.0001), larger numbers of sensitized allergens (P=0.03), and higher rates of sensitization to dog dander (24% vs. 3%, P<0.0001), HDM (46% vs. 28%, P=0.02), and moulds (17% vs. 7%, P=0.047) than did patients with cough variant asthma. Wheezing developed in six (15%) patients with cough variant asthma, who were sensitized to larger numbers of allergens (P=0.02) and had higher rates of sensitization to HDM (P=0.01) and dog dander (P=0.02) than the 34 patients in whom wheezing did not develop. Among the patients with classic asthma, total and specific IgE variables were similar in the subgroup with mild disease (n=60) and the subgroup with moderate-to-severe disease (n=55), as reported previously. CONCLUSIONS Atopy may be related to the development of wheezing in patients with cough variant asthma. To prevent the progression of cough variant asthma to classic asthma, avoidance of relevant allergens may be essential.
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Affiliation(s)
- M Takemura
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Ito Y, Osawa M, Isozumi R, Imai S, Ito I, Hirai T, Ishida T, Ichiyama S, Mishima M. Pneumococcal surface protein A family types of Streptococcus pneumoniae from community-acquired pneumonia patients in Japan. Eur J Clin Microbiol Infect Dis 2007; 26:739-42. [PMID: 17665229 DOI: 10.1007/s10096-007-0364-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We assessed pneumococcal surface protein A (PspA) family types of 141 isolates of Streptococcus pneumoniae from community-acquired pneumonia patients in Japan. Families 1 and 2 were expressed in 78 (55.3%) and 58 (41.1%) isolates, respectively. Five isolates were not typed either as family 1 or 2. PspA family types were not associated with age, sex, or pneumonia severity. Penicillin-resistant S. pneumoniae was more likely to belong to family 2 whereas organisms highly resistant to erythromycin and positive for ermB were more prevalent in family 1. The association of PspA type with antimicrobial resistance was possibly affected by prevalent serotypes or resistance clones. It would therefore be necessary to include both family 1 and 2 proteins in a PspA-containing vaccine to cover the major PspA families and to reduce antimicrobial resistance.
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Affiliation(s)
- Y Ito
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54, Kawahara, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
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Sumi K, Chin K, Takahashi K, Nakamura T, Matsumoto H, Niimi A, Mishima M. Effect of nCPAP therapy on heart rate in patients with obstructive sleep apnoea-hypopnoea. QJM 2006; 99:545-53. [PMID: 16861714 DOI: 10.1093/qjmed/hcl074] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Elevated heart rate (HR) is a risk factor for cardiovascular disease. The effects of obstructive sleep apnoea-hypopnoea syndrome (OSAHS) on HR are controversial. AIM To investigate the effect of nasal continuous positive airway pressure (nCPAP) therapy on HR in OSAHS patients. METHODS Sixty-two OSAHS patients underwent 24-h electrocardiographic recording, both before and 3 or 4 days after instigation of nCPAP. RESULTS After nCPAP was started, HR significantly decreased (mean +/- SD 71.8 +/- 10.6 vs. 67.5 +/- 9.4 bpm, p < 0.0001), both in the daytime (0600-2200 h, 76.3 +/- 12.2 vs. 72.2 +/- 10.2 bpm, p < 0.0001) and at night-time (2200-0600 h, 64.5 +/- 9.1 vs. 60.0 +/- 8.9 bpm, p < 0.0001). HR was significantly reduced in both periods in the 44 patients with hypertension and/or diabetes mellitus, but only during the night-time in the 18 with neither condition. Before nCPAP treatment, HR was positively correlated with percentage time of arterial O2 saturation <90% during sleep (p = 0.008) and with the apnoea-hypopnoea index during sleep (p = 0.003). In 15 patients undergoing HR for 2 days before starting nCPAP, the mean HRs for the two periods were similar (p = 0.95). DISCUSSION nCPAP therapy appears to decrease HR in OSAHS patients, and may thereby reduce their risk of cardiovascular disease.
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Affiliation(s)
- K Sumi
- Department of Respiratory Medicine, Kyoto University Hospital of Medicine, 54 Shogoin Kawahara-cho, Sakyo-Ku, 606-8507 Kyoto, Japan
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Ichikawa M, Mio T, Teramukai S, Nakagawa M, Nagata Y, Fujita S, Yanagihara K, Ishiguro H, Hiraoka M, Mishima M. Clinical outcomes of a multi-institutional retrospective study for 419 patients with locally advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17058] [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: 11/20/2022] Open
Abstract
17058 Background: Chemo-Radiotherapy (CRT) is considered the standard of care in locally advanced NSCLC. However, regimen of chemotherapy (CT), schedule of radiotherapy (RT), and application for surgical interventions (OP) are still controversial. We performed a study to establish clinical outcomes of NSCLC patients treated with CRT in Japan. Methods: A total of 373 consecutive patients (CRT: 307, OP after CRT (OP/CRT): 66) with stage III NSCLC, PS 0–2, no indications of OP at the initial evaluation, treated with CRT between January 1997 and December 2002 were analyzed. We also investigated 46 patients treated with RT alone as control. Results: We investigated a total of 419 patients (354 men and 65 women; average age: 64.5 ± 9.5 years) from nine institutes. Distributions of pathological subtypes were: squamous cell carcinoma: 225; adenocarcinoma: 154; large cell carcinoma: 14; non-small cell carcinoma: 26. In 189 stage IIIA patients, median survival time (MST) was 21.2 M, and MST of CRT, OP/CRT and RT were 19.1 M, 61.7 M, and 18.0 M, respectively. Multivariate analysis with Cox proportional hazards model indicates age, PS, existence of double cancer, existence of diabetes mellitus, stage IIIB, white blood cell counts increase, hemoglobin decrease as significant prognostic factors in CRT or OP/CRT patients. Multivariate analysis in stage IIIA patients indicated BMI decrease, double cancer, body weight loss, white blood cell increase, hemoglobin decrease as prognostic factors. There was a statistically significant difference between overall survival of CRT and OP/CRT in stage IIIA patients (p = 0.038 after adjustment for the effect of prognostic factors). However, there were no differences between CRT and RT, and among any schedules of CRT therapy. Conclusions: This clinical study suggests that OP after CRT could results in good survival compared with CRT alone, and BMI, double cancer, body weight loss, white blood cell, and hemoglobin could be prognostic factors in locally advanced NSCLC. No significant financial relationships to disclose.
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Affiliation(s)
| | - T. Mio
- Kyoto University, Kyoto, Japan
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Takemura M, Matsumoto H, Niimi A, Ueda T, Matsuoka H, Yamaguchi M, Jinnai M, Muro S, Hirai T, Ito Y, Nakamura T, Mio T, Chin K, Mishima M. High sensitivity C-reactive protein in asthma. Eur Respir J 2006; 27:908-12. [PMID: 16707391 DOI: 10.1183/09031936.06.00114405] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Asthma is characterised by chronic inflammation of the airways, but the relevance of high-sensitivity assays for C-reactive protein (hs-CRP), which are known to be a sensitive marker of low-grade systemic inflammation, has not been fully studied in asthma. The objective was to examine serum hs-CRP levels in patients with asthma and their relationship to clinical characteristics and degree of airway inflammation. Serum hs-CRP levels were cross-sectionally examined in steroid-naive (n = 22) and steroid-inhaling (n = 23) adult patients with asthma and healthy controls (n = 14). All were nonsmokers. Serum hs-CRP levels were significantly increased in steroid-naive patients (mean+/-sd 1.33+/-1.48 mg.L(-1)) compared with controls (0.21+/-0.30 mg.L(-1)), but not in patients on inhaled corticosteroid. Among steroid-naive patients, serum hs-CRP levels significantly negatively correlated with indices of pulmonary function (forced expiratory volume in one second/forced vital capacity and forced mid-expiratory flow) and positively with sputum eosinophil count. Among patients on inhaled corticosteroid, hs-CRP levels did not correlate with any indices. In conclusion, an increase in serum C-reactive protein levels measured by high-sensitivity assays may be associated with airflow obstruction and airway inflammation, and may serve as a surrogate marker of airway inflammation in asthma.
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Affiliation(s)
- M Takemura
- Dept of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan
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50
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Nakagawa M, Teramukai S, Tada H, Furuse K, Tanaka F, Mio T, Mishima M, Wada H, Fukushima M. Hypoalbuminemia as a risk factor of interstitial lung disease (ILD) during gefitinib treatment in patients with non-small cell lung cancer (NSCLC): A JMTO study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7190] [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: 11/20/2022] Open
Affiliation(s)
- M. Nakagawa
- Kyoto Univ Hosp, Kyoto, Japan; Translationnal Research Informatics Ctr, Kobe, Japan
| | - S. Teramukai
- Kyoto Univ Hosp, Kyoto, Japan; Translationnal Research Informatics Ctr, Kobe, Japan
| | - H. Tada
- Kyoto Univ Hosp, Kyoto, Japan; Translationnal Research Informatics Ctr, Kobe, Japan
| | - K. Furuse
- Kyoto Univ Hosp, Kyoto, Japan; Translationnal Research Informatics Ctr, Kobe, Japan
| | - F. Tanaka
- Kyoto Univ Hosp, Kyoto, Japan; Translationnal Research Informatics Ctr, Kobe, Japan
| | - T. Mio
- Kyoto Univ Hosp, Kyoto, Japan; Translationnal Research Informatics Ctr, Kobe, Japan
| | - M. Mishima
- Kyoto Univ Hosp, Kyoto, Japan; Translationnal Research Informatics Ctr, Kobe, Japan
| | - H. Wada
- Kyoto Univ Hosp, Kyoto, Japan; Translationnal Research Informatics Ctr, Kobe, Japan
| | - M. Fukushima
- Kyoto Univ Hosp, Kyoto, Japan; Translationnal Research Informatics Ctr, Kobe, Japan
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