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Amano M, Ichikawa Y, Matsumoto S, Matsushita S, Shimada S, Mitsuya H. Longitudinal analysis of neutralization in sera from HCWs receiving 2 doses of Omicron BA.4/5-adapted bivalent vaccine. J Infect 2023; 87:e79-e82. [PMID: 37660755 DOI: 10.1016/j.jinf.2023.08.012] [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] [Received: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Masayuki Amano
- Department of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.
| | - Yasuko Ichikawa
- Kumamoto General Hospital, Japan Community Healthcare Organization, Kumamoto, Japan
| | - Shota Matsumoto
- Kumamoto General Hospital, Japan Community Healthcare Organization, Kumamoto, Japan
| | - Shuzo Matsushita
- Department of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Shinya Shimada
- Kumamoto General Hospital, Japan Community Healthcare Organization, Kumamoto, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
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2
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Kobayakawa T, Amano M, Nakayama M, Tsuji K, Ishii T, Miura Y, Shinohara K, Yamamoto K, Matsuoka M, Tamamura H. Development of anti-HBV agents targeting HBV capsid proteins. RSC Med Chem 2023; 14:1973-1980. [PMID: 37859721 PMCID: PMC10583812 DOI: 10.1039/d3md00258f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/31/2023] [Indexed: 10/21/2023] Open
Abstract
Hepatitis B is a viral hepatitis, which is caused by infection of hepatitis B virus (HBV). This disease progresses to chronic hepatitis, cirrhosis and liver cancer. To treat hepatitis B, exclusion of virus and covalently closed circular DNA (cccDNA) that is formed in hepatocyte nucleus is necessary. A hepatitis B capsid protein (HBc) is an indispensable protein, which forms the capsid that encapsulates viral DNA. Since HBc is correlated to the transcriptional regulation of cccDNA, this protein would be an attractive target for complete cure of hepatitis B. By in silico screening of a library of compounds, a small compound, Cpd4 (1), which binds to a hydrophobic cavity located in the inner pocket on the tetramer interface of HBc proteins, was identified. In anti-HBV assays, this synthetic compound, Cpd4 (1) decreased the amount of HBV core related antigen (HBcrAg), which has been correlated with the proliferation of HBV, and decreased the amount of HBV surface antigen (HBsAg), which is correlated with the amount of cccDNA. Based on Cpd4 (1) as a lead compound, 20 derivatives of 1 were designed and synthesized and their structure-activity relationships were examined. As a result, specific interactions between each compound and amino acid residues of the target protein appeared to be unimportant but the shape/size of compounds which can bind to the hydrophobic cavity might be important in the expression of high anti-HBV activity, and a more potent derivative, TKB-HBV-CA-001 (3b), was discovered. These results will be useful in the development of novel anti-HBV agents for a complete cure of hepatitis B.
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Affiliation(s)
- Takuya Kobayakawa
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU) 2-3-10 Kandasurugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - Masayuki Amano
- Department of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto and Kagoshima Universities Kumamoto 860-0811 Japan
- Department of Hematology, Rheumatology, and Infectious Diseases, Faculty of Life Sciences, Kumamoto University Kumamoto 860-8556 Japan
| | - Miyuki Nakayama
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU) 2-3-10 Kandasurugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - Kohei Tsuji
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU) 2-3-10 Kandasurugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - Takahiro Ishii
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU) 2-3-10 Kandasurugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - Yutaro Miura
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU) 2-3-10 Kandasurugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - Kouki Shinohara
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU) 2-3-10 Kandasurugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - Kenichi Yamamoto
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU) 2-3-10 Kandasurugadai, Chiyoda-ku Tokyo 101-0062 Japan
| | - Masao Matsuoka
- Department of Hematology, Rheumatology, and Infectious Diseases, Faculty of Life Sciences, Kumamoto University Kumamoto 860-8556 Japan
| | - Hirokazu Tamamura
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU) 2-3-10 Kandasurugadai, Chiyoda-ku Tokyo 101-0062 Japan
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Amano M, Otsu S, Uemura Y, Ichikawa Y, Matsumoto S, Higashi-Kuwata N, Matsushita S, Shimada S, Mitsuya H. Neutralization against Omicron sublineages (BA.2/BA.5/BQ.1.1/XBB/XBB.1.5) in bivalent BNT162b2-vaccinated HCWs with or without risk factors, or following BT infection with Omicron. Sci Rep 2023; 13:17404. [PMID: 37833390 PMCID: PMC10575932 DOI: 10.1038/s41598-023-44484-x] [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: 08/05/2023] [Accepted: 10/09/2023] [Indexed: 10/15/2023] Open
Abstract
SARS-CoV-2-BA.4/5-adapted-bivalent-BNT162b2-vaccine (bvBNT), developed in response to the recent emergence of immune-evasive Omicron-variants, has been given to individuals who completed at least 2-doses of the monovalent-BNT162b2-vaccine (mvBNT). In the present cohort study, we evaluated neutralization-titers (NT50s) against Wuhan-strain (SCoV2Wuhan) and Omicron-sublineages including BA.2/BA.5/BQ.1.1/XBB/XBB.1.5, and vaccine-elicited S1-binding-IgG in sera from participants-vaccinated with 5th-bvBNT following 4th-mvBNT. The 5th-bvBNT-dose elicited good protective-activity against SCoV2Wuhan with geometric-mean (gMean)-NT50 of 1966-2091, higher than the peak-values post-4th-mvBNT with no statistical significance, and favorable neutralization-activity against not only BA.5 but also BA.2, with ~ 3.2-/~ 2.2-fold greater gMean-NT50 compared to the peak-values post-4th-mvBNT-dose, in participants with or without risk factors. However, neutralization-activity of sera post-5th-bvBNT-dose was low against BQ.1.1/XBB/XBB.1.5. Interestingly, participants receiving bvBNT following breakthrough (BT) infection during Omicron-wave had significantly enhanced neutralization-activity against SCoV2Wuhan/BA.2/BA.5 with ~ 4.6-/~ 6.3-/~ 8.1-fold greater gMean-NT50, respectively, compared to uninfected participants receiving bvBNT. Sera from BT-infected-participants receiving bvBNT had enhanced neutralization-activity against BQ.1.1/XBB/XBB.1.5 by ~ 3.8-fold compared to those from the same participants post-4th-mvBNT-dose, and had enhanced gMean-NT50 ~ 5.4-fold greater compared to those of uninfected-participants' sera post-bvBNT. These results suggest that repeated stimulation brought about by exposure to BA.5's-Spike elicit favorable cross-neutralization-activity against various SARS-CoV-2-variants.
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Affiliation(s)
- Masayuki Amano
- Department of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Cyuou-ku, Kumamoto, 860-0811, Japan.
| | - Sachiko Otsu
- Department of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Cyuou-ku, Kumamoto, 860-0811, Japan
| | - Yukari Uemura
- Department of Data Sciences, Center for Clinical Sciences, National Center for Global Health and Medicine (NCGM), Tokyo, Japan
| | - Yasuko Ichikawa
- Kumamoto General Hospital, Japan Community Healthcare Organization (JCHO), Kumamoto, Japan
| | - Shota Matsumoto
- Kumamoto General Hospital, Japan Community Healthcare Organization (JCHO), Kumamoto, Japan
| | | | - Shuzo Matsushita
- Department of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, 2-2-1 Honjo, Cyuou-ku, Kumamoto, 860-0811, Japan
| | - Shinya Shimada
- Kumamoto General Hospital, Japan Community Healthcare Organization (JCHO), Kumamoto, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Diseases, NCGM Research Institute, Tokyo, Japan
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Ghosh AK, Mishevich JL, Kovela S, Shaktah R, Ghosh AK, Johnson M, Wang YF, Wong-Sam A, Agniswamy J, Amano M, Takamatsu Y, Hattori SI, Weber IT, Mitsuya H. Exploration of imatinib and nilotinib-derived templates as the P2-Ligand for HIV-1 protease inhibitors: Design, synthesis, protein X-ray structural studies, and biological evaluation. Eur J Med Chem 2023; 255:115385. [PMID: 37150084 PMCID: PMC10759558 DOI: 10.1016/j.ejmech.2023.115385] [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: 02/27/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/09/2023]
Abstract
Structure-based design, synthesis, X-ray structural studies, and biological evaluation of a new series of potent HIV-1 protease inhibitors are described. These inhibitors contain various pyridyl-pyrimidine, aryl thiazole or alkylthiazole derivatives as the P2 ligands in combination with darunavir-like hydroxyethylamine sulfonamide isosteres. These heterocyclic ligands are inherent to kinase inhibitor drugs, such as nilotinib and imatinib. These ligands are designed to make hydrogen bonding interactions with the backbone atoms in the S2 subsite of HIV-1 protease. Various benzoic acid derivatives have been synthesized and incorporation of these ligands provided potent inhibitors that exhibited subnanomolar level protease inhibitory activity and low nanomolar level antiviral activity. Two high resolution X-ray structures of inhibitor-bound HIV-1 protease were determined. These structures provided important ligand-binding site interactions for further optimization of this class of protease inhibitors.
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Affiliation(s)
- Arun K Ghosh
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN, 47907, United States.
| | - Jennifer L Mishevich
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN, 47907, United States
| | - Satish Kovela
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN, 47907, United States
| | - Ryan Shaktah
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN, 47907, United States
| | - Ajay K Ghosh
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN, 47907, United States
| | - Megan Johnson
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN, 47907, United States
| | - Yuan-Fang Wang
- Department of Biology, Georgia State University, Atlanta, GA, 30303, United States
| | - Andres Wong-Sam
- Department of Biology, Georgia State University, Atlanta, GA, 30303, United States
| | - Johnson Agniswamy
- Department of Biology, Georgia State University, Atlanta, GA, 30303, United States
| | - Masayuki Amano
- Departments of Infectious Diseases and Hematology, Kumamoto University Graduate School of Biomedical Sciences, Kumamoto, 860-8556, Japan
| | - Yuki Takamatsu
- Refractory Viral Diseases, National Center for Global Health and Medicine Research Institute, Tokyo, 162-8655, Japan
| | - Shin-Ichiro Hattori
- Refractory Viral Diseases, National Center for Global Health and Medicine Research Institute, Tokyo, 162-8655, Japan
| | - Irene T Weber
- Department of Biology, Georgia State University, Atlanta, GA, 30303, United States
| | - Hiroaki Mitsuya
- Departments of Infectious Diseases and Hematology, Kumamoto University Graduate School of Biomedical Sciences, Kumamoto, 860-8556, Japan; Refractory Viral Diseases, National Center for Global Health and Medicine Research Institute, Tokyo, 162-8655, Japan; Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, United States
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Ghosh AK, Shahabi D, Kipfmiller M, Ghosh AK, Johnson M, Wang YF, Agniswamy J, Amano M, Weber IT, Mitsuya H. Evaluation of darunavir-derived HIV-1 protease inhibitors incorporating P2' amide-derivatives: Synthesis, biological evaluation and structural studies. Bioorg Med Chem Lett 2023; 83:129168. [PMID: 36738797 PMCID: PMC10061991 DOI: 10.1016/j.bmcl.2023.129168] [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: 11/08/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
We report here the synthesis and biological evaluation of darunavir derived HIV-1 protease inhibitors and their functional effect on enzyme inhibition and antiviral activity in MT-2 cell lines. The P2' 4-amino functionality was modified to make a number of amide derivatives to interact with residues in the S2' subsite of the HIV-1 protease active site. Several compounds exhibited picomolar enzyme inhibitory and low nanomolar antiviral activity. The X-ray crystal structure of the chloroacetate derivative bound to HIV-1 protease was determined. Interestingly, the active chloroacetate group converted to the acetate functionality during X-ray exposure. The structure revealed that the P2' carboxamide functionality makes enhanced hydrogen bonding interactions with the backbone atoms in the S2'-subsite.
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Affiliation(s)
- Arun K Ghosh
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA.
| | - Dana Shahabi
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Maya Kipfmiller
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Ajay K Ghosh
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Megan Johnson
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Yuan-Fang Wang
- Department of Biology, Georgia State University, Atlanta, GA 30303, USA
| | - Johnson Agniswamy
- Department of Biology, Georgia State University, Atlanta, GA 30303, USA
| | - Masayuki Amano
- Department of Refractory Viral Diseases, National Center for Global Health and Medicine, Shinjuku, Tokyo 162-8655, Japan; Department of Infectious Diseases, Kumamoto University School of Medicine, Kumamoto 860-8556, Japan
| | - Irene T Weber
- Department of Biology, Georgia State University, Atlanta, GA 30303, USA
| | - Hiroaki Mitsuya
- Department of Refractory Viral Diseases, National Center for Global Health and Medicine, Shinjuku, Tokyo 162-8655, Japan; Experimental Retrovirology Section, HIV and AIDS Malignancy Branch National Cancer Institute, Bethesda, MD 20892, USA; Division of Clinical Sciences, Kumamoto University Hospital, Kumamoto 860-8556, Japan
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Amano M, Ichikawa Y, Uemura Y, Matsumoto S, Maeda K, Matsushita S, Shimada S, Mitsuya H. Comparison of neutralization activity against Omicron BA.2/BA.5 in sera from HCWs receiving heterologous/homologous COVID-19 vaccines. J Infect 2023; 86:e130-e132. [PMID: 36736492 PMCID: PMC9892251 DOI: 10.1016/j.jinf.2023.01.038] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023]
Affiliation(s)
- Masayuki Amano
- Department of Clinical Retrovirology, Joint research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.
| | - Yasuko Ichikawa
- Kumamoto General Hospital, Japan Community Health Care Organization, Kumamoto, Japan
| | - Yukari Uemura
- Department of Data Sciences, Center for Clinical Sciences, National Center for Global Health and Medicine (NCGM), Tokyo, Japan
| | - Shota Matsumoto
- Kumamoto General Hospital, Japan Community Health Care Organization, Kumamoto, Japan
| | - Kenji Maeda
- Department of Refractory Viral Infections, NCGM Research Institute, Tokyo, Japan
| | - Shuzo Matsushita
- Department of Clinical Retrovirology, Joint research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Shinya Shimada
- Kumamoto General Hospital, Japan Community Health Care Organization, Kumamoto, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infections, NCGM Research Institute, Tokyo, Japan
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Boateng A, Amano M, Sugiura M. Synthesis of Selenoesters via Aldol Condensation and/or Conjugate Reduction and Their Antiviral Activities. ACS Omega 2023; 8:1369-1374. [PMID: 36643423 PMCID: PMC9835172 DOI: 10.1021/acsomega.2c06784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
A variety of unsaturated selenoesters (including phenolic ones) were produced in good to high yields and with high E/Z ratios using TiCl4-promoted aldol condensation between Se-phenyl selenoacetate and their respective aldehydes without aqueous workup. A representative phenolic unsaturated selenoester was applied to acylation of tyrosine methyl ester without protection of the phenolic hydroxy groups to furnish the corresponding amino acid conjugate. The conjugate reduction of the unsaturated selenoesters including phenolic ones and selenocoumarin with HSiEt3 was catalyzed by B(C6F5)3 to afford the corresponding saturated selenoesters in good to high yields. This method was also applicable to the reduction of a saturated selenoester to the corresponding O-silyl hemiselenoacetal in a high yield. Moreover, most acyclic unsaturated selenoesters were found to show good multiple antiviral activities against HIV-1, HBV, and SARS-CoV-2.
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Affiliation(s)
- Alex Boateng
- Graduate
School of Pharmaceutical Sciences, Sojo
University, 4-22-1 Ikeda, Nishi-ku, Kumamoto 860-0082, Japan
| | - Masayuki Amano
- Department
of Hematology, Rheumatology and Infectious Diseases, School of Medicine, Kumamoto University, Kumamoto 860-8556, Japan
- Department
of Clinical Retrovirology, Joint research Center for Human Retrovirus
Infection, Kumamoto University, Kumamoto 860-0811, Japan
| | - Masaharu Sugiura
- Graduate
School of Pharmaceutical Sciences, Sojo
University, 4-22-1 Ikeda, Nishi-ku, Kumamoto 860-0082, Japan
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Amano M, Harada Y, Shimizu T. Effectual Diagnostic Approach: A New Strategy to Achieve Diagnostic Excellence in High Diagnostic Uncertainty. Int J Gen Med 2022; 15:8327-8332. [DOI: 10.2147/ijgm.s389691] [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] [Received: 09/15/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
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Sato S, Yamakawa H, Takemura T, Nakamura T, Nishizawa T, Oba T, Kawabe R, Akasaka K, Amano M, Matsushima H. Evaluation of large airway specimens obtained by transbronchial lung cryobiopsy in diffuse parenchymal lung diseases. BMC Pulm Med 2022; 22:384. [PMID: 36258160 PMCID: PMC9578247 DOI: 10.1186/s12890-022-02186-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/04/2022] [Indexed: 11/26/2022] Open
Abstract
Background The difference in diagnostic yield between surgical lung biopsy and transbronchial lung cryobiopsy (TBLC) in diffuse parenchymal lung diseases (DPLD) has been reported to be due to differences in the rate of interpathologist agreement, specimen size, and specimen adequacy. In TBLC, the specimens containing large airway components are generally believed as inadequate specimens for histological evaluation, but the detailed characteristics of TBLC specimens including the large airway and the impact on histological diagnostic rates of DPLD have not been investigated. Methods We retrospectively reviewed the specimen characteristics of patients with DPLD who underwent TBLC. Results Between February 2018 and January 2020, 74 patients and 177 specimens were included. There were 85 (48.0%) large airway specimens (LAS) that contained bronchial gland or bronchial cartilage. The ideal specimen ratio was significantly lower in the LAS-positive group than that in the LAS-negative group (5.8% vs. 45.6%), and the proportion of bronchioles, alveoli, and perilobular area were similarly lower in the LAS-positive group. The presence of traction bronchiectasis and diaphragm overlap sign on high-resolution computed tomography (HRCT) were also significantly higher in the LAS-positive group than those in the LAS-negative group. We observed a statistically significant trend in histological diagnostic yield (40.7% in LAS positive group; 60.8% in LAS positive and negative group; 91.6% in LAS negative group) (Cochran-Armitage trend test). Conclusion LAS is a specimen often collected in TBLC and contains a low percentage of bronchioles, alveoli, and perilobular area. Since the histological diagnostic yield tends to be higher in cases that do not contain LAS, it may be important to determine the biopsy site that reduces the frequency of LAS collection by referring to the HRCT findings in TBLC.
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Affiliation(s)
- S Sato
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan.
| | - H Yamakawa
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - T Takemura
- Department of Pathology, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - T Nakamura
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - T Nishizawa
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - T Oba
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - R Kawabe
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - K Akasaka
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - M Amano
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - H Matsushima
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
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Amano M, Otsu S, Ichikawa Y, Higashi-Kuwata N, Matsushita S, Shimada S, Mitsuya H. Restoration of Neutralization Activity Against Omicron BA.2 and BA.5 in Older Adults and Individuals With Risk Factors Following the Fourth Dose of Severe Acute Respiratory Syndrome Coronavirus 2 BNT162b2 Vaccine. J Infect Dis 2022; 227:161-163. [PMID: 36134611 PMCID: PMC9619461 DOI: 10.1093/infdis/jiac393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 01/19/2023] Open
Affiliation(s)
- Masayuki Amano
- Department of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Sachiko Otsu
- Department of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Yasuko Ichikawa
- Kumamoto Ganeral Hospital, Japan Community Health Care Organization, Kumamoto, Japan
| | - Nobuyo Higashi-Kuwata
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Shuzo Matsushita
- Department of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Shinya Shimada
- Kumamoto Ganeral Hospital, Japan Community Health Care Organization, Kumamoto, Japan
| | - Hiroaki Mitsuya
- Correspondence: Hiroaki Mitsuya, MD, PhD, Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan ()
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Amano M, Maeda K, Tsuchiya K, Shimada S, Mitsuya H. Third-Dose BNT162b2 Vaccination Elicits Markedly High-Level SARS-CoV-2-Neutralizing Antibodies in Vaccinees Who Responded Poorly to a Second Dose in Japan. J Infect Dis 2022; 226:2038-2039. [PMID: 35580786 PMCID: PMC9129163 DOI: 10.1093/infdis/jiac209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 05/15/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- Masayuki Amano
- Department of Hematology, Rheumatology, and Infectious Diseases, Kumamoto University Hospital, Kumamoto, Japan
| | - Kenji Maeda
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Kiyoto Tsuchiya
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital,Tokyo, Japan
| | - Shinya Shimada
- Japan Community Health care Organization (JCHO) Kumamoto General Hospital, Kumamoto, Japan
| | - Hiroaki Mitsuya
- Correspondence: Hiroaki Mitsuya, MD, PhD, National Center for Global Health and Medicine Research Institute, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan ()
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Ghosh AK, Kovela S, Sharma A, Shahabi D, Ghosh AK, Hopkins DR, Yadav M, Johnson ME, Agniswamy J, Wang YF, Aoki M, Amano M, Weber IT, Mitsuya H. Design, Synthesis and X-ray Structural Studies of Potent HIV-1 Protease Inhibitors Containing C-4 Substituted Tricyclic Hexahydro-furofuran derivatives as P2 ligands. ChemMedChem 2022; 17:e202200058. [PMID: 35170223 PMCID: PMC9081228 DOI: 10.1002/cmdc.202200058] [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: 01/26/2022] [Indexed: 11/06/2022]
Abstract
The design, synthesis, X-ray structural, and biological evaluation of a series of highly potent HIV-1 protease inhibitors are reported herein. These inhibitors incorporated novel cyclohexane-fused tricyclic bis -tetrahydrofuran as P2 ligands in combination with a variety of P1 and P2'-ligands. Compound 4d with a difluoromethylphenyl P1 ligand and a cyclopropylaminobenzothiazole P2' ligand exhibited the most potent antiviral activity. Also, it maintained highly potent antiviral activity against a panel of highly multidrug-resistant HIV-1 variants. The corresponding inhibitor 5d with an enantiomeric ligand was significantly less potent in these antiviral assays. The new P2 ligands were synthesized in optically active form using enzymatic desymmetrization of meso -diols as the key step. To obtain molecular insight, high resolution X-ray structures of inhibitors 4b and 5d -bound HIV-1 protease were determined and structural analyses are highlighted here.
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Affiliation(s)
- Arun K Ghosh
- Purdue University, Departments of Chemistry and Medicinal Chemistry, 560 Oval Drive, 47907, West Lafayette, UNITED STATES
| | | | | | | | | | | | | | | | - Johnson Agniswamy
- Georgia State University Department of Biology, Biology and Chemistry, UNITED STATES
| | - Yuan-Fang Wang
- Georgia State University Department of Biology, Biology and Chemistry, UNITED STATES
| | - Manabu Aoki
- Kumamoto University: Kumamoto Daigaku, Department of Hematology and Infectious Disease, JAPAN
| | - Masayuki Amano
- Kumamoto University: Kumamoto Daigaku, Department of Hematology and Infectious Disease, JAPAN
| | - Irene T Weber
- Georgia State University Department of Biology, Biology and Chemistry, UNITED STATES
| | - Hiroaki Mitsuya
- National Center for Global Health and Medicine: Kokuritsu Kenkyu Kaihatsu Hojin Kokuritsu Kokusai Iryo Kenkyu Center, Center for Clinical Sciences, JAPAN
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Maeda K, Amano M, Uemura Y, Tsuchiya K, Matsushima T, Noda K, Shimizu Y, Fujiwara A, Takamatsu Y, Ichikawa Y, Nishimura H, Kinoshita M, Matsumoto S, Gatanaga H, Yoshimura K, Oka SI, Mikami A, Sugiura W, Sato T, Yoshida T, Shimada S, Mitsuya H. Correlates of neutralizing/SARS-CoV-2-S1-binding antibody response with adverse effects and immune kinetics in BNT162b2-vaccinated individuals. Sci Rep 2021; 11:22848. [PMID: 34819514 PMCID: PMC8613264 DOI: 10.1038/s41598-021-01930-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023] Open
Abstract
While mRNA vaccines against SARS-CoV-2 are exceedingly effective in preventing symptomatic infection, their immune response features remain to be clarified. In the present prospective study, 225 healthy individuals in Japan, who received two BNT162b2 doses, were enrolled. Correlates of BNT162b2-elicited SARS-CoV-2-neutralizing activity (50% neutralization titer: NT50; assessed using infectious virions) with various determinants were examined and the potency of sera against variants of concerns was determined. Significant rise in NT50s was seen in sera on day 28 post-1st dose. A moderate inverse correlation was seen between NT50s and ages, but no correlation seen between NT50s and adverse effects. NT50s and SARS-CoV-2-S1-binding-IgG levels on day 28 post-1st dose and pain scores following the 2nd dose were greater in women than in men. The average half-life of NT50s was ~ 68 days, and 23.6% (49 out of 208 individuals) failed to show detectable neutralizing activity on day 150. While sera from elite-responders (NT50s > 1,500: the top 4% among the participants) potently to moderately blocked all variants of concerns examined, some sera with low NT50s failed to block the B.1.351-beta strain. Since BNT162b2-elicited immunity against SARS-CoV-2 is short, an additional vaccine or other protective measures are needed.
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Affiliation(s)
- Kenji Maeda
- Department of Refractory Viral Infections, National Center for Global Health and Medicine (NCGM) Research Institute, Tokyo, Japan.
| | - Masayuki Amano
- Department of Clinical Sciences, Kumamoto University Hospital, Kumamoto, Japan
| | | | | | | | | | | | - Asuka Fujiwara
- Department of Refractory Viral Infections, National Center for Global Health and Medicine (NCGM) Research Institute, Tokyo, Japan
| | - Yuki Takamatsu
- Department of Refractory Viral Infections, National Center for Global Health and Medicine (NCGM) Research Institute, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | - Hiroaki Mitsuya
- Department of Refractory Viral Infections, National Center for Global Health and Medicine (NCGM) Research Institute, Tokyo, Japan.
- Department of Clinical Sciences, Kumamoto University Hospital, Kumamoto, Japan.
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Chia T, Nakamura T, Amano M, Takamune N, Matsuoka M, Nakata H. A Small Molecule, ACAi-028, with Anti-HIV-1 Activity Targets a Novel Hydrophobic Pocket on HIV-1 Capsid. Antimicrob Agents Chemother 2021; 65:e0103921. [PMID: 34228546 PMCID: PMC8448090 DOI: 10.1128/aac.01039-21] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 05/22/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022] Open
Abstract
The human immunodeficiency virus type 1 (HIV-1) capsid (CA) is an essential viral component of HIV-1 infection and an attractive therapeutic target for antivirals. Here, we report that a small molecule, ACAi-028, inhibits HIV-1 replication by targeting a hydrophobic pocket in the N-terminal domain of CA (CA-NTD). ACAi-028 is 1 of more than 40 candidate anti-HIV-1 compounds identified by in silico screening and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays. Our binding model showed that ACAi-028 interacts with the Q13, S16, and T19 amino acid residues, via hydrogen bonds, in the targeting pocket of CA-NTD. Using recombinant fusion methods, TZM-bl, time-of-addition, and colorimetric reverse transcriptase (RT) assays, the compound was found to exert anti-HIV-1 activity in the early stage between reverse transcription and proviral DNA integration, without any effect on RT activity in vitro, suggesting that this compound may affect HIV-1 core disassembly (uncoating) as well as a CA inhibitor, PF74. Moreover, electrospray ionization mass spectrometry (ESI-MS) also showed that the compound binds directly and noncovalently to the CA monomer. CA multimerization and thermal stability assays showed that ACAi-028 decreased CA multimerization and thermal stability via S16 or T19 residues. These results indicate that ACAi-028 is a new CA inhibitor by binding to the novel hydrophobic pocket in CA-NTD. This study demonstrates that a compound, ACAi-028, targeting the hydrophobic pocket should be a promising anti-HIV-1 inhibitor.
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Affiliation(s)
- Travis Chia
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomofumi Nakamura
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masayuki Amano
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Nobutoki Takamune
- Kumamoto Innovative Development Organization, Kumamoto University, Kumamoto, Japan
| | - Masao Matsuoka
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hirotomo Nakata
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Maeda K, Amano M, Uemura Y, Tsuchiya K, Matsushima T, Noda K, Shimizu Y, Fujiwara A, Takamatsu Y, Ichikawa Y, Nishimura H, Kinoshita M, Matsumoto S, Gatanaga H, Yoshimura K, Oka SI, Mikami A, Sugiura W, Sato T, Yoshida T, Shimada S, Mitsuya H. Correlates of Neutralizing/SARS-CoV-2-S1-binding Antibody Response with Adverse Effects and Immune Kinetics in BNT162b2-Vaccinated Individuals. medRxiv 2021:2021.07.27.21261237. [PMID: 34373860 PMCID: PMC8351777 DOI: 10.1101/2021.07.27.21261237] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND While mRNA vaccines against SARS-CoV-2 have been exceedingly effective in preventing symptomatic viral infection, the features of immune response remain to be clarified. METHODS In the present prospective observational study, 225 healthy individuals in Kumamoto General Hospital, Japan, who received two BNT162b2 doses in February 2021, were enrolled. Correlates of BNT162b2-elicited SARS-CoV-2-neutralizing activity (50% neutralization titer: NT 50 ; assessed using infectious virions and live target cells) with SARS-CoV-2-S1-binding-IgG and -IgM levels, adverse effects (AEs), ages, and genders were examined. The average half-life of neutralizing activity and the average time length for the loss of detectable neutralizing activity were determined and the potency of serums against variants of concerns was also determined. FINDINGS Significant rise in NT 50 s was seen in serums on day 28 post-1st dose. A moderate inverse correlation was seen between NT 50 s and ages, but no correlation was seen between NT 50 s and AEs. NT 50 s and IgG levels on day 28 post-1st dose and pain scores following the 2nd shot were greater in women than in men. The average half-life of neutralizing activity in the vaccinees was approximately 67.8 days and the average time length for their serums to lose the detectable neutralizing activity was 198.3 days. While serums from elite-responders (NT 50 s>1,500-fold: the top 4% among all participants' NT 50 s) potently to moderately blocked the infectivity of variants of concerns, some serums with moderate NT 50 s failed to block the infectivity of a beta strain. INTERPRETATION BNT162b2-elicited immune response has no significant association with AEs. BNT162b2-efficacy is likely diminished to under detection limit by 6-7 months post-1st shot. High-level neutralizing antibody-containing serums potently to moderately block the infection of SARS-CoV-2 variants; however, a few moderate-level neutralizing antibody-containing serums failed to do so. If BNT162b2-elicited immunity memory is short, an additional vaccine or other protective measures would be needed. RESEARCH IN CONTEXT Evidence before this study: While mRNA vaccines against SARS-CoV-2 have been exceedingly effective in preventing symptomatic viral infection, the salient features of immune response including the persistence of protection remain to be clarified. There is a report that anti-SARS-CoV-2 antibodies persist through 6 months after the second dose of mRNA-1273 vaccine (Doria-Rose et al. N Engl J Med . 2021;384:2259-2261); however, more definite immune kinetics following mRNA-vaccine-elicited protection have to be clarified. The mRNA-vaccine-elicited protection against SARS-CoV-2 variants are also to be determined. Added value of this study: In the present prospective study, 225 twice-BNT162b2-dose-receiving individuals in Japan were enrolled. No significant correlation was seen between 50% neutralizing titers (NT 50 s), determined by using infectious SARS-CoV-2 virions and live target cells, and adverse effects. Largely, NT 50 s and IgG levels were greater in women than in men. Following 28 days post-2 nd shot, significant reduction was seen in NT 50 s, IgG, and IgM levels. The average half-life of NT 50 s was ∼68 days and the average time-length for participants' serums to lose the detectable activity was ∼198 days. Although serums from elite-responders potently to moderately blocked the infectivity of variants of concerns, some serums with moderate NT 50 s failed to block the infectivity of a beta strain. Implications of all the available evidence: BNT162b2 efficacy is likely to be diminished to under detection limit by 6-7 months post-1 st shot on average. Individuals with moderate NT 50 s may fail to block beta variants. If BNT162b2-elicited immune memory is lost soon, additional vaccine(s) or other protective means would be needed.
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Affiliation(s)
- Kenji Maeda
- Department of Refractory Viral Infections, National Center for Global Health and Medicine (NCGM) Research Institute, Tokyo, Japan
| | - Masayuki Amano
- Department of Clinical Sciences, Kumamoto University Hospital, Kumamoto, Japan
| | | | | | | | | | | | - Asuka Fujiwara
- Department of Refractory Viral Infections, National Center for Global Health and Medicine (NCGM) Research Institute, Tokyo, Japan
| | - Yuki Takamatsu
- Department of Refractory Viral Infections, National Center for Global Health and Medicine (NCGM) Research Institute, Tokyo, Japan
| | | | | | | | | | | | | | | | - Ayako Mikami
- Department of Clinical Sciences, NCGM, Tokyo, Japan
| | | | | | | | | | - Hiroaki Mitsuya
- Department of Refractory Viral Infections, National Center for Global Health and Medicine (NCGM) Research Institute, Tokyo, Japan
- Department of Clinical Sciences, Kumamoto University Hospital, Kumamoto, Japan
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Okamoto C, Okada A, Moriuchi K, Amano M, Takahama H, Amaki M, Hasegawa T, Kanzaki H, Fujita T, Kobayashi J, Yasuda S, Izumi C. Prognostic differences between atrial functional mitral regurgitation and ventricular functional mitral regurgitation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Atrial functional mitral regurgitation (A-FMR) has been under-recognized until recently as a cause of FMR, and the prognostic difference between A-FMR and ventricular FMR (V-FMR) has not been fully elucidated. As there has been different mechanisms of FMR suggested in A-FMR and V-FMR, we hypothesized that prognosis and prognostic predictors of A-FMR may differ from those of V-FMR.
Purpose
To investigate the prognosis and prognostic predictors of A-FMR in comparison with V-FMR.
Methods
Among 1312 consecutive patients with grade 3+ (moderate to severe) or 4+ (severe) MR, 378 consecutive FMR patients were identified by excluding patients with degenerative MR, previous cardiac surgery, or concomitant aortic valve disease and/or mitral stenosis. FMR with ejection fraction (EF) <40% or FMR due to regional wall motion abnormalities with leaflet tethering were classified as V-FMR (N=288), and FMR due to left atrial (LA) and/or annular dilatation with preserved or mid-range EF (≥40%) were classified as A-FMR (N=90). All-cause death and heart failure hospitalization were analyzed as cardiovascular (CV) events in this study. Surgical or percutaneous mitral valve intervention without CV events was handled as not reaching an endpoint and these cases were censored.
Results
A-FMR were significantly older (76 [69–82] vs. 70 [58–77] years), higher rates of female (64 vs. 35%) and atrial fibrillation (88 vs. 42%), and lower B-type natriuretic peptide (BNP) values (169 [101–318] vs. 447 [213–952] pg/ml) compared to V-FMR (all P<0.05). On echocardiography, LV end-diastolic and end-systolic dimensions (52 [48–57] vs. 64 [58–72] mm, 34 [31–37] vs. 55 [48–64] mm), respectively) were smaller, and EF (55 [50–60] vs. 28 [19–35] %) and LA volume (99 [73–137] vs. 73 [57–91] ml/m2) were larger in A-FMR (all P<0.05). Effective regurgitant orifice area (32 [26–40] vs. 31 [24–45] mm2) and regurgitant volume (50±15 vs. 52±16 ml) were similar (both n.s.). During a median follow up of 1407 days, 206 (54%) patients developed CV events. Kaplan-Meier analysis revealed that V-FMR had a significantly higher rates of CV events compared to A-FMR (Figure) with adjusted hazard ratio (HR) of 1.762 [1.168–2.660], P=0.007 after adjusted for variables including age, sex, New York Heart Association functional class, previous heart failure hospitalization, estimated glomerular filtration rate (eGFR) and BNP. Further, stepwise multivariate analysis showed that independent prognostic predictors of A-FMR were LA volume and eGFR, while those for V-FMR were LA volume, age, and LV end-systolic dimension.
Conclusions
A-FMR had relatively better prognosis compared to V-FMR, and there were different prognostic predictors between A-FMR and V-FMR. Our results suggest that different treatment strategies need to be considered between A-FMR and V-FMR.
The Kaplan-Meier life table
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Okamoto
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - A Okada
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Moriuchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Amano
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Takahama
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Amaki
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Hasegawa
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Kanzaki
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Fujita
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Surgery, Osaka, Japan
| | - J Kobayashi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Surgery, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
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Kaneta K, Takahama H, Tateishi E, Moriuchi K, Amano M, Okada A, Amaki M, Hasegawa T, Ohta Y, Kiso K, Kanzaki H, Kusano K, Yasuda S, Izumi C. Recurrences of disease activity in patients with cardiac sarcoidosis under corticosteroid therapy: prevalence, clinical background and prognosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Corticosteroid therapy (CTx) has been widely accepted as first-line therapy for cardiac sarcoidosis (CS), but there are very limited data regarding recurrence of disease activity of CS. We retrospectively investigated the prevalence, patient characteristics and prognostic significance in patients with recurrences of CS.
Methods
We identified 102 consecutive patients who were clinically diagnosed CS (admission: 2012 and 2019) and whose disease activity was diminished clinically at least once. Recurrence of CS was defined as detection of increased uptake of 18F-fluoro-2-deoxyglucose or gallium-67 in the follow-up examination. Composite adverse events (events) were defined as all-cause of death or hospitalization for heart failure. Echocardiographic and laboratory data before initiation of CTx were obtained.
Results
During the follow-up term (median: 4.9 years), the recurrences of CS occurred in 28 patients at 30 months (median) after the initiation of CTx. In patients with recurrence, left ventricular (LV) ejection fraction before initiation of CTx was lower than in those without recurrences (median: 31% vs. 39%, p<0.05). After the detection of CS recurrences, 17 patients were treated with only increases of PSL and remaining 11 patients were treated with adding other immunosuppressive therapies to CTx. The univariate analysis demonstrated that there were no parameters in echocardiographic and laboratory examinations to predict the recurrences of CS. The results of univariate analysis for event occurrences (n=12) are shown in the Table. Additionally, the Kaplan-Meier analysis showed that there were no differences in event free survival rate in the patients with and without CS recurrences (Figure).
Conclusion
This study showed that the recurrences of disease activity were observed in a substantial number of patients with CS even under the CTx. All patients received intensification of CTx or additional immunosuppressive therapy, and LV systolic function, rather than the recurrence itself, was associated with clinical outcomes in this study.
Kaplan-Meier analysis for events
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Kaneta
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - H Takahama
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - E Tateishi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Moriuchi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - M Amano
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - A Okada
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - M Amaki
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - T Hasegawa
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Ohta
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Kiso
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - H Kanzaki
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Kusano
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yasuda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - C Izumi
- National Cerebral & Cardiovascular Center, Suita, Japan
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Ghosh AK, Kovela S, Osswald HL, Amano M, Aoki M, Agniswamy J, Wang YF, Weber IT, Mitsuya H. Structure-Based Design of Highly Potent HIV-1 Protease Inhibitors Containing New Tricyclic Ring P2-Ligands: Design, Synthesis, Biological, and X-ray Structural Studies. J Med Chem 2020; 63:4867-4879. [PMID: 32348139 PMCID: PMC7425579 DOI: 10.1021/acs.jmedchem.0c00202] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We describe here design, synthesis, and biological evaluation of a series of highly potent HIV-1 protease inhibitors containing stereochemically defined and unprecedented tricyclic furanofuran derivatives as P2 ligands in combination with a variety of sulfonamide derivatives as P2' ligands. These inhibitors were designed to enhance the ligand-backbone binding and van der Waals interactions in the protease active site. A number of inhibitors containing the new P2 ligand, an aminobenzothiazole as the P2' ligand and a difluorophenylmethyl as the P1 ligand, displayed very potent enzyme inhibitory potency and also showed excellent antiviral activity against a panel of highly multidrug-resistant HIV-1 variants. The tricyclic P2 ligand has been synthesized efficiently in an optically active form using enzymatic desymmetrization of meso-1,2-(dihydroxymethyl)cyclohex-4-ene as the key step. We determined high-resolution X-ray structures of inhibitor-bound HIV-1 protease. These structures revealed extensive interactions with the backbone atoms of HIV-1 protease and provided molecular insights into the binding properties of these new inhibitors.
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Affiliation(s)
- Arun K. Ghosh
- Department of Chemistry, Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, United States
| | - Satish Kovela
- Department of Chemistry, Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, United States
| | - Heather L. Osswald
- Department of Chemistry, Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, United States
| | - Masayuki Amano
- Departments of Infectious Diseases and Hematology, Kumamoto University Graduate School of Biomedical Sciences, Kumamoto 860-8556, Japan
| | - Manabu Aoki
- Department of Medical Technology, Kumamoto Health Science University, Kumamoto 861-5598, Japan; Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, United States; Department of Clinical Sciences, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Johnson Agniswamy
- Department of Biology, Georgia State University, Atlanta, Georgia 30303, United States
| | - Yuan-Fang Wang
- Department of Biology, Georgia State University, Atlanta, Georgia 30303, United States
| | - Irene T. Weber
- Department of Biology, Georgia State University, Atlanta, Georgia 30303, United States
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infection, National Center for Global Health and Medicine Research Institute, Tokyo 162-8655, Japan; Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, United States; Department of Clinical Sciences, Kumamoto University Hospital, Kumamoto 860-8556, Japan
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19
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Sato S, Akasaka K, Ohta H, Tsukahara Y, Kida G, Tsumiyama E, Kusano K, Oba T, Nishizawa T, Kawabe R, Yamakawa H, Amano M, Matsushima H, Takada T. Autoimmune pulmonary alveolar proteinosis developed during immunosuppressive treatment in polymyositis with interstitial lung disease: a case report. BMC Pulm Med 2020; 20:84. [PMID: 32252718 PMCID: PMC7132862 DOI: 10.1186/s12890-020-1110-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 03/10/2020] [Indexed: 11/15/2022] Open
Abstract
Background Pulmonary alveolar proteinosis (PAP) is characterized by the accumulation of surfactant proteins within the alveolar spaces. Autoimmune PAP (APAP) caused by elevated levels of GM-CSF autoantibodies (GM-Ab) is very rarely associated with systemic autoimmune disease. Here we report a case of APAP manifested during immunosuppressive treatment for polymyositis with interstitial lung disease. Case presentation A 52-year-old woman treated at our hospital because of polymyositis with interstitial pneumonia had maintained remission by immunosuppressive treatment for 15 years. She had progressive dyspnea subsequently over several months with her chest CT showing ground-glass opacities (GGO) in bilateral geographic distribution. Her bronchoalveolar lavage fluid with cloudy appearance revealed medium-sized foamy macrophages and PAS-positive amorphous eosinophilic materials by cytological examination. We diagnosed her as APAP due to an increased serum GM-CSF autoantibody level. Attenuating immunosuppression failed to lead GGO improvement, but whole lung lavage (WLL) was effective in her condition. Conclusions PAP should be considered as one of the differential diseases when the newly interstitial shadow was observed during immunosuppressive treatment. WLL should be regarded as the treatment option for APAP concurred in connective tissue disease (CTD).
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Affiliation(s)
- S Sato
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan.
| | - K Akasaka
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - H Ohta
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - Y Tsukahara
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - G Kida
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - E Tsumiyama
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - K Kusano
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - T Oba
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - T Nishizawa
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - R Kawabe
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - H Yamakawa
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - M Amano
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - H Matsushima
- Department of Respiratory Medicine, Saitama Red Cross Hospital, 1-5, Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - T Takada
- Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-Uonuma, Japan
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20
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Tanaka M, Takechi M, Homma A, Fukuda M, Nishimura D, Suzuki T, Tanaka Y, Moriguchi T, Ahn DS, Aimaganbetov A, Amano M, Arakawa H, Bagchi S, Behr KH, Burtebayev N, Chikaato K, Du H, Ebata S, Fujii T, Fukuda N, Geissel H, Hori T, Horiuchi W, Hoshino S, Igosawa R, Ikeda A, Inabe N, Inomata K, Itahashi K, Izumikawa T, Kamioka D, Kanda N, Kato I, Kenzhina I, Korkulu Z, Kuk Y, Kusaka K, Matsuta K, Mihara M, Miyata E, Nagae D, Nakamura S, Nassurlla M, Nishimuro K, Nishizuka K, Ohnishi K, Ohtake M, Ohtsubo T, Omika S, Ong HJ, Ozawa A, Prochazka A, Sakurai H, Scheidenberger C, Shimizu Y, Sugihara T, Sumikama T, Suzuki H, Suzuki S, Takeda H, Tanaka YK, Tanihata I, Wada T, Wakayama K, Yagi S, Yamaguchi T, Yanagihara R, Yanagisawa Y, Yoshida K, Zholdybayev TK. Swelling of Doubly Magic ^{48}Ca Core in Ca Isotopes beyond N=28. Phys Rev Lett 2020; 124:102501. [PMID: 32216444 DOI: 10.1103/physrevlett.124.102501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/20/2019] [Accepted: 01/30/2020] [Indexed: 06/10/2023]
Abstract
Interaction cross sections for ^{42-51}Ca on a carbon target at 280 MeV/nucleon have been measured for the first time. The neutron number dependence of derived root-mean-square matter radii shows a significant increase beyond the neutron magic number N=28. Furthermore, this enhancement of matter radii is much larger than that of the previously measured charge radii, indicating a novel growth in neutron skin thickness. A simple examination based on the Fermi-type distribution, and mean field calculations point out that this anomalous enhancement of the nuclear size beyond N=28 results from an enlargement of the core by a sudden increase in the surface diffuseness of the neutron density distribution, which implies the swelling of the bare ^{48}Ca core in Ca isotopes beyond N=28.
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Affiliation(s)
- M Tanaka
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
- Research Center for Superheavy Elements, Kyushu University, Fukuoka 819-0395, Japan
| | - M Takechi
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - A Homma
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - M Fukuda
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - D Nishimura
- Department of Physics, Tokyo City University, Setagaya, Tokyo 158-8557, Japan
| | - T Suzuki
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - Y Tanaka
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Moriguchi
- Institute of Physics, University of Tsukuba, Tsukuba, Ibaraki 305-8571, Japan
| | - D S Ahn
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - A Aimaganbetov
- Institute of Nuclear Physics, 050032 Almaty, Kazakhstan
- L.N. Gumilyov Eurasian National University, 010008 Astana, Kazakhstan
| | - M Amano
- Institute of Physics, University of Tsukuba, Tsukuba, Ibaraki 305-8571, Japan
| | - H Arakawa
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - S Bagchi
- Astronomy and Physics Department, Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
- Justus Liebig University, 35392 Giessen, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - K-H Behr
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - N Burtebayev
- Institute of Nuclear Physics, 050032 Almaty, Kazakhstan
| | - K Chikaato
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - H Du
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S Ebata
- Department of Physics, Saitama University, Saitama 338-8570, Japan
- School of Environment and Society, Tokyo Institute of Technology, Meguro, Tokyo 152-8551, Japan
| | - T Fujii
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - N Fukuda
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - H Geissel
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - T Hori
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - W Horiuchi
- Department of Physics, Hokkaido University, Sapporo 060-0810, Japan
| | - S Hoshino
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - R Igosawa
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - A Ikeda
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - N Inabe
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - K Inomata
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - K Itahashi
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - T Izumikawa
- Institute for Research Promotion, Niigata University, Niigata 950-8510, Japan
| | - D Kamioka
- Institute of Physics, University of Tsukuba, Tsukuba, Ibaraki 305-8571, Japan
| | - N Kanda
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - I Kato
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - I Kenzhina
- Institute of Nuclear Physics, 050032 Almaty, Kazakhstan
- Al-Farabi Kazakh National University, 050040 Almaty, Kazakhstan
| | - Z Korkulu
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - Y Kuk
- Institute of Nuclear Physics, 050032 Almaty, Kazakhstan
- L.N. Gumilyov Eurasian National University, 010008 Astana, Kazakhstan
| | - K Kusaka
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - K Matsuta
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - M Mihara
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - E Miyata
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - D Nagae
- Research Center for Superheavy Elements, Kyushu University, Fukuoka 819-0395, Japan
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - S Nakamura
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - M Nassurlla
- Institute of Nuclear Physics, 050032 Almaty, Kazakhstan
- Al-Farabi Kazakh National University, 050040 Almaty, Kazakhstan
| | - K Nishimuro
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - K Nishizuka
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - K Ohnishi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - M Ohtake
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - T Ohtsubo
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - S Omika
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - H J Ong
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - A Ozawa
- Institute of Physics, University of Tsukuba, Tsukuba, Ibaraki 305-8571, Japan
| | - A Prochazka
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - H Sakurai
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - C Scheidenberger
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - Y Shimizu
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - T Sugihara
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Sumikama
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - S Suzuki
- Institute of Physics, University of Tsukuba, Tsukuba, Ibaraki 305-8571, Japan
| | - H Takeda
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - Y K Tanaka
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - I Tanihata
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191 Beijing, China
| | - T Wada
- Department of Physics, Niigata University, Ikarashi, Niigata 951-2181, Japan
| | - K Wakayama
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - S Yagi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Yamaguchi
- Department of Physics, Saitama University, Saitama 338-8570, Japan
- Tomonaga Center for the History of the Universe, University of Tsukuba, Ibaraki 305-8571, Japan
| | - R Yanagihara
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y Yanagisawa
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - K Yoshida
- RIKEN Nishina Center, Wako, Saitama 351-0198, Japan
| | - T K Zholdybayev
- Institute of Nuclear Physics, 050032 Almaty, Kazakhstan
- Al-Farabi Kazakh National University, 050040 Almaty, Kazakhstan
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Amano M, Izumi C, Kim YJ, Park SJ, Park SW, Tanaka H, Hozumi T, Ling LH, Yu CM, Fukuda S, Otsuji Y, Song JK, Sohn DW. P914 Changes of echocardiographic parameters in primary mitral regurgitation and determinants of symptom: an assessment from the Asian valve registry data. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
[Background]Clinicians often have a difficulty in determining the presence of mitral regurgitation (MR)-relatedsymptoms because of subjectivity.However, there are few actual measurement data for echocardiographic left ventricular (LV) and left atrial (LA) size related to the severity of MR and the relationship between MR-related symptoms and these echocardiographic parameters.
[Purpose] The purpose of this study was to clarify actual values for echocardiographic parameters related to severity of MR and determinant factors of MR-related symptoms.
[Methods] Among patients enrolled in the Asian Valve Registry, we investigated 778 consecutive patients with primary MR showing sinus rhythm. Symptoms were determined by NYHA (≤ II or ≥ III).
[Results]MR severity was mild in 106, moderate in 285, and severe in 387 patients. LA volume index, LV end-diastolic diameter, and LV mass index increased with increasing MR grade [LA volume index: 47.9 (mild), 56.2 (moderate), and 64.9 ml/m2(severe) (p < 0.001), LV end-diastolic diameter: 51.2, 54.5, 58.1 mm (p < 0.001), and LV mass index: 101, 109, 123 g/m2(p < 0.001)]. Regarding moderate and severe MR, 70 patients (10.4%) were symptomatic. Table shows multivariable analysis for being symptomatic in moderate and severe MR patients. LV mass index (p = 0.040), ejection fraction (p < 0.001), female gender (p = 0.004), and heart rate (p = 0.007) were independent factors for MR-related symptoms.
[Conclusions] LV and LA parameters on echocardiography worsened as MR severity progressed. Larger LV mass index and lower ejection fraction were independent determinant factors for MR-related symptoms. We should also pay attention to LV hypertrophy in patients with primary MR.
Determinant factors for mitral regurgita Model 1 Model 2 OR (95% CI) P-value OR (95% CI) P-value Age, per 1-y increment 1.03 (1.00-1.05) 0.035 1.02 (0.99-1.05) 0.053 Sex (female) 2.23 (1.20-4.16) 0.011 2.28 (1.31-3.98) 0.004 Hear rate, per 1 bpm increment 1.03 (1.00-1.05) 0.025 1.03 (1.01-1.05) 0.007 LVDs index, per 1 mm increment 0.99 (0.90-1.09) 0.90 EF, per 1% increment 0.95 (0.92-0.99) 0.019 0.96 (0.93-0.98) <0.001 LV mass index, per 10 g/m2increment 1.12 (1.01-1.25) 0.033 1.09 (1.005-1.18) 0.040 LA volume index, per 10 mL/m2increment 0.96 (0.90-1.03) 0.23 E wave, per 1cm/s increment 1.81 (0.70-4.66) 0.23 TR pressure gradient >40 mmHg 2.11 (0.97-4.57) 0.057 Hypertention 1.40 (0.75-2.63) 0.29
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Affiliation(s)
- M Amano
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - Y J Kim
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - S W Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - H Tanaka
- Kobe University, Cardiovascular Medicine, Kobe, Japan
| | - T Hozumi
- Wakayama Medical University, Cardiovascular Medicine, Wakayama, Japan
| | - L H Ling
- National Heart Centre Singapore, Singapore, Singapore
| | - C M Yu
- The University of Hong Kong, Medicine and Therapeutics, Hong Kong, Hong Kong
| | - S Fukuda
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Y Otsuji
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - J K Song
- Asan Medical Center, Seoul, Korea (Republic of)
| | - D W Sohn
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
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Mizumoto A, Amano M, Kamakura T, Hashimoto S, Oonishi E, Tanaka N, Izumi C. P1742 Occurrence of right ventricle dysfunction in patients with Brugada syndrome: a follow-up study by echocardiography and electrophysiological examination. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Brugada syndrome (BrS) has been characterized by no apparent structural abnormalities in both ventricles, but, recently, the presence of subtle right ventricular (RV) structural abnormalities in patients with BrS has been reported.
Purpose
The aim of this study was to evaluate the occurrence of RV dysfunction in patients with BrS and their characteristics.
Methods
We enrolled 49 consecutive patients (54 ± 11 years old) diagnosed with Brs and underwent echocardiography from 2017 to 2018. The echocardiographic parameters and electrophysiological examinations were evaluated including RV size and function such as RV outflow and inflow tract diameter, TAPSE, S’, and FAC. Abnormality threshold for parameters of RV dysfunction is defined as followed: a TAPSE of <17 mm, an S’ of <9.5 cm, and an FAC of <35%.
Results
Among 49 patients, one patient showed a TAPSE of <17 mm, 5 patients an S’ of <9.5 cm, and 10 patients an FAC of <35%. Evaluating characteristics of Brs patients with RV dysfunction, all patients were divided into 2 groups by the value of RV FAC; 39 patients showing FAC >35% (group A), 10 patients FAC ≤35% (group B). The comparison of each parameter between 2 groups is shown in Table. TAPSE and S’ in group B were lower than in group A. RV inflow tract diameter in group B was larger than in group A, although there was no differences in RV out tract diameter. There were no significant differences in left ventricular parameters, and grade of tricuspid regurgitation. QRS duration prolonged and the rate of ICD implantation was higher in group B than in group A. Moreover, all patients in group B showed RV wall motion abnormalities and the distribution was as followed: diffuse (n = 2), RV mid (n = 2), RV apex (n = 6).
Conclusions
BrS patients frequently showed RV dysfunction during follow-up, and it may be related to the prolongation of QRS duration. We should pay much attention to the occurrence of RV dysfunction in follow-up echocardiography.
Group A (FAC >35%) N = 39 Group B (FAC ≤35%) N = 10 p-value TAPSE, mm 22.9 ± 2.1 20.4 ± 2.6 0.009 S", cm/s 12.8 ± 2.0 11.1 ± 1.4 0.010 RV outflow tract, mm 29.7 ± 4.4 31.2 ± 5.0 0.49 RV mid inflow tract, mm 30.4 ± 2.9 33.8 ± 3.7 0.008 RV basal inflow tract, mm 38.5 ± 3.2 43.7 ± 4.0 0.001 QRS duration, ms 112.9 ± 12.9 136.3 ± 28.4 0.006 Late potential positive, n (%) 25 (64) 8 (80) 0.34 ICD implantation, n (%) 19 (68) 9 (90) 0.019
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Affiliation(s)
- A Mizumoto
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - M Amano
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - S Hashimoto
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - E Oonishi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - N Tanaka
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
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Matsutani H, Amano M, Izumi C, Baba M, Abe R, Hashiwada S, Kuwano K, Shimada M, Sakamoto J, Miyake M, Tamura T, Matsuo S. P1444 Occurrence and predictors of right ventricular dysfunction after pericardiocentesis. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background—The changes in cardiac function that occur after pericardiocentesis are unclear.Purpose—This study was performed to assess right ventricular (RV) and left ventricular (LV) function with echocardiography before and after pericardiocentesis.
Method and Results—In total, 19 consecutive patients who underwent pericardiocentesis for more than moderate pericardial effusion were prospectively enrolled from August 2015 to October 2017. Comprehensive transthoracic echocardiography was performed before, immediately after (within 3 hours), and 1 day after pericardiocentesis to investigate the changes in RV and LV function. RV dysfunction is defined as meeting three of the four criteria: a TAPSE of <17 mm, an S’ of <9.5 cm, an FAC of <35%, and an RV free wall longitudinal strain >−20%. The mean age of all patients was 72.6 ± 12.2 years. The changes of echocardiographic parameters related to RV function are shown in Table. After pericardiocentesis, RV inflow and outflow diameters increased and the parameters of RV function significantly decreased. These abnormal values or RV dysfunction remained at 1 day after pericardiocentesis. Conversely, no parameters of LV function parameters changed after pericardiocentesis. Of 19 patients, 13 patients showed RV dysfunction immediately after pericardiocentesis and 6 patients did not. RV free wall longitudinal strain before pericardiocentesis was higher in patients with post-procedural RV dysfunction (−18.9 ± 3.6%) than in those without (−28.4 ± 6.3%). ROC analysis revealed that a RV free wall longitudinal strain cut-off value of −23.0% had a sensitivity of 100% and a specificity of 83.3% for predicting the occurrence of RV dysfunction after pericardiocentesis (AUC = 0.910).
Conclusions—The occurrence of RV dysfunction after pericardiocentesis should be given more attention. Pre-existing RV dysfunction maybe related to the occurrence of RV dysfunction after pericardiocentesis.
Changes in RV function before and after Before Immediately after One day after P−value Basal right ventricular linear dimension (mm) 32.8 ± 5.0 37.1 ± 4.4† 33.6 ± 5.4 0.028 Mid-cavity right ventricular linear dimension (mm) 34.5 ± 4.6 38.8 ± 5.3† 37.0 ± 5.6 0.0504 Proximal right ventricular outflow diameter (mm) 30.2 ± 4.0 33.9 ± 3.5† 31.4 ± 3.9 0.014 TAPSE (mm) 20.0 ± 4.2 13.6 ± 4.3* 14.7 ± 3.9 <0.001 S" (cm/s) 12.6 ± 3.3 8.7 ± 2.4* 9.1 ± 2.4 <0.001 Fractional area change (%) 48.3 ± 5.9 37.8 ± 8.0* 40.0 ± 9.0 <0.001 Right ventricular free wall strain (%) −21.3 ± 6.3 −15.8 ± 6.7* −16.9 ± 5.2 0.036 Tricuspid regurgitation velocity peak (m/s) 2.41 ± 0.29 2.43 ± 0.25 2.34 ± 0.32 0.37
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Affiliation(s)
- H Matsutani
- Tenri Hospital, Department of Clinical Laboratory, Tenri, Japan
| | - M Amano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Baba
- Tenri Hospital, Department of Clinical Laboratory, Tenri, Japan
| | - R Abe
- Tenri Hospital, Department of Clinical Laboratory, Tenri, Japan
| | - S Hashiwada
- Tenri Hospital, Department of Clinical Laboratory, Tenri, Japan
| | - K Kuwano
- Tenri Hospital, Department of Clinical Laboratory, Tenri, Japan
| | - M Shimada
- Tenri Hospital, Department of Clinical Laboratory, Tenri, Japan
| | - J Sakamoto
- Tenri Hospital, Department of Cardiology, Tenri, Japan
| | - M Miyake
- Tenri Hospital, Department of Cardiology, Tenri, Japan
| | - T Tamura
- Tenri Hospital, Department of Cardiology, Tenri, Japan
| | - S Matsuo
- Tenri Hospital, Department of Clinical Laboratory, Tenri, Japan
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Brownell Jr RL, Reeves RR, Read AJ, Smith BD, Thomas PO, Ralls K, Amano M, Berggren P, Chit AM, Collins T, Currey R, Dolar MLL, Genov T, Hobbs RC, Kreb D, Marsh H, Zhigang M, Perrin WF, Phay S, Rojas-Bracho L, Ryan GE, Shelden KEW, Slooten E, Taylor BL, Vidal O, Ding W, Whitty TS, Wang JY. Bycatch in gillnet fisheries threatens Critically Endangered small cetaceans and other aquatic megafauna. ENDANGER SPECIES RES 2019. [DOI: 10.3354/esr00994] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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25
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Hishiya N, Uno K, Amano M, Asada K, Masui K, Ishida Y, Suzuki Y, Hirai N, Nakano A, Nakano R, Kasahara K, Yano H, Mikasa K. Filifactor alocis brain abscess identified by 16S ribosomal RNA gene sequencing: A case report. J Infect Chemother 2019; 26:305-307. [PMID: 31711830 DOI: 10.1016/j.jiac.2019.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/19/2019] [Revised: 08/16/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Abstract
We report a clinical case of Filifactor alocis brain abscess in an 85-year-old man who had decayed teeth 1 week prior. In this case, the abscess was surgically drained after empirical antibiotics had been initiated. Although the causative organism could not be identified by culture, F. alocis was detected via 16S ribosomal RNA (16S rRNA) gene sequencing of the pus isolated from the abscess. The patient recovered without serious sequelae after surgical drainage and prolonged antibiotic treatment, including metronidazole, ceftriaxone and meropenem for 8 weeks. The findings in this case emphasize that 16S rRNA gene sequencing allows bacterial diagnosis of brain abscess when phenotypic identification fails, such as in cases where patients are undergoing antimicrobial treatment at the time of sampling or where patients are infected with fastidious organisms.
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Affiliation(s)
- Naokuni Hishiya
- Department of Infectious Diseases, Minami Nara General Medical Center, Nara, Japan.
| | - Kenji Uno
- Department of Infectious Diseases, Minami Nara General Medical Center, Nara, Japan
| | - Masayuki Amano
- Department of General Medicine, Minami Nara General Medical Center, Nara, Japan
| | - Kiyokazu Asada
- Department of Neurosurgery, Minami Nara General Medical Center, Nara, Japan
| | - Katsuya Masui
- Department of Neurosurgery, Minami Nara General Medical Center, Nara, Japan
| | - Yasuhito Ishida
- Department of Neurosurgery, Minami Nara General Medical Center, Nara, Japan
| | - Yuki Suzuki
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan
| | - Nobuyasu Hirai
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Akiyo Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan
| | - Ryuichi Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Hisakazu Yano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan
| | - Keiichi Mikasa
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
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26
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Nakagawa S, Okada A, Hamatani Y, Amano M, Takahama H, Amaki M, Hasegawa T, Kanzaki H, Yasuda S, Izumi C. P5551Comparison of prognostic predictors of heart failure admission and progression to end-stage in hypertrophic cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is a common complication within the clinical spectrum of hypertrophic cardiomyopathy (HCM). HCM-related HF is recognized to be multifactorial, including outflow obstruction, diastolic dysfunction, or progression to end-stage; however, prognostic predictors of HF events are not fully understood. We sought to investigate predictors for various HF outcomes in HCM.
Methods
We studied 289 consecutive HCM patients with EF≥50%. Patients with outflow obstruction (peak pressure gradient ≥30mmHg) were defined as obstructive HCM. HF events assessed in this study were 1) HF admission and 2) progression to end-stage (EF<50%).
Results
The mean age was 63±16 years, 53% male, EF 61±5%, NYHA class 1.8±0.7, and 39% obstructive. During a median follow up of 5.2 [3.7–7.0] years, 48 HF admission and 19 progression to end-stage were observed. Only 8/48 (17%) patients with HF admission had progressed to end-stage; while 11/19 (58%) patients with progression to end-stage remained free from HF admission. Univariate Cox regression hazard analysis showed different prognostic predictors between HF admission and progression to end-stage (Table). Multivariate Cox regression hazard analysis showed atrial fibrillation was an independent predictor of HF admission (adjusted HR 2.711 [1.094–7.389], P=0.031); while LV end-systolic dimension was an independent predictor of progression to end-stage (adjusted HR 1.114 [1.018–1.229], P=0.025).
Cox hazard analysis for predicting event HF admission Progression to end-stage HR (95% CI) P value HR (95% CI) P value Age, 1 year 1.042 (1.017–1.071) <0.001 1.002 (0.975–1.035) 0.89 Male sex 1.052 (0.595–1.882) 0.86 2.853 (1.034–10.02) 0.043 Atrial fibrillation 3.247 (1.809–6.608) <0.001 1.434 (0.570–3.559) 0.44 Non-obstructive 0.850 (0.481–1.531) 0.58 5.439 (1.558–34.30) 0.005 LV end-diastolic dimension, 1mm 1.027 (0.981–1.077) 0.25 1.120 (1.035–1.218) 0.005 LV end-systolic dimension, 1mm 1.059 (1.008–1.110) 0.023 1.167 (1.080–1.258) <0.001 EF, 1% 0.974 (0.926–1.032) 0.36 0.894 (0.825–0.980) 0.018 LA volume, 1ml/m2 1.012 (1.001–1.020) 0.044 1.006 (0.978–1.023) 0.64 Transmitral E wave, 1m/s 1.013 (1.002–1.024) 0.025 1.006 (0.987–1.023) 0.50 Transmitral DcT, 1msec 0.999 (0.995–1.003) 0.59 0.985 (0.974–0.994) <0.001 E/e', 1.0 1.062 (1.012–1.109) 0.015 1.089 (1.010–1.164) 0.027
Conclusions
Different prognostic predictors were found for HF admission and progression to end-stage, suggesting the difficulty and multifactorial nature of HCM-related HF.
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Affiliation(s)
- S Nakagawa
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - A Okada
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - Y Hamatani
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - M Amano
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - H Takahama
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - M Amaki
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - T Hasegawa
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - H Kanzaki
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
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27
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Kuyama N, Hamatani Y, Okada A, Yanagi Y, Jo Y, Amano M, Takahama H, Amaki M, Hasegawa T, Kanzaki H, Yasuda S, Izumi C. P915Clinical characteristics, natural history and predictors of disease progression in patients with degenerative mitral stenosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Mitral annular calcification (MAC) is a common echocardiographic finding and an increasingly recognized cause of degenerative mitral stenosis (DMS). However, little is known about the natural history and predictors of disease progression of DMS, especially compared with rheumatic mitral stenosis (RMS).
Purpose
To compare the clinical characteristics and disease progression among patients with DMS and those with RMS, and to investigate the determinants of disease progression in DMS patients.
Methods
We retrospectively reviewed consecutive MS patients with a trans-mitral mean gradient ≥2 mmHg who underwent echocardiography at our institution between January 2014 and December 2017. We selected patients who had an initial and follow-up echocardiography with a ≥3-month interval and without prior and interim mitral valve intervention. DMS was defined as MS with MAC with normal or minimally reduced leaflet motion without tips restriction. RMS was defined as MS with tip restriction, thickening and restriction of leaflet mainly. We defined MAC severity as mild (focal), moderate (marked density >1/3 but <1/2 of the mitral annulus) and severe (marked density involving >1/2 of the mitral annulus) based on previous reports. We calculated disease progression from the annual increase rate of trans-mitral mean gradient. First, we compared the backgrounds and disease progression between DMS group and RMS group. Second, we investigated the predictors of disease progression in DMS group.
Results
We enrolled 111 patients (64 in DMS group and 47 in RMS group) with a mean follow-up period of 2.1 years. Patients in DMS group were significantly older (79±9 vs. 70±10 years; P<0.01), had higher prevalence of hypertension (P<0.01) and coronary artery disease (P=0.02), and had higher plasma BNP level (P<0.01) than those in RMS group. Baseline trans-mitral mean gradient was slightly lower in DMS group than in RMS group (3.9±1.9 vs. 4.7±1.8 mmHg; P=0.02). There were wide variations among individuals in progression rate (range: 0 to 3.5 mmHg/year in DMS group and 0 to 5.8 mmHg/year in RMS group, respectively), and the progression rate was comparable between DMS group and RMS group (0.49±0.79 vs. 0.61±1.37 mmHg/year; P=0.59). In DMS group, higher prevalence of dyslipidemia (P=0.01) and lower baseline trans-mitral mean gradient (P<0.01) were significantly associated with disease progression even after adjustment for age and sex. Unexpectedly, there was no significant difference in the disease progression regardless of the MAC severity among DMS group (Picture).
MAC severity and disease progression
Conclusions
Progression in DMS group is highly variable, but generally slow as that in RMS group. Initial mean gradient was inversely associated with disease progression in DMS group. Furthermore, baseline MAC severity did not correlate with the progression, suggesting the importance of follow-up echocardiography in spite of the MAC severity and initial mean gradient.
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Affiliation(s)
- N Kuyama
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Hamatani
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - A Okada
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Yanagi
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Jo
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Amano
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - H Takahama
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Amaki
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Hasegawa
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - H Kanzaki
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center, Osaka, Japan
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28
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Nakai E, Hamatani Y, Miyata M, Nakamura E, Kawano Y, Takada Y, Anchi Y, Funabashi S, Hirayama A, Kuroda K, Amano M, Sugano Y, Anzai T, Izumi C. P767Survey of palliative sedation at the end-of-life in terminally ill heart failure patients - a five year experience in national cardiovascular center. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Palliative sedation is a therapeutic option when symptom relief is difficult to achieve at the end-of-life. However, little is known regarding palliative sedation in terminally ill heart failure (HF) patients.
Purpose
To survey the practice of palliative sedation in terminally ill HF patients at a tertiary referral cardiovascular center, and to investigate the efficacy and safety of sedative agents in HF patients.
Methods
We retrospectively reviewed consecutive patients who were referred to palliative care team at our institution between September 2013 and August 2018. Patients who were hospitalized for HF and died during hospitalization despite optimal medical therapy were selected and defined as terminally ill HF. We investigated the practice of palliative sedation in terminally ill HF patients and analysed the vital signs and sedation scale before starting sedative agents and about 1 hour afterward.
Results
Among 95 terminally ill HF patients, 37 were prescribed palliative sedation at the end-of-life (Picture). Of 37 patients (mean age: 70 years, median B-type natriuretic peptide: 1018 pg/ml, median creatinine: 3.0 mg/dl, intravenous inotrope: 81%), 25 were prescribed dexmedetomidine, and 12 were prescribed midazolam as first agent for sedation. Patient's backgrounds were comparable between the two groups. Richmond Agitation-Sedation Scale was significantly reduced (P<0.01), whereas blood pressure and heart rate were not altered after treatments in both groups. In midazolam group, significant decreases were noted regarding respiratory rate (P=0.01) and oxygen saturation (P=0.02); however, these parameters were not changed in dexmedetomidine group (Table).
Table 1. Vital signs and sedation scale Dexmedetomidine group (n=25) Midazolam group (n=12) Baseline After P value Baseline After P value Richmond Agitation-Sedation Scale 1 (0, 1) −1 (−2, 0) <0.01 1 (0, 1) −2 (−3, −1) <0.01 Vital signs Systolic blood pressure (mmHg) 90±15 89±16 0.51 89±21 84±23 0.33 Diastolic blood pressure (mmHg) 52±13 54±11 0.34 60±14 56±23 0.48 Heart rate (beats per minute) 95±20 91±22 0.17 90±21 90±19 0.70 Respiratory rate (breaths per minute) 22±5 20±5 0.24 21±5 17±2 0.01 Oxygen saturation (%) 97±3 96±6 0.59 96±5 94±5 0.02
Picture. Study flowchart
Conclusions
Dexmedetomidine and midazolam were commonly used in real-word practice for HF patients at the end-of-life. Although impact on respiratory system differed by treatments, both agents could be prescribed effectively and safely in terminally ill HF patients.
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Affiliation(s)
- E Nakai
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - Y Hamatani
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - M Miyata
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - E Nakamura
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - Y Kawano
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - Y Takada
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - Y Anchi
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - S Funabashi
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - A Hirayama
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - K Kuroda
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - M Amano
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - Y Sugano
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - T Anzai
- Hokkaido University Graduate School of Medicine, Cardiovascular Medicine, Hokkaido, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center, Suita, Japan
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29
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Onitsuka K, Tokuda R, Kuwata-Higashi N, Kumamoto H, Aoki M, Amano M, Kohgo S, Das D, Haraguchi K, Mitsuya H, Imoto S. Synthesis and evaluation of the anti-hepatitis B virus activity of 4'-Azido-thymidine analogs and 4'-Azido-2'-deoxy-5-methylcytidine analogs: structural insights for the development of a novel anti-HBV agent. Nucleosides Nucleotides Nucleic Acids 2019; 39:518-529. [PMID: 31514570 DOI: 10.1080/15257770.2019.1664749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hepatitis B virus (HBV) infection is a major worldwide health problem that requires the development of improved antiviral therapies. Here, a series of 4'-Azido-thymidine/4'-Azido-2'-deoxy-5-methylcytidine derivatives (6, 10-15) were synthesized, and their anti-HBV activities evaluated. Compounds 10-15 were synthesized via an SNAr reaction of 18, in which the 4-position of the thymine moiety was activated as the 2,4,6-triisopropylbenzenesulfonate. Compounds 11-15 showed no antiviral activity. However, 4'-Azido thymidine (6) and 4'-Azido-2'-deoxy-5-methylcytidine (10) displayed significant anti-HBV activity (EC50 = 0.63 and 5.99 µM, respectively) with no detectable cytotoxicity against MT-2 cells up to 100 µM.
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Affiliation(s)
- Kengo Onitsuka
- Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan
| | - Ryoh Tokuda
- Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan
| | - Nobuyo Kuwata-Higashi
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Hiroki Kumamoto
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan
| | - Manabu Aoki
- Experimental Retrovirology Section, HIV & AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Masayuki Amano
- Departments of Infectious Diseases and Hematology, Kumamoto University School of Medicine, Kumamoto, Japan
| | - Satoru Kohgo
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Debananda Das
- Experimental Retrovirology Section, HIV & AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kazuhiro Haraguchi
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan.,Experimental Retrovirology Section, HIV & AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.,Departments of Infectious Diseases and Hematology, Kumamoto University School of Medicine, Kumamoto, Japan
| | - Shuhei Imoto
- Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan
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30
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Nishimura N, Radwan MO, Amano M, Endo S, Fujii E, Hayashi H, Ueno S, Ueno N, Tatetsu H, Hata H, Okamoto Y, Otsuka M, Mitsuya H, Matsuoka M, Okuno Y. Novel p97/VCP inhibitor induces endoplasmic reticulum stress and apoptosis in both bortezomib-sensitive and -resistant multiple myeloma cells. Cancer Sci 2019; 110:3275-3287. [PMID: 31368616 PMCID: PMC6778635 DOI: 10.1111/cas.14154] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 10/04/2018] [Revised: 07/10/2019] [Accepted: 07/23/2019] [Indexed: 12/30/2022] Open
Abstract
p97/VCP is an endoplasmic reticulum (ER)‐associated protein that belongs to the AAA (ATPases associated with diverse cellular activities) ATPase family. It has a variety of cellular functions including ER‐associated protein degradation, autophagy, and aggresome formation. Recent studies have shown emerging roles of p97/VCP and its potential as a therapeutic target in several cancer subtypes including multiple myeloma (MM). We conducted a cell‐based compound screen to exploit novel small compounds that have cytotoxic activity in myeloma cells. Among approximately 2000 compounds, OSSL_325096 showed relatively strong antiproliferative activity in MM cell lines (IC50, 100‐500 nmol/L). OSSL_325096 induced apoptosis in myeloma cell lines, including a bortezomib‐resistant cell line and primary myeloma cells purified from patients. Accumulation of poly‐ubiquitinated proteins, PERK, CHOP, and IREα, was observed in MM cell lines treated with OSSL_325096, suggesting that it induces ER stress in MM cells. OSSL_325096 has a similar chemical structure to DBeQ, a known p97/VCP inhibitor. Knockdown of the gene encoding p97/VCP induced apoptosis in myeloma cells, accompanied by accumulation of poly‐ubiquitinated protein. IC50 of OSSL_325096 to myeloma cell lines were found to be lower (0.1‐0.8 μmol/L) than those of DBeQ (2‐5 μmol/L). In silico protein–drug‐binding simulation suggested possible binding of OSSL_325096 to the ATP binding site in the D2 domain of p97/VCP. In cell‐free ATPase assays, OSSL_325096 showed dose‐dependent inhibition of p97/VCP ATPase activity. Finally, OSSL_325096 inhibited the growth of subcutaneous myeloma cell tumors in vivo. The present data suggest that OSSL_325096 exerts anti‐myeloma activity, at least in part through p97/VCP inhibition.
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Affiliation(s)
- Nao Nishimura
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Mohamed O Radwan
- Faculty of Life Sciences, Department of Bioorganic Medicinal Chemistry, Kumamoto University, Kumamoto, Japan.,Chemistry of Natural Compounds Department, Pharmaceutical and Drug Industries Research Division, National Research Centre, Cairo, Egypt
| | - Masayuki Amano
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Shinya Endo
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Eri Fujii
- Faculty of Medical Sciences, Division of Informative Clinical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hironori Hayashi
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Shikiko Ueno
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Niina Ueno
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Hiro Tatetsu
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Hiroyuki Hata
- Faculty of Medical Sciences, Division of Informative Clinical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshinari Okamoto
- Faculty of Life Sciences, Department of Bioorganic Medicinal Chemistry, Kumamoto University, Kumamoto, Japan
| | - Masami Otsuka
- Faculty of Life Sciences, Department of Bioorganic Medicinal Chemistry, Kumamoto University, Kumamoto, Japan
| | - Hiroaki Mitsuya
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Masao Matsuoka
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Yutaka Okuno
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
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31
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Amano M, Bulut H, Tamiya S, Nakamura T, Koh Y, Mitsuya H. Amino-acid inserts of HIV-1 capsid (CA) induce CA degradation and abrogate viral infectivity: Insights for the dynamics and mechanisms of HIV-1 CA decomposition. Sci Rep 2019; 9:9806. [PMID: 31285456 PMCID: PMC6614453 DOI: 10.1038/s41598-019-46082-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/18/2019] [Indexed: 11/09/2022] Open
Abstract
Accumulation of amino acid (AA) insertions/substitutions are observed in the Gag-protein of HIV-1 variants resistant to HIV-1 protease inhibitors. Here, we found that HIV-1 carrying AA insertions in capsid protein (CA) undergoes aberrant CA degradation. When we generated recombinant HIV-1s (rHIV-1s) containing 19-AAs in Gag, such insertions caused significant CA degradation, which initiated in CA's C-terminal. Such rHIV-1s had remarkable morphological abnormality, decreased infectivity, and no replicative ability, which correlated with levels of CA degradation. The CA degradation observed was energy-independent and had no association with cellular/viral proteolytic mechanisms, suggesting that the CA degradation occurs due to conformational/structural incompatibility caused by the 19-AA insertions. The incorporation of degradation-prone CA into the wild-type CA resulted in significant disruption of replication competence in "chimeric" virions. The data should allow better understanding of the dynamics and mechanisms of CA decomposition/degradation and retroviral uncoating, which may lead to new approach for antiretroviral modalities.
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Affiliation(s)
- Masayuki Amano
- Department of Hematology, Rheumatology, and Infectious Diseases, Kumamoto University School of Medicine, Kumamoto, 860-8556, Japan.,Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.,Department of Refractory Viral Infection, National Center for Global Health and Medicine Research Institute, Tokyo, 162-8655, Japan
| | - Haydar Bulut
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Sadahiro Tamiya
- Department of Hematology, Rheumatology, and Infectious Diseases, Kumamoto University School of Medicine, Kumamoto, 860-8556, Japan.,Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Tomofumi Nakamura
- Department of Hematology, Rheumatology, and Infectious Diseases, Kumamoto University School of Medicine, Kumamoto, 860-8556, Japan
| | - Yasuhiro Koh
- Department of Hematology, Rheumatology, and Infectious Diseases, Kumamoto University School of Medicine, Kumamoto, 860-8556, Japan
| | - Hiroaki Mitsuya
- Department of Hematology, Rheumatology, and Infectious Diseases, Kumamoto University School of Medicine, Kumamoto, 860-8556, Japan. .,Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. .,Department of Refractory Viral Infection, National Center for Global Health and Medicine Research Institute, Tokyo, 162-8655, Japan.
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32
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Uno K, Hishiya N, Matsuda M, Kai Y, Amano M, Nakamura A, Tohjyo T, Kawaguchi T, Nakano R, Yano H, Kasahara K, Mikasa K. Case of endobronchial metastasis from breast cancer accompanied with Cunninghamella bertholletiae tracheobronchial mycetoma. J Infect Chemother 2019; 25:1065-1069. [PMID: 31227382 DOI: 10.1016/j.jiac.2019.05.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 02/26/2019] [Revised: 05/09/2019] [Accepted: 05/27/2019] [Indexed: 11/19/2022]
Abstract
Cunninghamella is a member of the class Zygomycetes. Cunninghamella species include ubiquitous filamentous fungi; infections caused by Cunninghamella species are less frequent but have higher mortality rates than infections caused by Mucorales group members such as Rhizopus and Mucor. Herein, we reported a rare fatal case of endobronchial metastasis from breast cancer accompanied with Cunninghamella bertholletiae tracheobronchial mycetoma. A 73-year-old female with a history of right-sided breast cancer who had undergone mastectomy 11 years previously and had no recurrence presented to our emergency department with a 1-week history of left-sided back pain. Chest X-ray revealed left lung atelectasis; bronchoscopy revealed an endobronchial mass lesion in the left main bronchus. Pathological examination revealed fungal mycetoma but malignant lesions were not detected. Endobronchial and lung mycetoma caused by Cunninghamella bertholletiae were initially diagnosed; liposomal amphotericin B was administered, but her condition deteriorated. Rigid endoscopy showed growth of hemorrhagic tissue occupying the left main bronchus just under the carina. Pathological examination of the shaved lesion revealed metastasis from breast cancer covered with abundant necrotic tissue. No mold was observed in the necrotic tissue; this was probably due to liposomal amphotericin B treatment. To our knowledge, this is the first case of endobronchial metastasis from breast cancer accompanied with Cunninghamella bertholletiae mycetoma. Distinguishing endobronchial metastases from breast cancer and atypical presentations of Cunninghamella endobronchial mycetomas can be very difficult. Repeated bronchoscopies maybe helpful in establishing an accurate diagnosis when clinical prognosis does not match the initial diagnosis.
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Affiliation(s)
- Kenji Uno
- Department of Infectious Diseases, Minami-Nara General Medical Center, Fukugami 8-1, Oyodocho, Yoshino-gun, Nara, Japan.
| | - Naokuni Hishiya
- Department of Infectious Diseases, Minami-Nara General Medical Center, Fukugami 8-1, Oyodocho, Yoshino-gun, Nara, Japan
| | - Masayuki Matsuda
- Department of Respiratory Medicine, Minami-Nara General Medical Center, Fukugami 8-1, Oyodocho, Yoshino-gun, Nara, Japan
| | - Yoshiro Kai
- Department of Respiratory Medicine, Minami-Nara General Medical Center, Fukugami 8-1, Oyodocho, Yoshino-gun, Nara, Japan
| | - Masayuki Amano
- Department of General Medicine, Minami-Nara General Medical Center, Fukugami 8-1, Oyodocho, Yoshino-gun, Nara, Japan
| | - Atsuhiro Nakamura
- Department of Respiratory Medicine, Nara Prefectural Seiwa Medical Center, Mimuro1-14-16, Sango-cho, Ikoma-gun, Nara, Japan
| | - Takashi Tohjyo
- Department of Thoracic Surgery, Saiseikai Chuwa Hospital, Abe323, Sakurai City, Nara, Japan
| | - Takeshi Kawaguchi
- Department of Thoracic Surgery, Nara Medical University, Shijyo-cho 840, Kashihara City, Nara, Japan
| | - Ryuichi Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Shijyo-cho 840, Kashihara City, Nara, Japan
| | - Hisakazu Yano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Shijyo-cho 840, Kashihara City, Nara, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Keiichi Mikasa
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
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Kumamoto H, Imoto S, Amano M, Kuwata-Higashi N, Baba M, Mitsuya H, Odanaka Y, Shimbara Matsubayashi S, Tanaka H, Haraguchi K. Synthesis, Anti-HBV, and Anti-HIV Activities of 3'-Halogenated Bis(hydroxymethyl)-cyclopentenyladenines. ACS Med Chem Lett 2018; 9:1211-1216. [PMID: 30613328 DOI: 10.1021/acsmedchemlett.8b00374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/09/2018] [Indexed: 12/18/2022] Open
Abstract
Synthesis of 3'-halogeno analogues (5a-d) of 9-[c-4,t-5-bis(hydroxymethyl)-cyclopent-2-en-r-1-yl]-9H-adenine (BCA, 3) was accomplished by means of dual utilization of the vinyl sulfone functional moieties in both 10 and 16 utilizing a SN2' conjugate-addition reaction and a sulfur-extrusive stannylation, respectively. Evaluation of the antiviral activities of 5a-d revealed that introduction of a halogeno-substituent into the 3'-position of (-)-BCA diminished its anti-HIV-1 activity but increased the inhibitory activity for the reverse transcriptase of HBV in that the 3'-fluorinated BCA 5d exhibited the highest activity without significant cytotoxicity.
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Affiliation(s)
- Hiroki Kumamoto
- Nihon Pharmaceutical University, 10281 Komuro, Inamachi, Kita-adachi-gun, Saitama 362-0806, Japan
| | - Shuhei Imoto
- Faculty of Pharmaceutical Sciences, Sojo University, 4-22-1 Ikeda, Kumamoto 860-0082, Japan
| | - Masayuki Amano
- Departments of Infectious Diseases and Hematology, Kumamoto University School of Medicine, Kumamoto 860-8556, Japan
| | - Nobuyo Kuwata-Higashi
- Clinical Research Center, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-ku, Tokyo 162-8655, Japan
| | - Masanori Baba
- Division of Antiviral Chemotherapy, Center for Chronic Viral Diseases, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Japan
| | - Hiroaki Mitsuya
- Departments of Infectious Diseases and Hematology, Kumamoto University School of Medicine, Kumamoto 860-8556, Japan
- Clinical Research Center, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-ku, Tokyo 162-8655, Japan
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - Yuki Odanaka
- School of Pharmacy, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | | | - Hiromichi Tanaka
- School of Pharmacy, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Kazuhiro Haraguchi
- Nihon Pharmaceutical University, 10281 Komuro, Inamachi, Kita-adachi-gun, Saitama 362-0806, Japan
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Abstract
Mondor's disease (MD) is a rare disease that manifests with a palpable cord-like induration on the body surface. In general, MD is a self-limited, benign thrombophlebitis that resolves in four to eight weeks without any specific treatment. Cases of MD can be roughly categorized into three different groups based on the site of the lesion as follows: original MD of the anterolateral thoracoabdominal wall, penile MD with dorsum and dorsolateral aspects of the penis, and axillary web syndrome with mid-upper arm after axillary surgery. The diagnosis of MD is rather straightforward and based on a physical examinations. However, some case occur "secondary" with another underlying disease, including malignancy, a hypercoagulative state, and vasculitis. Therefore, it is critical to identify MD precisely, evaluate any possible underlying disease, and avoid any unnecessary invasive tests or treatment. In this paper, we comprehensively review the clinical characteristics of MD.
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Affiliation(s)
- Masayuki Amano
- General Internal Medicine, Minami-Nara General Medical Center, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Japan
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Ghosh AK, Nyalapatla PR, Kovela S, Rao KV, Brindisi M, Osswald HL, Amano M, Aoki M, Agniswamy J, Wang YF, Weber IT, Mitsuya H. Design and Synthesis of Highly Potent HIV-1 Protease Inhibitors Containing Tricyclic Fused Ring Systems as Novel P2 Ligands: Structure-Activity Studies, Biological and X-ray Structural Analysis. J Med Chem 2018; 61:4561-4577. [PMID: 29763303 PMCID: PMC6044451 DOI: 10.1021/acs.jmedchem.8b00298] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The design, synthesis, and biological evaluation of a new class of HIV-1 protease inhibitors containing stereochemically defined fused tricyclic polyethers as the P2 ligands and a variety of sulfonamide derivatives as the P2' ligands are described. A number of ring sizes and various substituent effects were investigated to enhance the ligand-backbone interactions in the protease active site. Inhibitors 5c and 5d containing this unprecedented fused 6-5-5 ring system as the P2 ligand, an aminobenzothiazole as the P2' ligand, and a difluorophenylmethyl as the P1 ligand exhibited exceptional enzyme inhibitory potency and maintained excellent antiviral activity against a panel of highly multidrug-resistant HIV-1 variants. The umbrella-like P2 ligand for these inhibitors has been synthesized efficiently in an optically active form using a Pauson-Khand cyclization reaction as the key step. The racemic alcohols were resolved efficiently using a lipase catalyzed enzymatic resolution. Two high resolution X-ray structures of inhibitor-bound HIV-1 protease revealed extensive interactions with the backbone atoms of HIV-1 protease and provided molecular insight into the binding properties of these new inhibitors.
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Affiliation(s)
- Arun K. Ghosh
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA,The corresponding author: Department of Chemistry and Department of Medicinal Chemistry, Purdue University, 560 Oval Drive, West Lafayette, IN 47907, Phone: (765)-494-5323; Fax: (765)-496-1612,
| | - Prasanth R. Nyalapatla
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Satish Kovela
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Kalapala Venkateswara Rao
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Margherita Brindisi
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Heather L. Osswald
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Masayuki Amano
- Departments of Infectious Diseases and Hematology, Kumamoto University Graduate School of Biomedical Sciences, Kumamoto 860-8556, Japan,Department of Medical Technology, Kumamoto Health Science University, Kumamoto 861-5598, Japan
| | - Manabu Aoki
- Departments of Infectious Diseases and Hematology, Kumamoto University Graduate School of Biomedical Sciences, Kumamoto 860-8556, Japan,Department of Medical Technology, Kumamoto Health Science University, Kumamoto 861-5598, Japan,Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Johnson Agniswamy
- Department of Biology, Molecular Basis of Disease, Georgia State University, Atlanta, Georgia 30303, USA
| | - Yuan-Fang Wang
- Department of Biology, Molecular Basis of Disease, Georgia State University, Atlanta, Georgia 30303, USA
| | - Irene T. Weber
- Department of Biology, Molecular Basis of Disease, Georgia State University, Atlanta, Georgia 30303, USA
| | - Hiroaki Mitsuya
- Departments of Infectious Diseases and Hematology, Kumamoto University Graduate School of Biomedical Sciences, Kumamoto 860-8556, Japan,Department of Refractory Viral Infection, National Center for Global Health and Medicine Research Institute, Tokyo 162-8655, Japan,Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Kohgo S, Imoto S, Tokuda R, Takamatsu Y, Higashi-Kuwata N, Aoki M, Amano M, Kansui H, Onitsuka K, Maeda K, Mitsuya H. Synthesis of 4′-Substituted Purine 2′-Deoxynucleosides and Their Activity against Human Immunodeficiency Virus Type 1 and Hepatitis B Virus. ChemistrySelect 2018. [DOI: 10.1002/slct.201800527] [Citation(s) in RCA: 6] [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] [Indexed: 12/20/2022]
Affiliation(s)
- Satoru Kohgo
- Department of Refractory Viral Infection; National Center for Global Health and Medicine Research Institute; 1-21-1 Toyama, Shinjuku Tokyo 162-8655 Japan
- Faculty of Pharmaceutical Sciences; Sojo University; 4-22-1 Ikeda, Nishi-ku Kumamoto 860-0082 Japan
| | - Shuhei Imoto
- Faculty of Pharmaceutical Sciences; Sojo University; 4-22-1 Ikeda, Nishi-ku Kumamoto 860-0082 Japan
| | - Ryoh Tokuda
- Faculty of Pharmaceutical Sciences; Sojo University; 4-22-1 Ikeda, Nishi-ku Kumamoto 860-0082 Japan
| | - Yuki Takamatsu
- Experimental Retrovirology Section; HIV & AIDS Malignancy Branch; National Cancer Institute; National Institutes of Health; 10 Center Drive Room 5 A11 - MSC 1868 Bethesda MD 20892-1868 USA
| | - Nobuyo Higashi-Kuwata
- Department of Refractory Viral Infection; National Center for Global Health and Medicine Research Institute; 1-21-1 Toyama, Shinjuku Tokyo 162-8655 Japan
- Departments of Hematology; Rheumatology & Clinical Immunology and Infectious Diseases; Kumamoto University Graduate School of Medical Sciences, Honjo, Chuou-ku; Kumamoto 860-8556 Japan
| | - Manabu Aoki
- Experimental Retrovirology Section; HIV & AIDS Malignancy Branch; National Cancer Institute; National Institutes of Health; 10 Center Drive Room 5 A11 - MSC 1868 Bethesda MD 20892-1868 USA
- Departments of Hematology; Rheumatology & Clinical Immunology and Infectious Diseases; Kumamoto University Graduate School of Medical Sciences, Honjo, Chuou-ku; Kumamoto 860-8556 Japan
- Department of Medical Technology; Kumamoto Health Science University; 325 Izumi-cho, Kita-ku Kumamoto 861-5598 Japan
| | - Masayuki Amano
- Departments of Hematology; Rheumatology & Clinical Immunology and Infectious Diseases; Kumamoto University Graduate School of Medical Sciences, Honjo, Chuou-ku; Kumamoto 860-8556 Japan
| | - Hisao Kansui
- Faculty of Pharmaceutical Sciences; Sojo University; 4-22-1 Ikeda, Nishi-ku Kumamoto 860-0082 Japan
| | - Kengo Onitsuka
- Faculty of Pharmaceutical Sciences; Sojo University; 4-22-1 Ikeda, Nishi-ku Kumamoto 860-0082 Japan
| | - Kenji Maeda
- Department of Refractory Viral Infection; National Center for Global Health and Medicine Research Institute; 1-21-1 Toyama, Shinjuku Tokyo 162-8655 Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infection; National Center for Global Health and Medicine Research Institute; 1-21-1 Toyama, Shinjuku Tokyo 162-8655 Japan
- Experimental Retrovirology Section; HIV & AIDS Malignancy Branch; National Cancer Institute; National Institutes of Health; 10 Center Drive Room 5 A11 - MSC 1868 Bethesda MD 20892-1868 USA
- Departments of Hematology; Rheumatology & Clinical Immunology and Infectious Diseases; Kumamoto University Graduate School of Medical Sciences, Honjo, Chuou-ku; Kumamoto 860-8556 Japan
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37
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Ghosh AK, Fyvie WS, Brindisi M, Steffey M, Agniswamy J, Wang YF, Aoki M, Amano M, Weber IT, Mitsuya H. Design, Synthesis, Biological Evaluation, and X-ray Studies of HIV-1 Protease Inhibitors with Modified P2' Ligands of Darunavir. ChemMedChem 2017; 12:1942-1952. [PMID: 29110408 PMCID: PMC5896574 DOI: 10.1002/cmdc.201700614] [Citation(s) in RCA: 5] [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: 10/02/2017] [Revised: 10/30/2017] [Indexed: 01/07/2023]
Abstract
The structure-based design, synthesis, and biological evaluation of a series of nonpeptidic HIV-1 protease inhibitors with rationally designed P2' ligands are described. The inhibitors are designed to enhance backbone binding interactions, particularly at the S2' subsite. Synthesis of inhibitors was carried out efficiently. The stereochemistry of alcohol functionalities of the P2' ligands was set by asymmetric reduction of the corresponding ketone using (R,R)- or (S,S)-Noyori catalysts. A number of inhibitors displayed very potent enzyme inhibitory and antiviral activity. Inhibitors 3g and 3h showed enzyme Ki values of 27.9 and 49.7 pm and antiviral activity of 6.2 and 3.9 nm, respectively. These inhibitors also remained quite potent against darunavir-resistant HIV-1 variants. An X-ray structure of inhibitor 3g in complex with HIV-1 protease revealed key interactions in the S2' subsite.
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Affiliation(s)
- Arun K. Ghosh
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907 (USA)
| | - W. Sean Fyvie
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907 (USA)
| | - Margherita Brindisi
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907 (USA)
| | - Melinda Steffey
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907 (USA)
| | - Johnson Agniswamy
- Departments of Biology and Chemistry, Molecular Basis of Disease, Georgia State University, Atlanta, GA 30303 (USA)
| | - Yuan-Fang Wang
- Departments of Biology and Chemistry, Molecular Basis of Disease, Georgia State University, Atlanta, GA 30303 (USA)
| | - Manabu Aoki
- Departments of Hematology and Infectious Diseases, Kumamoto University School of Medicine, Kumamoto 860-8556 (Japan)
| | - Masayuki Amano
- Departments of Hematology and Infectious Diseases, Kumamoto University School of Medicine, Kumamoto 860-8556 (Japan)
| | - Irene T. Weber
- Departments of Biology and Chemistry, Molecular Basis of Disease, Georgia State University, Atlanta, GA 30303 (USA)
| | - Hiroaki Mitsuya
- Departments of Hematology and Infectious Diseases, Kumamoto University School of Medicine, Kumamoto 860-8556 (Japan),Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, MD 20892 (USA),Center for Clinical Sciences, National Center for Global Heath and Medicine, Shinjuku, Tokyo 162-8655 (Japan)
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38
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Amano M, Miguel Salcedo-Gómez P, Yedidi RS, Delino NS, Nakata H, Venkateswara Rao K, Ghosh AK, Mitsuya H. GRL-09510, a Unique P2-Crown-Tetrahydrofuranylurethane -Containing HIV-1 Protease Inhibitor, Maintains Its Favorable Antiviral Activity against Highly-Drug-Resistant HIV-1 Variants in vitro. Sci Rep 2017; 7:12235. [PMID: 28947797 PMCID: PMC5613016 DOI: 10.1038/s41598-017-12052-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/30/2017] [Indexed: 11/12/2022] Open
Abstract
We report that GRL-09510, a novel HIV-1 protease inhibitor (PI) containing a newly-generated P2-crown-tetrahydrofuranylurethane (Crwn-THF), a P2′-methoxybenzene, and a sulfonamide isostere, is highly active against laboratory and primary clinical HIV-1 isolates (EC50: 0.0014–0.0028 μM) with minimal cytotoxicity (CC50: 39.0 μM). Similarly, GRL-09510 efficiently blocked the replication of HIV-1NL4-3 variants, which were capable of propagating at high-concentrations of atazanavir, lopinavir, and amprenavir (APV). GRL-09510 was also potent against multi-drug-resistant clinical HIV-1 variants and HIV-2ROD. Under the selection condition, where HIV-1NL4-3 rapidly acquired significant resistance to APV, an integrase inhibitor raltegravir, and a GRL-09510 congener (GRL-09610), no variants highly resistant against GRL-09510 emerged over long-term in vitro passage of the virus. Crystallographic analysis demonstrated that the Crwn-THF moiety of GRL-09510 forms strong hydrogen-bond-interactions with HIV-1 protease (PR) active-site amino acids and is bulkier with a larger contact surface, making greater van der Waals contacts with PR than the bis-THF moiety of darunavir. The present data demonstrate that GRL-09510 has favorable features for treating patients infected with wild-type and/or multi-drug-resistant HIV-1 variants, that the newly generated P2-Crwn-THF moiety confers highly desirable anti-HIV-1 potency. The use of the novel Crwn-THF moiety sheds lights in the design of novel PIs.
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Affiliation(s)
- Masayuki Amano
- Departments of Infectious Diseases and Hematology, Kumamoto University School of Medicine, Kumamoto, 860-8556, Japan
| | - Pedro Miguel Salcedo-Gómez
- Departments of Infectious Diseases and Hematology, Kumamoto University School of Medicine, Kumamoto, 860-8556, Japan
| | - Ravikiran S Yedidi
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.,Department of Biochemistry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nicole S Delino
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Hirotomo Nakata
- Departments of Infectious Diseases and Hematology, Kumamoto University School of Medicine, Kumamoto, 860-8556, Japan
| | | | - Arun K Ghosh
- Departments of Chemistry and Medicinal Chemistry, Purdue University, West Lafayette, IN, 47907, USA
| | - Hiroaki Mitsuya
- Departments of Infectious Diseases and Hematology, Kumamoto University School of Medicine, Kumamoto, 860-8556, Japan. .,Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA. .,National Center for Global Health and Medicine Research Institute, Tokyo, 162-8655, Japan.
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39
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Amano M, Namiki T, Yoshioka Y, Arima Y, Kato K, Nojima K, Hanafusa T, Tokoro S, Miura K, Yokozeki H. Necrotizing fasciitis of the lower leg caused by Escherichia coli, and an association with pyogenic spondylitis. Clin Exp Dermatol 2017; 42:918-920. [PMID: 28925014 DOI: 10.1111/ced.13209] [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] [Accepted: 03/04/2017] [Indexed: 11/30/2022]
Affiliation(s)
- M Amano
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - T Namiki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Y Yoshioka
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Y Arima
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - K Kato
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - K Nojima
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - T Hanafusa
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - S Tokoro
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - K Miura
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - H Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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40
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Ghosh AK, Sean Fyvie W, Brindisi M, Steffey M, Agniswamy J, Wang YF, Aoki M, Amano M, Weber IT, Mitsuya H. Design, synthesis, X-ray studies, and biological evaluation of novel macrocyclic HIV-1 protease inhibitors involving the P1'-P2' ligands. Bioorg Med Chem Lett 2017; 27:4925-4931. [PMID: 28958624 DOI: 10.1016/j.bmcl.2017.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 07/28/2017] [Accepted: 09/03/2017] [Indexed: 11/30/2022]
Abstract
Design, synthesis, and evaluation of a new class of HIV-1 protease inhibitors containing diverse flexible macrocyclic P1'-P2' tethers are reported. Inhibitor 5a with a pyrrolidinone-derived macrocycle exhibited favorable enzyme inhibitory and antiviral activity (Ki=13.2nM, IC50=22nM). Further incorporation of heteroatoms in the macrocyclic skeleton provided macrocyclic inhibitors 5m and 5o. These compounds showed excellent HIV-1 protease inhibitory (Ki=62pM and 14pM, respectively) and antiviral activity (IC50=5.3nM and 2.0nM, respectively). Inhibitor 5o also remained highly potent against a DRV-resistant HIV-1 variant.
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Affiliation(s)
- Arun K Ghosh
- Department of Chemistry, Purdue University, West Lafayette, IN 47907, USA; Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA.
| | - W Sean Fyvie
- Department of Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | | | - Melinda Steffey
- Department of Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Johnson Agniswamy
- Departments of Biology and Chemistry, Georgia State University, Atlanta, GA 30303, USA
| | - Yuan-Fang Wang
- Departments of Biology and Chemistry, Georgia State University, Atlanta, GA 30303, USA
| | - Manabu Aoki
- Departments of Hematology and Infectious Diseases, Kumamoto University of Medicine, Kumamoto 860-8556, Japan
| | - Masayuki Amano
- Departments of Hematology and Infectious Diseases, Kumamoto University of Medicine, Kumamoto 860-8556, Japan
| | - Irene T Weber
- Departments of Biology and Chemistry, Georgia State University, Atlanta, GA 30303, USA
| | - Hiroaki Mitsuya
- Departments of Hematology and Infectious Diseases, Kumamoto University of Medicine, Kumamoto 860-8556, Japan; Experimental Retrovirology Section, HIV and AIDS Malignancy Branch National Cancer Institute, Bethesda, MD 20892, USA; Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku, Tokyo 162-8655, Japan
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41
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Nishimura S, Izumi C, Obayashi Y, Fuki M, Imanaka M, Kuroda M, Amano M, Onishi N, Sakamoto J, Tamaki Y, Enomoto S, Miyake M, Tamura T, Kondo H, Nakagawa Y. P2976Incidence of recovery and recurrence in patients with idiopathic dilated cardiomyopathy; usefulness of 123I-MIBG scintigraphy in predicting prognosis and effectiveness of beta-blockers. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p2976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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42
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Kumamoto H, Fukano M, Imoto S, Kohgo S, Odanaka Y, Amano M, Kuwata-Higashi N, Mitsuya H, Haraguchi K, Fukuhara K. A novel entecavir analogue constructing with a spiro[2.4]heptane core structure in the aglycon moiety: Its synthesis and evaluation for anti-hepatitis B virus activity. Nucleosides Nucleotides Nucleic Acids 2017; 36:463-473. [PMID: 28574799 DOI: 10.1080/15257770.2017.1322209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Synthesis of a novel 2'-deoxy-guanine carbocyclic nucleoside 4 constructed with spiro[2.4]heptane core structure in the aglycon moiety was carried out. Radical-mediated 5-exo-dig mode cyclization and following cyclopropanation proceeded efficiently to furnish the spiro alcohol 10. Subsequent Mitsunobu-type glycosylation between 13 and 14, deoxygenation of the 2'-hydroxyl group of 16 and deprotection of 17 gave the title compound 4. Compound 4 demonstrated moderate anti-HBV activity (EC50 value of 0.12 ± 0.02 µM) and no cytotoxicity against HepG2 cells was observed up to 100 µM.
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Affiliation(s)
- Hiroki Kumamoto
- a School of Pharmacy , Showa University , Shinagawa-ku , Tokyo , Japan
| | - Misato Fukano
- a School of Pharmacy , Showa University , Shinagawa-ku , Tokyo , Japan
| | - Shuhei Imoto
- b Faculty of Pharmaceutical Sciences , Sojo University , Kumamoto , Japan
| | - Satoru Kohgo
- c Cinical Research Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Yuki Odanaka
- a School of Pharmacy , Showa University , Shinagawa-ku , Tokyo , Japan
| | - Masayuki Amano
- d Departments of Infectious Diseases and Hematology , Kumamoto University School of Medicine , Kumamoto , Japan
| | - Nobuyo Kuwata-Higashi
- c Cinical Research Center, National Center for Global Health and Medicine , Tokyo , Japan
| | - Hiroaki Mitsuya
- c Cinical Research Center, National Center for Global Health and Medicine , Tokyo , Japan.,d Departments of Infectious Diseases and Hematology , Kumamoto University School of Medicine , Kumamoto , Japan.,e Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute , National Institutes of Health , Bethesda , Maryland , USA
| | | | - Kiyoshi Fukuhara
- a School of Pharmacy , Showa University , Shinagawa-ku , Tokyo , Japan
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Ghosh AK, Brindisi M, Nyalapatla PR, Takayama J, Ella-Menye JR, Yashchuk S, Agniswamy J, Wang YF, Aoki M, Amano M, Weber IT, Mitsuya H. Design of novel HIV-1 protease inhibitors incorporating isophthalamide-derived P2-P3 ligands: Synthesis, biological evaluation and X-ray structural studies of inhibitor-HIV-1 protease complex. Bioorg Med Chem 2017; 25:5114-5127. [PMID: 28434781 DOI: 10.1016/j.bmc.2017.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 02/07/2017] [Accepted: 04/04/2017] [Indexed: 11/29/2022]
Abstract
Based upon molecular insights from the X-ray structures of inhibitor-bound HIV-1 protease complexes, we have designed a series of isophthalamide-derived inhibitors incorporating substituted pyrrolidines, piperidines and thiazolidines as P2-P3 ligands for specific interactions in the S2-S3 extended site. Compound 4b has shown an enzyme Ki of 0.025nM and antiviral IC50 of 69nM. An X-ray crystal structure of inhibitor 4b-HIV-1 protease complex was determined at 1.33Å resolution. We have also determined X-ray structure of 3b-bound HIV-1 protease at 1.27Å resolution. These structures revealed important molecular insight into the inhibitor-HIV-1 protease interactions in the active site.
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Affiliation(s)
- Arun K Ghosh
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA.
| | - Margherita Brindisi
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Prasanth R Nyalapatla
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Jun Takayama
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Jean-Rene Ella-Menye
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Sofiya Yashchuk
- Department of Chemistry and Department of Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Johnson Agniswamy
- Department of Biology, Georgia State University, Atlanta, GA 30303, USA
| | - Yuan-Fang Wang
- Department of Biology, Georgia State University, Atlanta, GA 30303, USA
| | - Manabu Aoki
- Department of Hematology, Kumamoto University of Medicine, Kumamoto 860-8556, Japan; Department of Infectious Diseases, Kumamoto University of Medicine, Kumamoto 860-8556, Japan
| | - Masayuki Amano
- Department of Hematology, Kumamoto University of Medicine, Kumamoto 860-8556, Japan; Department of Infectious Diseases, Kumamoto University of Medicine, Kumamoto 860-8556, Japan
| | - Irene T Weber
- Department of Biology, Georgia State University, Atlanta, GA 30303, USA; Department of Chemistry, Georgia State University, Atlanta, GA 30303, USA
| | - Hiroaki Mitsuya
- Department of Hematology, Kumamoto University of Medicine, Kumamoto 860-8556, Japan; Department of Infectious Diseases, Kumamoto University of Medicine, Kumamoto 860-8556, Japan; Experimental Retrovirology Section, HIV and AIDS Malignancy Branch National Cancer Institute, Bethesda, MD 20892, USA; Department of Refractory Viral Infection, National Center for Global Health and Medicine Research Institute, Shinjuku, Tokyo 162-8655, Japan
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44
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Amano M, Kusumoto M, Abe M, Akamatsu T. Long-term effectiveness of pingers on a small population of finless porpoises in Japan. ENDANGER SPECIES RES 2017. [DOI: 10.3354/esr00776] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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45
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Affiliation(s)
- N. Kurihara
- Joint Faculty of Veterinary Medicine Yamaguchi University Yamaguchi Japan
| | - M. Amano
- Graduate School of Fisheries and Environmental Sciences Nagasaki University Nagasaki Japan
| | - T. K. Yamada
- Department of Zoology National Museum of Nature and Science Tsukuba Japan
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46
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Imoto S, Kohgo S, Tokuda R, Kumamoto H, Aoki M, Amano M, Kuwata-Higashi N, Mitsuya H, Haraguchi K. Design, Synthesis, and Evaluation of Anti-HBV Activity of Hybrid Molecules of Entecavir and Adefovir: Exomethylene Acycloguanine Nucleosides and Their Monophosphate Derivatives. Nucleosides Nucleotides Nucleic Acids 2016; 34:590-602. [PMID: 26167667 DOI: 10.1080/15257770.2015.1037456] [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] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Exomethylene acycloguanine nucleosides 4, 6 and its monophosphate derivatives 5, 7, and 8 have been synthesized. Mitsunobu-type coupling of 2-N-acetyl-6-O-diphenylcarbamoylguanine (11) with primary alcohols proceeded regioselectively to furnish the desired N(9)-substituted products in moderate yield. Evaluation of 4-8 for anti-HBV activity in HepG2 cells revealed that the phosphonate derivative 8 was found to exhibit moderated activity (EC50 value of 0.29 μM), but cytotoxicity (CC50 value of 39 μM) against the host cells was also observed.
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Affiliation(s)
- Shuhei Imoto
- a Faculty of Pharmaceutical Sciences, Sojo University , Nishi-ku , Kumamoto , Japan
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47
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Kumamoto H, Fukano M, Nakano T, Iwagami K, Takeyama C, Kohgo S, Imoto S, Amano M, Kuwata-Higashi N, Aoki M, Abe H, Mitsuya H, Fukuhara K, Haraguchi K. Diastereoselective Synthesis of 6″-(Z)- and 6″-(E)-Fluoro Analogues of Anti-hepatitis B Virus Agent Entecavir and Its Evaluation of the Activity and Toxicity Profile of the Diastereomers. J Org Chem 2016; 81:2827-36. [PMID: 27009432 DOI: 10.1021/acs.joc.6b00105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A method for the diastereoselective synthesis of 6″-(Z)- and 6″-(E)-fluorinated analogues of the anti-HBV agent entecavir has been developed. Construction of the methylenecyclopentane skeleton of the target molecules has been accomplished by radical-mediated 5-exo-dig cyclization of the selenides 6 and 15 having the phenylsulfanylethynyl structure as a radical accepting moiety. In the radical reaction of the TBS-protected precursor 6, (Z)-anti-12 was formed as a major product. On the other hand, TIPS-protected 15 gave (E)-anti-12. The sulfur-extrusive stannylation of anti-12 furnished a mixture of geometric isomers of the respective vinylstannane, whereas benzoyl-protected 17 underwent the stannylation in the manner of retention of configuration. Following XeF2-mediated fluorination, introduction of the purine base and deoxygenation of the resulting carbocyclic guanosine gave the target (E)- and (Z)-3 after deprotection. Evaluation of the anti-HBV activity of 3 revealed that fluorine-substitution at the 6″-position of entecavir gave rise to a reduction in the cytotoxicity in HepG2 cells with retention of the antiviral activity.
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Affiliation(s)
- Hiroki Kumamoto
- School of Pharmacy, Showa University , 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Misato Fukano
- School of Pharmacy, Showa University , 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Tomohiko Nakano
- School of Pharmacy, Showa University , 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Keito Iwagami
- School of Pharmacy, Showa University , 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Chiaki Takeyama
- School of Pharmacy, Showa University , 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Satoru Kohgo
- Center for Clinical Sciences, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan
| | - Shuhei Imoto
- Faculty of Pharmaceutical Sciences, Sojo University , 4-22-1 Ikeda, Kumamoto 860-0082, Japan
| | - Masayuki Amano
- Department of Infectious Diseases and Hematology, Kumamoto University School of Medicine , Kumamoto 860-8556, Japan
| | - Nobuyo Kuwata-Higashi
- Department of Infectious Diseases and Hematology, Kumamoto University School of Medicine , Kumamoto 860-8556, Japan
| | - Manabu Aoki
- Department of Medical Technology, Kumamoto Heath Science University , 325 Izumimachi, Kumamoto 861-5598, Japan
| | - Hiroshi Abe
- Department of Chemistry, Graduate School of Science, Nagoya University , Furo-cho, Chikusa-ku, Nagoya 464-8602, Japan
| | - Hiroaki Mitsuya
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health , Bethesda, Maryland 20892, United States
| | - Kiyoshi Fukuhara
- School of Pharmacy, Showa University , 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Kazuhiro Haraguchi
- Nihon Pharmaceutical University , 10281 Komuro, Inamachi, Kita-adachi-gun, Saitama 362-0806, Japan
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48
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Ghosh AK, Martyr CD, Kassekert LA, Nyalapatla PR, Steffey M, Agniswamy J, Wang YF, Weber IT, Amano M, Mitsuya H. Design, synthesis, biological evaluation and X-ray structural studies of HIV-1 protease inhibitors containing substituted fused-tetrahydropyranyl tetrahydrofuran as P2-ligands. Org Biomol Chem 2015; 13:11607-21. [PMID: 26462551 PMCID: PMC4666783 DOI: 10.1039/c5ob01930c] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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] [Indexed: 11/21/2022]
Abstract
Design, synthesis, biological and X-ray crystallographic studies of a series of potent HIV-1 protease inhibitors are described. Various polar functionalities have been incorporated on the tetrahydropyranyl-tetrahydrofuran-derived P2 ligand to interact with the backbone atoms in the S2-subsite. The majority of the inhibitors showed very potent enzyme inhibitory and antiviral activity. Two high-resolution X-ray structures of 30b- and 30j-bound HIV-1 protease provide insight into ligand-binding site interactions. In particular, the polar functionalities on the P2-ligand appear to form unique hydrogen bonds with Gly48 amide NH and amide carbonyl groups in the flap region.
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Affiliation(s)
- Arun K Ghosh
- Departments of Chemistry and Medicinal Chemistry, Purdue University, West Lafayette, IN 47907, USA.
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Endo S, Amano M, Nishimura N, Ueno N, Ueno S, Yuki H, Fujiwara S, Wada N, Hirata S, Hata H, Mitsuya H, Okuno Y. Immunomodulatory drugs act as inhibitors of DNA methyltransferases and induce PU.1 up-regulation in myeloma cells. Biochem Biophys Res Commun 2015; 469:236-42. [PMID: 26657848 DOI: 10.1016/j.bbrc.2015.11.116] [Citation(s) in RCA: 7] [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: 11/10/2015] [Accepted: 11/25/2015] [Indexed: 11/27/2022]
Abstract
Immunomodulatory drugs (IMiDs) such as thalidomide, lenalidomide, and pomalidomide are efficacious in the treatment of multiple myeloma and significantly prolong their survival. However, the mechanisms of such effects of IMiDs have not been fully elucidated. Recently, cereblon has been identified as a target binding protein of thalidomide. Lenalidomide-resistant myeloma cell lines often lose the expression of cereblon, suggesting that IMiDs act as an anti-myeloma agent through interacting with cereblon. Cereblon binds to damaged DNA-binding protein and functions as a ubiquitin ligase, inducing degradation of IKZF1 and IKZF3 that are essential transcription factors for B and T cell development. Degradation of both IKZF1 and IKZF3 reportedly suppresses myeloma cell growth. Here, we found that IMiDs act as inhibitors of DNA methyltransferases (DMNTs). We previously reported that PU.1, which is an ETS family transcription factor and essential for myeloid and lymphoid development, functions as a tumor suppressor in myeloma cells. PU.1 induces growth arrest and apoptosis of myeloma cell lines. In this study, we found that low-dose lenalidomide and pomalidomide up-regulate PU.1 expression through inducing demethylation of the PU.1 promoter. In addition, IMiDs inhibited DNMT1, DNMT3a, and DNMT3b activities in vitro. Furthermore, lenalidomide and pomalidomide decreased the methylation status of the whole genome in myeloma cells. Collectively, IMiDs exert demethylation activity through inhibiting DNMT1, 3a, and 3b, and up-regulating PU.1 expression, which may be one of the mechanisms of the anti-myeloma activity of IMiDs.
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Affiliation(s)
- Shinya Endo
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masayuki Amano
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Nao Nishimura
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Niina Ueno
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Shikiko Ueno
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hiromichi Yuki
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Shiho Fujiwara
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Naoko Wada
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Shinya Hirata
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hiroyuki Hata
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hiroaki Mitsuya
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yutaka Okuno
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
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50
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Takamatsu Y, Tanaka Y, Kohgo S, Murakami S, Singh K, Das D, Venzon DJ, Amano M, Higashi-Kuwata N, Aoki M, Delino NS, Hayashi S, Takahashi S, Sukenaga Y, Haraguchi K, Sarafianos SG, Maeda K, Mitsuya H. 4'-modified nucleoside analogs: potent inhibitors active against entecavir-resistant hepatitis B virus. Hepatology 2015; 62:1024-36. [PMID: 26122273 PMCID: PMC4589464 DOI: 10.1002/hep.27962] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 06/24/2015] [Indexed: 12/23/2022]
Abstract
UNLABELLED Certain nucleoside/nucleotide reverse transcriptase (RT) inhibitors (NRTIs) are effective against human immunodeficiency virus type 1 (HIV-1) and hepatitis B virus (HBV). However, both viruses often acquire NRTI resistance, making it crucial to develop more-potent agents that offer profound viral suppression. Here, we report that 4'-C-cyano-2-amino-2'-deoxyadenosine (CAdA) is a novel, highly potent inhibitor of both HBV (half maximal inhibitory concentration [IC50 ] = 0.4 nM) and HIV-1 (IC50 = 0.4 nM). In contrast, the approved anti-HBV NRTI, entecavir (ETV), potently inhibits HBV (IC50 = 0.7 nM), but is much less active against HIV-1 (IC50 = 1,000 nM). Similarly, the highly potent HIV-1 inhibitor, 4'-ethynyl-2-fluoro-2'-deoxyadenosine (EFdA; IC50 = 0.3 nM) is less active against HBV (IC50 = 160 nM). Southern analysis using Huh-7 cells transfected with HBV-containing plasmids demonstrated that CAdA was potent against both wild-type (IC50 = 7.2 nM) and ETV-resistant HBV (IC50 = 69.6 nM for HBVETV-RL180M/S202G/M204V), whereas ETV failed to reduce HBVETV-RL180M/S202G/M204V DNA even at 1 μM. Once-daily peroral administration of CAdA reduced HBVETV-RL180M/S202G/M204V viremia (P = 0.0005) in human-liver-chimeric/ HBVETV-RL180M/S202G/M204V-infected mice, whereas ETV completely failed to reduce HBVETV-RL180M/S202G/M204V viremia. None of the mice had significant drug-related body-weight or serum human-albumin concentration changes. Molecular modeling suggests that a shallower HBV-RT hydrophobic pocket at the polymerase active site can better accommodate the slightly shorter 4'-cyano of CAdA-triphosphate (TP), but not the longer 4'-ethynyl of EFdA-TP. In contrast, the deeper HIV-1-RT pocket can efficiently accommodate the 4'-substitutions of both NRTIs. The ETV-TP's cyclopentyl ring can bind more efficiently at the shallow HBV-RT binding pocket. CONCLUSION These data provide insights on the structural and functional associations of HBV- and HIV-1-RTs and show that CAdA may offer new therapeutic options for HBV patients.
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Affiliation(s)
- Yuki Takamatsu
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Yasuhito Tanaka
- Department of Virology & Liver unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoru Kohgo
- Research Institute & Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan,Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan
| | - Shuko Murakami
- Department of Virology & Liver unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kamalendra Singh
- Molecular Microbiology & Immunology, Biochemistry, School of Medicine and Bond Life Sciences Center, University of Missouri, Columbia MO
| | - Debananda Das
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - David J. Venzon
- Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Masayuki Amano
- Departments of Hematology, Rheumatology, and Clinical Immunology & Infectious Disease, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Nobuyo Higashi-Kuwata
- Research Institute & Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Manabu Aoki
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD USA,Departments of Hematology, Rheumatology, and Clinical Immunology & Infectious Disease, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan,Department of Medical Technology, Kumamoto Health Science University, Kumamoto, Japan
| | - Nicole S. Delino
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD USA
| | - Sanae Hayashi
- Department of Virology & Liver unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoru Takahashi
- Department of Experimental Pathology & Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshikazu Sukenaga
- Research Institute & Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuhiro Haraguchi
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan
| | - Stefan G. Sarafianos
- Molecular Microbiology & Immunology, Biochemistry, School of Medicine and Bond Life Sciences Center, University of Missouri, Columbia MO
| | - Kenji Maeda
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD USA,Research Institute & Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan,Correspondence should be addressed to: K.M., Postal address: Kenji Maeda, M.D., Ph.D., Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Phone: +81-3-3202-7181 Facsimile: +81-3-3207-1038,
| | - Hiroaki Mitsuya
- Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD USA,Research Institute & Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan,Departments of Hematology, Rheumatology, and Clinical Immunology & Infectious Disease, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
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