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Ohsawa Y, Ohtsubo H, Munekane A, Ohkubo K, Murakami T, Fujino M, Nishimatsu SI, Hagiwara H, Nishimura H, Kaneko R, Suzuki T, Tatsumi R, Mizunoya W, Hinohara A, Fukunaga M, Sunada Y. Circulating α-Klotho Counteracts Transforming Growth Factor-β-Induced Sarcopenia. Am J Pathol 2023; 193:591-607. [PMID: 36773783 DOI: 10.1016/j.ajpath.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 02/12/2023]
Abstract
α-Klotho is a longevity-related protein. Its deficiency shortens lifespan with prominent senescent phenotypes, including muscle atrophy and weakness in mice. α-Klotho has two forms: membrane α-Klotho and circulating α-Klotho (c-α-Klotho). Loss of membrane α-Klotho impairs a phosphaturic effect, thereby accelerating phosphate-induced aging. However, the mechanisms of senescence on c-α-Klotho loss remain largely unknown. Here, we show that, with the aging of wild-type mice, c-α-Klotho declined, whereas Smad2, an intracellular transforming growth factor (TGF)-β effector, became activated in skeletal muscle. Moreover, c-α-Klotho suppressed muscle-wasting TGF-β molecules, including myostatin, growth and differentiation factor 11, activin, and TGF-β1, through binding to ligands as well as type I and type II serine/threonine kinase receptors. Indeed, c-α-Klotho reversed impaired in vitro myogenesis caused by these TGF-βs. Oral administration of Ki26894, a small-molecule inhibitor of type I receptors for these TGF-βs, restored muscle atrophy and weakness in α-Klotho (-/-) mice and in elderly wild-type mice by suppression of activated Smad2 and up-regulated Cdkn1a (p21) transcript, a target of phosphorylated Smad2. Ki26894 also induced the slow to fast myofiber switch. These findings show c-α-Klotho's potential as a circulating inhibitor counteracting TGF-β-induced sarcopenia. A novel therapy involving TGF-β blockade could thus be developed to prevent sarcopenia.
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Affiliation(s)
- Yutaka Ohsawa
- Department of Neurology, Kawasaki Medical School, Kurashiki City, Okayama, Japan.
| | - Hideaki Ohtsubo
- Department of Neurology, Kawasaki Medical School, Kurashiki City, Okayama, Japan
| | - Asami Munekane
- Department of Neurology, Kawasaki Medical School, Kurashiki City, Okayama, Japan
| | - Kohei Ohkubo
- Department of Neurology, Kawasaki Medical School, Kurashiki City, Okayama, Japan
| | - Tatsufumi Murakami
- Department of Neurology, Kawasaki Medical School, Kurashiki City, Okayama, Japan
| | - Masahiro Fujino
- Department of Health and Sports Science, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki City, Okayama, Japan
| | | | - Hiroki Hagiwara
- Department of Medical Science, Teikyo University of Science, Adachi-ku, Tokyo, Japan
| | - Hirotake Nishimura
- Department of Pathology, Kawasaki Medical School, Kurashiki City, Okayama, Japan
| | - Ryuki Kaneko
- Department of Animal and Marine Bioresource Sciences, Graduate School of Agriculture, Kyushu University, Fukuoka, Japan
| | - Takahiro Suzuki
- Department of Animal and Marine Bioresource Sciences, Graduate School of Agriculture, Kyushu University, Fukuoka, Japan
| | - Ryuichi Tatsumi
- Department of Animal and Marine Bioresource Sciences, Graduate School of Agriculture, Kyushu University, Fukuoka, Japan
| | - Wataru Mizunoya
- Department of Food and Life Science, School of Life and Environmental Science, Azabu University, Sagamihara, Japan
| | - Atsushi Hinohara
- Research Coordination Group, Tokyo Research Park, R&D Division, Kyowa Kirin Co, Ltd, Machida-shi, Tokyo, Japan
| | | | - Yoshihide Sunada
- Department of Neurology, Kawasaki Medical School, Kurashiki City, Okayama, Japan.
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Mitsui K, Kataoka Y, Murai K, Kitahara S, Iwai T, Sawada K, Matama H, Honda S, Fujino M, Takagi K, Yoneda S, Otsuka F, Asaumi Y, Tsujita K, Noguchi T. Characterization of lipidic plaque materials at calcified atheroma: its association with calcification thickness evaluated by optical coherence tomography and near-infrared spectroscopy imaging. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The degree of calcification and its thickness have been considered to affect stent expansion, leading to an increases risk of repeat revascularization in patients receiving PCI. Pathophysiologically, accumulation of lipidic materials within vessel wall could trigger the formation of plaque calcification. Elucidating characteristics of lipidic plaque components at calcified atheroma may enable to identify phenotypes with thick calcification which less likely responds to PCI.
Purpose
This study investigated the relationship of calcification thickness with lipidic plaque materials at calcified atheroma by using OCT and near-infrared spectroscopy (NIRS) imaging.
Methods
We analyzed 52 calcified lesions (culprit/non culprit lesions=44/8) in 47 CAD patients (stable CAD/ACS=36/11) from the REASSURE-NIRS registry (NCT04864171). OCT and NIRS imaging evaluated 4-mm segment exhibiting maximum superficial calcification arc. Calcification thickness on OCT imaging, its arc on IVUS imaging, and NIRS-derived lipid arc were analyzed at every 1-mm interval cross-sectional images. In addition, yellow-calcification ratio (YCR = lipid arc/calcification arc) was calculated (Figure 1).
Results
53% of study subjects exhibited chronic kidney disease and 70% of them received a statin (averaged on-treatment LDL-C =89mg/dL). Throughout OCT and NIRS/IVUS imaging analysis of 260 cross-sectional images, the averaged calcification arc, its maximum thickness, lipid arc and YCR were 210° (167–285°), 0.78mm (0.62–0.95mm), 95° (31–169°) and 0.33 (0.09–0.59), respectively. As expected, thicker calcification more likely exhibited a greater calcification arc (r=0.30, p<0.001). Furthermore, a greater thickness of calcification was associated with smaller lipidic plaque burden, reflected by yellow arc (r=−0.36, p<0.001) and YCR (r=−0.36, p<0.001) (Figure 2). After adjusting age, gender and ACS, calcification arc (p<0.001) and YCR (p<0.001) continued to predict thicker calcification.
Conclusion
Thickening of calcification was associated with severer calcification arc, which was accompanied by the shrinkage of lipidic plaques. Our findings suggest the evaluation of lipidic plaque component as a potential tool to identify calcified atheroma harbouring thick calcification, which may cause a greater risk of stent underexpansion.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Mitsui
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - Y Kataoka
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - K Murai
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - S Kitahara
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - T Iwai
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - K Sawada
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - H Matama
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - S Honda
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - K Takagi
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - S Yoneda
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - F Otsuka
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - K Tsujita
- Kumamoto University, Cardiovascular Medicine Graduate School of Medical Sciences , Kumamoto , Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center , Suita , Japan
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Mukaida T, Kataoka Y, Murai Y, Iwai T, Sawada K, Matama H, Honda S, Takagi K, Fujino M, Yoneda S, Otsuka F, Tahara Y, Asaumi Y, Noguchi T. Deterioration of cardiogenic shock after acute myocardial infarction defined by the society for cardiovascular angiography and intervention cardiogenic shock classification scheme. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiogenic shock (CS) in patients with AMI presents worse cardiovascular outcomes, which suggests the need for better risk stratification and management. The Society for Cardiovascular Angiography and Intervention (SCAI) has recently proposed CS classification scheme, which stratifies CS into 5 groups according to hypotension and hypoperfusion. While stage A and B exhibits CS without hypotension and/or hypoperfusion, their clinical condition could rapidly deteriorate into stage C-E. However, clinical characteristics and in-hospital outcomes of CS exhibiting its deterioration remains uncertain.
Purpose
To characterize AMI patients who deteriorated their CS status from stage A and B into stage C-E.
Methods
This single-center observational study included 326 consecutive AMI patients receiving primary PCI who presented CS stage A and B on arrival (2019.09.01–2021.09.30). Deterioration of CS (D-CS) was defined as the progression from stage A and B on arrival to stage C-E after primary PCI. Clinical characteristics and outcomes were compared in those with and without D-CS.
Results
D-CS was identified in 16.0% of entire subjects (=52/326). Of these, 94.2 and 5.8% of them exhibited stage C and E, respectively (Figure). Patients with D-CS more likely presented STEMI (84.6 vs. 67.9%, p=0.01) with a lower systolic BP (sBP) level (130±31 vs. 148±26mmHg, p<0.001) and a reduced LVEF (43±13 vs. 51±9%, p<0.001), whereas there was no significant difference in lactate level (1.5±0.4 vs. 1.2±0.3 mmol/L, p=0.22). Pre-TIMI flow grade 0–1 (69.2 vs. 47.8%, p=0.006), left main trunk stenosis (9.6 vs. 1.5%, p=0.007) and chronic total occlusion (21.2 vs. 8.4%, p=0.01) were more frequently observed in those with D-CS. Despite achieving a shorter onset-to-reperfusion time (199 vs. 276 minutes, p=0.002), D-CS was associated with in-hospital all-cause mortality after adjusting clinical characteristics (HR=33.6, 95% CI: 2.2–502.0, p=0.01). Furthermore, mechanical circulatory support (MCS) (30.8 vs. 0%, p<0.001) was more frequently required in patients with D-CS (IABP: 28.8 vs. 0%, p<0.001, ECMO: 11.5 vs. 0%, p<0.001, Impella: 3.8 vs. 0%, p=0.02). Further analysis identified sBP (HR=0.98, 95% CI: 0.97–1.00, p=0.008), LVEF (HR=0.94, 95% CI: 0.90–0.97, p<0.001) and pre-TIMI flow grade 0–1 (HR=0.41, 95% CI: 0.19–0.86, p=0.01) as independent contributors to D-CS. ROC analysis demonstrated sBP <135 mmHg (AUC=0.65) and LVEF <50% (AUC=0.69) as best cut-off values to predict D-CS. Of note, a risk of D-CS increased in association with the number of these three factors (p<0.001), and 44.0% of those with all of these factors presented D-CS (Figure).
Conclusion
16.0% of AMI without any hypotension/hypoperfusion on arrival exhibited deterioration of CS status on SCAI classification. The combination of sBP, LVEF and pre-TIMI flow grade could help to identify AMI subjects with a risk of D-CS, who may benefit from early adoption of intensified management including MCS prior to PCI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Mukaida
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - Y Kataoka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - Y Murai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - T Iwai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - K Sawada
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - H Matama
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - S Honda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - K Takagi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - M Fujino
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - S Yoneda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - F Otsuka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - Y Tahara
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - Y Asaumi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - T Noguchi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
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Fujino M, Watanabe K, Yamakawa Y. The Personal Trait of Spiritual Growth Is Correlated With the White Matter Integrity of the Brain. Front Hum Neurosci 2022; 16:890160. [PMID: 35634199 PMCID: PMC9133783 DOI: 10.3389/fnhum.2022.890160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Determining the relationship between the entire brain structure and individual differences is important in extending healthy life expectancy, which can be affected by brain atrophy. The entire brain structure has been gradually known to be correlated not only with age but also with individual differences, such as quality of life, general intelligence, and lifestyle. However, little attention has been paid to the relationship between the entire brain structure and personal traits. We herein focused on one personal trait, namely spiritual growth, and examined its relationship with the entire brain structure using two neuroimaging-derived measures, namely the gray matter Brain Healthcare Quotient (GM-BHQ), a measure of GM volume, and the fractional anisotropy Brain Healthcare Quotient (FA-BHQ), a measure of white matter (WM) integrity, in 229 healthy participants (53 female, 176 male). The results indicated no significant relationship between the GM-BHQ and spiritual growth, but there was a significant positive correlation between the FA-BHQ and spiritual growth after controlling for age, sex, and body mass index (BMI) with partial correlation analysis. Furthermore, multiple regression analysis revealed a significant positive correlation between the FA-BHQ and spiritual growth after controlling for physical characteristics, such as age, sex, and BMI, as well as other variables related to lifestyle that were collected using the Health-Promoting Lifestyle Profile. These results support the idea that there is a relationship between the entire WM brain structure and spiritual growth. Further studies are required to clarify the causal relationship between the entire WM brain structure and spiritual growth with some interventions to improve spiritual growth. Such studies will help extend healthy life expectancy from a new perspective of personal trait.
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Affiliation(s)
- Masahiro Fujino
- Open Innovation Institute, Kyoto University, Kyoto, Japan
- *Correspondence: Masahiro Fujino,
| | - Keita Watanabe
- Open Innovation Institute, Kyoto University, Kyoto, Japan
| | - Yoshinori Yamakawa
- Open Innovation Institute, Kyoto University, Kyoto, Japan
- Institute of Innovative Research, Tokyo Institute of Technology, Tokyo, Japan
- Academic and Industrial Innovation, Kobe University, Hyogo, Japan
- ImPACT Program of Council for Science, Technology, and Innovation (Cabinet Office, Government of Japan), Tokyo, Japan
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5
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Takahashi T, Saito J, Fujino M, Sato M, Kumano H. The Validity and Reliability of the Short Form of the Five Facet Mindfulness Questionnaire in Japan. Front Psychol 2022; 13:833381. [PMID: 35496204 PMCID: PMC9046677 DOI: 10.3389/fpsyg.2022.833381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background A brief measure of dispositional mindfulness is important for applied research on mindfulness. Although short forms of the Five Facet Mindfulness Questionnaire (FFMQ), which measures the five aspects of mindfulness (i.e., observing, describing, acting with awareness, non-judging, and non-reactivity), have been developed worldwide, the validity and reliability of the Japanese version has not been examined. This study aims to examine the validity and reliability of the 24-item and 15-item versions of the FFMQ in Japan, which are the most widely used versions worldwide. Methods Online surveys were conducted for 889 adults in Japan through an online survey company using self-reported questionnaires including the FFMQ to confirm the factor structure and validity. To examine construct validity, we examined the relationship between the short form of FFMQ and mind wandering, interoceptive awareness, experiential avoidance, cognitive fusion, openness, neuroticism, self-compassion, depression, and anxiety, which have been theoretically or empirically shown to be related to mindfulness. In addition, 137 adults responded to the FFMQ again, after four weeks, for the test-retest reliability. Results The correlated five-factor and four-factor (excluding observing) models and the higher-order factor hierarchical model did not show sufficient goodness of fit, while the 24-item version showed acceptable fit when uncorrelated method factors loaded on by the positive and negative (reverse-scored) items were added. However, the 15-item version did not show acceptable fits for any of the models. Regarding reliability, the 24-item version showed acceptable values. In terms of the relationship between the original and the shortened version of the FFMQ, the 24-item version shared approximately 80% of the variance with the original one. In addition, although the wording effects of positive and negative items seemed to affect the correlations between the FFMQ and the other scales, the associations with related concepts were as predicted generally, supporting the construct validity of the short form of the FFMQ. Conclusion In Japan, the 24-item version of FFMQ showed acceptable validity and reliability similar to the original version, and we recommend that the 24-item version be used.
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Affiliation(s)
- Toru Takahashi
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Junichi Saito
- Comprehensive Research Organization, Waseda University, Tokyo, Japan
| | - Masahiro Fujino
- Human Information Science Laboratory, NTT Communication Science Laboratories, Atsugi, Japan.,Open Innovation Institute, Kyoto University, Kyoto, Japan
| | - Masashi Sato
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Hiroaki Kumano
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
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Kataoka Y, Iwai T, Sawada K, Matama H, Honda S, Takagi K, Fujino M, Yoneda S, Otsuka F, Tahara Y, Asaumi Y, Toyoda K, Noguchi T. Substantially elevated thromboembolic and bleeding risks in patients with AMI following acute/subacute stroke events. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
AMI infrequently but concomitantly occurs after stroke events. Current guideline recommends primary PCI with DAPT in the setting of AMI. However, this approach is not necessarily applicable in AMI subjects following acute/subacute stroke events due to its bleeding risk. Clinical management and outcomes of these AMI subjects following remains uncertain.
Purpose
To characterize management and clinical outcomes in patients with AMI following acute/subacute stroke events (=post-stroke AMI).
Methods
The current study retrospectively analyzed 2041 AMI patients hospitalized at our institute from 2007 to 2018. Post-stroke AMI was defined as its occurrence within 14 days after ischemic/hemorrhagic stroke. The use of reperfusion and anti-thrombotic therapies, and the occurrence of major adverse cardiovascular events (=CV death, non-fatal MI and non-fatal stroke) and major bleeding events (BARC type 3 or 5) were compared in post-stroke and non-post-stroke AMI patients.
Results
Post-stroke AMI was identified in 1.1% of entire subjects (=23/2041). Of these, 65% of them (=15/23) had AMI within 3 days from the onset of stoke event. Over 60% of them was due to cardioembolic stroke, followed by hemorrhagic (9%), atherothrombotic ones (8%) and other causes (22%). Post-stroke AMI patients were more likely to exhibit Af (p=0.02) and a history of hemodialysis (p=0.009), and have a lower BMI (p=0.04) and hemoglobin level (p=0.02). They were less likely to receive emergent coronary angiography, and primary PCI was conducted in only 65% of post-stroke AMI patients (Table). Furthermore, they more frequently received thrombectomy (p=0.04) alone rather than stent implantation (p=0.002) (Table). With regard to anti-thrombotic therapy, the proportion of DAPT use was significantly lower in post-stroke AMI subjects (52 vs. 89%, p=0.0001), and 17% of them did not receive any anti-thrombotic agents. Of note, only 48% (p=0.04) and 43% (p=0.0001) of post-stroke AMI patients were treated with other established medical therapies including β-blocker and statin, respectively. During the observational period (median = 2.9 years), post-stroke AMI was associated with a greater likelihood experiencing major adverse cardiovascular events (log-rank p<0.001, Figure), CV death (log-rank p<0.0001) and stroke events (log-rank p<0.0001). Furthermore, the frequency of their major bleeding events was substantially elevated (log-rank p<0.001, Figure).
Conclusions
In our real-world data, the adoption of guideline-recommended reperfusion and anti-thrombotic therapies were considerably low in AMI subjects following acute/subacute stroke events. Given their elevated risk of cardiovascular and bleeding events, it is required to establish better therapeutic management for mitigating their thrombotic/bleeding risks.
Funding Acknowledgement
Type of funding sources: None. Table 1Figure 1
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Affiliation(s)
- Y Kataoka
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Iwai
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Sawada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - H Matama
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Honda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Takagi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Yoneda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - F Otsuka
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Tahara
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Toyoda
- National Cerebral & Cardiovascular Center, Department of Cerebrovascular Medicine and Neurology, Suita, Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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Murai K, Kataoka Y, Iwai T, Sawada K, Matama H, Honda S, Fujino M, Yoneda S, Takagi K, Nishihira K, Kanaya T, Otsuka F, Asaumi Y, Tsujita K, Noguchi T. The relationship of the underlying lipidic plaque at the implanted newer-generation drug-eluting stents with future stent-related events: insights from the REASSURE-NIRS registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Lipid-rich plaque is an important substrate causing acute coronary events. Near-infrared spectroscopy (NIRS) imaging has been shown to visualize lipidic coronary plaque at non-culprit site associated with future coronary events. Given that histopathological studies reported that the unstable plaque underlying the implanted drug-eluting stent (DES) could cause neoatherosclerosis formation, we hypothesized that NIRS-based evaluation of lipidic plaque burden behind the implanted DES may clinically predict the occurrence of stent failure in patients with CAD receiving PCI.
Purpose
We aimed to investigate the relationship of stent-related events' risk with lipidic plaque materials behind the implanted DES imaged by NIRS/intravascular ultrasound (NIRS/IVUS) imaging.
Methods
The REASSURE-NIRS registry is an on-going multi-center registry to enroll CAD subjects receiving NIRS/IVUS-guided PCI. In this registry data, 406 lesions in 379 CAD subjects (ACS/non-ACS=150/229) receiving new-generation DES were analyzed. Minimum stent area (MSA) after PCI and maximum lipid-core-burden index in any 4mm-segment within the implanted stents (in-stent maxLCBI4mm) were measured. A 3-year lesion-oriented composite outcome [LOCO: culprit lesion-related MI + ischemia-driven target lesion revascularization (ID-TLR)] was compared in subjects stratified according to the tertile of in-stent maxLCBI4mm.
Results
The mean value of in-stent maxLCBI4mm was 221, and 17% of lesions exhibited in-stent maxLCBI4mm >400. Patients with a greater in-stent maxLCBI4mm were more likely to exhibit a higher LDL-C level (p=0.026) with a longer stent length (p<0.001) and a smaller MSA (p=0.033) (Picture 1). Over 95% of entire study subjects received a statin. During the observational period (median=726 days), the frequency of LOCO up to 3 years was 3.4% in entire study subjects (culprit lesion-related MI=1.0%, ID-TLR=2.8%). Kaplan-Meier curve analysis demonstrated that the occurrence of LOCO did not increase in association with in-stent maxLCBI4mm (log-rank p-value=0.25, Picture 2). In addition, in-stent maxLCBI4mm did not associate with each component of LOCO (culprit lesion-related MI: p=0.502, ID-TLR: p=0.872). Receiver Operating Characteristic analysis revealed that the predictive ability of in-stent maxLCBI4mm for the occurrence of LOCO was unsatisfactorily (c-statistics=0.486).
Conclusion
The amount of underlying lipidic materials at culprit lesions receiving new-generation DES implantation did not necessarily predict future stent-related events. Clinical significance of maxLCBI4mm behind the implanted DES may be different from that at naïve non-culprit plaques.
Funding Acknowledgement
Type of funding sources: None. Background and lesion characteristicsKaplan-Meier analysis for LOCO
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Affiliation(s)
- K Murai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Kataoka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - T Iwai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Sawada
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - H Matama
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Honda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yoneda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Takagi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Nishihira
- Miyazaki Medical Association Hospital, Department of Cardiology, Miyazaki, Japan
| | - T Kanaya
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - F Otsuka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Tsujita
- Kumamoto University, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center, Suita, Japan
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8
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Iwai T, Katoka Y, Murai K, Hosoda H, Honda S, Fujino M, Yoneda S, Otsuka F, Nishihira K, Kanaya T, Asaumi Y, Murata S, Miyamoto Y, Yasuda S, Noguchi T. Comparison of coronary atherosclerotic features in response to achieving LDL-C <55 mg/dl between non-diabetic and diabetic patients: insights from the REASSURE-NIRS registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Current ESC guideline recommends achieving LDL-C <1.4 mmol/l in very high-risk subjects. Despite fabvourable anti-atherosclerotic effects of lowering LDL-C, its efficacy is diminished in type 2 diabetic patients. Whether response of coronary atheroma to on-treatment LDL-C <1.4 mmol/l differs in diabetic and non-diabetic subjects has not been elucidated yet.
Methods
The REASSURE-NIRS registry is an on-going multi-center registry to enroll CAD subjects receiving PCI under the guidance of near-infrared spectroscopy/intravascular ultrasound (NIRS/IVUS: DualProTM, Nipro, Tokyo, Japan) imaging. Culprit lesions in 557 CAD patients who already received a statin were evaluated by NIRS/IVUS. Maximum 4-mm-lipid-core burden-index (maxLCBI4mm) and plaque calcification grade at culprit sites were measured. Calcification grade at each 1-mm cross-sectional image was defined as follows: calcium arc 0° = 0, 0–90° = 1, 90–180° = 2, 180–270° = 3, 270–360° = 4. MaxLCBI4mm and the averaged calcification grade were compared in diabetic and non-diabetic subjects stratified according to on-treatment LDL-C level, respectively.
Result
The proportion of diabetic (n=293, HbA1c; 6.9±0.9%) and non-diabetic patients (n=264) with on-treatment LDL-C <1.4 mmol/l was 8.54 and 16.67%, respectivey (p=0.01). In non-diabetic patients, achieving LDL-C <1.4mmol/L was associated with a lower maxLCBI4mm, whereas, in diabetic patients, maxLCBI4mm was numerically smaller under achieving LDL-C <1.4 mmol/l, but this comparison did not meet statistical significance (Figure 1). Furthermore, a greater degree of calcification grade in non-diabetic patients was observed in association with on-treatment LDL-C level (Figure 2). However, plaque calcification at diabetic coronary atheroma was not necessarily induced under achieving stricter LDL-C goal. Subgroup analysis demonstrated that diabetic patients with body mass index ≥25 (odds ratio = 0.15; 95% CI: 0.18–1.19, p=0.04), estimated glomerular filtration rate <60 (mL/min/1.73m2) (odds ratio = 0.31; 95% CI: 0.10–0.90, p=0.03) and non-insulin use (odds ratio = 0.36; 95% CI: 0.14–0.87, p=0.02) benefit from achieving LDL-C <1.4 mmol/l.
Conclusion
Achieving LDL-C <1.4 mmol/l was associated with more stabilized atheroma in non-diabetic patients with CAD, whereas these favourable effects were not observed in diabetic subjects. Our findings suggest the potential need to modify additional atherogenic risks for stabilizing diabetic coronary atheroma under achieving LDL-C <1.4 mmol/l.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- T Iwai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Katoka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Murai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - H Hosoda
- Chikamori Hospital, Department of Cardiology, Kochi, Japan
| | - S Honda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yoneda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - F Otsuka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Nishihira
- Miyazaki Medical Association Hospital, Department of Cardiology, Miyazaki, Japan
| | - T Kanaya
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Murata
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Miyamoto
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yasuda
- Tohoku University, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center, Suita, Japan
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9
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Kitahara S, Kataoka Y, Iwai T, Sawada K, Matama H, Honda S, Fujino M, Yoneda S, Takagi K, Nishihira K, Kanaya T, Otsuka F, Asaumi Y, Tsujita K, Noguchi T. Characterization of residual lipid-rich plaques despite achieving LDL-C <1.8mmol/l with a statin in patients with coronary artery disease: insights from the REASSURE-NIRS registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Recent studies have demonstrated favourable modification of lipidic plaque materials under achieving LDL-C <1.8mmol/l with a statin, which potentially accounts for its clinical benefit. However, coronary events still occur even under optimal LDL-C management. This may suggest the presence of residual lipid-rich coronary plaque despite on-treatment LDL-C <1.8mmol/l. Given that near-infrared spectroscopy (NIRS) enables quantitative evaluation of lipidic plaque in vivo, we employed this imaging modality to investigate characteristics and drivers of residual lipid-rich plaques in statin-treated patients with coronary artery disease (CAD) who achieved LDL-C <1.8mmol/l.
Purpose
To clarify the frequency, clinical demographics and factors associated with residual lipid-rich plaques under LDL-C <1.8mmol/l.
Methods
The REASSURE-NIRS registry is an on-going multi-center registry to enroll CAD subjects receiving NIRS/intravascular ultrasound-guided PCI. The current analysis included 133 statin-treated stable CAD patients with on-treatment LDL-C <1.8mmol/l from August 2015 to December 2020. The maximum 4-mm lipid core burden index (maxLCBI4mm) at culprit lesions was measured by NIRS imaging prior to PCI. Clinical characteristics were compared in patients with and without maxLCBI4mm ≥400 at culprit lesions.
Results
In the current study, 45% (=58/128) of study subjects exhibited maxLCBI4mm ≥400 at culprit lesions under on-treatment LDL-C <1.8 mmol/l. They were more likely to be female, whereas there were no differences in age and the frequency of risk factors. Most of study subjects received moderate to high-intensity statin (p=0.79), and over one-fourth of them were treated with ezetimibe (p=0.56). Under these lipid-lowering therapies, LDL-C level was significantly higher in patients with maxLCBI4mm ≥400 (Table). Additionally, a lower frequency of LDL-C <1.4mmol/l was observed in those exhibiting maxLCBI4mm ≥400 (31.0 vs. 45.7%), but this comparison failed to meet statistical significance (p=0.09). Despite LDL-C control with a statin, deterioration of coronary flow after PCI with stent implantation more frequently occurred in patients with maxLCBI4mm ≥400 (Table). Multivariate analysis demonstrated that an independent factor associated with maxLCBI4mm ≥400 was LDL-C level (OR=1.05; 95% CI=1.00–1.10, p=0.03), but not other lipid and clinical parameters.
Conclusion
Almost half of CAD subjects who achieved LDL-C level <1.8mmol/l still exhibited the accumulation of lipidic plaque materials within vessel wall. Given that LDL-C level was associated with this residual lipid-rich plaque features, our findings support current ESC-guideline recommended LDL-C goal (<1.4mmol/l) to optimize the secondary prevention in stable CAD patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Kitahara
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Iwai
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Sawada
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Matama
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Honda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yoneda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Takagi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Nishihira
- Miyazaki Medical Association Hospital, Department of Cardiology, Miyazaki, Japan
| | - T Kanaya
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - F Otsuka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Tsujita
- Kumamoto University, Department of Cardiovascular Medicine Graduate School of Medical Sciences, Kumamoto, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
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10
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Ooishi Y, Fujino M, Inoue V, Nomura M, Kitagawa N. Differential Effects of Focused Attention and Open Monitoring Meditation on Autonomic Cardiac Modulation and Cortisol Secretion. Front Physiol 2021; 12:675899. [PMID: 34335292 PMCID: PMC8320390 DOI: 10.3389/fphys.2021.675899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/22/2021] [Indexed: 12/18/2022] Open
Abstract
Mindfulness-based interventions (MBIs) have been used widely as a useful tool for the alleviation of various stress-related symptoms. However, the effects of MBIs on stress-related physiological activity have not yet been ascertained. MBIs primarily consist of focused-attention (FA) and open-monitoring (OM) meditation. Since differing effects of FA and OM meditation on brain activities and cognitive tasks have been mentioned, we hypothesized that FA and OM meditation have also differing effects on stress-related physiological activity. In this study, we examined the effects of FA and OM meditation on autonomic cardiac modulation and cortisol secretion. Forty-one healthy adults (aged 20-46 years) who were meditation novices experienced 30-min FA and OM meditation tasks by listening to instructions. During resting- and meditation-states, electrocardiogram transducers were attached to participants to measure the R-R interval, which were used to evaluate heart rate (HR) and perform heart rate variability (HRV) analyses. Saliva samples were obtained from participants pre- and post-meditation to measure salivary cortisol levels. Results showed that FA meditation induced a decrease in HR and an increase in the root mean square of successive differences (rMSDD). In contrast, OM meditation induced an increase in the standard deviation of the normal-to-normal interval (SDNN) to rMSSD ratio (SDNN/rMSSD) and a decrease in salivary cortisol levels. These results suggest that FA meditation elevates physiological relaxation, whereas OM meditation elevates physiological arousal and reduces stress.
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Affiliation(s)
- Yuuki Ooishi
- NTT Communication Science Laboratories, NTT Corporation, Atsugi, Japan
| | - Masahiro Fujino
- Open Innovation Institute, Kyoto University, Kyoto, Japan.,Division of Cognitive Psychology in Education, Graduate School of Education, Kyoto University, Kyoto, Japan
| | - Vimala Inoue
- Faculty of Health Science, Health Science University, Fujikawaguchiko, Japan
| | - Michio Nomura
- Division of Cognitive Psychology in Education, Graduate School of Education, Kyoto University, Kyoto, Japan
| | - Norimichi Kitagawa
- NTT Communication Science Laboratories, NTT Corporation, Atsugi, Japan.,BKC Research Organization of Social Sciences, Ritsumeikan University, Kusatsu, Japan.,Yoshika Institute of Psychology, Kanoashi, Japan
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11
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Takeuchi S, Noguchi T, Nakao K, Miura H, Asaumi Y, Morita Y, Fujino M, Yamamoto H, Hamasaki T, Yasuda S. Effect of eicosapentaenoic acid/docosahexaenoic acid on coronary high-intensity plaques detected with non-contrast T1-weighted imaging: subgroup analysis of the AQUAMARINE EPA/DHA study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In the recent the Reduction of Cardiovascular Events with EPA-Intervention Trial (REDUCE-IT), statin therapy plus high-dose eicosapentaenoic acid (EPA) significantly reduced the risk of cardiovascular death in patients with coronary artery disease (CAD) with elevated triglyceride (TG) levels. An epidemiologic study has shown that increasing the intake of long-chain n-3 polyunsaturated fatty acids, especially EPA and docosahexaenoic acid (DHA), are associated with a lower risk of fatal CAD. However, the anti-atherosclerotic effect of high-dose EPA/DHA has not be clarified.
We reported that coronary high-intensity plaques (HIPs) detected with non-contrast T1-weighted imaging (T1WI) on cardiac magnetic resonance (CMR), which can be uniquely quantitative assessed using the plaque-to-myocardium signal intensity ratio (PMR) of ≥1.4, are significantly associated with future coronary events. Moreover, we demonstrated that intensive statin therapy reduces the PMR of coronary HIPs by 19% but is unlikely to completely resolve HIP (PMR<1.0).
In the AQUAMARINE EPA/DHA study, our goal was to assess the anti-atherogenic effect of EPA/DHA in an exploratory manner by examining the change in PMR of coronary HIPs after 12 months of EPA/DHA therapy in patients with CAD on statin therapy.
Methods
This study was designed as a single-center, triple-arm, parallel-group, randomized controlled, open-label, superiority trial examining the effect of 12 months of additional EPA/DHA therapy on coronary HIPs in patients with CAD who receiving statin therapy. Eligible subjects are randomly assigned to the 2 g/day EPA/DHA group (n=26), the 4 g/day group (n=23), or the no EPA/DHA (statin-only) group (n=24) between May 2014 and December 2017. The PMR was defined as the signal intensity of the coronary plaque divided by that of nearby left ventricular myocardium. The primary endpoint is the change in PMR after EPA/DHA treatment.
Results
These 3 groups were well matched at baseline, with no statistically significant differences in age, male sex, conventional coronary risk factors, TG level, medications, and PMR. Figure 1 shows subgroup analysis of patients with high triglyceride levels (>150mg/dl). In the patient-based analysis (A), 12 months of EPA/DHA therapy significantly reduced the PMR of primary lesions. In the segment-based analysis (B), additional reduction of PMR was observed in the high-dose EPA/DHA group compared with the no EPA/DHA treatment group.
Discussion
The present study of patients with high triglyceride levels demonstrated that EPA/DHA had a dose-dependent anti-atherosclerotic effect. This finding may provide additional information of EPA/DHA for lowering the residual risk in patients with CAD on statin therapy.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Takeda Pharmaceutical Co., Ltd.
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Affiliation(s)
- S Takeuchi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Nakao
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - H Miura
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Morita
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - H Yamamoto
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - T Hamasaki
- George Washington University School of Medicine and Health Sciences, Washington, DC, United States of America
| | - S Yasuda
- National Cerebral & Cardiovascular Center, Suita, Japan
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12
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Hayashi H, Kataoka Y, Hosoda H, Nakashima T, Honda S, Fujino M, Nakao K, Yoneda S, Otsuka F, Asaumi Y, Noguchi T, Izumiya Y, Yoshiyama M, Yasuda S. Characterization of thromboembolic and bleeding risks in cancer patients with acute myocardial infarction under the use of guideline-recommended dual-antiplatelet therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atherosclerotic cardiovascular disease including acute myocardial infarction (AMI) has become one of major co-existing diseases in cancer patients due to their improved survival rate. Current guideline recommends dual-antiplatelet therapy (DAPT) in patients with AMI. Given that the presence of cancer elevates not only coagulability but bleeding risks, these substrate may further worsen cardiovascular outcomes and bleeding risks in cancer subjects with AMI receiving DAPT.
Methods
We retrospectively analyzed 712 AMI patients treated by primary PCI with drug-eluting stent and DAPT between 2007 and 2017. The diagnosis of cancer was determined through medical record review. Clinical characteristics, thromboembolic (=all-cause death+non-fatal MI+stroke) and bleeding events were compared in AMI subjects with vs. without cancer.
Results
Cancer was identified in 11.1% (=79/712) of study subjects. Of these, around 40% of them had gastrointestinal cancer (=35/79), followed by lung cancer (=5/79) and breast cancer (=8/79). Cancer patients were more likely to be older (77±7 v. 69±13 years, p<0.001) with a history of Af (25 v. 10%, p<0.001), CKD (eGFR<60: 60 v. 42%, p=0.002), anemia (hemoglobin: 12.8±1.8 v. 13.9±1.8 g/dl, p<0.001). Under anti-thrombotic (DAPT=86%, triple-antiplatelet therapy=14%) and optimal medical therapies (ACE-I=90%, beta-blocker=76%, statin=96%), more frequent occurrence of thromboembolic events was observed in patients with cancer (34.2 v. 12.6%, p=0.004, Picture). Furthermore, the presence of cancer was associated with more than four times greater risk of bleeding events compared to non-cancer subjects (18.9 v. 4.3%, p<0.001, Picture). In particular, the frequency of both major (10.1 vs. 3.3%, p=0.003) and minor (8.9 vs. 0.9%, p<0.001) bleeding events was significantly higher in patients with cancer. In multivariate analysis, cancer independently predicted bleeding events (Table).
Conclusions
Under the use of guideline recommended DAPT, the concomitance of cancer in AMI subjects was a predictor for thromboembolic as well as bleeding events. In particular, the relationship between cancer and bleeding was significant. These observations underscore the appropriate selection and duration of anti-thrombotic agents in AMI subjects with cancer.
Cardiac/Bleeding Events in AMI Subjects
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Hayashi
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Hosoda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Nakashima
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Honda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Nakao
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yoneda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - F Otsuka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Izumiya
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Yoshiyama
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
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13
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Murai K, Kataoka Y, Hosoda H, Nakashima T, Honda S, Fujino M, Nakao K, Yoneda S, Otsuka F, Nishihira K, Kanaya T, Asaumi Y, Noguchi T, Yasuda S. Characterization of plaque features exhibiting physiological mismatch between fractional flow reserve and resting index: near-infrared spectroscopy imaging analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In addition to fractional flow reserve (FFR), resting indexes (RI) have been shown as another physiological measure to evaluate myocardial ischemia. Despite the clinical usefulness of RI without the use of intravenous vasodilatory agent, discrepancy between FFR and RI infrequently occurs. Whether this physiological mismatch is derived by specific plaque feature remains unknown.
Purpose
To characterize coronary plaques associated with coronary physiological mismatch.
Methods
We analyzed 59 coronary arteries (LAD/RCA/LCX=49/4/6) with FFR≤0.80 in 57 stable CAD subjects receiving PCI. Following measurement of FFR and RI, culprit lesion was evaluated by near-infrared spectroscopy and intravascular ultrasound (NIRS/IVUS). The analyzed vessels were stratified according to FFR and RI values: FFR≤0.75+RI>0.89 (n=6: physiological mismatch), FFR>0.75+RI>0.89 (n=6), FFR≤0.75+RI≤0.89 (n=33) and FFR>0.75+RI≤0.89 (n=14).
Results
The median values of percent diameter stenosis, FFR and RI were 51%, 0.75 and 0.87, respectively. Physiological mismatch was observed in 10.1% (=6/59) of analyzed vessels. On IVUS imaging, maximum percent plaque area was greater than 70% in all groups (p=0.29). Furthermore, there were no significant differences in angiographic and IVUS-derived minimum lumen area across 4 groups (Table). However, culprit lesions exhibiting physiological mismatch contained a substantially larger amount of lipid plaque, reflected by a higher maximum 4-mm lipid-core burned index (maxLCBI4mm: p=0.04) on NIRS imaging (Table). Multivariate analysis demonstrated maxLCBI4mm as the only plaque feature associated with physiological mismatch (odds ratio=1.010, 95% CI: 1.001–1.019, p=0.02).
Conclusion
Plaque feature associated with coronary physiological mismatch was the extent of lipidic materials but not the quantity of coronary atheroma. Since the accumulation of lipidic plaque component is caused by endothelial dysfunction, this vascular substrate could impair baseline vasomotion, thereby causing a lower FFR despite preserved RI value. Evaluation of lipidic burden may be a potential option to avoid unnecessary deferral of revascularization in subjects with normal RI value.
maxLCBI4mm in each group
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Murai
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Hosoda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Nakashima
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Honda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Nakao
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yoneda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - F Otsuka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Nishihira
- Miyazaki Medical Association Hospital, Department of Cardiology, Miyazaki, Japan
| | - T Kanaya
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
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14
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Murai K, Kataoka Y, Hirayama A, Hosoda H, Nakashima T, Honda S, Fujino M, Nakao K, Yoneda S, Otsuka F, Nishihira K, Kanaya T, Asaumi Y, Noguchi T, Yasuda S. P5635Predictive ability of lipdic burden for FFR-derived physiological measures: insights from near-infrared spectroscopy imaging analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Fractional flow reserve (FFR) has enabled to physiologically assess the myocardial ischemia of coronary artery with intermediate stenosis. Mechanistically, not only the severity of coronary stenosis but also the extent of maximal vasodilatation within the entire coronary artery potentially affects this physiological measure. Since the accumulation of lipidic materials within vessel wall increases vascular stiffness via inducing endothelial dysfunction, the presence of lipidic atheroma burden may affect physiological measures.
Purpose
To investigate the association of FFR with lipidic coronary atheroma by near-infrared spectroscopy/intravascular ultrasound (NIRS/IVUS) imaging, which quantitatively visualize lipidic burden in vivo.
Methods
We analyzed 61 coronary arteries (LAD/RCA/LCX=52/5/4) with FFR≤0.80 in 59 stable coronary artery disease subjects receiving PCI. Following FFR measurement, NIRS/IVUS imaging was conducted to evaluate the extent of atheroma burden (maximum percent plaque area=max%PA) and lipidic materials (lipid core burden index within the entire vessel=LCBIvessel). The analyzed vessels were stratified according to FFR: definite FFR group (FFR≤0.74, n=34) and gray-zone FFR group (0.75≤FFR≤0.80, n=27).
Results
NIRS/IVUS imaging analysis (analyzed longitudinal length=77±7mm) was more likely to exhibit a significantly higher LCBIvessel and a larger max%PA in the definite FFR group (Table). Of note, FFR was significantly correlated to LCBIvessel (ρ=-0.299, p=0.02), but not max%PA (ρ=-0.255, p=0.07). Multivariate analysis demonstrated that an independent determinant of FFR≤0.74 was LCBIvessel [odds ratio (OR)=1.016, 95% confidential interval (CI)=1.002–1.031, p=0.02], but not max%PA [OR=1.084, 95% CI=0.994–1.182, p=0.07]. Area under the receiver-operating characteristic curve analysis elucidated that the addition of LCBIvessel to angiography- and IVUS-derived measures resulted in a significant improvement for detecting FFR≤0.74 (picture).
Definite FFR Group (FFR≤0.74, n=34) Gray-zone FFR Group (0.75≤FFR≤0.80, n=27) p value Fractional flow reserve (FFR) 0.68±0.05 0.78±0.02 <0.01 Percent diameter stenosis (%) 56.2±13.1 51.9±7.8 0.16 Maximum percent plaque area (max%PA, %) 84.3±6.9 79.9±7.2 0.01 Lipid core burden index within the entire vessel (LCBIvessel) 102.0±60.2 65.6±51.6 0.01
ROC analysis for detecting FFR≦0.74
Conclusion
The propagation of lipidic burden associates with the physiological measures. The present findings indicate the possibility that vessel characteristics or instability may have influence for causing ischemia on the coronary artery.
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Affiliation(s)
- K Murai
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - A Hirayama
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Hosoda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Nakashima
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Honda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Nakao
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yoneda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - F Otsuka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Nishihira
- Miyazaki Medical Association Hospital, Department of Cardiology, Miyazaki, Japan
| | - T Kanaya
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
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15
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Tsuda K, Kataoka Y, Nishikawa R, Doi T, Nakashima T, Hosoda H, Honda S, Fujino M, Yoneda S, Otsuka F, Nakao K, Tahara Y, Asaumi Y, Noguchi T, Yasuda S. P1561An elevated risk of heart failure and stroke events in octogenarian Japanese patients with acute myocardial infarction who received percutaneous coronary intervention. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The proportion of the octogenarian population is expanding especially in Eastern society. Due to the clustering of risk factors, acute myocardial infarction (AMI) represents a major cardiovascular complication in octogenarian subjects. This suggests the need to further optimize their therapeutic management to prevent future cardiac events after AMI. However, analysis of clinical characteristics and cardiovascular outcomes in octogenarian subjects with AMI who received the current established medical therapies is limited.
Purpose
To investigate clinical features and prognosis in octogenarian AMI subjects treated with percutaneous coronary intervention (PCI).
Methods
We analyzed 1547 AMI subjects underwent PCI between 2007 and 2017. Baseline characteristics and the occurrence of composite major adverse cardiovascular events (cardiac death, non-fatal MI, revascularization, heart failure and stroke) were compared in octogenarian and non-octogenarian subjects.
Results
22.0% (340/1547) of study subjects was octogenarian. They were more likely to have chronic kidney disease (CKD) and a lower level of LDL-C on admission (Table). Moreover, a higher prevalence of severer Killip class and LVEF <30% were observed in octogenarians (Table). However, they were not optimally treated with the established medical therapies at discharge (Table). During the observational period (median=3.1 years), the composite of cardiovascular events more frequently occurred in octogenarian subjects. Of note, they exhibited a 2.15-fold and 3.01-fold increased risk for heart failure and stroke events, respectively (Figure).
Table 1 Non-Octogenarian (n=1207) Octogenarian (n=340) P-value CKD* (%) 33.8 63.2 <0.0001 LVEF <30% (%) 5.7 10.3 0.02 Killip class 1.33±0.03 1.55±0.05 <0.0001 LDL-C (mmol/L) 3.20±0.03 2.80±0.05 <0.0001 Statin (%) 86.3 78.2 0.0006 Beta-blocker (%) 74.0 65.8 0.005 ACE-I/ARB (%) 87.3 76.6 <0.0001 DAPT (%) 86.0 88.6 0.42 *CKD is defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2.
Figure 1
Conclusions
Octogenarian subjects with AMI were high-risk group associated with heart failure and stroke events. Their distinct clinical backgrounds may affect the adoption of optimal medical therapies, potentially resulting in worse cardiovascular outcomes. Further intensified management should be applied to octogenarian subjects with AMI.
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Affiliation(s)
- K Tsuda
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - R Nishikawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Doi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Nakashima
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - H Hosoda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Honda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Yoneda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - F Otsuka
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - K Nakao
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Tahara
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
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16
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Tsuda K, Kataoka Y, Nishikawa R, Doi T, Nakashima T, Kawakami S, Fujino M, Nakao K, Nishihira K, Tahara Y, Asaumi Y, Noguchi T, Yasuda S. P906Diminished response to statin therapy predicts future occurrence of heart failure in patients with acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p906] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Tsuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - R Nishikawa
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Doi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Nakashima
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Kawakami
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - K Nakao
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - K Nishihira
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Tahara
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
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17
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Miura H, Morita Y, Hosoda H, Yoneda S, Nakao K, Fujino M, Otsuka F, Arakawa T, Asaumi Y, Kataoka Y, Tahara Y, Nakanishi M, Fukuda T, Noguchi T, Yasuda S. P4676Prediction of adverse left ventricular remodeling after acute myocardial infarction using feature-tracking imaging. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4676] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Miura
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - Y Morita
- National Cerebral and Cardiovascular Center, Radiology, Suita, Japan
| | - H Hosoda
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - S Yoneda
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - K Nakao
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - F Otsuka
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - T Arakawa
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - Y Tahara
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - M Nakanishi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - T Fukuda
- National Cerebral and Cardiovascular Center, Radiology, Suita, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Suita, Japan
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18
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Yuta F, Yutaka O, Ohtsubo H, Nishimatsu S, Fujino M, Sunada Y. Caveolin-3 controls sarcolemmal nNOS activity: Implication in limb-girdle muscular dystrophy 1C. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3066] [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: 11/26/2022]
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19
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Usami S, Kataoka Y, Nakano H, Nakashima T, Kawakami S, Fujino M, Nakao K, Nagai T, Nishihira K, Kanaya T, Tahara Y, Asaumi Y, Noguchi T, Goto Y, Yasuda S. P639Triglyceride associated with cholesterol crystallization of atheroma in patients with coronary artery disease who received a statin: optical coherence tomographic analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Tsuda K, Kataoka Y, Nishikawa R, Doi T, Nakashima T, Kawakami S, Fujino M, Nakao K, Nishihira K, Kanaya T, Tahara Y, Asaumi Y, Noguchi T, Goto Y, Yasuda S. P6236Clinical characteristics and cardiovascular outcomes in subjects who developed acute myocardial infarction despite statin therapy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Enosawa S, Suzuki S, Fujino M, Amemiya H, Omasa T, Urayama S, Tanimura N, Suga K. An Attempt to Add Biological Functions by Genetic Engineering in Order to Produce High-Performance Bioreactor Cells for Hybrid Artificial Liver: Transfection of Glutamine Synthetase into Chinese Hamster Ovary (CHO) Cell. Cell Transplant 2017; 6:537-40. [PMID: 9331509 DOI: 10.1177/096368979700600518] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 11/16/2022] Open
Abstract
In the course of immortalization, hepatocyte cell lines lose their original differentiated functions, such as ammonia removal and urea formation, drug metabolism, serum protein synthesis, etc. (Enosawa et al., Cell Transplant. 5:S39-S40; 1996). With the aim of adding lost or deficient functions and producing cell lines for the bioreactor of a hybrid artificial liver, rat glutamine synthetase (GS) gene was transfected into Chinese hamster ovary (CHO) cells, because it is able to lower the ammonia level. The GS gene-inserted pSV2 plasmid was transfected into the CHO-K1 line by electroporation. Transfected CHO (GS-CHO) cells were cultured in a glutamine-free medium containing ammonia, glutamic acid, and the GS inhibitor methionine sulfoximine (MSX). The MSX concentration was increased stepwise from 25 μmol/L to 1600 μmol/L to amplify the GS gene. In several GS-CHO sublines resistant to 300-1600 μmol/L of MSX, the specific activities of GS were increased from 0.2 × 10-4 to 1.7-2.9 × 10-4 unit/106 cells. When the amplified GS-CHO cells were cultured in the ammonia-containing medium, a slow but steady decrease of the ammonia level was observed when the level was high. Finally, the prospect of genetically modulated cells for bioreactors in the hybrid artificial liver is discussed.
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Affiliation(s)
- S Enosawa
- Department of Experimental Surgery and Bioengineering, National Children's Medical Research Center, Tokyo, Japan
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22
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Enosawa S, Suzuki S, Li XK, Okuyama T, Fujino M, Amemiya H. Higher Efficiency of Retrovirus Transduction in the Late Stage of Primary Culture of Hepatocytes from Nontreated than from Partially Hepatectomized Rat. Cell Transplant 2017; 7:413-6. [PMID: 9710313 DOI: 10.1177/096368979800700412] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The aim of this investigation was to optimize the conditions for gene transduction by a retroviral vector into primary cultured hepatocytes. Because a retrovirus infection is dependent upon the proliferative activity of the target cells, we examined the thymidine incorporation of the primary culture, using cells from nontreated and partially hepatectomized donor rats. Partial hepatectomy 1 day before cell isolation greatly enhanced the thymidine incorporation, and similarly, the transduction of LacZ, the gene for E. coli β-galactosidase, although the percentage of transduced cells remained low. With cells from the normal rat, the thymidine incorporation increased gradually after the beginning of the culture and reached 16 times the initial activity on day 2, while hepatocytes from the partially hepatectomized donor showed no increase at that stage of the culture. Correspondingly, the number of gene-transduced hepatocytes was increased when the vector was added to the cells 1 or 2 days after isolation. Therefore, hepatocytes cultured for 1 or 2 days after isolation are suitable for retroviral transduction.
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Affiliation(s)
- S Enosawa
- Department of Experimental Surgery and Bioengineering, National Children's Medical Research Center, Tokyo, Japan
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23
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Sunada Y, Ohsawa Y, Fukai Y, Fujino M, Nishimatsu S, Ohta S. MELAS, a first-ever tRNA modification disorder is alleviated by taurine supplementation therapy. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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24
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Sunada Y, Ohsawa Y, Fukai Y, Fujino M, Nishimatsu S, Ohta S. Taurine supplemental therapy in prevention of stroke-like episodes in MELAS. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Zhao M, Guo H, Chen J, Fujino M, Ito H, Takahashi K, Abe F, Nakajima M, Tanaka T, Wang J, Huang H, Zheng S, Hei M, Li J, Huang S, Li J, Ma X, Chen Y, Zhao L, Zhuang J, Zhu P, Li XK. 5-aminolevulinic acid combined with sodium ferrous citrate ameliorates H2O2-induced cardiomyocyte hypertrophy via activation of the MAPK/Nrf2/HO-1 pathway. Am J Physiol Cell Physiol 2015; 308:C665-72. [PMID: 25652453 DOI: 10.1152/ajpcell.00369.2014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 02/02/2015] [Indexed: 11/22/2022]
Abstract
Hydrogen peroxide (H2O2) causes cell damage via oxidative stress. Heme oxygenase-1 (HO-1) is an antioxidant enzyme that can protect cardiomyocytes against oxidative stress. In this study, we investigated whether the heme precursor 5-aminolevulinic acid (5-ALA) with sodium ferrous citrate (SFC) could protect cardiomyocytes from H2O2-induced hypertrophy via modulation of HO-1 expression. HL-1 cells pretreated with/without 5-ALA and SFC were exposed to H2O2 to induce a cardiomyocyte hypertrophy model. Hypertrophy was evaluated by planar morphometry, (3)H-leucine incorporation, and RT-PCR analysis of hypertrophy-related gene expressions. Reactive oxygen species (ROS) production was assessed by 5/6-chloromethyl-2',7'-ichlorodihydrofluorescein diacetate acetylester. HO-1 and nuclear factor erythroid 2-related factor 2 (Nrf2) protein expressions were analyzed by Western blot. In our experiments, HL-1 cells were transfected with Nrf2 siRNA or treated with a signal pathway inhibitor. We found several results. 1) ROS production, cell surface area, protein synthesis, and expressions of hypertrophic marker genes, including atrial natriuretic peptide, brain natriuretic peptide, atrial natriuretic factor, and β-myosin heavy chain, were decreased in HL-1 cells pretreated with 5-ALA and SFC. 2) 5-ALA and SFC increased HO-1 expression in a dose- and time-dependent manner, associated with upregulation of Nrf2. Notably, Nrf2 siRNA dramatically reduced HO-1 expression in HL-1 cells. 3) ERK1/2, p38, and SAPK/JNK signaling pathways were activated and modulate 5-ALA- and SFC-enhanced HO-1 expression. SB203580 (p38 kinase), PD98059 (ERK), or SP600125 (JNK) inhibitors significantly reduced this effect. In conclusion, our data suggest that 5-ALA and SFC protect HL-1 cells from H2O2-induced cardiac hypertrophy via activation of the MAPK/Nrf2/HO-1 signaling pathway.
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Affiliation(s)
- Mingyi Zhao
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Huiming Guo
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jimei Chen
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | | | | | | | | | | | | | - Jinju Wang
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
| | - Huanlei Huang
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shaoyi Zheng
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mingyan Hei
- Department of Pediatrics, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiaxin Li
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shuai Huang
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jiani Li
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaotang Ma
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical College, Zhanjiang, China
| | - Yanfang Chen
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
| | - Lingling Zhao
- Department of Pediatrics, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Jian Zhuang
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ping Zhu
- Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China;
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26
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Zhang Q, Ichimaru N, Higuchi S, Cai S, Hou J, Fujino M, Nonomura N, Kobayashi M, Ando H, Uno A, Sakurai K, Mochizuki S, Adachi Y, Ohno N, Zou H, Xu J, Li XK, Takahara S. Permanent acceptance of mouse cardiac allografts with CD40 siRNA to induce regulatory myeloid cells by use of a novel polysaccharide siRNA delivery system. Gene Ther 2015; 22:217-26. [DOI: 10.1038/gt.2014.119] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 11/06/2014] [Accepted: 11/17/2014] [Indexed: 01/27/2023]
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27
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Fujino M, Kajimura S, Nomura M. Development and Validation of the Japanese Version of the Mindful Attention Awareness Scale Using Item Response Theory Analysis. ACTA ACUST UNITED AC 2015. [DOI: 10.2132/personality.24.61] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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28
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Ueda Y, Nunoi M, Ichimura K, Shirasuna Y, Fujino M. Saccade trajectories are immediately curved in accordance with the degree of threat from task-irrelevant stimuli. J Vis 2014. [DOI: 10.1167/14.10.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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29
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Abdelsalam M, Fujino M, Eissa A, Chen S, Warda M. Expression, genetic localization and phylogenic analysis of NAPlr in piscine Streptococcus dysgalactiae subspecies dysgalactiae isolates and their patterns of adherence. J Adv Res 2014; 6:747-55. [PMID: 26425363 PMCID: PMC4563591 DOI: 10.1016/j.jare.2014.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/16/2014] [Accepted: 05/16/2014] [Indexed: 01/19/2023] Open
Abstract
Streptococcus dysgalactiae, the long recognized mammalian pathogen, has currently received a major concern regarding fish bacterial infection. Adhesion to host epithelial cells and the presence of wall-associated plasminogen binding proteins are prerequisites to Streptococcus infection. This is the first study of the occurrence of nephritis-associated plasminogen-binding receptor (NAPlr) and α-enolase genes in piscine S. dysgalactiae subspecies dysgalactiae (SDSD) isolates. Further characterization of surface localized NAPlr of fish SDSD revealed a similar immune-reactive band of 43 KDa as that from porcine S. dysgalactiae subsp. equisimilis (SDSE). The phylogenetic analysis revealed that NAPlr of fish SDSD is more associated with those of mammalian SDSE and Streptococcus pyogenes rather than of other streptococci. Our findings warrant public attention to the possible implication of these virulence genes in dissemination of SDSD to different tissues of infected hosts and to get advantage to new niches. The SDSD adherence patterns were also studied to better understand their pathogenicity. The patterns of adherence of SDSD on two different cell lines showed a different pattern of adherence. Such difference gives an insight about the variance in host susceptibility to infection.
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Affiliation(s)
- M. Abdelsalam
- Department of Fish Diseases and Management, Faculty of Veterinary Medicine, Cairo University, 12211 Giza, Egypt
- Corresponding authors. Tel.: +20 2 1122671243, +2 2 35720399; fax: +20 2 35725240, +20 2 35710305.
| | - M. Fujino
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - A.E. Eissa
- Department of Fish Diseases and Management, Faculty of Veterinary Medicine, Cairo University, 12211 Giza, Egypt
- Departments of Poultry and Fish Diseases, Faculty of Veterinary Medicine, Tripoli University, Tripoli, Libya
| | - S.C. Chen
- Graduate Institute of Animal Vaccine Technology, National Pingtung University of Science and Technology, Pingtung, Taiwan
- Department of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - M. Warda
- Department of Biochemistry, Biotechnology Center for Services and Researches, Faculty of Veterinary Medicine, Cairo University, 12211 Giza, Egypt
- Corresponding authors. Tel.: +20 2 1122671243, +2 2 35720399; fax: +20 2 35725240, +20 2 35710305.
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Chinen D, Fujino M, Anzai T, Kitakaze M, Goto Y, Ishihara M, Shimizu W, Yokoyama H, Yasuda S, Ogawa H. Left ventricular outflow tract velocity time integral correlates with low cardiac output syndrome in patients with acute decompensated heart failure. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Fujino A, Sakamoto H, Fujino M, Yamane T, Nagai T, Asaumi Y, Miyagi T, Ishihara M, Yasuda S, Ogawa H. Long-term survival benefit of revascularization for chronic total occlusions in patients with reduced left ventricular ejection fraction in comparison with medical treatment. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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32
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Fujino A, Sakamoto H, Fujino M, Yamane T, Nagai T, Asaumi Y, Miyagi T, Ishihara M, Yasuda S, Ogawa H. No added benefits of percutaneous coronary intervention over medical treatment in patients with chronic total occlusions. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5319] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ohsawa Y, Okada T, Nishimatsu SI, Ishizaki M, Suga T, Fujino M, Murakami T, Uchino M, Tsuchida K, Noji S, Hinohara A, Shimizu T, Shimizu K, Sunada Y. An inhibitor of transforming growth factor beta type I receptor ameliorates muscle atrophy in a mouse model of caveolin 3-deficient muscular dystrophy. J Transl Med 2012; 92:1100-14. [PMID: 22584670 DOI: 10.1038/labinvest.2012.78] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Skeletal muscle expressing Pro104Leu mutant caveolin 3 (CAV3(P104L)) in mouse becomes atrophied and serves as a model of autosomal dominant limb-girdle muscular dystrophy 1C. We previously found that caveolin 3-deficient muscles showed activated intramuscular transforming growth factor beta (TGF-β) signals. However, the cellular mechanism by which loss of caveolin 3 leads to muscle atrophy is unknown. Recently, several small-molecule inhibitors of TGF-β type I receptor (TβRI) kinase have been developed as molecular-targeting drugs for cancer therapy by suppressing intracellular TGF-β1, -β2, and -β3 signaling. Here, we show that a TβRI kinase inhibitor, Ki26894, restores impaired myoblast differentiation in vitro caused by activin, myostatin, and TGF-β1, as well as CAV3(P104L). Oral administration of Ki26894 increased muscle mass and strength in vivo in wild-type mice, and improved muscle atrophy and weakness in the CAV3(P104L) mice. The inhibitor restored the number of satellite cells, the resident stem cells of adult skeletal muscle, with suppression of the increased phosphorylation of Smad2, an effector, and the upregulation of p21 (also known as Cdkn1a), a target gene of the TGF-β family members in muscle. These data indicate that both TGF-β-dependent reduction in satellite cells and impairment of myoblast differentiation contribute to the cellular mechanism underlying caveolin 3-deficient muscle atrophy. TβRI kinase inhibitors could antagonize the activation of intramuscular anti-myogenic TGF-β signals, thereby providing a novel therapeutic rationale for the alternative use of this type of anticancer drug in reversing muscle atrophy in various clinical settings.
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Affiliation(s)
- Yutaka Ohsawa
- Department of Neurology, Kawasaki Medical School, Okayama, Japan
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Miura SI, Kiya Y, Hanzawa H, Nakao N, Fujino M, Imaizumi S, Matsuo Y, Yanagisawa H, Koike H, Komuro I, Karnik SS, Saku K. Small molecules with similar structures exhibit agonist, neutral antagonist or inverse agonist activity toward angiotensin II type 1 receptor. PLoS One 2012; 7:e37974. [PMID: 22719858 PMCID: PMC3375280 DOI: 10.1371/journal.pone.0037974] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 05/01/2012] [Indexed: 11/29/2022] Open
Abstract
Small differences in the chemical structures of ligands can be responsible for agonism, neutral antagonism or inverse agonism toward a G-protein-coupled receptor (GPCR). Although each ligand may stabilize the receptor conformation in a different way, little is known about the precise conformational differences. We synthesized the angiotensin II type 1 receptor blocker (ARB) olmesartan, R239470 and R794847, which induced inverse agonism, antagonism and agonism, respectively, and then investigated the ligand-specific changes in the receptor conformation with respect to stabilization around transmembrane (TM)3. The results of substituted cysteine accessibility mapping studies support the novel concept that ligand-induced changes in the conformation of TM3 play a role in stabilizing GPCR. Although the agonist-, neutral antagonist and inverse agonist-binding sites in the AT(1) receptor are similar, each ligand induced specific conformational changes in TM3. In addition, all of the experimental data were obtained with functional receptors in a native membrane environment (in situ).
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Affiliation(s)
- Shin-ichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
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Kono H, Nakamura M, Ohtsuka T, Fujino M, Ideno N, Aso T, Nagayoshi Y, Mori Y, Takahata S, Oda Y, Tanaka M. MicroRNA-155 Expression in Gallbladder Carcinoma and Pancreaticobiliary Maljunction. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.708] [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: 10/14/2022]
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Mukai T, Kamitani S, Shimizu T, Fujino M, Tsutamoto Y, Endo Y, Hanasawa K, Tani T. Development of a Novel, Nearly Insoluble Antiadhesive Membrane. Eur Surg Res 2011; 47:248-53. [DOI: 10.1159/000333093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 08/15/2011] [Indexed: 11/19/2022]
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37
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Kamikubo Y, Fujita Y, Shimomura T, Miyajima T, Fujino M, Tabata T, Fukurotani K, Kano M, Sakurai T. Adenosine A1 receptor interacts with mGluR1 and regulates cerebellar LTD. Neurosci Res 2011. [DOI: 10.1016/j.neures.2011.07.472] [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: 11/29/2022]
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38
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Suzuki K, Nishio M, Nishiyama N, Fujino M, Tanaka N, Todo Y, Kato H. The Results of Radiotherapy Alone for Cervical Squamous Cell Carcinoma of the Patients Aged 75 and Older. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.959] [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: 10/19/2022]
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39
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Ohsawa Y, Okada T, Fujii I, Nishimatsu S, Fujino M, Hayashi S, Rikimaru M, Murakami T, Matsukura M, Nohno T, Sunada Y. P3.22 Reprogrammed fibroblasts as a feasible source of cell-based therapy for muscular dystrophy. Neuromuscul Disord 2010. [DOI: 10.1016/j.nmd.2010.07.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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40
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Kiya Y, Miura SI, Fujino M, Imaizumi S, Karnik SS, Saku K. Clinical and pharmacotherapeutic relevance of the double-chain domain of the angiotensin II type 1 receptor blocker olmesartan. Clin Exp Hypertens 2010; 32:129-36. [PMID: 20374187 DOI: 10.3109/10641960903254430] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
We previously reported that the angiotensin II type 1 (AT(1)) receptor blocker (ARB) olmesartan has two important interactions to evoke inverse agonism (IA). We refer to these interactions as the "double-chain domain (DCD)." Since the clinical pharmacotherapeutic relevance of olmesartan is still unclear, we examined these effects in rats and humans. We analyzed the effects at an advanced stage of renal insufficiency in Dahl salt-sensitive hypertensive rats (Study 1). Rats were fed a high-salt diet from age 9 weeks and arbitrarily assigned to three treatment regimens at age 16 to 21 weeks: olmesartan (2 mg/kg/day) with DCD, a compound related to olmesartan without DCD (6 mg/kg/day, R-239470) or placebo. We also compared the depressor effects of olmesartan to those of other ARBs in patients with essential hypertension (Study 2). Thirty essential hypertensive outpatients who had been receiving ARBs other than olmesartan were recruited for this study. Our protocol was approved by the hospital ethics committee and informed consent was obtained from all patients 12 weeks prior to switching from ARBs other than olmesartan to olmesartan. In Study 1, olmesartan induced a more prominent suppression of the ratio of urinary protein excretion to creatinine at age 21 weeks without lowering blood pressure among the three groups. In Study 2, the depressor effect of olmesartan was significantly stronger than those of other ARBs, which do not contain the DCD. These additive effects by olmesartan may be due to DCD.
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Affiliation(s)
- Yoshihiro Kiya
- Department of Cardiology, Fukuoka University School of Medicine, Jonan-Ku, Fukuoka, Japan
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Ohsawa Y, Fujino M, Okada T, Kuga A, Hayashi S, Rikimaru M, Sunada Y. T.P.5.10 Introduction of wound-healing MRL-MpJ phenotype improves skeletal muscle pathology in mdx mouse. Neuromuscul Disord 2009. [DOI: 10.1016/j.nmd.2009.06.235] [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: 11/15/2022]
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42
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Inamoto Y, Ito M, Suzuki R, Nishida T, Iida H, Kohno A, Sawa M, Murata M, Nishiwaki S, Naoe T, Fujino M, Morishita Y, Hirabayashi N, Kodera Y, Miyamura K. Clinicopathological Manifestations and Treatment of Intestinal Transplant-Associated Microangiopathy (i-TAM). Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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43
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Sakurai M, Todaka K, Takada N, Kamigaki S, Anami S, Shikata A, Ueno H, Iseki C, Fujii C, Fujino M, Yamamura J, Masuda H, Ishitobi M, Nakayama T, Masuda N. Multicenter phase II study of a frozen glove to prevent docetaxel-induced onycholysis and cutaneous toxicity for the breast cancer patients (Kinki Multidisciplinary Breast Oncology Group: KMBOG-0605). Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-4093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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
Abstract #4093
Background: We have learned from the questionnaire survey of description and hearing type that the onycholysis and skin toxicity occur in approximately 90% of patients(pts) treated with docetaxel (DTX) on hands and 65% on feet. Besides neurotoxicity and edema, these adverse events cause the worse quality of life (QOL) assessment because of the exposure, public noticed site. According to the report that the Elasto-Gel frozen glove (FG) was effective for the prevention of DTX-induced onycholysis and skin toxicity (Scotte F, JCO 23, 4424-29, 2005), we have planned to reanalyze the efficacy and safety of FG for Japanese breast cancer pts by the multicenter, prospective phase II study.
 Patients and Methods: Patients receiving DTX 75 mg/m2 alone or in combination chemotherapy more than 4 cycles were eligible for this case-control study. Each patient on case group wore an FG for a total of 90 minutes on the both hands. Her feet were not protected. The control data was obtained by the questionnaire survey from the pts who had not used FG during the chemotherapy. Onycholysis and skin toxicity were assessed at each cycle by National Cancer Institute Common Toxicity Criteria and documented by photography. This study had accomplished by multidisciplinary approach by nurses, pharmacists, and doctors. Wilcoxon matched-pairs rank test was used.
 Results: Between March 2006 and May 2007, 70 pts on case and 52 pts on control were evaluated. Median age were similar for each group, 52 [29-74 years] on case and 51 [25-73 years] on control. Onycholysis and skin toxicity were significantly lower in the FG-protected hands compared with the control hands (P = .0001). Onycholysis was grade (G) 0 in 41% v 8%, G1 in 54% v 74%, and G2 to 3 in 4.3% v 18% for the FG-protected hands and the control hands, respectively. For the feet, there was no difference in frequency between pts on case and on control. Skin toxicity was G0 in 76.6% v 44%, G1 in 13.6% v 42%, and G2 to 3 in 4.4% v 14% for the FG-protected hands and the control, respectively. 32 pts (46%) had experienced the deterioration of pigmentation on hands and/or feet, the FG had seemed not to be able to prevent these unfavorable events. Median time to nail and skin toxicity occurrence was not significantly different between the FG-protected and the control hands of feet, respectively. Although one pt (1.4%) experienced discomfort due to cold intolerance, there were no serious adverse events caused by FG.
 Conclusion: FG significantly reduces the nail and skin toxicity associated with DTX and is a safety tool on supportive care management. This should be provided in general practice widely to improve a patient's QOL.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4093.
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Affiliation(s)
- M Sakurai
- 1 Breast Oncology Group, Osaka National Hospital, Osaka, Japan
| | - K Todaka
- 1 Breast Oncology Group, Osaka National Hospital, Osaka, Japan
| | - N Takada
- 2 Breast Oncology Group, Sakai Municipal Hospital, Sakai, Japan
| | - S Kamigaki
- 2 Breast Oncology Group, Sakai Municipal Hospital, Sakai, Japan
| | - S Anami
- 2 Breast Oncology Group, Sakai Municipal Hospital, Sakai, Japan
| | - A Shikata
- 1 Breast Oncology Group, Osaka National Hospital, Osaka, Japan
| | - H Ueno
- 1 Breast Oncology Group, Osaka National Hospital, Osaka, Japan
| | - C Iseki
- 2 Breast Oncology Group, Sakai Municipal Hospital, Sakai, Japan
| | - C Fujii
- 2 Breast Oncology Group, Sakai Municipal Hospital, Sakai, Japan
| | - M Fujino
- 2 Breast Oncology Group, Sakai Municipal Hospital, Sakai, Japan
| | - J Yamamura
- 1 Breast Oncology Group, Osaka National Hospital, Osaka, Japan
| | - H Masuda
- 1 Breast Oncology Group, Osaka National Hospital, Osaka, Japan
| | - M Ishitobi
- 3 Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - T Nakayama
- 2 Breast Oncology Group, Sakai Municipal Hospital, Sakai, Japan
| | - N Masuda
- 1 Breast Oncology Group, Osaka National Hospital, Osaka, Japan
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Inamoto Y, Ito M, Suzuki R, Nishida T, Iida H, Kohno A, Sawa M, Murata M, Nishiwaki S, Oba T, Yanada M, Naoe T, Ichihashi R, Fujino M, Yamaguchi T, Morishita Y, Hirabayashi N, Kodera Y, Miyamura K. Clinicopathological manifestations and treatment of intestinal transplant-associated microangiopathy. Bone Marrow Transplant 2009; 44:43-9. [PMID: 19139727 DOI: 10.1038/bmt.2008.419] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Intestinal transplant-associated microangiopathy (i-TAM) is an important complication after allogeneic hematopoietic SCT. From 1997 to 2006, 87 of 886 patients with diarrhea after transplantation received colonoscopic biopsy. i-TAM, GVHD and CMV colitis were diagnosed histopathologically. The median duration from transplantation to the onset of diarrhea was 32 days (range: 9-130 days) and that from the onset of diarrhea to biopsy was 12 days (range: 0-74 days). The median maximal amount of diarrhea was 2 l/day (range: 130-5600 ml/day). Histopathological diagnosis included i-TAM (n=80), GVHD (n=26), CMV colitis (n=17) and nonspecific findings (n=2) with overlapping. Among 80 patients with i-TAM, abdominal pain was a major symptom, and only 11 patients fulfilled the proposed criteria for systemic TAM. Non-relapse mortality (NRM) among patients without resolution of diarrhea was 72% and i-TAM comprised 57% of NRM. NRM was 25% among patients without intensified immunosuppression, but was 52, 79 and 100% among those with intensified immunosuppression before diarrhea, after diarrhea, and before and after diarrhea, respectively. In conclusion, i-TAM is a major complication presenting massive refractory diarrhea and abdominal pain, which causes NRM. Avoiding intensified immunosuppression that damages vascular endothelium until the resolution of i-TAM may improve transplant outcome.
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Affiliation(s)
- Y Inamoto
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya 466-8560, Japan.
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45
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Matsuo Y, Miura SI, Fujino M, Saku K. Molecular mechanisms of the antagonistic action between AT1 and AT2 receptors. J Mol Cell Cardiol 2008. [DOI: 10.1016/j.yjmcc.2008.09.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Takamiya Y, Shirai K, Fujino M, Miller N, Tsuchiya Y, Okabe M, Saku K. Purulent pericarditis with Salmonella enteritidis in a patient with CD4/CD8 depression. J Cardiol 2008; 51:201-4. [PMID: 18522796 DOI: 10.1016/j.jjcc.2007.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2007] [Revised: 12/18/2007] [Accepted: 12/25/2007] [Indexed: 02/06/2023]
Abstract
A 65-year-old man was admitted for high-grade fever with a shaking chill and general fatigue. Chest X-ray showed cardiomegaly, and echocardiography revealed a large amount of pericardial effusion. Emergency pericardiocentesis was performed, and Salmonella enteritidis was found in pericardial fluids. We diagnosed purulent pericarditis with S. enteritidis, and administered antibiotics. While high-grade fever resolved 10 days after beginning of treatment, effusive-constrictive pericarditis (ECP) without definite symptoms persisted for 2 months. Because of the improvement of his hemodynamic states on cardiac catheterization after 1 year, an operative procedure was not required. He was diagnosed as having CD4/CD8 depression without apparent diseases. There are few reports of pericarditis with S. enteritidis, and we believe this case might be only the second recorded case of ECP with S. enteritidis.
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Affiliation(s)
- Yosuke Takamiya
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
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47
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Miura SI, Kiya Y, Kanazawa T, Imaizumi S, Fujino M, Matsuo Y, Karnik SS, Saku K. Differential bonding interactions of inverse agonists of angiotensin II type 1 receptor in stabilizing the inactive state. Mol Endocrinol 2008; 22:139-46. [PMID: 17901125 PMCID: PMC2725753 DOI: 10.1210/me.2007-0312] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2007] [Accepted: 09/20/2007] [Indexed: 01/06/2023] Open
Abstract
Although the sartan family of angiotensin II type 1 (AT(1)) receptor blockers (ARBs), which includes valsartan, olmesartan, and losartan, have a common pharmacophore structure, their effectiveness in therapy differs. Although their efficacy may be related to their binding strength, this notion has changed with a better understanding of the molecular mechanism. Therefore, we hypothesized that each ARB differs with regard to its molecular interactions with AT(1) receptor in inducing inverse agonism. Interactions between valsartan and residues Ser(105), Ser(109), and Lys(199) were important for binding. Valsartan is a strong inverse agonist of constitutive inositol phosphate production by the wild-type and N111G mutant receptors. Substituted cysteine accessibility mapping studies indicated that valsartan, but not losartan, which has only weak inverse agonism, may stabilize the N111G receptor in an inactive state upon binding. In addition, the inverse agonism by valsatan was mostly abolished with S105A/S109A/K199Q substitutions in the N111G background. Molecular modeling suggested that Ser(109) and Lys(199) bind to phenyl and tetrazole groups of valsartan, respectively. Ser(105) is a candidate for binding to the carboxyl group of valsartan. Thus, the most critical interaction for inducing inverse agonism involves transmembrane (TM) V (Lys(199)) of AT(1) receptor although its inverse agonist potency is comparable to olmesartan, which bonds with TM III (Tyr(113)) and TM VI (His(256)). These results provide new insights into improving ARBs and development of new G protein-coupled receptor antagonists.
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Affiliation(s)
- Shin-ichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine, Jonan-Ku, Fukuoka 814-0180, Japan.
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48
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Nakatsuji S, Fujino M, Hasegawa S, Akutsu H, Yamada JI, Gurman VS, Kh Vorobiev A. Azobenzene Derivatives Carrying a Nitroxide Radical. J Org Chem 2007; 72:2021-9. [PMID: 17309306 DOI: 10.1021/jo062266f] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Several trans-azobenzene derivatives carrying a nitroxide (aminoxyl) radical (2a, 6a-12a) were prepared, and their photoisomerization reactions to the corresponding cis-isomers were investigated. Although no fruitful results could be obtained for the photoisomerizations of the derivatives with para-subsituents (9a-12a), the unsubstututed derivatives at the para-position (2a, 6a, 7a, 8a) were found to show photoisomerizations by irradiation to give the corresponding cis-isomers (2b, 6b, 7b, 8b), being isolated as relatively stable solid materials, and the change of the intermolecular magnetic interactions was apparently observed by the structural change for each photochromic couple.
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Affiliation(s)
- Shin'ichi Nakatsuji
- Department of Material Science, Graduate School of Material Science, University of Hyogo, 3-2-1 Kouto, Kamigori, Hyogo 678-1297, Japan.
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49
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Abstract
Thrombotic microangiopathy (TMA) is one of the severe complications after stem cell transplantation (SCT) and is associated with graft-versus-host disease (GVHD) prophylaxis including FK506. In this study, we experimented on rats using FK506 to demonstrate the occurrence of intestinal TMA. FK506 was administrated into Wistar/ST rats intraperitoneally for 7 days. Rats were examined histopathologically after FK506 injection using light and electron microscopy and immunohistochemistry. FK506 concentrations in whole blood were measured by enzyme immunoassay. In the acute phase, hemorrhagic lesions with multifocal erosions and crypt loss were found in the small intestines of all treated rats. Capillary vessels were dilated, and a few platelet thrombi were found. Electron microscopy demonstrated degenerative swelling of endothelial cells and platelet aggregates adhering to the vessel walls. In the later phase, epithelial regenerative failure, characterized by crypt ghosts, was found in the affected mucosa. Apoptotic epithelial cells were increased in number. The extent of intestinal injury was proportional to the whole blood levels of FK506. The intestinal lesions in rats were consistent with TMA and induced by the injection of FK506 alone. Apoptotic enteropathy was also observed and similar to intestinal GVHD. In this study, we established an intestinal TMA model induced by immunosuppressant (Tacrolimus) only without irradiation.
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Affiliation(s)
- M Fujino
- Department of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
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50
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Hara Y, Fujino M, Nakada K, Kimura K, Adachi K, Li XK. Influence of the numbers of islets on the models of rat syngeneic-islet and allogeneic-islet transplantations. Transplant Proc 2007; 38:2726-8. [PMID: 17098051 DOI: 10.1016/j.transproceed.2006.08.002] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
One of the main barriers to widespread application of islet transplantation is the limited availability of human pancreatic islets. The reduction of graft islet mass for transplantation to a recipient is one of the strategies in islet transplantation. However, transplantation of only a small number of islets may result in primary nonfunction. To optimize the sites and numbers of islets for transplantation, we analyzed these factors using pancreatic islets from Lewis or F344 rats transplanted into rats rendered diabetic by streptozotocin (50 mg/kg IV) and confirmed as such prior to transplantation (>300 mg/dL blood glucose). Approximately 500 to 1500 islets were injected via the portal vein or under the renal capsule into the diabetic F344 rats. The blood glucose level of all animals bearing 1500 syngeneic or allogeneic islets transplanted to the liver or under the kidney capsule exhibited restored normoglycemia (<200 mg/dL) at 1 day after transplantation. Graft function deteriorated after only 3 days in three animals (5.8%). The loss of graft function after 3 days occurred in 10 of 28 rats transplanted with 1000 to 1200 syngeneic islets, 4 of 19 rats transplanted with 800 to 900 syngeneic islets, and 7 of 17 rats transplanted with 500 to 600 syngeneic islets. There was no significant difference in the loss of graft function between the sites of transplantation via portal vein or under the kidney capsule. In conclusion, higher frequencies of primary nonfunction occurred with less than 1500 islets transplanted. They were independent of the sites in the rat-islet transplantation model.
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Affiliation(s)
- Y Hara
- Laboratory of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
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