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Ito Y, Takeuchi S, Tozawa T, Hisada S, Yamada Y, Kodera M, Kobayashi M, Shirahata M, Matsubara A. Anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis with possible complication of thrombotic microangiopathy. J Dermatol 2024; 51:448-452. [PMID: 37830409 DOI: 10.1111/1346-8138.17004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/05/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
This case study illustrates a 63-year-old Japanese woman who presented with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis. She was administered a therapeutic regimen consisting of corticosteroids, tacrolimus, and cyclophosphamide. However, after a month of treatment, symptoms of confusion and depressive tendencies emerged, followed by the manifestation of hematuria, thrombocytopenia, and fragmented erythrocytes. A disintegrin-like and metalloprotease with thrombospondin type 1 motifs 13 activity was 45%. Thrombotic microangiopathy was contemplated, yet a definitive diagnosis remained elusive. She died 2 months after admission. Although the occurrence of thrombotic microangiopathy in patients with dermatomyositis is rare, the prognosis is poor, emphasizing the importance of prompt diagnosis and treatment.
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Affiliation(s)
- Yumi Ito
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
| | - Saki Takeuchi
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
| | - Takahisa Tozawa
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
| | - Satoko Hisada
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
| | - Yoshihiro Yamada
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
| | - Masahiro Kobayashi
- Department of Respiratory Medicine, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
| | - Mizuho Shirahata
- Department of Hematology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
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Ishikawa Y, Tanaka N, Asano Y, Kodera M, Shirai Y, Akahoshi M, Hasegawa M, Matsushita T, Saito K, Motegi SI, Yoshifuji H, Yoshizaki A, Kohmoto T, Takagi K, Oka A, Kanda M, Tanaka Y, Ito Y, Nakano K, Kasamatsu H, Utsunomiya A, Sekiguchi A, Niiro H, Jinnin M, Makino K, Makino T, Ihn H, Yamamoto M, Suzuki C, Takahashi H, Nishida E, Morita A, Yamamoto T, Fujimoto M, Kondo Y, Goto D, Sumida T, Ayuzawa N, Yanagida H, Horita T, Atsumi T, Endo H, Shima Y, Kumanogoh A, Hirata J, Otomo N, Suetsugu H, Koike Y, Tomizuka K, Yoshino S, Liu X, Ito S, Hikino K, Suzuki A, Momozawa Y, Ikegawa S, Tanaka Y, Ishikawa O, Takehara K, Torii T, Sato S, Okada Y, Mimori T, Matsuda F, Matsuda K, Amariuta T, Imoto I, Matsuo K, Kuwana M, Kawaguchi Y, Ohmura K, Terao C. GWAS for systemic sclerosis identifies six novel susceptibility loci including one in the Fcγ receptor region. Nat Commun 2024; 15:319. [PMID: 38296975 PMCID: PMC10830486 DOI: 10.1038/s41467-023-44541-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 12/18/2023] [Indexed: 02/02/2024] Open
Abstract
Here we report the largest Asian genome-wide association study (GWAS) for systemic sclerosis performed to date, based on data from Japanese subjects and comprising of 1428 cases and 112,599 controls. The lead SNP is in the FCGR/FCRL region, which shows a penetrating association in the Asian population, while a complete linkage disequilibrium SNP, rs10917688, is found in a cis-regulatory element for IRF8. IRF8 is also a significant locus in European GWAS for systemic sclerosis, but rs10917688 only shows an association in the presence of the risk allele of IRF8 in the Japanese population. Further analysis shows that rs10917688 is marked with H3K4me1 in primary B cells. A meta-analysis with a European GWAS detects 30 additional significant loci. Polygenic risk scores constructed with the effect sizes of the meta-analysis suggest the potential portability of genetic associations beyond populations. Prioritizing the top 5% of SNPs of IRF8 binding sites in B cells improves the fitting of the polygenic risk scores, underscoring the roles of B cells and IRF8 in the development of systemic sclerosis. The results also suggest that systemic sclerosis shares a common genetic architecture across populations.
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Affiliation(s)
- Yuki Ishikawa
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan
| | - Nao Tanaka
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihide Asano
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Dermatology, The University of Tokyo, Tokyo, Japan
| | - Masanari Kodera
- Department of Dermatology, Chukyo Hospital, Japan Community Health Care Organization, Nagoya, Japan
| | - Yuichiro Shirai
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan
| | - Mitsuteru Akahoshi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
- Department of Rheumatology, Saga University Hospital, Saga, Japan
| | - Minoru Hasegawa
- Faculty of Medical Sciences, Department of Dermatology, University of Fukui, Fukui, Japan
| | - Takashi Matsushita
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Kazuyoshi Saito
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Sei-Ichiro Motegi
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ayumi Yoshizaki
- Department of Dermatology, The University of Tokyo, Tokyo, Japan
| | - Tomohiro Kohmoto
- Aichi Cancer Center Research Institute, Division of Molecular Genetics, Nagoya, Japan
| | - Kae Takagi
- Tokyo Women's Medical University, Adachi Medical Center, Tokyo, Japan
| | - Akira Oka
- Department of Molecular Life Sciences, Division of Basic Medical Science and Molecular Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Miho Kanda
- Department of Dermatology, Chukyo Hospital, Japan Community Health Care Organization, Nagoya, Japan
| | - Yoshihito Tanaka
- Department of Dermatology, Chukyo Hospital, Japan Community Health Care Organization, Nagoya, Japan
| | - Yumi Ito
- Department of Dermatology, Chukyo Hospital, Japan Community Health Care Organization, Nagoya, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Hiroshi Kasamatsu
- Faculty of Medical Sciences, Department of Dermatology, University of Fukui, Fukui, Japan
| | - Akira Utsunomiya
- Faculty of Medical Sciences, Department of Dermatology, University of Fukui, Fukui, Japan
| | - Akiko Sekiguchi
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiroaki Niiro
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Masatoshi Jinnin
- Department of Dermatology, Wakayama Medical University Graduate School of Medicine, Wakayama, Japan
| | - Katsunari Makino
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takamitsu Makino
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Motohisa Yamamoto
- Department of Rheumatology and Allergy, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Chisako Suzuki
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroki Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Emi Nishida
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Department of Dermatology, Okazaki City Hospital, Okazaki, Japan
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toshiyuki Yamamoto
- Department of Dermatology, Fukushima Medical University, School of Medicine, Fukushima, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuya Kondo
- Department of Rheumatology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Daisuke Goto
- Department of Rheumatology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takayuki Sumida
- Department of Rheumatology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Naho Ayuzawa
- Department of Clinical Immunology, National Hospital Organization, Utano National Hospital, Kyoto, Japan
| | - Hidetoshi Yanagida
- Department of Clinical Immunology, National Hospital Organization, Utano National Hospital, Kyoto, Japan
| | - Tetsuya Horita
- Faculty of Medicine and Graduate School of Medicine, Department of Rheumatology, Endocrinology and Nephrology, Hokkaido University, Sapporo, Japan
| | - Tatsuya Atsumi
- Faculty of Medicine and Graduate School of Medicine, Department of Rheumatology, Endocrinology and Nephrology, Hokkaido University, Sapporo, Japan
| | - Hirahito Endo
- Omori Medical Center, Toho University, Rheumatic Disease Center, Tokyo, Japan
| | - Yoshihito Shima
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun Hirata
- Immunology Frontier Center, Osaka University, Statistical Immunology, Osaka, Japan
| | - Nao Otomo
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan
| | - Hiroyuki Suetsugu
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan
| | - Yoshinao Koike
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan
| | - Kohei Tomizuka
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan
| | - Soichiro Yoshino
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan
| | - Xiaoxi Liu
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan
| | - Shuji Ito
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan
| | - Keiko Hikino
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Pharmacogenomics, Yokohama, Japan
| | - Akari Suzuki
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Autoimmune Diseases, Yokohama, Japan
| | - Yukihide Momozawa
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Genotyping Development, Yokohama, Japan
| | - Shiro Ikegawa
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Bone and Joint Diseases, Yokohama, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Osamu Ishikawa
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kazuhiko Takehara
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | | | - Shinichi Sato
- Department of Dermatology, The University of Tokyo, Tokyo, Japan
| | - Yukinori Okada
- Immunology Frontier Center, Osaka University, Statistical Immunology, Osaka, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Ijinkai Takeada General Hospital, Kyoto, Japan
| | - Fumihiko Matsuda
- Graduate School of Medicine, Kyoto University, Center for Genomic Medicine, Kyoto, Japan
| | - Koichi Matsuda
- Institute of Medical Science, The University of Tokyo, Laboratory of Genome Technology, Human Genome Center, Tokyo, Japan
- Department of Computational Biology and Medical Sciences, Laboratory of Clinical Genome Sequencing, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Tiffany Amariuta
- Center for Data Sciences, Harvard Medical School, Boston, MA, USA
- Divisions of Genetics and Rheumatology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
- Graduate School of Arts and Sciences, Harvard University, Cambridge, MA, USA
| | - Issei Imoto
- Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Keitaro Matsuo
- Aichi Cancer Center Research Institute, Division of Cancer Epidemiology and Prevention, Nagoya, Japan
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan
| | - Yasushi Kawaguchi
- Tokyo Women's Medical University, Division of Rheumatology, Department of Internal Medicine, Tokyo, Japan
| | - Koichiro Ohmura
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chikashi Terao
- RIKEN Center for Integrative Medical Sciences, The Laboratory for Statistical and Translational Genetics, Yokohama, Japan.
- Shizuoka General Hospital, The Clinical Research Center, Shizuoka, Japan.
- The Department of Applied Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan.
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3
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Kodera M, Nakamura K, Ezaki T, Suzuki T, Yokoyama S. Quantitative assessment of urinary equol levels, equol-producing bacteria, and the faecal microbiota in healthy Japanese individuals. Benef Microbes 2023; 14:445-458. [PMID: 38656099 DOI: 10.1163/18762891-20230038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/22/2023] [Indexed: 04/26/2024]
Abstract
Equol (4',7-isoflavandiol) has attracted considerable attention for its potential efficacy in treating hormonal diseases. In this study we collected samples from healthy Japanese individuals (n = 91) to observe the relationship between the abundance of equol-producing bacteria in their faeces and the concentration of equol in their urine. Quantitative polymerase chain reaction (qPCR) targeting the dihydrodaidzein reductase gene (dhdr) was used to detect equol-producing bacteria. Equol producers, who were defined as individuals with >1000 nmol/l equol in their urine, exhibited 4-8 log10 copies of dhdr/g faeces of equol-producing bacteria. We assessed the accuracy of these findings by determining the rate of correspondence between possessing equol-producing bacteria and producing urinary equol. Of the 91 participants, 33 were found to be positive for both equol-producing bacteria and urinary equol, 52 were negative for both, one was positive for equol-producing bacteria and negative for urinary equol, and five were negative for equol-producing bacteria and positive for urinary equol. The sensitivity and specificity of the qPCR for detecting equol-producing bacteria were 86.8% and 98.1%, respectively. On the whole, the presence of equol-producing bacteria and urinary equol displayed 93.4% concordance, with a kappa coefficient of 0.862. No apparent correlation was observed between dhdr copy number in the faeces and urinary equol concentrations. Analysis of the faecal microbiota showed that alpha diversity indices (OTU, ACE, Chao1, Shannon) were significantly higher in equol producers. Specifically, the relative abundance of phylum Pseudomonadota was increased in non-equol producers, while abundance of genus Alistipes, Barnesiella, Butyricimonas, Odoribacter, and Ruminococcus, which produce short chain fatty acids and/or hydrogen, were only observed in equol producers. These results suggest that a certain amount of equol-producing bacteria must be present in the intestine to produce detectable levels of equol, and that equol productivity might be affected by other components of the microbiota.
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Affiliation(s)
- M Kodera
- The United Graduate School of Agricultural Science, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
- Gifu Prefectural Research Institute for Food Science, 1-1 Yanagido, Gifu 501-1112, Japan
| | - K Nakamura
- The United Graduate School of Agricultural Science, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - T Ezaki
- Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
| | - T Suzuki
- The United Graduate School of Agricultural Science, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - S Yokoyama
- Gifu Prefectural Research Institute for Food Science, 1-1 Yanagido, Gifu 501-1112, Japan
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Miyawaki Y, Fujii T, Anan K, Kodera M, Kikuchi M, Sada KE, Nagasaka K, Bando M, Sugiyama H, Kaname S, Harigai M, Tamura N. Concordance between practice and published evidence in the management of ANCA-associated vasculitis in Japan: A cross-sectional web-questionnaire survey. Mod Rheumatol 2023; 33:990-997. [PMID: 36181464 DOI: 10.1093/mr/roac118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/02/2022] [Accepted: 09/17/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES We conducted a descriptive study of the physicians' evidence-practice gap for adults covered by the 2017 clinical practice guidelines for the management of antineutrophil cytoplasmic antibody-associated vasculitis in Japan. METHODS This web-based survey, conducted between January and February 2021, involved physicians who had treated at least five patients in the preceding year at a regional core hospital. The outcome was the physicians' experience in treating patients with microscopic polyangiitis or granulomatosis with polyangiitis [prevalence with 95% confidence intervals (CIs)], defined as treating at least 60% of their patients with the recommended therapy during the year. A modified Poisson regression analysis was performed to explore the factors associated with concordance. RESULTS The 202 participants included 49 pulmonologists, 65 nephrologists, 61 rheumatologists, and other physicians. The concordance was 31.5% (95% CI, 25.1-38.5) of physicians who used cyclophosphamide or rituximab for the induction of remission. Rheumatology showed the highest concordance with published evidence (risk ratio = 2.4; 95% CI, 1.10-5.22, p = .03). CONCLUSIONS These results suggest an evidence-practice gap, which varies substantially among subspecialties. Further studies and a new promotional initiative are necessary to close this gap in clinical practice.
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Affiliation(s)
- Yoshia Miyawaki
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Takao Fujii
- Department of Rheumatology and Clinical Immunology, Wakayama Medical University, Wakayama, Japan
| | - Keisuke Anan
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Healthcare, Organization Chukyo Hospital, Nagoya, Japan
| | - Masao Kikuchi
- Faculty of Medicine College Hospital Hemocatharsis treatment part, University of Miyazaki Hospital, Miyazaki, Japan
| | - Ken-Ei Sada
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Clinical Epidemiology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Kenji Nagasaka
- Department of Rheumatology, Ome Municipal General Hospital, Ome, Tokyo, Japan
- Department of Rheumatology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Masashi Bando
- Department of Medicine, Division of Pulmonary Medicine, Jichi Medical University, Tochigi, Japan
| | - Hitoshi Sugiyama
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Medicine, Kawasaki Medical School General Medical Center and Department of Medical Care Work, Kawasaki College of Allied Health Professions, Okayama, Japan
| | - Shinya Kaname
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Masayoshi Harigai
- Department of Rheumatology, Division of Epidemiology and Pharmacoepidemiology, School of Medicine, Tokyo Women's Medical University of Medicine, Tokyo, Japan
| | - Naoto Tamura
- Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Tokyo, Japan
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Watanabe A, Shima Y, Takahashi H, Akiyama Y, Kodera M, Jinnin M, Azuma N, Ishii K, Kumanogoh A. Arm heating to relieve Raynaud's phenomenon in systemic sclerosis: A single-arm multicentre prospective clinical trial. Mod Rheumatol 2023; 33:968-974. [PMID: 36124934 DOI: 10.1093/mr/roac116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Raynaud's phenomenon, one of the major symptoms of systemic sclerosis (SSc), is difficult to treat. Although it is empirically considered that warming is a beneficial technique, there is no supportive evidence. We conducted a multicentre study to evaluate whether continuous heating of the arm alleviates Raynaud's phenomenon in SSc. METHODS A pair of disposable warmers was applied to the upper arm near the elbow of patients with SSc. Two weeks of non-warmer application were followed by 2 weeks of warmer application, which was repeated twice. The Raynaud Condition Score (RCS), number of episodes, and duration of Raynaud's phenomenon were recorded. The differences in the mean RCS, frequency, and duration of Raynaud's phenomenon between the warmer application and non-application periods were analysed. RESULTS Twenty-eight patients were included in the analysis. The average RCS was 1.98 and 2.66 during the warmer application and non-application periods, respectively. The change between the two periods was statistically significant by paired t-test. In addition, the frequency and total duration of Raynaud's phenomenon in the warmer application period were significantly lower than those in the non-application period. CONCLUSIONS Heating of the upper arm near the elbow is effective in alleviating Raynaud's phenomenon in SSc.
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Affiliation(s)
- Akane Watanabe
- Laboratory of Thermo-therapeutics for Vascular Dysfunction, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshihito Shima
- Laboratory of Thermo-therapeutics for Vascular Dysfunction, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroki Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Yuji Akiyama
- Division of Rheumatology, Department of Internal Medicine, Ogawa Red Cross Hospital, Saitama, Japan
- Department of Rheumatology and Applied Immunology, Saitama Medical University, Saitama, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Aichi, Japan
| | - Masatoshi Jinnin
- Department of Dermatology, Wakayama Medical University Graduate School of Medicine, Wakayama, Japan
| | - Naoto Azuma
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University School of Medicine, Hyogo, Japan
| | - Koji Ishii
- Department of Rheumatology, Oita Red Cross Hospital, Oita, Japan
| | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
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Kokubu H, Takeuchi S, Tozawa T, Hisada S, Yamada Y, Itoh Y, Kodera M. Assessing prognostic factors correlating with response to nintedanib for connective tissue disease-associated interstitial lung disease: A real-world single-center study. Int J Rheum Dis 2023; 26:682-688. [PMID: 36808836 DOI: 10.1111/1756-185x.14611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE For patients with connective tissue disease-associated interstitial lung disease (CTD-ILD), early medical intervention would be desirable. This study analyzed the real-world, single-center use of nintedanib for CTD-ILD patients. METHODS Patients with CTD who received nintedanib from January 2020 to July 2022 were enrolled. Medical records review and stratified analyses of the collected data were conducted. RESULTS Reduction in the percentage of predicted forced vital capacity (%FVC) was seen in the elderly group (>70 years; P = .210), males (P = .027), the late group who started nintedanib >80 months after confirmation of an ILD disease activity (P = .03), the severe %DLco (diffusing capacity for carbon monoxide as a percentage of predicted) group (<40%; P = .20), the group who had extensive pulmonary fibrosis at the beginning of nintedanib (pulmonary fibrosis score >35%), and the low-dose group (nintedanib 50-100 mg/d; P = .40). %FVC did not decrease by >5% in the young group (<55 years), the early group who started nintedanib within 10 months after confirmation of an ILD disease activity, and the group whose pulmonary fibrosis score at the beginning of nintedanib was <35%. CONCLUSION It is important to diagnose ILD early and start antifibrotic drugs with proper timing for cases in need. It is better to start nintedanib early, especially for patients at risk (>70 years old, male, <40% DLco, and >35% areas of pulmonary fibrosis).
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Affiliation(s)
- Hiraku Kokubu
- Department of Dermatology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan.,Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Saki Takeuchi
- Department of Dermatology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan
| | - Takahisa Tozawa
- Department of Dermatology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan
| | - Satoko Hisada
- Department of Dermatology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan
| | - Yoshihiro Yamada
- Department of Dermatology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan
| | - Yumi Itoh
- Department of Dermatology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan
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Ebata S, Yoshizaki A, Oba K, Kashiwabara K, Ueda K, Uemura Y, Watadani T, Fukasawa T, Miura S, Yoshizaki-Ogawa A, Okiyama N, Kodera M, Hasegawa M, Sato S. Safety and efficacy of rituximab in systemic sclerosis (DESIRES): open-label extension of a double-blind, investigators-initiated, randomised, placebo-controlled trial. Lancet Rheumatol 2022; 4:e546-e555. [PMID: 38294008 DOI: 10.1016/s2665-9913(22)00131-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Results from the double-blind phase 2 DESIRES trial showed that rituximab improves skin thickening in systemic sclerosis. Here, we present the findings of a subsequent 24-week open-label extension phase. METHODS Patients with systemic sclerosis aged 20-79 years, who fulfilled the 2013 American College of Rheumatology and European League Against Rheumatism classification criteria, with a baseline modified Rodnan Skin Score (mRSS) of 10 or greater were enrolled into the DESIRES trial, which was an investigator-initiated, phase 2, double-blind, randomised controlled trial of rituximab versus placebo conducted at four sites in Japan. After completion of 24 weeks of treatment with either rituximab or placebo, patients in both groups received a further 24 weeks of rituximab (375 mg/m2 intravenously, once per week for 4 consecutive weeks) in an open-label extension. The primary endpoint of the double-blind trial was mRSS at week 24, which was reassessed at week 48 in the open-label extension. All endpoints were exploratory. Safety analyses included all participants who received at least one dose of study drug; efficacy analyses included those who had received at least one dose and undergone efficacy assessment at 24 weeks in the double-blind phase and at 48 weeks in the extension phase. The DESIRES study is registered with ClinicalTrials.gov, NCT04274257, and UMIN-CTR, UMIN000030139. FINDINGS Between Nov 28, 2017, and Nov 6, 2018, 56 patients were randomly assigned to either rituximab (n=28) or placebo (n=28) in a double-blind study. 26 patients initially assigned to rituximab and 20 assigned to placebo transitioned to the open-label extension and all received at least one dose of rituximab; 24 participants in the rituximab-rituximab group and 19 in the placebo-rituximab group completed the extension phase. In the rituximab-rituximab group, there was an improvement in mRSS from baseline at week 24 (-5·81 [SD 3·16]), with further improvement at week 48 (-8·88 [3·10]). In the placebo-rituximab group, mRSS worsened at week 24 (2·14 [SD 5·51]) but improved at the week 48 assessment (-6·05 [4·43]). One patient each in the rituximab-rituximab and placebo-rituximab groups experienced one serious adverse event during the open-label phase (cholangitis and pneumococcal pneumonia, respectively). There were no deaths during follow-up. INTERPRETATION Two courses of rituximab is a safe treatment that can provide sustained improvement in systemic sclerosis for at least 48 weeks. FUNDING Japan Agency for Medical Research and Development. TRANSLATION For the Japanese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Satoshi Ebata
- Department of Dermatology, The University of Tokyo, Tokyo, Japan
| | - Ayumi Yoshizaki
- Department of Dermatology, The University of Tokyo, Tokyo, Japan.
| | - Koji Oba
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan; Graduate School of Medicine, and Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Kosuke Kashiwabara
- Clinical Research Support Center, Tokyo University Hospital, Tokyo, Japan
| | - Keiko Ueda
- Clinical Research Support Center, Tokyo University Hospital, Tokyo, Japan
| | - Yukari Uemura
- Clinical Research Support Center, Tokyo University Hospital, Tokyo, Japan; Biostatistics Section, Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeyuki Watadani
- Department of Diagnostic Radiology, The University of Tokyo, Tokyo, Japan
| | | | - Shunsuke Miura
- Department of Dermatology, The University of Tokyo, Tokyo, Japan
| | | | - Naoko Okiyama
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Aichi, Japan
| | - Minoru Hasegawa
- Department of Dermatology, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinichi Sato
- Department of Dermatology, The University of Tokyo, Tokyo, Japan
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Ishikawa Y, Tanaka N, Asano Y, Kodera M, Shirai Y, Akahoshi M, Hasegawa M, Matsushita T, Kazuyoshi S, Motegi S, Yoshifuji H, Yoshizaki A, Kohmoto T, Takagi K, Oka A, Kanda M, Tanaka Y, Ito Y, Nakano K, Kasamatsu H, Utsunomiya A, Sekiguchi A, Niro H, Jinnin M, Makino K, Makino T, Ihn H, Yamamoto M, Suzuki C, Takahashi H, Nishida E, Morita A, Yamamoto T, Fujimoto M, Kondo Y, Goto D, Sumida T, Ayuzawa N, Yanagida H, Horita T, Atsumi T, Endo H, Shima Y, Kumanogoh A, Hirata J, Otomo N, Suetsugu H, Koike Y, Tomizuka K, Yoshino S, Liu X, Ito S, Hikino K, Suzuki A, Momozawa Y, Ikegawa S, Tanaka Y, Ishikawa O, Takehara K, Torii T, Sato S, Okada Y, Mimori T, Matsuda F, Matsuda K, Imoto I, Matsuo K, Kuwana M, Kawaguchi Y, Ohmura K, Terao C. OP0112 THE EVER-LARGEST ASIAN GWAS FOR SYSTEMIC SCLEROSIS AND TRANS-POPULATION META-ANALYSIS IDENTIFIED SEVEN NOVEL LOCI AND A CANDIDATE CAUSAL SNP IN A CIS-REGULATORY ELEMENT OF THE FCGR REGION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundGenome-wide association studies (GWASs) have identified 29 disease-associated single nucleotide polymorphisms (SNPs) for systemic sclerosis (SSc) in non-human leukocyte antigen (HLA) regions (1-7). While these GWASs have clarified genetic architectures of SSc, study subjects were mainly Caucasians limiting application of the findings to Asians.ObjectivesThe study was conducted to identify novel causal variants for SSc specific to Japanese subjects as well as those shared with European population. We also aimed to clarify mechanistic effects of the variants on pathogenesis of SSc.MethodsA total of 114,108 subjects comprising 1,499 cases and 112,609 controls were enrolled in the two-staged study leading to the ever-largest Asian GWAS for SSc. After applying a strict quality control both for genotype and samples, imputation was conducted using the reference panel of the phase 3v5 1,000 genome project data combined with a high-depth whole-genome sequence data of 3,256 Japanese subjects. We conducted logistic regression analyses and also combined the Japanese GWAS results with those of Europeans (6) by an inverse-variance fixed-effect model. Polygenicity and enrichment of functional annotations were evaluated by linkage disequilibrium score regression (LDSC), Haploreg and IMPACT programs. We also constructed polygenic risk score (PRS) to predict SSc development.ResultsWe identified three (FCRLA-FCGR, TNFAIP3, PLD4) and four (EOMES, ESR1, SLC12A5, TPI1P2) novel loci in Japanese GWAS and a trans-population meta-analysis, respectively. One of Japanese novel risk SNPs, rs6697139, located within FCGR gene clusters had a strong effect size (OR 2.05, P=4.9×10-11). We also found the complete LD variant, rs10917688, was positioned in cis-regulatory element and binding motif for an immunomodulatory transcription factor IRF8 in B cells, another genome-wide significant locus in our trans-ethnic meta-analysis and the previous European GWAS. Notably, the association of risk allele of rs10917688 was significant only in the presence of the risk allele of the IRF8. Intriguingly, rs10917688 was annotated as one enhancer-related histone marks, H3K4me1, in B cells, implying that FCGR gene(s) in B cells may play an important role in the pathogenesis of SSc. Furhtermore, significant heritability enrichment of active histone marks and a transcription factor C-Myc were found in B cells both in European and Japanese populations by LDSC and IMPACT, highlighting a possibility of a shared disease mechanism where abnormal B-cell activation may be one of the key drivers for the disease development. Finally, PRS using effects sizes of European GWAS moderately fit in the development of Japanese SSc (AUC 0.593), paving a path to personalized medicine for SSc.ConclusionOur study identified seven novel susceptibility loci in SSc. Downstream analyses highlighted a novel disease mechanism of SSc where an interactive role of FCGR gene(s) and IRF8 may accelerate the disease development and B cells may play a key role on the pathogenesis of SSc.References[1]F. C. Arnett et al. Ann Rheum Dis, 2010.[2]T. R. Radstake et al. Nat Genet, 2010.[3]Y. Allanore et al. PLoS Genet, 2011.[4]O. Gorlova et al. PLoS Genet, 2011.[5]C. Terao et al. Ann Rheum Dis, 2017.[6]E. López-Isac et al. Nat Commun, 2019.[7]W. Pu et al. J Invest Dermatol, 2021.Disclosure of InterestsNone declared
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Kawazoe M, Nanki T, Hagino N, Ikegaya N, Ito S, Kodera M, Nakano N, Suzuki M, Kaname S, Harigai M. Clinical characteristics of patients with polyarteritis nodosa based on a nationwide database in Japan. Mod Rheumatol 2021; 32:598-605. [PMID: 34894268 DOI: 10.1093/mr/roab019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/05/2021] [Accepted: 06/14/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES This study aimed to clarify the epidemiological and clinical features and treatment of patients with polyarteritis nodosa (PAN) in Japan. METHODS We used the database of the Ministry of Health, Labour and Welfare (MHLW) of Japan in 2013 and 2014. We analysed 121 patients who were antineutrophil cytoplasmic antibodies negative among the patients certified as PAN according to the MHLW diagnostic criteria. RESULTS The analysis included 60 males and 61 females, with a mean age of 52.9 ± 21.0 years. As a general manifestation, fever was observed in 53.7%. Regarding organ involvement, skin manifestations (82.6%), joint and muscle manifestations (75.2%), and neuropsychiatric manifestations (50.4%) were common. Male patients had a higher proportion of mononeuritis multiplex involving motor neuropathy than female patients. Elderly patients had a higher proportion of general and respiratory manifestations. Glucocorticoids were used for treatment in all patients, and 19.0% underwent methylprednisolone pulse. Concomitant immunosuppressants were used in 25.6%, one-third of whom received cyclophosphamide. Methylprednisolone pulse and cyclophosphamide were mostly used in patients with life-threatening organ involvement. CONCLUSIONS PAN developed in middle-aged people and led to numerous clinical manifestations. The common manifestations varied with age, and treatment was determined based on the type of organ involvement and disease severity.
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Affiliation(s)
- Mai Kawazoe
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Toshihiro Nanki
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Noboru Hagino
- Division of Hematology and Rheumatology, Teikyo University Chiba Medical Center, Chiba, Japan
| | - Noriko Ikegaya
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Satoshi Ito
- Department of Rheumatology, Niigata Rheumatic Center, Niigata, Japan
| | - Masanari Kodera
- Department of Dermatology and Rheumatology, Japan Community Health Care Organization Chukyo Hospital, Aichi, Japan
| | - Naoko Nakano
- Department of Pediatrics, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Miki Suzuki
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Shinya Kaname
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Masayoshi Harigai
- Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
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Ebata S, Yoshizaki A, Oba K, Kashiwabara K, Ueda K, Uemura Y, Watadani T, Fukasawa T, Miura S, Yoshizaki-Ogawa A, Asano Y, Okiyama N, Kodera M, Hasegawa M, Sato S. Safety and efficacy of rituximab in systemic sclerosis (DESIRES): a double-blind, investigator-initiated, randomised, placebo-controlled trial. Lancet Rheumatol 2021; 3:e489-e497. [PMID: 38279402 DOI: 10.1016/s2665-9913(21)00107-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Systemic sclerosis is a connective tissue disease characterised by multiorgan fibrosis with an autoimmune background and poor prognosis. Although a few drugs have shown some efficacy in treating the disease, there remains a great unmet medical need. We aimed to investigate the efficacy and safety of rituximab in patients with systemic sclerosis. METHODS We did a double-blind, investigator-initiated, randomised, placebo-controlled trial at four hospitals in Japan. Patients aged 20-79 years, who fulfilled the 2013 American College of Rheumatology and European League Against Rheumatism classification criteria for systemic sclerosis, with a modified Rodnan Skin Score (mRSS) of 10 or greater, and an expected survival of at least 6 months were randomly assigned (1:1) to receive intravenous rituximab (375 mg/m2) or placebo once per week for 4 weeks. Patients and investigators were masked to treatment allocation. The primary endpoint was the absolute change in mRSS 24 weeks after initiation of study treatment, measured in all patients who received at least one dose of study treatment and had one endpoint assessment. This study is registered with ClinicalTrials.gov, NCT04274257, and UMIN-CTR, UMIN000030139. FINDINGS Between Nov 28, 2017, and Nov 6, 2018, 80 individuals were screened and 56 (70%) were enrolled and randomly assigned; 51 (91%) were women and five (9%) were men. 27 (96%) of 28 patients in the rituximab group and 22 (79%) of 28 patients in the placebo group received at least one dose of their allocated treatment and completed 24 weeks of follow-up. The absolute change in mRSS 24 weeks after initiation of study treatment was lower in the rituximab group than in the placebo group (-6·30 in the rituximab group vs 2·14 in the placebo group; difference -8·44 [95% CI -11·00 to -5·88]; p<0·0001). Adverse events were similar in both groups and occurred in 28 (100%) of 28 patients in the rituximab group and 23 (88%) of 26 patients in the placebo group. One serious adverse event leading to treatment discontinuation occurred in one patient in each group (decreased serum albumin in the rituximab group and biliary enzyme increase in the placebo group). The most common adverse event was upper respiratory infection, which occurred in 11 patients (39%) in the rituximab group and ten patients (38%) in the placebo group. There were no deaths during follow-up. INTERPRETATION Rituximab appears to be an effective and safe treatment for systemic sclerosis. Although this study has some limitations, this is the first clinical trial to show efficacy of rituximab with skin sclerosis as the primary endpoint. FUNDING Japan Agency for Medical Research and Development (AMED), Zenyaku Kogyo. TRANSLATION For the Japanese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Satoshi Ebata
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Ayumi Yoshizaki
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
| | - Koji Oba
- Department of Biostatistics, School of Public Health, University of Tokyo Graduate School of Medicine, Tokyo, Japan; Interfaculty Initiative in Information Studies, University of Tokyo, Tokyo, Japan
| | - Kosuke Kashiwabara
- Clinical Research Support Centre, Tokyo University Hospital, Tokyo, Japan
| | - Keiko Ueda
- Clinical Research Support Centre, Tokyo University Hospital, Tokyo, Japan
| | - Yukari Uemura
- Clinical Research Support Centre, Tokyo University Hospital, Tokyo, Japan; Biostatistics Section, Department of Data Science, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Takeyuki Watadani
- Department of Diagnostic Radiology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Takemichi Fukasawa
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Shunsuke Miura
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Asako Yoshizaki-Ogawa
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yoshihide Asano
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Naoko Okiyama
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Health Care Organisation Chukyo Hospital, Aichi, Japan
| | - Minoru Hasegawa
- Department of Dermatology, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinichi Sato
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Kawakami T, Okiyama N, Kodera M, Seishima M, Yamaguchi Y. The relationship between anti-phosphatidylserine/prothrombin complex IgM antibodies and cutaneous ulcers in patients with cutaneous vasculitis. J Dermatol 2021; 48:1457-1458. [PMID: 34173266 DOI: 10.1111/1346-8138.16014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Tamihiro Kawakami
- Division of Dermatology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Naoko Okiyama
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masanari Kodera
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Mariko Seishima
- Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
| | - Yukie Yamaguchi
- Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Furukawa Y, Yokoyama S, Tanaka Y, Kodera M, Kaga T. A case of severe choroidal detachment in both eyes due to systemic lupus erythematosus. Am J Ophthalmol Case Rep 2020; 19:100829. [PMID: 32695932 PMCID: PMC7363651 DOI: 10.1016/j.ajoc.2020.100829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/30/2020] [Accepted: 07/09/2020] [Indexed: 02/06/2023] Open
Abstract
Purpose We report a case of severe choroidal detachments (CDs) in both eyes caused by systemic lupus erythematosus (SLE). Observations The patient was a 50-year-old woman who presented with conjunctival edema in both eyes, visual dysfunction, and generalized fatigue. At the first visit, the best corrected visual acuity (BCVA) was 20/70 OD and 20/70 OS, and the intraocular pressure (IOP) was 22 mmHg OD and 27 mmHg OS. She had serous retinal detachments (SRDs), CDs, ciliary dissections, and a shallow anterior chamber with partial angle closure in both eyes. Systemic findings included hypoalbuminemia, pleural fluid, generalized fatigue, and brown papules on the back and both legs. First, we suspected Vogt-Koyanagi-Harada disease and administered two courses of methylprednisolone pulse therapy, but the CDs in both eyes gradually deteriorated and worsened to the extent that the optic nerve in both eyes could not be observed, and the BCVA deteriorated to 20/200 OD and 6/200 OS. Further multidisciplinary evaluations for diagnosing collagen diseases revealed vasculitis in the skin histopathology examination, positive results for anti-double stranded DNA antibody and anti-SS-A antibody, and hypocomplementemia in the blood examination, and she was diagnosed with severe SLE in the dermatology department. After administration of high dose intravenous γ-globulin therapy, albumin infusion, and intravenous cyclophosphamide pulse therapy, the SRDs and severe CDs improved along with improvement in hypoalbuminemia, pleural fluid, and generalized fatigue. Moreover, the shallow anterior chamber and high IOP improved to normal in both eyes. The CDs and SRDs completely disappeared, and the BCVA improved to 20/13 OU 6 months after the SLE therapy. Conclusion and importance In patients with observed SRDs and CDs accompanying hypoalbuminemia, it is necessary to consider collagen diseases such as SLE.
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Affiliation(s)
- Yudai Furukawa
- Department of Ophthalmology, Daiyukai General Hospital, Ichinomiya, Japan
| | - Sho Yokoyama
- Department of Ophthalmology, Japan Community Health care Organization Chukyo Hospital, Nagoya, Japan
| | - Yoshihito Tanaka
- Department of Dermatology, Japan Community Health care Organization Chukyo Hospital, Nagoya, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Health care Organization Chukyo Hospital, Nagoya, Japan
| | - Tatsushi Kaga
- Department of Ophthalmology, Japan Community Health care Organization Chukyo Hospital, Nagoya, Japan
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Hasegawa M, Inoue Y, Kaneko S, Kanoh H, Shintani Y, Tsujita J, Fujita H, Motegi SI, Le Pavoux A, Asai J, Asano Y, Abe M, Amano M, Ikegami R, Ishii T, Isei T, Isogai Z, Ito T, Irisawa R, Iwata Y, Otsuka M, Omoto Y, Kato H, Kadono T, Kawakami T, Kawaguchi M, Kukino R, Kono T, Koga M, Kodera M, Sakai K, Sakurai E, Sarayama Y, Tanioka M, Tanizaki H, Doi N, Nakanishi T, Hashimoto A, Hayashi M, Hirosaki K, Fujimoto M, Fujiwara H, Maekawa T, Matsuo K, Madokoro N, Yatsushiro H, Yamasaki O, Yoshino Y, Tachibana T, Ihn H. Wound, pressure ulcer and burn guidelines - 1: Guidelines for wounds in general, second edition. J Dermatol 2020; 47:807-833. [PMID: 32614097 DOI: 10.1111/1346-8138.15401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/19/2020] [Indexed: 01/22/2023]
Abstract
The Japanese Dermatological Association prepared the clinical guidelines for the "Wound, pressure ulcer and burn guidelines", second edition, focusing on treatments. Among them, "Guidelines for wounds in general" is intended to provide the knowledge necessary to heal wounds, without focusing on particular disorders. It informs the basic principles of wound treatment, before explanations are provided in individual chapters of the guidelines. We updated all sections by collecting references published since the publication of the first edition. In particular, we included new wound dressings and topical medications. Additionally, we added "Question 6: How should wound-related pain be considered, and what should be done to control it?" as a new section addressing wound pain, which was not included in the first edition.
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Affiliation(s)
- Minoru Hasegawa
- Department of Dermatology, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Japan
| | - Yuji Inoue
- Suizenji Dermatology Clinic, Kumamoto, Japan
| | - Sakae Kaneko
- Department of Dermatology, School of Medicine, Shimane University, Izumo, Japan
| | - Hiroyuki Kanoh
- Department of Dermatology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | | | - Jun Tsujita
- Department of Dermatology, Social Insurance Inatsuki Hospital, Fukuoka Prefecture Social Insurance Hospital Association, Fukuoka, Japan
| | - Hideki Fujita
- Department of Dermatology, School of Medicine, Nihon University, Tokyo, Japan
| | - Sei-Ichiro Motegi
- Department of Dermatology, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | | | - Jun Asai
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshihide Asano
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | | | - Masahiro Amano
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Ryuta Ikegami
- Department of Dermatology, JCHO Osaka Hospital, Osaka, Japan
| | - Takayuki Ishii
- Division of Dermatology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Taiki Isei
- Department of Dermatology, Osaka National Hospital, Osaka, Japan
| | - Zenzo Isogai
- Division of Dermatology and Connective Tissue Medicine, Department of Advanced Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takaaki Ito
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Ryokichi Irisawa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Yohei Iwata
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masaki Otsuka
- Division of Dermatology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoichi Omoto
- Department of Dermatology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Hiroshi Kato
- Department of Geriatric and Environmental Dermatology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Takafumi Kadono
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tamihiro Kawakami
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masakazu Kawaguchi
- Department of Dermatology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | | | - Takeshi Kono
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzei, Japan
| | - Monji Koga
- Department of Dermatology, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masanari Kodera
- Department of Dermatology, JCHO Chukyo Hospital, Nagoya, Japan
| | - Keisuke Sakai
- Department of Dermatology, Minamata City General Hospital & Medical Center, Minamata, Japan
| | | | | | | | - Hideaki Tanizaki
- Department of Dermatology, Osaka Medical College, Takatsuki, Japan
| | - Naotaka Doi
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Takeshi Nakanishi
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masahiro Hayashi
- Department of Dermatology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Kuninori Hirosaki
- Department of Dermatology, Hokkaido Medical Care Center, Sapporo, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshi Fujiwara
- Department of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Dermatology, Uonuma Kikan Hospital, Minamiuonuma, Japan
| | - Takeo Maekawa
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | | | - Naoki Madokoro
- Department of Dermatology, MAZDA Hospital, Aki-gun, Japan
| | | | - Osamu Yamasaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yuichiro Yoshino
- Department of Dermatology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Takao Tachibana
- Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Kawazoe M, Nanki T, Hagino N, Iketani N, Ito S, Kodera M, Nakano N, Suzuki M, Kaname SY, Harigai M. AB0494 CHARACTERISTICS OF THE PATIENTS WITH POLYARTERITIS NODOSA IN JAPAN. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1289] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Since the number of polyarteritis nodosa (PAN) patients is small not only in Japan but also in the world, the characteristics of PAN have not been fully clarified and appropriate treatment has not been established.Objectives:This study aimed to describe the epidemiological and clinical features and treatment of patients with PAN in Japan.Methods:We used the database of the Ministry of Health, Labour and Welfare (MHLW) in 2013 and 2014. Data of 178 patients who fulfilled the diagnostic criteria by MHLW and had registered within a year after onset of PAN was analyzed.Results:The analysis included 75 males and 103 females, with a mean age of 64.5 ± 20.3 years. PAN was diagnosed by clinical symptoms in 27.6% of the patients, 11.5% of the patients by pathological findings, and the rest of the patients by both. Pathological examination was performed in 71.3% of the patients, of whom 11.2% had evidence of necrotizing vasculitis of the small and medium arteries. As a systemic symptom, fever was observed in 55.2% of cases. As organ symptoms, muscle and joint symptoms (74.7%), skin symptoms (73.0%), neuropsychiatric symptoms (50.0%), respiratory symptoms (32.6%), and renal symptoms (19.7%) were common. Patients aged 65 or older had a higher rate of systemic, renal and respiratory symptoms, and lower rate of skin symptoms compared with the patients younger than 65. Patients with renal symptoms had a high prevalence of respiratory, cardiac and ocular symptoms, while those with respiratory symptoms had a high prevalence of systemic and cardiac symptoms. Laboratory findings showed that MPO- and/or p-ANCA positive rate was 30.5% and PR3- and/or c-ANCA positive rate was 11.0%. The Hepatitis B antigen positive rate was 3.9%. Angiography was performed in 20.7%, among which 27.0% were found to have multiple small aneurysms, wall irregularities and stenosis at the abdominal aortic branches. Glucocorticoids were used for treatment in all cases with an average maximum prednisolone dose of 32.5 mg/day. Concomitant immunosuppressants were used in 28.7%, half of which was cyclophosphamide. In other cases, azathioprine or methotrexate was used. Immunosuppressants have been used more frequently in patients with systemic symptoms and nasal and ear symptoms. Among the immunosuppressants, cyclophosphamide tends to be used for patients with higher CRP or patients with respiratory symptoms, and the maximum dose of glucocorticoids was significantly higher in patients who used cyclophosphamide compared to those who used other immunosuppressants.Conclusion:PAN developed in middle-aged and elderly people and exhibited various clinical symptoms. We found that common symptoms varied with age, and treatment options were determined depending on the types of organ symptoms and severity. Hepatitis B virus infection was rare in patients with PAN in Japan.References:None.Disclosure of Interests: :Mai Kawazoe: None declared, Toshihiro Nanki Grant/research support from: Chugai Pharmaceutical Co., Eisai Co., Ltd., Teijin Pharma Ltd., Eli Lilly Japan K.K., Bristol-Myers K.K., Ono Pharmaceutical Co., Ltd., Novartis Pharma K.K., Asahikasei Pharma Corp., Mitsubishi-Tanabe Pharma Co., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Pfizer Japan Inc., Daiichi Sankyo Co., Ltd., Shionogi & Co., Ltd., Sanofi K.K., Nippon Kayaku Co., Ltd., Yutoku Pharmaceutical Ind. Co., Ltd., UCB Japan Co. Ltd., Nihon Pharmaceutical Co., Ltd., and Bayer Yakuhin, Ltd., Consultant of: UCB Japan Co., Ltd., Eisai Co., Ltd., and Chugai Pharmaceutical Co., Speakers bureau: Mitsubishi-Tanabe Pharma Co., Chugai Pharmaceutical Co., Eisai Co., Ltd., Astellas Pharma Inc., Janssen Pharmaceutical K.K., Ayumi Pharmaceutical Co., Pfizer Japan Inc., Asahikasei Pharma Corp., Sanofi K.K., Novartis Pharma K.K., Eli Lilly Japan K.K., Nippon Kayaku Co., Ltd., Teijin Pharma Ltd., Takeda Pharmaceutical Co., Nippon Boehringer Ingelheim Co., Ltd., and AbbVie GK., Noboru Hagino: None declared, Noriko Iketani: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Masanari Kodera: None declared, Naoko Nakano: None declared, Miki Suzuki: None declared, Shin-ya Kaname: None declared, masayoshi harigai Grant/research support from: AbbVie Japan GK, Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Nippon Kayaku Co., Ltd., and Teijin Pharma Ltd. MH has received speaker’s fee from AbbVie Japan GK, Ayumi Pharmaceutical Co., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline K.K., Kissei Pharmaceutical Co., Ltd., Oxford Immuotec, Pfizer Japan Inc., and Teijin Pharma Ltd. MH is a consultant for AbbVie, Boehringer-ingelheim, Kissei Pharmaceutical Co., Ltd. and Teijin Pharma.
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Yoshino Y, Hashimoto A, Ikegami R, Irisawa R, Kanoh H, Sakurai E, Nakanishi T, Maekawa T, Tachibana T, Amano M, Hayashi M, Ishii T, Iwata Y, Kawakami T, Sarayama Y, Hasegawa M, Matsuo K, Ihn H, Omoto Y, Madokoro N, Isei T, Otsuka M, Kukino R, Shintani Y, Hirosaki K, Motegi S, Kawaguchi M, Asai J, Isogai Z, Kato H, Kono T, Tanioka M, Fujita H, Yatsushiro H, Sakai K, Asano Y, Ito T, Kadono T, Koga M, Tanizaki H, Fujimoto M, Yamasaki O, Doi N, Abe M, Inoue Y, Kaneko S, Kodera M, Tsujita J, Fujiwara H, Le Pavoux A. Wound, pressure ulcer and burn guidelines – 6: Guidelines for the management of burns, second edition. J Dermatol 2020; 47:1207-1235. [DOI: 10.1111/1346-8138.15335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/05/2020] [Indexed: 01/28/2023]
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16
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Ikeda T, Kawakami T, Arimura Y, Ishiguro N, Ishizu A, Ito F, Ito-Ihara T, Okiyama N, Ono S, Suzuki K, Sugawara K, Seishima M, Kodera M, Tanaka M, Hasegawa M, Furukawa F, Yamaguchi Y, Yoshizaki A. Survey of Japanese dermatological vasculitis specialists on cases of cutaneous arteritis (cutaneous polyarteritis nodosa). J Dermatol 2020; 47:534-537. [PMID: 32096266 DOI: 10.1111/1346-8138.15273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/23/2020] [Indexed: 11/29/2022]
Abstract
We developed a questionnaire to examine the findings of cutaneous arteritis among dermatological specialists experienced in vasculitis as certified by the Committee for guidelines for the management of vasculitis and vascular disorders of the Japanese Dermatological Association. We sent a questionnaire to 12 dermatological facilities identified through the revised Committee for guidelines for the management of vasculitis and vascular disorders of the Japanese Dermatological Association. Retrospective data obtained from 84 patients at the 12 dermatological facilities between 2012 January 2016 December were evaluated. The 84 patients were categorized into two groups, a systemic steroid treatment group (group 1, n = 52) and a no systemic steroid treatment group (group 2, n = 32). C-reactive protein in group 1 patients was significantly higher than that in group 2 patients. Frequency of fever, arthritis, myalgia- and peripheral neuropathy in group 1 was significantly higher than that in group 2. We propose that these symptoms could serve as early markers for the transfer from cutaneous arteritis to systemic polyarteritis nodosa. We further suggest that patients who are subsequently associated with cerebral hemorrhage and infarction, who are originally diagnosed as having cutaneous arteritis, could progress to systemic polyarteritis nodosa. The study demonstrated that it is important for dermatologists to detect these findings early in order to establish an accurate diagnosis and a timely treatment.
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Affiliation(s)
- Takaharu Ikeda
- Division of Dermatology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Tamihiro Kawakami
- Division of Dermatology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yoshihiro Arimura
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine/Internal Medicine, Kichijoji Asahi Hospital, Tokyo, Japan
| | - Naoko Ishiguro
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Akihiro Ishizu
- Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Fuyu Ito
- Asia International Institute of Infectious Disease Control, Teikyo University, Tokyo, Japan
| | - Toshiko Ito-Ihara
- Division of Research Management, The Clinical and Translational Research Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naoko Okiyama
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Sachiko Ono
- Division of Dermatology, Kyoto University, Kyoto, Japan
| | - Kazuo Suzuki
- Asia International Institute of Infectious Disease Control, Teikyo University, Tokyo, Japan
| | - Koji Sugawara
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mariko Seishima
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masanari Kodera
- Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan
| | - Maiko Tanaka
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Minoru Hasegawa
- Division of Medicine, Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | | | - Yukie Yamaguchi
- Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ayumi Yoshizaki
- Department of Dermatology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
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17
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Fujimoto M, Asai J, Asano Y, Ishii T, Iwata Y, Kawakami T, Kodera M, Abe M, Amano M, Ikegami R, Isei T, Isogai Z, Ito T, Inoue Y, Irisawa R, Ohtsuka M, Omoto Y, Kato H, Kadono T, Kaneko S, Kanoh H, Kawaguchi M, Kukino R, Kono T, Koga M, Sakai K, Sakurai E, Sarayama Y, Shintani Y, Tanioka M, Tanizaki H, Tsujita J, Doi N, Nakanishi T, Hashimoto A, Hasegawa M, Hayashi M, Hirosaki K, Fujita H, Fujiwara H, Maekawa T, Matsuo K, Madokoro N, Motegi SI, Yatsushiro H, Yamasaki O, Yoshino Y, Pavoux AJLE, Tachibana T, Ihn H. Wound, pressure ulcer and burn guidelines - 4: Guidelines for the management of connective tissue disease/vasculitis-associated skin ulcers. J Dermatol 2020; 47:1071-1109. [PMID: 31960490 DOI: 10.1111/1346-8138.15186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 11/17/2019] [Indexed: 11/30/2022]
Abstract
The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS.
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Affiliation(s)
- Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Jun Asai
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshihide Asano
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Takayuki Ishii
- Department of Dermatology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Yohei Iwata
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tamihiro Kawakami
- Department of Dermatology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Masanari Kodera
- Department of Dermatology, JCHO Chukyo Hospital, Nagoya, Japan
| | | | - Masahiro Amano
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Ryuta Ikegami
- Department of Dermatology, JCHO Osaka Hospital, Osaka, Japan
| | - Taiki Isei
- Department of Dermatology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Zenzo Isogai
- Division of Dermatology and Connective Tissue Medicine, Department of Advanced Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takaaki Ito
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yuji Inoue
- Suizenji Dermatology Clinic, Kumamoto, Japan
| | - Ryokichi Irisawa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Masaki Ohtsuka
- Department of Dermatology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoichi Omoto
- Department of Dermatology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Hiroshi Kato
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takafumi Kadono
- Department of Dermatology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Sakae Kaneko
- Department of Dermatology, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Hiroyuki Kanoh
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masakazu Kawaguchi
- Department of Dermatology, Yamagata University, Faculty of Medicine, Yamagata, Japan
| | | | - Takeshi Kono
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzei, Japan
| | - Monji Koga
- Department of Dermatology, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Keisuke Sakai
- Department of Dermatology, Minamata City General Hospital & Medical Center, Minamata, Japan
| | | | | | | | | | - Hideaki Tanizaki
- Department of Dermatology, Osaka Medical College, Takatsuki, Japan
| | - Jun Tsujita
- Department of Dermatology, Social Insurance Inatsuki Hospital, Fukuoka Prefecture Social Insurance Hospital Association, Fukuoka, Japan
| | - Naotaka Doi
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - Takeshi Nakanishi
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Minoru Hasegawa
- Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Japan
| | - Masahiro Hayashi
- Department of Dermatology, Yamagata University, Faculty of Medicine, Yamagata, Japan
| | | | - Hideki Fujita
- Division of Dermatological Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroshi Fujiwara
- Department of Dermatology, Niigata University Graduate, School of Medical and Dental Sciences, Niigata, Japan.,Department of Dermatology, Uonuma Kikan Hospital, Minamiuonuma, Japan
| | - Takeo Maekawa
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | | | - Naoki Madokoro
- Department of Dermatology, MAZDA Hospital, Aki-gun, Japan
| | - Sei-Ichiro Motegi
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | | | - Osamu Yamasaki
- Department of Dermatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yuichiro Yoshino
- Department of Dermatology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | | | - Takao Tachibana
- Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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18
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Okiyama N, Yamaguchi Y, Kodera M, Hamaguchi Y, Yokozeki H, Ishiguro N, Fujimoto M. Distinct Histopathologic Patterns of Finger Eruptions in Dermatomyositis Based on Myositis-Specific Autoantibody Profiles. JAMA Dermatol 2019; 155:1080-1082. [PMID: 31290941 DOI: 10.1001/jamadermatol.2019.1668] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Naoko Okiyama
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yukie Yamaguchi
- Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Healthcare Organization, Chukyo Hospital, Nagoya, Aichi, Japan
| | - Yasuhito Hamaguchi
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naoko Ishiguro
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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19
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Kono M, Kodera M, Inasaka Y, Hasegawa I, Muro Y, Nakazawa Y, Ogi T, Akiyama M. Hailey-Hailey disease with oesophageal involvement due to a previously unreported ATP2C1 mutation. Eur J Dermatol 2019:ejd.2019.3507. [PMID: 31475910 DOI: 10.1684/ejd.2019.3507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Michihiro Kono
- Department of Dermatology, Nagoya University Graduate School of Medicine
| | - Masanari Kodera
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital
| | - Yu Inasaka
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital
| | - Izumi Hasegawa
- Department of Gastroenterological Medicine, Japan Community Health Care Organization Chukyo Hospital
| | - Yoshinao Muro
- Department of Dermatology, Nagoya University Graduate School of Medicine
| | - Yuka Nakazawa
- Department of Genetics, Research Institute of Environmental Medicine, Nagoya University,, Department of Human Genetics and Molecular Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoo Ogi
- Department of Genetics, Research Institute of Environmental Medicine, Nagoya University,, Department of Human Genetics and Molecular Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine
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20
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Fujiwara H, Isogai Z, Irisawa R, Otsuka M, Kadono T, Koga M, Hirosaki K, Asai J, Asano Y, Abe M, Amano M, Ikegami R, Ishii T, Isei T, Ito T, Inoue Y, Iwata Y, Omoto Y, Kato H, Kaneko S, Kanoh H, Kawakami T, Kawaguchi M, Kukino R, Kono T, Kodera M, Sakai K, Sakurai E, Sarayama Y, Shintani Y, Tanioka M, Tanizaki H, Tsujita J, Doi N, Nakanishi T, Hashimoto A, Hasegawa M, Hayashi M, Fujita H, Fujimoto M, Maekawa T, Matsuo K, Madokoro N, Motegi SI, Yatsushiro H, Yamasaki O, Yoshino Y, Pavoux AL, Tachibana T, Ihn H. Wound, pressure ulcer and burn guidelines - 2: Guidelines for the diagnosis and treatment of pressure ulcers, second edition. J Dermatol 2018; 47:929-978. [PMID: 30194884 DOI: 10.1111/1346-8138.14587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/03/2018] [Indexed: 01/22/2023]
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21
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Yamaguchi Y, Kuwana M, Kanaoka M, Watanabe T, Okiyama N, Gono T, Kodera M, Kambara T, Hamaguchi Y, Seishima M, Takehara K, Fujimoto M, Aihara M. 521 DRB1 is the primary genetic locus contributing to susceptibility to dermatomyositis positive for anti-TIF1γ antibody in Japanese. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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López I, Porras-Gutiérrez AG, Douziech B, Wojcik L, Le Mest Y, Kodera M, Le Poul N. O–O bond cleavage via electrochemical reduction of a side-on peroxo dicopper model of hemocyanin. Chem Commun (Camb) 2018; 54:4931-4934. [DOI: 10.1039/c8cc01959b] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The redox properties of the μ-η2:η2 peroxo complex [Cu2(H6M4h)(O2)]2+ were elucidated.
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Affiliation(s)
- I. López
- UMR CNRS 6521
- Université de Bretagne Occidentale
- 29238 Brest Cedex 3
- France
| | | | - B. Douziech
- UMR CNRS 6521
- Université de Bretagne Occidentale
- 29238 Brest Cedex 3
- France
| | - L. Wojcik
- UMR CNRS 6521
- Université de Bretagne Occidentale
- 29238 Brest Cedex 3
- France
| | - Y. Le Mest
- UMR CNRS 6521
- Université de Bretagne Occidentale
- 29238 Brest Cedex 3
- France
| | - M. Kodera
- Department of Molecular Chemistry and Biochemistry
- Doshisha University
- Kyoto 610-0321
- Japan
| | - N. Le Poul
- UMR CNRS 6521
- Université de Bretagne Occidentale
- 29238 Brest Cedex 3
- France
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23
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Iwata Y, Kodera M, Okumoto T, Numata S, Watanabe S, Saito K, Inasaka Y, Ito Y, Tanaka Y, Sugiura K. Nasal dermoid sinus cyst in a young girl: A case report. J Dermatol 2017; 45:e132-e133. [PMID: 29164669 DOI: 10.1111/1346-8138.14141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Yohei Iwata
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Healthcare Organization, Chukyo Hospital, Nagoya, Japan
| | - Takayuki Okumoto
- Department of Plastic and Reconstructive Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shigeki Numata
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Soichiro Watanabe
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kenta Saito
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yu Inasaka
- Department of Dermatology, Japan Community Healthcare Organization, Chukyo Hospital, Nagoya, Japan
| | - Yumi Ito
- Department of Dermatology, Japan Community Healthcare Organization, Chukyo Hospital, Nagoya, Japan
| | - Yoshihito Tanaka
- Department of Dermatology, Japan Community Healthcare Organization, Chukyo Hospital, Nagoya, Japan
| | - Kazumitsu Sugiura
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
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24
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Wang QH, Ri S, Tsuda H, Kodera M, Suguro K, Miyashita N. Visualization and automatic detection of defect distribution in GaN atomic structure from sampling Moiré phase. Nanotechnology 2017; 28:455704. [PMID: 29039360 DOI: 10.1088/1361-6528/aa8d83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Quantitative detection of defects in atomic structures is of great significance to evaluating product quality and exploring quality improvement process. In this study, a Fourier transform filtered sampling Moiré technique was proposed to visualize and detect defects in atomic arrays in a large field of view. Defect distributions, defect numbers and defect densities could be visually and quantitatively determined from a single atomic structure image at low cost. The effectiveness of the proposed technique was verified from numerical simulations. As an application, the dislocation distributions in a GaN/AlGaN atomic structure in two directions were magnified and displayed in Moiré phase maps, and defect locations and densities were detected automatically. The proposed technique is able to provide valuable references to material scientists and engineers by checking the effect of various treatments for defect reduction.
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Affiliation(s)
- Q H Wang
- Research Institute for Measurement and Analytical Instrumentation, National Institute of Advanced Industrial Science and Technology, 1-1-1 Umezono, Tsukuba, Ibaraki 305-8568, Japan
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25
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Ikeda T, Furukawa F, Kawakami T, Ishiguro N, Uzuki M, Ozaki S, Katsuoka K, Kono T, Kawana S, Kodera M, Sawai T, Sawada Y, Seishima M, Tanikawa A, Chen KR, Hasegawa M. Outline of guidelines for the management of vasculitis and vascular disorders in Japan, 2016 revised edition. J Dermatol 2017; 45:122-127. [DOI: 10.1111/1346-8138.14086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 09/06/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Takaharu Ikeda
- Department of Dermatology; Wakayama Medical University Graduate School of Medicine; Wakayama Japan
| | - Fukumi Furukawa
- Department of Dermatology; Wakayama Medical University Graduate School of Medicine; Wakayama Japan
| | - Tamihiro Kawakami
- Department of Dermatology; St. Marianna University School of Medicine; Kawasaki Japan
| | - Naoko Ishiguro
- Department of Dermatology; Tokyo Women's Medical University; Tokyo Japan
| | - Miwa Uzuki
- Division of Leading Pathophysiology; Department of Pathology; Iwate Medical University School of Medicine; Morioka Japan
| | - Shoichi Ozaki
- Division of Rheumatology and Allergology; Department of Internal Medicine; St. Marianna University School of Medicine; Kawasaki Japan
| | - Kensei Katsuoka
- Department of Dermatology; Kitasato University School of Medicine; Sagamihara Japan
| | - Takeshi Kono
- Department of Dermatology; Nippon Medical School Chiba Hokusoh Hospital; Inzai Japan
| | - Seiji Kawana
- Department of Dermatology; Nippon Medical School; Tokyo Japan
| | - Masanari Kodera
- Department of Dermatology; Japan Community Health care Organization Chukyo Hospital; Nagoya Japan
| | - Takashi Sawai
- Division of Leading Pathophysiology; Department of Pathology; Iwate Medical University School of Medicine; Morioka Japan
| | - Yasuyuki Sawada
- Department of Dermatology; Tokyo Metropolitan Bokutoh Hospital; Tokyo Japan
| | - Mariko Seishima
- Department of Dermatology; Gifu University Graduate School of Medicine; Gifu Japan
| | - Akiko Tanikawa
- Department of Dermatology; Keio University School of Medicine; Tokyo Japan
| | - Ko-Ron Chen
- Department of Dermatology; Saiseikai Central Hospital; Tokyo Japan
| | - Minoru Hasegawa
- Department of Dermatology; Faculty of Medical Sciences; University of Fukui; Fukui Japan
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26
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Inoue Y, Hasegawa M, Maekawa T, Le Pavoux A, Asano Y, Abe M, Ishii T, Ito T, Isei T, Imafuku S, Irisawa R, Ohtsuka M, Ohtsuka M, Ogawa F, Kadono T, Kodera M, Kawakami T, Kawaguchi M, Kukino R, Kono T, Sakai K, Takahara M, Tanioka M, Nakanishi T, Nakamura Y, Hashimoto A, Hayashi M, Fujimoto M, Fujiwara H, Matsuo K, Madokoro N, Yamasaki O, Yoshino Y, Tachibana T, Ihn H. The wound/burn guidelines - 1: Wounds in general. J Dermatol 2016; 43:357-75. [DOI: 10.1111/1346-8138.13276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 11/21/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Yuji Inoue
- Department of Dermatology and Plastic Surgery; Faculty of Life Sciences; Kumamoto University; Kumamoto Japan
| | - Minoru Hasegawa
- Department of Dermatology; Faculty of Medicine; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Takeo Maekawa
- Department of Dermatology; Jichi Medical University; Tochigi Japan
| | | | - Yoshihide Asano
- Department of Dermatology; Faculty of Medicine; University of Tokyo; Tokyo Japan
| | - Masatoshi Abe
- Department of Dermatology; Gunma University Graduate School of Medicine; Gunma Japan
| | - Takayuki Ishii
- Department of Dermatology; Faculty of Medicine; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Takaaki Ito
- Department of Dermatology; Hyogo College of Medicine; Hyogo Japan
| | - Taiki Isei
- Department of Dermatology; Kansai Medical University; Osaka Japan
| | - Shinichi Imafuku
- Department of Dermatology; Faculty of Medicine; Fukuoka University; Fukuoka Japan
| | - Ryokichi Irisawa
- Department of Dermatology; Tokyo Medical University; Tokyo Japan
| | - Masaki Ohtsuka
- Department of Dermatology; Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences; Okayama Japan
| | - Mikio Ohtsuka
- Department of Dermatology; Fukushima Medical University; Fukushima Japan
| | - Fumihide Ogawa
- Department of Dermatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Takafumi Kadono
- Department of Dermatology; Faculty of Medicine; University of Tokyo; Tokyo Japan
| | - Masanari Kodera
- Department of Dermatology; Japan Community Health Care Organization Chukyo Hospital; Aichi Japan
| | - Tamihiro Kawakami
- Department of Dermatology; St. Marianna University School of Medicine; Kanagawa Japan
| | - Masakazu Kawaguchi
- Department of Dermatology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Ryuichi Kukino
- Department of Dermatology; NTT Medical Center; Tokyo Japan
| | - Takeshi Kono
- Department of Dermatology; Nippon Medical School; Tokyo Japan
| | - Keisuke Sakai
- Intensive Care Unit; Kumamoto University Hospital; Kumamoto Japan
| | - Masakazu Takahara
- Department of Dermatology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Miki Tanioka
- Department of Dermatology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Takeshi Nakanishi
- Department of Dermatology; Osaka City University Graduate School of Medicine; Osaka Japan
| | | | - Akira Hashimoto
- Department of Dermatology; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Masahiro Hayashi
- Department of Dermatology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Manabu Fujimoto
- Department of Dermatology; Jichi Medical University; Tochigi Japan
| | - Hiroshi Fujiwara
- Department of Dermatology; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Koma Matsuo
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Naoki Madokoro
- Department of Dermatology; Mazda Hospital; Hiroshima Japan
| | - Osamu Yamasaki
- Department of Dermatology; Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences; Okayama Japan
| | - Yuichiro Yoshino
- Department of Dermatology; Japanese Red Cross Kumamoto Hospital; Kumamoto Japan
| | - Takao Tachibana
- Department of Dermatology; Osaka Red Cross Hospital; Osaka Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery; Faculty of Life Sciences; Kumamoto University; Kumamoto Japan
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27
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Isei T, Abe M, Nakanishi T, Matsuo K, Yamasaki O, Asano Y, Ishii T, Ito T, Inoue Y, Imafuku S, Irisawa R, Ohtsuka M, Ohtsuka M, Ogawa F, Kadono T, Kodera M, Kawakami T, Kawaguchi M, Kukino R, Kono T, Sakai K, Takahara M, Tanioka M, Nakamura Y, Hashimoto A, Hasegawa M, Hayashi M, Fujimoto M, Fujiwara H, Maekawa T, Madokoro N, Yoshino Y, Le Pavoux A, Tachibana T, Ihn H. The wound/burn guidelines - 3: Guidelines for the diagnosis and treatment for diabetic ulcer/gangrene. J Dermatol 2016; 43:591-619. [DOI: 10.1111/1346-8138.13285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/02/2015] [Indexed: 12/16/2022]
Affiliation(s)
- Taiki Isei
- Department of Dermatology; Kansai Medical University; Osaka Japan
| | - Masatoshi Abe
- Department of Dermatology; Gunma University Graduate School of Medicine; Gunma Japan
| | - Takeshi Nakanishi
- Department of Dermatology; Osaka City University Graduate School of Medicine; Osaka Japan
| | - Koma Matsuo
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Osamu Yamasaki
- Department of Dermatology; Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences; Okayama Japan
| | - Yoshihide Asano
- Department of Dermatology; Faculty of Medicine; University of Tokyo; Tokyo Japan
| | - Takayuki Ishii
- Department of Dermatology; Faculty of Medicine; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Takaaki Ito
- Department of Dermatology; Hyogo College of Medicine; Hyogo Japan
| | - Yuji Inoue
- Department of Dermatology and Plastic Surgery; Faculty of Life Sciences; Kumamoto University; Kumamoto Japan
| | - Shinichi Imafuku
- Department of Dermatology; Faculty of Medicine; Fukuoka University; Fukuoka Japan
| | - Ryokichi Irisawa
- Department of Dermatology; Tokyo Medical University; Tokyo Japan
| | - Masaki Ohtsuka
- Department of Dermatology; Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences; Okayama Japan
| | - Mikio Ohtsuka
- Department of Dermatology; Fukushima Medical University; Fukushima Japan
| | - Fumihide Ogawa
- Department of Dermatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Takafumi Kadono
- Department of Dermatology; Faculty of Medicine; University of Tokyo; Tokyo Japan
| | - Masanari Kodera
- Department of Dermatology; Japan Community Health Care Organization Chukyo Hospital; Aichi Japan
| | - Tamihiro Kawakami
- Department of Dermatology; St. Marianna University School of Medicine; Kanagawa Japan
| | - Masakazu Kawaguchi
- Department of Dermatology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Ryuichi Kukino
- Department of Dermatology; NTT Medical Center; Tokyo Japan
| | - Takeshi Kono
- Department of Dermatology; Nippon Medical School; Tokyo Japan
| | - Keisuke Sakai
- Intensive Care Unit; Kumamoto University Hospital; Kumamoto Japan
| | - Masakazu Takahara
- Department of Dermatology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Miki Tanioka
- Department of Dermatology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | | | - Akira Hashimoto
- Department of Dermatology; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Minoru Hasegawa
- Department of Dermatology; Faculty of Medicine; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Masahiro Hayashi
- Department of Dermatology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Manabu Fujimoto
- Department of Dermatology; Faculty of Medicine; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Hiroshi Fujiwara
- Department of Dermatology; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Takeo Maekawa
- Department of Dermatology; Jichi Medical University; Tochigi Japan
| | - Naoki Madokoro
- Department of Dermatology; Mazda Hospital; Hiroshima Japan
| | - Yuichiro Yoshino
- Department of Dermatology; Japanese Red Cross Kumamoto Hospital; Kumamoto Japan
| | | | - Takao Tachibana
- Department of Dermatology; Osaka Red Cross Hospital; Osaka Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery; Faculty of Life Sciences; Kumamoto University; Kumamoto Japan
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28
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Fujimoto M, Asano Y, Ishii T, Ogawa F, Kawakami T, Kodera M, Abe M, Isei T, Ito T, Inoue Y, Imafuku S, Irisawa R, Ohtsuka M, Ohtsuka M, Kadono T, Kawaguchi M, Kukino R, Kono T, Sakai K, Takahara M, Tanioka M, Nakanishi T, Nakamura Y, Hashimoto A, Hasegawa M, Hayashi M, Fujiwara H, Maekawa T, Matsuo K, Madokoro N, Yamasaki O, Yoshino Y, Le Pavoux A, Tachibana T, Ihn H. The wound/burn guidelines - 4: Guidelines for the management of skin ulcers associated with connective tissue disease/vasculitis. J Dermatol 2016; 43:729-57. [PMID: 26972733 DOI: 10.1111/1346-8138.13275] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 11/21/2015] [Indexed: 11/27/2022]
Abstract
The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS.
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Affiliation(s)
- Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Yoshihide Asano
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Takayuki Ishii
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Fumihide Ogawa
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tamihiro Kawakami
- Department of Dermatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Aichi, Japan
| | - Masatoshi Abe
- Department of Dermatology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Taiki Isei
- Department of Dermatology, Kansai Medical University, Osaka, Japan
| | - Takaaki Ito
- Department of Dermatology, Hyogo College of Medicine, Hyogo, Japan
| | - Yuji Inoue
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Shinichi Imafuku
- Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryokichi Irisawa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Masaki Ohtsuka
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Mikio Ohtsuka
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - Takafumi Kadono
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Masakazu Kawaguchi
- Department of Dermatology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Ryuichi Kukino
- Department of Dermatology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Takeshi Kono
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Keisuke Sakai
- Intensive Care Unit, Kumamoto University Hospital, Kumamoto, Japan
| | - Masakazu Takahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Miki Tanioka
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Nakanishi
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Minoru Hasegawa
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Masahiro Hayashi
- Department of Dermatology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hiroshi Fujiwara
- Department of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takeo Maekawa
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
| | - Koma Matsuo
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Naoki Madokoro
- Department of Dermatology, Mazda Hospital, Hiroshima, Japan
| | - Osamu Yamasaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yuichiro Yoshino
- Department of Dermatology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | | | - Takao Tachibana
- Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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29
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Tachibana T, Imafuku S, Irisawa R, Ohtsuka M, Kadono T, Fujiwara H, Asano Y, Abe M, Ishii T, Isei T, Ito T, Inoue Y, Ohtsuka M, Ogawa F, Kodera M, Kawakami T, Kawaguchi M, Kukino R, Kono T, Sakai K, Takahara M, Tanioka M, Nakanishi T, Nakamura Y, Hashimoto A, Hasegawa M, Hayashi M, Fujimoto M, Maekawa T, Matsuo K, Madokoro N, Yamasaki O, Yoshino Y, Le Pavoux A, Ihn H. The wound/burn guidelines - 2: Guidelines for the diagnosis and treatment for pressure ulcers. J Dermatol 2016; 43:469-506. [DOI: 10.1111/1346-8138.13274] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 11/21/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Takao Tachibana
- Department of Dermatology; Osaka Red Cross Hospital; Osaka Japan
| | - Shinichi Imafuku
- Department of Dermatology; Faculty of Medicine, Fukuoka University; Fukuoka Japan
| | - Ryokichi Irisawa
- Department of Dermatology; Tokyo Medical University; Tokyo Japan
| | - Masaki Ohtsuka
- Department of Dermatology; Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences; Okayama Japan
| | - Takafumi Kadono
- Department of Dermatology; Faculty of Medicine, University of Tokyo; Tokyo Japan
| | - Hiroshi Fujiwara
- Department of Dermatlogy; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Yoshihide Asano
- Department of Dermatlogy; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Masatoshi Abe
- Department of Dermatology; Gunma University Graduate School of Medicine; Gunma Japan
| | - Takayuki Ishii
- Department of Dermatology; Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University; Ishikawa Japan
| | - Taiki Isei
- Department of Dermatology; Kansai Medical University; Osaka Japan
| | - Takaaki Ito
- Department of Dermatology; Hyogo College of Medicine; Hyogo Japan
| | - Yuji Inoue
- Department of Dermatology and Plastic Surgery; Faculty of Life Sciences, Kumamoto University; Kumamoto Japan
| | - Mikio Ohtsuka
- Department of Dermatology; Fukushima Medical University; Fukushima Japan
| | - Fumihide Ogawa
- Department of Dermatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Masanari Kodera
- Department of Dermatology; Japan Community Health Care Organization Chukyo Hospital; Aichi Japan
| | - Tamihiro Kawakami
- Department of Dermatology; St Marianna University School of Medicine; Kanagawa Japan
| | - Masakazu Kawaguchi
- Department of Dermatology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Ryuichi Kukino
- Department of Dermatology; NTT Medical Center; Tokyo Japan
| | - Takeshi Kono
- Department of Dermatology; Nippon Medical School; Tokyo Japan
| | - Keisuke Sakai
- Intensive Care Unit; Kumamoto University Hospital; Kumamoto Japan
| | - Masakazu Takahara
- Department of Dermatology; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Miki Tanioka
- Department of Dermatology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Takeshi Nakanishi
- Department of Dermatology; Osaka City University Graduate School of Medicine; Osaka Japan
| | | | - Akira Hashimoto
- Department of Dermatology; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Minoru Hasegawa
- Department of Dermatology; Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University; Ishikawa Japan
| | | | - Manabu Fujimoto
- Department of Dermatology; Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University; Ishikawa Japan
| | - Takeo Maekawa
- Department of Dermatology; Jichi Medical University; Tochigi Japan
| | - Koma Matsuo
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Naoki Madokoro
- Department of Dermatology; Mazda Hospital; Hiroshima Japan
| | - Osamu Yamasaki
- Department of Dermatology; Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences; Okayama Japan
| | - Yuichiro Yoshino
- Department of Dermatology; Japanese Red Cross Kumamoto Hospital; Kumamoto Japan
| | | | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery; Faculty of Life Sciences, Kumamoto University; Kumamoto Japan
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30
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Yoshino Y, Ohtsuka M, Kawaguchi M, Sakai K, Hashimoto A, Hayashi M, Madokoro N, Asano Y, Abe M, Ishii T, Isei T, Ito T, Inoue Y, Imafuku S, Irisawa R, Ohtsuka M, Ogawa F, Kadono T, Kawakami T, Kukino R, Kono T, Kodera M, Takahara M, Tanioka M, Nakanishi T, Nakamura Y, Hasegawa M, Fujimoto M, Fujiwara H, Maekawa T, Matsuo K, Yamasaki O, Le Pavoux A, Tachibana T, Ihn H. The wound/burn guidelines - 6: Guidelines for the management of burns. J Dermatol 2016; 43:989-1010. [PMID: 26971391 DOI: 10.1111/1346-8138.13288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 12/04/2015] [Indexed: 12/16/2022]
Abstract
Burns are a common type of skin injury encountered at all levels of medical facilities from private clinics to core hospitals. Minor burns heal by topical treatment alone, but moderate to severe burns require systemic management, and skin grafting is often necessary also for topical treatment. Inappropriate initial treatment or delay of initial treatment may exert adverse effects on the subsequent treatment and course. Therefore, accurate evaluation of the severity and initiation of appropriate treatment are necessary. The Guidelines for the Management of Burn Injuries were issued in March 2009 from the Japanese Society for Burn Injuries as guidelines concerning burns, but they were focused on the treatment for extensive and severe burns in the acute period. Therefore, we prepared guidelines intended to support the appropriate diagnosis and initial treatment for patients with burns that are commonly encountered including minor as well as moderate and severe cases. Because of this intention of the present guidelines, there is no recommendation of individual surgical procedures.
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Affiliation(s)
- Yuichiro Yoshino
- Department of Dermatology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Mikio Ohtsuka
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - Masakazu Kawaguchi
- Department of Dermatology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Keisuke Sakai
- Intensive Care Unit, Kumamoto University Hospital, Kumamoto, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Masahiro Hayashi
- Department of Dermatology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Naoki Madokoro
- Department of Dermatology, Mazda Hospital, Hiroshima, Japan
| | - Yoshihide Asano
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Masatoshi Abe
- Department of Dermatology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Takayuki Ishii
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Taiki Isei
- Department of Dermatology, Kansai Medical University, Osaka, Japan
| | - Takaaki Ito
- Department of Dermatology, Hyogo College of Medicine, Hyogo, Japan
| | - Yuji Inoue
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Shinichi Imafuku
- Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryokichi Irisawa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Masaki Ohtsuka
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Fumihide Ogawa
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takafumi Kadono
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Tamihiro Kawakami
- Department of Dermatology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Ryuichi Kukino
- Department of Dermatology, NTT Medical Center, Tokyo, Japan
| | - Takeshi Kono
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Masanari Kodera
- Department of Dermatology, Japan Community Health Care Organization Chukyo Hospital, Aichi, Japan
| | - Masakazu Takahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Miki Tanioka
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Nakanishi
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Minoru Hasegawa
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Hiroshi Fujiwara
- Department of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takeo Maekawa
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
| | - Koma Matsuo
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Osamu Yamasaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | | | - Takao Tachibana
- Department of Dermatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Ito T, Kukino R, Takahara M, Tanioka M, Nakamura Y, Asano Y, Abe M, Ishii T, Isei T, Inoue Y, Imafuku S, Irisawa R, Ohtsuka M, Ohtsuka M, Ogawa F, Kadono T, Kawakami T, Kawaguchi M, Kono T, Kodera M, Sakai K, Nakanishi T, Hashimoto A, Hasegawa M, Hayashi M, Fujimoto M, Fujiwara H, Maekawa T, Matsuo K, Madokoro N, Yamasaki O, Yoshino Y, Le Pavoux A, Tachibana T, Ihn H. The wound/burn guidelines - 5: Guidelines for the management of lower leg ulcers/varicose veins. J Dermatol 2016; 43:853-68. [DOI: 10.1111/1346-8138.13286] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/02/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Takaaki Ito
- Department of Dermatology; Hyogo College of Medicine; Hyogo Japan
| | - Ryuichi Kukino
- Department of Dermatology; NTT Medical Center Tokyo; Tokyo Japan
| | - Masakazu Takahara
- Department of Dermatology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Miki Tanioka
- Department of Dermatology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | | | - Yoshihide Asano
- Department of Dermatology; Faculty of Medicine; University of Tokyo; Tokyo Japan
| | - Masatoshi Abe
- Department of Dermatology; Gunma University Graduate School of Medicine; Gunma Japan
| | - Takayuki Ishii
- Department of Dermatology; Faculty of Medicine; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Taiki Isei
- Department of Dermatology; Kansai Medical University; Osaka Japan
| | - Yuji Inoue
- Department of Dermatology and Plastic Surgery; Faculty of Life Sciences; Kumamoto University; Kumamoto Japan
| | - Shinichi Imafuku
- Department of Dermatology; Faculty of Medicine; Fukuoka University; Fukuoka Japan
| | - Ryokichi Irisawa
- Department of Dermatology; Tokyo Medical University; Tokyo Japan
| | - Masaki Ohtsuka
- Department of Dermatology; Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences; Okayama Japan
| | - Mikio Ohtsuka
- Department of Dermatology; Fukushima Medical University; Fukushima Japan
| | - Fumihide Ogawa
- Department of Dermatology; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Takafumi Kadono
- Department of Dermatology; Faculty of Medicine; University of Tokyo; Tokyo Japan
| | - Tamihiro Kawakami
- Department of Dermatology; St. Marianna University School of Medicine; Kanagawa Japan
| | - Masakazu Kawaguchi
- Department of Dermatology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Takeshi Kono
- Department of Dermatology; Nippon Medical School; Tokyo Japan
| | - Masanari Kodera
- Department of Dermatology; Japan Community Health Care Organization Chukyo Hospital; Aichi Japan
| | - Keisuke Sakai
- Intensive Care Unit; Kumamoto University Hospital; Kumamoto Japan
| | - Takeshi Nakanishi
- Department of Dermatology; Osaka City University Graduate School of Medicine; Osaka Japan
| | - Akira Hashimoto
- Department of Dermatology; Tohoku University Graduate School of Medicine; Miyagi Japan
| | - Minoru Hasegawa
- Department of Dermatology; Faculty of Medicine; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Masahiro Hayashi
- Department of Dermatology; Yamagata University Faculty of Medicine; Yamagata Japan
| | - Manabu Fujimoto
- Department of Dermatology; Faculty of Medicine; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Hiroshi Fujiwara
- Department of Dermatology; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Takeo Maekawa
- Department of Dermatology; Jichi Medical University; Tochigi Japan
| | - Koma Matsuo
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Naoki Madokoro
- Department of Dermatology; Mazda Hospital; Hiroshima Japan
| | - Osamu Yamasaki
- Department of Dermatology; Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences; Okayama Japan
| | - Yuichiro Yoshino
- Department of Dermatology; Japanese Red Cross Kumamoto Hospital; Kumamoto Japan
| | | | - Takao Tachibana
- Department of Dermatology; Osaka Red Cross Hospital; Osaka Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery; Faculty of Life Sciences; Kumamoto University; Kumamoto Japan
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Hamaguchi Y, Kodera M, Matsushita T, Hasegawa M, Inaba Y, Usuda T, Kuwana M, Takehara K, Fujimoto M. Clinical and Immunologic Predictors of Scleroderma Renal Crisis in Japanese Systemic Sclerosis Patients With Anti-RNA Polymerase III Autoantibodies. Arthritis Rheumatol 2015; 67:1045-52. [DOI: 10.1002/art.38994] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 12/09/2014] [Indexed: 01/25/2023]
Affiliation(s)
| | | | | | | | - Yuki Inaba
- Social Insurance Chukyo Hospital; Nagoya Japan
| | | | | | | | - Manabu Fujimoto
- Kanazawa University, Kanazawa, Japan, and University of Tsukuba; Tsukuba Japan
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Sekiya A, Kodera M, Yamaoka T, Iwata Y, Usuda T, Ohzono A, Yasukochi A, Koga H, Ishii N, Hashimoto T. A case of lichen planus pemphigoides with autoantibodies to the NC16a and C-terminal domains of BP180 and to desmoglein-1. Br J Dermatol 2014; 171:1230-5. [PMID: 24813536 DOI: 10.1111/bjd.13097] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2014] [Indexed: 11/29/2022]
Abstract
Lichen planus pemphigoides (LPP) is a rare autoimmune blistering disease that occurs in association with lichen planus (LP). This report describes a 59-year-old Japanese female patient with LPP. The patient first showed LP lesions on her hands, and subsequently developed bullae on her extremities and erosions of the oral mucosa. The patient's serum was positive for IgG autoantibodies against the BP180 NC16a domain, the BP180 C-terminal domain and desmoglein-1. However, a serum sampled one and a half years before the diagnosis of LPP was negative for autoantibodies against BP180 NC16a and BP180 C-terminal domains. These findings strongly suggest that the damage to the basal cells in the LP lesions exposed a sequestered antigen or formed neoantigens, leading to the production of pathogenic autoantibodies for LPP. Most of the previous cases of LPP have produced autoantibodies to the NC16a domain of BP180. This is the first case in which autoantibodies to the C-terminal domain of BP180 were detected. The oral mucosal symptoms in this case may have been caused by autoantibodies to the BP180 C-terminal domain.
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Affiliation(s)
- A Sekiya
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Syouwa-ku, Nagoya, Aichi, 4668550, Japan
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Iwata Y, Kodera M, Usuda T, Murakami S, Hisaoka M, Arima M, Yagami A, Matsunaga K. Case of congenital dermatofibrosarcoma protuberans: change of clinical features and pathological findings over 10 years. J Dermatol 2013; 40:943-4. [PMID: 24127849 DOI: 10.1111/1346-8138.12279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yohei Iwata
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
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Hamaguchi Y, Fujimoto M, Matsushita T, Kaji K, Komura K, Hasegawa M, Kodera M, Muroi E, Fujikawa K, Seishima M, Yamada H, Yamada R, Sato S, Takehara K, Kuwana M. Common and distinct clinical features in adult patients with anti-aminoacyl-tRNA synthetase antibodies: heterogeneity within the syndrome. PLoS One 2013; 8:e60442. [PMID: 23573256 PMCID: PMC3616126 DOI: 10.1371/journal.pone.0060442] [Citation(s) in RCA: 249] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 02/27/2013] [Indexed: 12/04/2022] Open
Abstract
Objective To identify similarities and differences in the clinical features of adult Japanese patients with individual anti-aminoacyl-tRNA synthetase antibodies (anti-ARS Abs). Methods This was a retrospective analysis of 166 adult Japanese patients with anti-ARS Abs detected by immunoprecipitation assays. These patients had visited Kanazawa University Hospital or collaborating medical centers from 2003 to 2009. Results Anti-ARS Ab specificity included anti-Jo-1 (36%), anti-EJ (23%), anti-PL-7 (18%), anti-PL-12 (11%), anti-KS (8%), and anti-OJ (5%). These anti-ARS Abs were mutually exclusive, except for one serum Ab that had both anti-PL-7 and PL-12 reactivity. Myositis was closely associated with anti-Jo-1, anti-EJ, and anti-PL-7, while interstitial lung disease (ILD) was correlated with all 6 anti-ARS Abs. Dermatomyositis (DM)-specific skin manifestations (heliotrope rash and Gottron’s sign) were frequently observed in patients with anti-Jo-1, anti-EJ, anti-PL-7, and anti-PL-12. Therefore, most clinical diagnoses were polymyositis or DM for anti-Jo-1, anti-EJ, and anti-PL-7; clinically amyopathic DM or ILD for anti-PL-12; and ILD for anti-KS and anti-OJ. Patients with anti-Jo-1, anti-EJ, and anti-PL-7 developed myositis later if they had ILD alone at the time of disease onset, and most patients with anti-ARS Abs eventually developed ILD if they did not have ILD at disease onset. Conclusion Patients with anti-ARS Abs are relatively homogeneous. However, the distribution and timing of myositis, ILD, and rashes differ among patients with individual anti-ARS Abs. Thus, identification of individual anti-ARS Abs is beneficial to define this rather homogeneous subset and to predict clinical outcomes within the “anti-synthetase syndrome.”
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Affiliation(s)
- Yasuhito Hamaguchi
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
- * E-mail:
| | - Takashi Matsushita
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kenzo Kaji
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kazuhiro Komura
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Minoru Hasegawa
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Masanari Kodera
- Department of Dermatology, Social Insurance Chukyo Hospital, Nagoya, Japan
| | - Eiji Muroi
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Keita Fujikawa
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mariko Seishima
- Department of Dermatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Hidehiro Yamada
- Division of Rheumatology, Department of Internal Medicine, and Allergy, St. Marianna University, Kawasaki, Japan
| | - Ryo Yamada
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichi Sato
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Kazuhiko Takehara
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Masataka Kuwana
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Subramanian H, Grailer JJ, Ohlrich KC, Rymaszewski AL, Loppnow JJ, Kodera M, Conway RM, Steeber DA. Signaling through L-selectin mediates enhanced chemotaxis of lymphocyte subsets to secondary lymphoid tissue chemokine. J Immunol 2012; 188:3223-36. [PMID: 22387549 DOI: 10.4049/jimmunol.1101032] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
L-selectin functions as an important adhesion molecule that mediates tethering and rolling of lymphocytes by binding to high endothelial venule (HEV)-expressed ligands during recirculation. Subsequent lymphocyte arrest and transmigration require activation through binding of HEV-decorated homeostatic chemokines such as secondary lymphoid tissue chemokine (SLC; CCL21) to its counterreceptor, CCR7. Importantly, L-selectin also functions as a signaling molecule. In this study, signaling induced by ligation of L-selectin using mAb or endothelial cell-expressed ligand significantly enhanced the chemotaxis of murine T cells and B cells to SLC but not to other homeostatic chemokines. Consistent with the expression levels of L-selectin in different lymphocyte subsets, L-selectin-mediated enhancement of chemotaxis to SLC was observed for all naive lymphocytes and effector/memory CD8(+) T cells, whereas only a subpopulation of effector/memory CD4(+) T cells responded. During in vivo mesenteric lymph node migration assays, the absence of L-selectin on lymphocytes significantly attenuated both their ability to migrate out of the HEV and their chemotaxis away from the vessel wall. Notably, ligation of L-selectin and/or CCR7 did not result in increased CCR7 expression levels, internalization, or re-expression. Pharmacologic inhibitor studies showed that L-selectin-mediated enhanced chemotaxis to SLC required intact intracellular kinase function. Furthermore, treatment of lymphocytes with the spleen tyrosine kinase family inhibitor piceatannol reduced their ability to migrate across the HEV in peripheral lymph nodes. Therefore, these results suggest that "cross-talk" in the signaling pathways initiated by L-selectin and CCR7 provides a novel mechanism for functional synergy between these two molecules during lymphocyte migration.
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Affiliation(s)
- Hariharan Subramanian
- Department of Biological Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
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Fujimoto M, Hamaguchi Y, Kaji K, Matsushita T, Ichimura Y, Kodera M, Ishiguro N, Ueda-Hayakawa I, Asano Y, Ogawa F, Fujikawa K, Miyagi T, Mabuchi E, Hirose K, Akimoto N, Hatta N, Tsutsui K, Higashi A, Igarashi A, Seishima M, Hasegawa M, Takehara K. Myositis-specific anti-155/140 autoantibodies target transcription intermediary factor 1 family proteins. ACTA ACUST UNITED AC 2012; 64:513-22. [DOI: 10.1002/art.33403] [Citation(s) in RCA: 212] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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38
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Hamaguchi Y, Kuwana M, Hoshino K, Hasegawa M, Kaji K, Matsushita T, Komura K, Nakamura M, Kodera M, Suga N, Higashi A, Ogusu K, Tsutsui K, Furusaki A, Tanabe H, Sasaoka S, Muro Y, Yoshikawa M, Ishiguro N, Ayano M, Muroi E, Fujikawa K, Umeda Y, Kawase M, Mabuchi E, Asano Y, Sodemoto K, Seishima M, Yamada H, Sato S, Takehara K, Fujimoto M. Clinical Correlations With Dermatomyositis-Specific Autoantibodies in Adult Japanese Patients With Dermatomyositis. ACTA ACUST UNITED AC 2011; 147:391-8. [DOI: 10.1001/archdermatol.2011.52] [Citation(s) in RCA: 226] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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39
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Fujita T, Kinukawa T, Hattori R, Suzuki A, Ishida S, Kimura T, Kato M, Tsuji Y, Kodera M, Mihara K. Successful Renal Transplantation for a Patient With Pyoderma Gangrenosum. Transplant Proc 2009; 41:437-40. [DOI: 10.1016/j.transproceed.2008.10.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Accepted: 10/20/2008] [Indexed: 10/21/2022]
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40
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Komura K, Yoshizaki A, Kodera M, Iwata Y, Ogawa F, Shimizu K, Wayaku T, Yukami T, Murata M, Hasegawa M, Fujimoto M, Takehara K, Sato S. Increased serum soluble OX40 in patients with systemic sclerosis. J Rheumatol 2008; 35:2359-2362. [PMID: 18843780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To determine levels of serum soluble OX40 (also termed CD134, a member of the tumor necrosis factor receptor superfamily) and their clinical associations in patients with systemic sclerosis (SSc). METHODS Serum soluble OX40 levels were examined by ELISA in 53 patients with SSc, 15 patients with systemic lupus erythematosus (SLE), and 32 healthy individuals. RESULTS OX40 levels were significantly elevated in SSc patients (125.7 +/- 5.7 pg/ml) compared to patients with SLE (80.7 +/- 1.7 pg/ml; p < 0.005) and controls (88.2 +/- 3.0 pg/ml; p < 0.0001). Elevated OX40 levels were found to be associated with disease duration of less than 2 years (p < 0.05). CONCLUSION Our results suggest that serum soluble OX40 levels correlate with the early-onset of SSc disease.
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Affiliation(s)
- Kazuhiro Komura
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Kodera M, Grailer JJ, Karalewitz APA, Subramanian H, Steeber DA. T lymphocyte migration to lymph nodes is maintained during homeostatic proliferation. Microsc Microanal 2008; 14:211-224. [PMID: 18312727 DOI: 10.1017/s1431927608080215] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The immune system maintains appropriate cell numbers through regulation of cell proliferation and death. Normal tissue distribution of lymphocytes is maintained through expression of specific adhesion molecules and chemokine receptors such as L-selectin and CCR7, respectively. Lymphocyte insufficiency or lymphopenia induces homeostatic proliferation of existing lymphocytes to increase cell numbers. Interestingly, homeostatic proliferation of T lymphocytes induces a phenotypic change from naïve- to memory-type cell. Naïve T cells recirculate between blood and lymphoid tissues whereas memory T cells migrate to nonlymphoid sites such as skin and gut. To assess effects of homeostatic proliferation on migratory ability of T cells, a murine model of lymphopenia-induced homeostatic proliferation was used. Carboxyfluorescein diacetate, succinimidyl ester-labeled wild-type splenocytes were adoptively transferred into recombination activation gene-1-deficient mice and analyzed by flow cytometry, in vitro chemotactic and in vivo migration assays, and immunofluorescence microscopy. Homeostatically proliferated T cells acquired a mixed memory-type CD44high L-selectinhigh CCR7low phenotype. Consistent with this, chemotaxis to secondary lymphoid tissue chemokine in vitro was reduced by 22%-34%. By contrast, no differences were found for migration or entry into lymph nodes during in vivo migration assays. Therefore, T lymphocytes that have undergone homeostatic proliferation recirculate using mechanisms similar to naïve T cells.
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Affiliation(s)
- Masanari Kodera
- Department of Biological Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin 53211, USA
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42
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Iwata Y, Komura K, Kodera M, Usuda T, Yokoyama Y, Hara T, Muroi E, Ogawa F, Takenaka M, Sato S. Correlation of IgE autoantibody to BP180 with a severe form of bullous pemphigoid. Arch Dermatol 2008; 144:41-8. [PMID: 18209167 DOI: 10.1001/archdermatol.2007.9] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
OBJECTIVE To determine the prevalence, immunoglobulin subclass distribution, and clinical correlation of antibodies (Abs), especially of IgE Abs, to BP180 and BP230 in patients with bullous pemphigoid (BP). DESIGN Retrospective case series analysis. SETTING Department of Dermatology, Nagasaki University Graduate School of Biomedical Science. PATIENTS Serum samples from 37 patients with BP, 6 with pemphigus vulgaris, 5 with pemphigus foliaceus, and 26 healthy controls (n = 26) were examined by enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES Prevalence, immunoglobulin subclass distribution, and clinical correlation of Abs, especially of IgE Abs, to BP180 and BP230. RESULTS IgG anti-BP180 and anti-BP230 Abs were detected in 35 (95%) and 26 (70%) of the 37 BP serum samples, respectively. IgG1 and IgG4 isotypes were positive in 32 (87%) and 25 (68%), respectively, of the BP serum samples for anti-BP180 Abs, while they were detected in 16 (44%) and 26 (70%), respectively, for anti-BP230 Abs. IgE anti-BP180 and anti-BP230 Abs were equally detected in 8 (22%) of the BP serum samples. Similar to IgG anti-BP180 Abs, the presence or levels of IgE anti-BP180 Abs was associated with broader skin lesions. Furthermore, patients with BP positive for IgE anti-BP180 Abs required longer duration for remission, higher dosage of prednisolone, and more intensive therapies for remission. By contrast, this was not true for those with of IgE anti-BP230 Abs. Remarkably, when analyzed in patients with BP who had a high titer of IgG anti-BP180 Abs, the presence or levels of IgE anti-BP180 Abs, but not IgG anti-BP180 Abs, were associated with a more severe form. CONCLUSIONS The present study suggests that IgE anti-BP180 Abs are related to the disease severity and activity of BP. Moreover, it may be possible to identify treatment-refractory patients with BP more specifically by assessing the presence or levels of IgE anti-BP180 Abs in those with a high IgG anti-BP180 Ab titer.
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Affiliation(s)
- Yohei Iwata
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
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Higuchi M, Miyasita M, Kodera M, Higuchi K. Simultaneous equations for calculating the pair density. J Phys Condens Matter 2007; 19:365219. [PMID: 21694164 DOI: 10.1088/0953-8984/19/36/365219] [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] [Indexed: 05/30/2023]
Abstract
We propose a practical scheme for calculating the pair density (PD) on the basis of the density functional theory. In order to avoid the N-representability problem of the PD, we implement the variational principle within the set of PDs that are constructed from the single Slater determinants (SSDs). For the kinetic energy functional, we utilize the approximate form that is developed by means of the electron-coordinate scaling laws. The variational principle results in the simultaneous equations for constituent orbitals of the SSD. It yields the best one within the SSD-representable PDs.
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Affiliation(s)
- M Higuchi
- Department of Physics, Faculty of Science, Shinshu University, Matsumoto 390-8621, Japan
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Komura K, Fujimoto M, Matsushita T, Yanaba K, Kodera M, Kawasuji A, Hasegawa M, Takehara K, Sato S. Increased serum soluble CD40 levels in patients with systemic sclerosis. J Rheumatol 2007; 34:353-8. [PMID: 17295440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To determine serum levels of soluble CD40 (sCD40) and clinical association in patients with systemic sclerosis (SSc). METHODS Serum sCD40 levels were examined by ELISA in 49 patients with SSc, 15 patients with systemic lupus erythematosus, and 26 healthy individuals. sCD40 levels in plasma samples, which were obtained at the same time, were also determined. SSc patients were grouped into 22 patients with limited cutaneous SSc (lcSSc) and 27 patients with diffuse cutaneous SSc (dcSSc). RESULTS There was no significant difference between sCD40 levels of sera and those of plasma. Serum sCD40 levels were significantly elevated in patients with SSc compared to patients with systemic lupus erythematosus and controls (p < 0.001). Serum sCD40 levels were higher in patients with lcSSc than in those with dcSSc (p <0.001). There was no correlation between sCD40 and sCD40 ligand levels in patients with SSc. CONCLUSION Elevated serum sCD40 levels were associated with lcSSc. These results suggest that the blockade of CD40/CD40 ligand interaction could be a potential therapeutic strategy in SSc.
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Affiliation(s)
- Kazuhiro Komura
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
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45
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Fujimoto M, Hasegawa M, Hamaguchi Y, Komura K, Matsushita T, Yanaba K, Kodera M, Takehara K, Sato S. A clue for telangiectasis in systemic sclerosis: elevated serum soluble endoglin levels in patients with the limited cutaneous form of the disease. Dermatology 2006; 213:88-92. [PMID: 16902284 DOI: 10.1159/000093846] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2005] [Accepted: 11/18/2005] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The transforming growth factor-beta (TGF-beta) system plays a critical role both in systemic sclerosis (SSc) and hereditary hemorrhagic telangiectasia (HHT). Endoglin, known as a gene responsible for HHT, is a TGF-beta receptor preferentially expressed on endothelial cells. The role of endoglin in SSc is potentially intriguing since limited cutaneous SSc (lcSSc) and HHT share several symptoms, including telangiectasia. OBJECTIVE To determine serum levels of soluble endoglin (sEndoglin) and clinical associations in patients with SSc. METHODS Serum sEndoglin levels were examined by ELISA in 70 patients with SSc, 20 patients with systemic lupus erythematosus and 20 healthy individuals. RESULTS Serum sEndoglin levels were significantly elevated in patients with lcSSc compared with diffuse cutaneous SSc and systemic lupus erythematosus patients as well as normal controls. Patients with elevated sEndoglin levels had telangiectasia more frequently than those with normal sEndoglin levels. Furthermore, pulmonary artery pressure was positively correlated with sEndoglin levels in patients with lcSSc. CONCLUSION Abnormal expression/function of endoglin may be linked to lcSSc-specific manifestations.
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Affiliation(s)
- M Fujimoto
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Japan.
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Matsushita T, Hasegawa M, Yanaba K, Kodera M, Takehara K, Sato S. Elevated serum BAFF levels in patients with systemic sclerosis: enhanced BAFF signaling in systemic sclerosis B lymphocytes. ACTA ACUST UNITED AC 2006; 54:192-201. [PMID: 16385515 DOI: 10.1002/art.21526] [Citation(s) in RCA: 193] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To determine serum levels of BAFF, a potent B cell survival factor, in patients with systemic sclerosis (SSc) and relate the results to the clinical features of SSc. METHODS Serum BAFF levels in 83 patients with SSc were examined by enzyme-linked immunosorbent assay (ELISA). In a longitudinal study, 131 serum samples obtained from 21 patients with SSc were analyzed. The expression of BAFF messenger RNA (mRNA) in the skin was quantified by real-time reverse transcription-polymerase chain reaction. The expression of BAFF receptor (BAFFR) on CD19+ B cells was assessed by flow cytometry. The production of IgG and interleukin-6 (IL-6) by isolated B cells was examined by ELISA. RESULTS Serum BAFF levels were elevated in SSc patients compared with healthy controls and correlated positively with the extent of skin fibrosis. Among the 21 patients with SSc in the longitudinal study, 7 had decreased BAFF levels, 11 had levels that remained unchanged, and 3 patients had increased levels. Decreasing BAFF levels were accompanied by regression of skin sclerosis, whereas increasing levels of BAFF were associated with the new onset or worsening of organ involvement. BAFF mRNA expression was up-regulated in the affected skin of patients with early diffuse cutaneous SSc. BAFFR expression on B cells was increased in SSc patients relative to healthy controls. Furthermore, SSc B cells that were stimulated by BAFF exhibited an enhanced ability to produce IgG and IL-6. CONCLUSION These results suggest that BAFF and its signaling in B cells contribute to B cell abnormalities and disease development in patients with SSc.
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Yanaba K, Komura K, Kodera M, Matsushita T, Hasegawa M, Takehara K, Sato S. Serum levels of monocyte chemotactic protein-3/CCL7 are raised in patients with systemic sclerosis: association with extent of skin sclerosis and severity of pulmonary fibrosis. Ann Rheum Dis 2006; 65:124-6. [PMID: 16344498 PMCID: PMC1797996 DOI: 10.1136/ard.2005.040782] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [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: 11/03/2022]
Abstract
OBJECTIVE To determine serum levels of monocyte chemotactic protein-3 (MCP-3) and its clinical associations in patients with systemic sclerosis (SSc). METHODS Serum MCP-3 levels from 69 patients with SSc were examined by ELISA. RESULTS Serum MCP-3 levels were raised in patients with SSc (n = 69) compared with healthy controls (n = 28). Patients with diffuse cutaneous SSc (n = 36) had higher levels of serum MCP-3 than those with limited cutaneous SSc (n = 33). Patients with raised MCP-3 levels had pulmonary fibrosis and decreased vital capacity (VC) more often than those with normal MCP-3 levels. MCP-3 levels correlated positively with the extent of skin fibrosis, and inversely with %VC and carbon monoxide transfer factor (Tlco) in patients with SSc. CONCLUSION MCP-3 levels were increased in patients with SSc, and correlated with the extent of skin sclerosis and the severity of pulmonary fibrosis. These results suggest that MCP-3 may have a role in the development of fibrosis in SSc.
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Affiliation(s)
- K Yanaba
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Japan
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Kodera M, Hasegawa M, Komura K, Yanaba K, Takehara K, Sato S. Serum pulmonary and activation-regulated chemokine/CCL18 levels in patients with systemic sclerosis: a sensitive indicator of active pulmonary fibrosis. ACTA ACUST UNITED AC 2005; 52:2889-96. [PMID: 16142750 DOI: 10.1002/art.21257] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.6] [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: 12/30/2022]
Abstract
OBJECTIVE To clarify the clinical significance of serum levels of pulmonary and activation-regulated chemokine (PARC) in the diagnosis and monitoring of pulmonary fibrosis (PF) in patients with systemic sclerosis (SSc) and to compare PARC levels with KL-6 antigen or surfactant protein D (SP-D) levels. METHODS Serum PARC levels were determined by enzyme-linked immunosorbent assay in 123 SSc patients. In a retrospective longitudinal study, correlation of serum PARC levels with the activity of PF was assessed in 21 SSc patients with active PF. RESULTS PARC levels at the first visit were higher in patients with SSc than in patients with systemic lupus erythematosus (SLE) or healthy controls. Increased serum PARC levels were associated with involvement of PF, decreased diffusing capacity for carbon monoxide, and decreased vital capacity in SSc patients. In the longitudinal study, serum PARC levels were significantly decreased in SSc patients with inactive PF compared with those with active PF. CONCLUSION Elevated serum PARC levels correlated with PF and more sensitively reflected the PF activity than did serum KL-6 or SP-D levels in SSc. Serum PARC levels may be a useful new serum marker for active PF in SSc.
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MESH Headings
- Antigens/blood
- Antigens, Neoplasm
- Biomarkers/blood
- Chemokines, CC/blood
- Enzyme-Linked Immunosorbent Assay
- Female
- Glycoproteins/blood
- Humans
- Lupus Erythematosus, Systemic/blood
- Lupus Erythematosus, Systemic/diagnosis
- Male
- Middle Aged
- Mucin-1
- Mucins/blood
- Pulmonary Fibrosis/blood
- Pulmonary Fibrosis/diagnosis
- Pulmonary Fibrosis/etiology
- Pulmonary Surfactant-Associated Protein D/blood
- Scleroderma, Diffuse/blood
- Scleroderma, Diffuse/complications
- Scleroderma, Diffuse/diagnosis
- Scleroderma, Limited/blood
- Scleroderma, Limited/complications
- Scleroderma, Limited/diagnosis
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Affiliation(s)
- Masanari Kodera
- Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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Kodera M, Hayakawa I, Komura K, Yanaba K, Hasegawa M, Takehara K, Sato S. Anti-lipoprotein lipase antibody in systemic sclerosis: association with elevated serum triglyceride concentrations. J Rheumatol 2005; 32:629-36. [PMID: 15801017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE The vascular damage systemic sclerosis (SSc) consists mainly of microvascular changes, but recently macrovascular changes with dyslipidemia were recognized. In systemic lupus erythematosus (SLE), autoantibody to lipoprotein lipase (LPL), a key enzyme that hydrolyzes triglycerides, suggested a role of autoimmunity for elevated serum triglyceride levels and atherosclerosis. We investigated the prevalence and levels of anti-LPL antibodies, their clinical correlation, and their functional significance in patients with SSc. METHODS Serum samples from patients with diffuse cutaneous SSc (dSSc; n = 55), limited cutaneous SSc (lSSc; n = 75), SLE (n = 21), and dermatomyositis (DM; n = 21) and healthy controls (n = 41) were examined by ELISA. The presence of anti-LPL antibody was evaluated by immunoblotting analysis using purified LPL. To determine the functional relevance of anti-LPL antibody in vivo, we assessed whether anti-LPL autoantibody was able to inhibit LPL activity using the LPL activity kit. RESULTS ELISA revealed that IgG or IgM anti-LPL antibodies were detected in 35% of SSc patients, while they were also positive in 67% of SLE patients and 43% of DM patients. The presence of IgG anti-LPL antibody was associated with elevated serum triglyceride levels, greater extent of skin fibrosis, and more frequent presence of lung fibrosis, heart involvement, and anti-topoisomerase I antibodies. The presence of anti-LPL autoantibody was confirmed by immunoblotting analysis. LPL activity was inhibited by IgG anti-LPL antibodies in sera from SSc patients with elevated serum triglyceride levels. CONCLUSION Our results suggest that anti-LPL autoantibody contributes to elevated serum triglyceride levels by inhibiting LPL enzyme activity in patients with SSc.
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Affiliation(s)
- Masanari Kodera
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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Hayakawa I, Hasegawa M, Matsushita T, Yanaba K, Kodera M, Komura K, Takehara K, Sato S. Increased cutaneous T-cell-attracting chemokine levels in sera from patients with systemic sclerosis. Rheumatology (Oxford) 2005; 44:873-8. [PMID: 15797972 DOI: 10.1093/rheumatology/keh625] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [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: 11/12/2022] Open
Abstract
OBJECTIVE We sought to assess serum cutaneous T-cell-attracting chemokine (CTACK) levels and CTACK expression levels in skin from patients with systemic sclerosis (SSc), and determine whether serum CTACK levels correlate with clinical features in SSc patients. METHODS Serum samples were obtained from 73 SSc patients, 32 patients with systemic lupus erythematosus and 26 patients with dermatomyositis. Serum CTACK levels were determined by enzyme-linked immunoabsorbent assay. CTACK mRNA expression in sclerotic skin was assessed by real-time reverse transcription-polymerase chain reaction. RESULTS Serum CTACK levels were significantly increased in patients with diffuse cutaneous SSc (dSSc; n=32) and those with limited cutaneous SSc (lSSc; n=41) compared with normal controls (n=31; P<0.05 and P<0.0005, respectively). The presence of calcinosis and muscle involvement was more frequently detected in SSc patients with elevated CTACK levels (P<0.05 and P<0.05, respectively). Elevated C-reactive protein levels were also observed more frequently in SSc patients with increased CTACK levels (P<0.05). CTACK mRNA expression levels in the sclerotic skin of SSc patients were augmented. In a longitudinal study, serum CTACK levels were generally decreased during the follow-up. CONCLUSIONS The increased serum CTACK levels and enhanced skin CTACK expression in SSc patients suggest that CTACK is related to the inflammation associated with SSc.
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Affiliation(s)
- I Hayakawa
- Department of Dermatology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan
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