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Nakashima R, Kotoku M, Gamachi A, Inagaki N, Kasaoka S. An Autopsy Case of Fulminant, Suppurative Bacterial Myocarditis Caused by Group B Streptococcus. Intern Med 2022; 61:907-912. [PMID: 34544955 PMCID: PMC8987262 DOI: 10.2169/internalmedicine.5498-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 61-year-old woman was admitted to our hospital with a fever, nausea, diarrhea, and back pain. Her condition rapidly deteriorated, and she was transferred to the intensive-care unit for mechanical circulatory support and antibiotics, but she died 40 hours after admission. Autopsy findings showed necrotic and suppurative myocardial changes due to group B Streptococcus (GBS). To date, only one case of bacterial myocarditis caused by GBS has been reported. We herein report a case of GBS myocarditis, the etiology of which is poorly understood due to the limited number of cases. Bacterial myocarditis should be considered in patients with sepsis and myocardial dysfunction.
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Affiliation(s)
- Ryuta Nakashima
- Graduate School of Medical Science, Kumamoto University, Japan
- Department of Emergency and Critical Care Medicine, Oita City Medical Association's Almeida Memorial Hospital, Japan
| | - Munenori Kotoku
- Department of Cardiovascular Medicine, Oita City Medical Association's Almeida Memorial Hospital, Japan
| | - Ayako Gamachi
- Department of Laboratory Medicine, Oita City Medical Association's Almeida Memorial Hospital, Japan
| | - Nobuhiro Inagaki
- Department of Emergency and Critical Care Medicine, Oita City Medical Association's Almeida Memorial Hospital, Japan
| | - Shunji Kasaoka
- Disaster Medical Education and Research Center, Kumamoto University, Japan
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Nakashima R, Inagaki N, Kasaoka S. Exploration of autonomic regulation reflecting on pathophysiological change of sepsis: a prospective observational study. Acute Med Surg 2022; 9:e776. [PMID: 35949315 PMCID: PMC9353857 DOI: 10.1002/ams2.776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/19/2022] [Indexed: 11/12/2022] Open
Abstract
Aim It remains unclear how autonomic regulation modulates pathophysiological changes of sepsis. This study aims to analyze and clarify those in patients with suspected sepsis. Methods In this single‐centered, prospective, observational study, adult patients who had an infection, a quick Sequential Organ Failure Assessment score of 2 or more at the emergency department, and underwent intensive care were screened. Heart rate variability (HRV) and serum adrenaline were measured immediately after arrival. The primary outcome was defined as vasopressor dependence during 48 h after arrival. Results A total of 63 patients were included. All the patients had SOFA score of 2 or more on admission. Vasopressor dependence, renal replacement therapy, and in‐hospital mortality were associated with higher adrenaline (which reflects sympathetic adrenergic system activity). Bacteremia was associated with lower high‐frequency components of HRV (parasympathetic nerve activity). The HRV parameter of sympathetic nerve activity had no significant association with the outcomes. In the multivariate logistic regression model adjusted for age and sex, vasopressor dependence remained associated with higher adrenaline (cut‐off 0.11 ng/mL, odds ratio 9.71, 95% confidence interval 2.55–37; P = 0.000874), and lower high‐frequency components with bacteremia (17.2 ms2, odds ratio 4.86, 95% confidence interval 1.36–17.4; P = 0.0152). There were no significant correlations between parameters of HRV and serum adrenaline. Conclusion Hypoperfusion, organ dysfunction, and in‐hospital mortality were associated with an increased sympathetic adrenergic activity. Bacteremia was associated with decreased parasympathetic nerve activity. The autonomic regulator may involve a multilayered and differentiated modulating process for sepsis.
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Affiliation(s)
- Ryuta Nakashima
- Graduate School of Medical Sciences Kumamoto University Kumamoto City Kumamoto Japan
- Department of Emergency and Intensive Care Medicine Oita City Medical Association's Almeida Memorial Hospital Oita City Oita Japan
- Department of Emergency Medicine Oita Prefecture Saiseikai Hita Hospital Hita City Oita Japan
| | - Nobuhiro Inagaki
- Department of Emergency and Intensive Care Medicine Oita City Medical Association's Almeida Memorial Hospital Oita City Oita Japan
| | - Shunji Kasaoka
- Disaster Medical Education and Research Center Kumamoto University Hospital Kumamoto City Kumamoto Japan
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Okamoto O, Sato T, Todoroki A, Suzuki R, Munemoto S, Nakashima R, Inagaki N, Shiota S, Hashimoto H. Statistical analysis of anti-mamushi venom serum injection time and clinical course. Acute Med Surg 2020; 7:e545. [PMID: 32728446 PMCID: PMC7383039 DOI: 10.1002/ams2.545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 11/24/2022] Open
Abstract
Aim Early injection of anti‐mamushi venom serum (antiserum) is believed to be effective for the treatment of patients with mamushi bites. However, there is no firm information that indicates the time range constituting “early” injection. We tried to quantify the cut‐off time of antiserum injection that brings favorable clinical courses by clarifying the relationship between the injection time and clinical outcome. Methods We retrospectively analyzed the relationships between the time after bite, injection time of the antiserum, swelling grades, and laboratory values. Results The injection time of the antiserum in severe cases was significantly delayed as compared with non‐severe cases. The best cut‐off time of the antiserum injection that could distinguish non‐severe and severe cases was 14 h. In the group that received the antiserum within 14 h, the antiserum injection may have successfully arrested the grade progression in a substantial number of cases. In the other group receiving the antiserum beyond 14 h, the grades in many cases possibly may have peaked by the time of antiserum injection. Conclusion The cut‐off time of early injection for favorable clinical course was determined to be 14 h. A statistical basis concerning the appropriate antiserum injection time was made to help prevent a severe clinical course due to delayed injection.
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Affiliation(s)
- Osamu Okamoto
- Dermatology Unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Takaoki Sato
- Dermatology Unit Oita Prefectural Hospital Oita Japan
| | | | - Rui Suzuki
- Plastic Surgery Unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Sekinori Munemoto
- Plastic Surgery Unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Ryuta Nakashima
- Emergency Medicine Unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Nobuhiro Inagaki
- Emergency Medicine Unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Seiji Shiota
- Department of General Medicine Faculty of Medicine Oita University Oita Japan
| | - Hiroyuki Hashimoto
- Plastic Surgery Unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
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Yatabe T, Egi M, Sakaguchi M, Ito T, Inagaki N, Kato H, Kaminohara J, Konishi A, Takahashi M, Tatsumi H, Tobe M, Nakashima I, Nakamoto N, Nishimura T, Nitta M, Nishimura M. Influence of Nutritional Management and Rehabilitation on Physical Outcome in Japanese Intensive Care Unit Patients: A Multicenter Observational Study. Ann Nutr Metab 2018; 74:35-43. [PMID: 30541003 DOI: 10.1159/000495213] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 11/02/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is lack of evidence regarding nutritional management among intensive care unit (ICU) patients in a population with relatively low body mass index. Therefore, we conducted an observational study to assess the nutritional management in Japanese ICUs. Also, we investigated the impact of nutritional management and rehabilitation on physical outcome. METHODS The study population comprised 389 consecutive patients who received mechanical ventilation for at least 24 h and those admitted to the ICU for > 72 h in 13 hospitals. The primary outcomes were caloric and protein intake in ICU on days 3 and 7, and at ICU discharge. The secondary outcome was the impact of nutritional management and rehabilitation on physical status at ICU discharge. We defined good physical status as more than end sitting and poor physical status as bed rest and sitting. We divided the participants into 2 groups, namely, the good physical status group (Good group) and poor physical status group (Poor group) for analysis of the secondary outcome. Data were expressed as median (interquartile range). RESULTS The median amount of caloric intake on days 3 and 7, and at ICU discharge via enteral and parenteral routes were 8.4 (3.1-15.6), 14.9 (7.5-22.0), and 11.2 (2.5-19.1) kcal/kg/day, respectively. The median amount of protein intake on days 3 and 7, and at ICU discharge were 0.2 (0-0.5), 0.4 (0.1-0.8), and 0.3 (0-0.7) g/kg/day, respectively. The amount of caloric intake on day 3 in the Poor group was significantly higher than that of the Good group (10.1 [5.8, 16.2] vs. 5.2 [1.9, 12.4] kcal/kg/day, p < 0.001). The proportion of patients who were received rehabilitation in ICU in the Good group was significantly higher than that of the Poor group (92 vs. 63%, p < 0.001). The multivariate analysis revealed that caloric intake on day 3 and rehabilitation in ICU were considered independent factors that affect physical status (OR 1.19; 95% CI 1.05-1.34; p = 0.005 and OR 0.07; 95% CI 0.01-0.34; p = 0.001). CONCLUSIONS The caloric and protein intakes in Japanese ICUs were 15 kcal/kg/day and 0.4 g/kg/day, respectively. In addition, critically ill patients might benefit from low caloric intake (less than 10 kcal/kg/day) until day 3 and rehabilitation during ICU stay.
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Affiliation(s)
- Tomoaki Yatabe
- Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Nankoku, Japan,
| | - Moritoki Egi
- Department of Anesthesiology, Kobe University Hospital, Kobe, Japan
| | - Masahiko Sakaguchi
- Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Takashi Ito
- Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Nobuhiro Inagaki
- Department of Emergency and Critical Care Medicine, Almeida Memorial Hospital, Oita, Japan
| | - Hiromi Kato
- Department of Intensive Care Unit, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Jun Kaminohara
- Department of Anesthesiology and Critical Care Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Amane Konishi
- Department of Anesthesia and Perioperative Medicine, Ehime University Graduate School of Medicine, Toon, Japan
| | - Michiko Takahashi
- Department of Nutrition, Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Hospital, Kobe, Japan
| | - Hiroomi Tatsumi
- Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masaru Tobe
- Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Ikue Nakashima
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | - Naoki Nakamoto
- Department of Emergency and Critical Care, Osaka General Medical Center, Osaka, Japan
| | - Takeshi Nishimura
- Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Masakazu Nitta
- Division of Emergency and Critical Care Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan
| | - Masaji Nishimura
- Emergency and Critical Care Medicine, Tokushima University Graduate School, Tokushima, Japan
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Egi M, Kataoka J, Ito T, Nishida O, Yasuda H, Okamaoto H, Shimoyama A, Izawa M, Matsumoto S, Furushima N, Yamashita S, Takada K, Ohtsuka M, Fujisaki N, Shime N, Inagaki N, Taira Y, Yatabe T, Nitta K, Yokoyama T, Kushimoto S, Tokunaga K, Doi M, Masuda T, Miki Y, Matsuda K, Asaga T, Hazama K, Matsuyama H, Nishimura M, Mizobuchi S. Oxygen management in mechanically ventilated patients: A multicenter prospective observational study. J Crit Care 2018; 46:1-5. [PMID: 29605719 DOI: 10.1016/j.jcrc.2018.03.024] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 03/19/2018] [Accepted: 03/19/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE To observe arterial oxygen in relation to fraction of inspired oxygen (FIO2) during mechanical ventilation (MV). MATERIALS AND METHODS In this multicenter prospective observational study, we included adult patients required MV for >48h during the period from March to May 2015. We obtained FIO2, PaO2 and SaO2 from commencement of MV until the 7th day of MV in the ICU. RESULTS We included 454 patients from 28 ICUs in this study. The median APACHE II score was 22. Median values of FIO2, PaO2 and SaO2 were 0.40, 96mmHg and 98%. After day two, patients spent most of their time with a FIO2 between 0.3 and 0.49 with median PaO2 of approximately 90mmHg and SaO2 of 97%. PaO2 was ≥100mmHg during 47.2% of the study period and was ≥130mmHg during 18.4% of the study period. FIO2 was more likely decreased when PaO2 was ≥130mmHg or SaO2 was ≥99% with a FIO2 of 0.5 or greater. When FIO2 was <0.5, however, FIO2 was less likely decreased regardless of the value of PaO2 and SaO2. CONCLUSIONS In our multicenter prospective study, we found that hyperoxemia was common and that hyperoxemia was not corrected.
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Affiliation(s)
- Moritoki Egi
- Department of Anesthesiology, Kobe University Hospital, Hyogo, Japan.
| | - Jun Kataoka
- Department of Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Takashi Ito
- Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Osamu Nishida
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Aichi, Japan
| | - Hideto Yasuda
- Department of Intensive Care Medicine, Kameda Medical Center, Chiba, Japan
| | - Hiroshi Okamaoto
- Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
| | - Akira Shimoyama
- Department of Emergency Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Masayo Izawa
- Emergency and Critical Care Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Shinsaku Matsumoto
- Department of Anesthesia and Intensive Care, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Nana Furushima
- Department of Anesthesiology, Kobe University Hospital, Hyogo, Japan
| | - Shigeki Yamashita
- Department of Anesthesiology, Kurashiki Central Hospital, Okayama, Japan
| | - Koji Takada
- Department of Anesthesiology, Toyonaka Municipal Hospital, Osaka, Japan
| | - Masahide Ohtsuka
- Department of Intensive Care Medicine, Yokohama City University Medical Center, Kanagawa, Japan
| | - Noritomo Fujisaki
- Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Nobuaki Shime
- Department of Emergency and CriticalCare Medicine, Institute of Biomedical & Health Sciences, HiroshimaUniversity, Hiroshima, Japan
| | - Nobuhiro Inagaki
- Department of Emergency and Critical Care Medicine, Oita City Medical Association's Almeida Memorial Hospital, Oita, Japan
| | - Yasuhiko Taira
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Tomoaki Yatabe
- Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kochi, Japan
| | - Kenichi Nitta
- Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Takeshi Yokoyama
- Intensive Care Unit, Department of Anesthesiology, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Shigeki Kushimoto
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kentaro Tokunaga
- Department of Intensive Care Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Matsuyuki Doi
- Intensive Care Unit, Hamamatsu University Hospital, Shizuoka, Japan
| | - Takahiro Masuda
- Department of Critical Care Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuo Miki
- Advanced Critical Care Center, Aichi Medical University Hospital, Aichi, Japan
| | - Kenichi Matsuda
- Department of Emergency and Critical Care Medicine, University of Yamanashi School of Medicine, Yamanashi, Japan
| | - Takehiko Asaga
- Intensive Care Unit, Kagawa University Hospital, Kagawa, Japan
| | - Keita Hazama
- Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School, Okayama, Japan
| | - Hiroki Matsuyama
- Department of Anesthesia, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Masaji Nishimura
- Emergency and Critical Care Medicine, Tokushima University Hospital, Tokushima, Japan
| | - Satoshi Mizobuchi
- Department of Anesthesiology, Kobe University Hospital, Hyogo, Japan
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Yamashita H, Matsuhara H, Miotani S, Sako Y, Matsui T, Tanaka H, Inagaki N. Artificial sweeteners and mixture of food additives cause to break oral tolerance and induce food allergy in murine oral tolerance model for food allergy. Clin Exp Allergy 2017; 47:1204-1213. [DOI: 10.1111/cea.12928] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 12/15/2022]
Affiliation(s)
- H. Yamashita
- Laboratory of Pharmacology; Department of Bioactive Molecules; Gifu Pharmaceutical University; Gifu Japan
| | - H. Matsuhara
- Laboratory of Pharmacology; Department of Bioactive Molecules; Gifu Pharmaceutical University; Gifu Japan
| | - S. Miotani
- Laboratory of Pharmacology; Department of Bioactive Molecules; Gifu Pharmaceutical University; Gifu Japan
| | - Y. Sako
- Laboratory of Pharmacology; Department of Bioactive Molecules; Gifu Pharmaceutical University; Gifu Japan
| | - T. Matsui
- Laboratory of Pharmacology; Department of Bioactive Molecules; Gifu Pharmaceutical University; Gifu Japan
- Department of Pediatrics; Graduate School of Medicine; Nagoya University; Nagoya Japan
| | - H. Tanaka
- Laboratory of Pharmacology; Department of Bioactive Molecules; Gifu Pharmaceutical University; Gifu Japan
| | - N. Inagaki
- Laboratory of Pharmacology; Department of Bioactive Molecules; Gifu Pharmaceutical University; Gifu Japan
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Kanoh H, Ishitsuka A, Nakamura M, Inagaki N, Ito H, Banno Y, Seishima M. 430 IFN-γ may disrupt skin barrier function through reduction of long-chain fatty acid ceramides in mite-induced dermatitis. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nakashima R, Hifumi T, Kawakita K, Okazaki T, Egawa S, Inoue A, Seo R, Inagaki N, Kuroda Y. Critical Care Management Focused on Optimizing Brain Function After Cardiac Arrest. Circ J 2017; 81:427-439. [PMID: 28239054 DOI: 10.1253/circj.cj-16-1006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/09/2022]
Abstract
The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia. We reviewed the literature and the latest research about the following issues and propose practical care recommendations. Issues are (1) prediction of TTM candidate on admission, (2) cerebral blood flow and metabolism and target value of them, (3) seizure management using continuous electroencephalography, (4) target value of hemodynamic stabilization and its method, (5) management and analysis of respiration, (6) sedation and its monitoring, (7) shivering control and its monitoring, and (8) glucose management. We hope to establish standards of neurocritical care to optimize brain function and produce a favorable neurologic outcome.
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Affiliation(s)
- Ryuta Nakashima
- Department of Emergency and Critical Care Medicine, Oita City Medical Association's Almeida Memorial Hospital
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Okamoto O, Nakashima R, Yamamoto S, Hashimoto T, Takasaki T, Tokuda H, Sato S, Gamachi A, Hashimoto H, Inagaki N. A lethal case of mamushi ( Gloydius blomhoffii) bite: severe bowel symptoms as a lethal sign. Acute Med Surg 2016; 4:135-139. [PMID: 29123851 PMCID: PMC5667284 DOI: 10.1002/ams2.240] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/01/2016] [Indexed: 11/12/2022] Open
Abstract
Case We report a lethal case of a mamushi (Gloydius blomhoffii) bite. An 84‐year‐old woman was bitten by a mamushi snake on her right elbow. She was initially treated at another hospital, however, because the swelling expanded and her renal function worsened, she was transferred to our hospital. Compartment syndrome, thrombocytopenia, respiratory arrest, and elevated creatinine kinase and lactose dehydrogenase levels were seen; renal failure progressed, and ileus and peritonitis due to colon perforation occurred. Outcome The patient died 35 days after the bite. An autopsy revealed widespread necrosis of the ileum, colon, and liver. Conclusion This report supplies useful clinical information on the treatment of severe mamushi bite cases, and severe abdominal symptoms, such as ileus and melena, may be a lethal sign.
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Affiliation(s)
- Osamu Okamoto
- Dermatology unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Ryuta Nakashima
- Emergency unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Soichiro Yamamoto
- Surgery unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Takuzo Hashimoto
- Surgery unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Tomomi Takasaki
- Emergency unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Hayato Tokuda
- Emergency unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Seiichi Sato
- Plastic Surgery unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Ayako Gamachi
- Clinical Pathology Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Hiroyuki Hashimoto
- Plastic Surgery unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
| | - Nobuhiro Inagaki
- Emergency unit Oita City Medical Association's Almeida Memorial Hospital Oita Japan
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Nagira Y, Goto K, Tanaka H, Aoki M, Furue S, Inagaki N, Tomita Y, Shichijo M. Prostaglandin D2 Modulates Neuronal Excitation of the Trigeminal Ganglion to Augment Allergic Rhinitis in Guinea Pigs. ACTA ACUST UNITED AC 2016; 357:273-80. [DOI: 10.1124/jpet.115.231225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 03/02/2016] [Indexed: 01/29/2023]
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Hosomi Y, Seto T, Nishio M, Goto K, Yamamoto N, Okamoto I, Tajima K, Inagaki N, Yamamoto N. 420O Erlotinib plus bevacizumab (EB) versus erlotinib alone (E) as first-line treatment for advanced non-squamous non–small-cell lung cancer (NSCLC) with activating EGFR mutation (mt): JO25567 exploratory subgroup analysis. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv532.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Seino Y, Ikeda Y, Niemoeller E, Watanabe D, Takagi H, Yabe D, Inagaki N. Efficacy and Safety of Lixisenatide in Japanese Patients with Type 2 Diabetes Insufficiently Controlled with Basal Insulin±Sulfonylurea: A Subanalysis of the GetGoal-L-Asia Study. Horm Metab Res 2015; 47:895-900. [PMID: 26039935 DOI: 10.1055/s-0035-1549875] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of the study was to evaluate the efficacy and safety of once-daily lixisenatide 20 μg as add-on to basal insulin with or without sulfonylurea in Asian patients with type 2 diabetes mellitus. The study as a subanalysis of the 159 Japanese patients from the 24-week double-blind GetGoal-L-Asia study (NCT00866658) who received once-daily lixisenatide or placebo. The primary endpoint was change from baseline in HbA1c evaluated using analysis of covariance. Once-daily lixisenatide significantly reduced mean HbA1c [least squares mean difference vs. placebo - 1.1% (- 12 mmol/mol); p<0.0001]. Significantly more patients in the lixisenatide group reached HbA1c targets of < 7% (53 mmol/mol; 31.4 vs. 2.3% for placebo; p<0.0001) and ≤ 6.5% (48 mmol/mol; 12.9 vs. 1.2% for placebo; p=0.0028). Lixisenatide significantly reduced 2-h postprandial plasma glucose (least squares mean difference vs. placebo-8.64 mmol/l; p<0.0001), glucose excursion (least squares mean difference vs. placebo - 7.80 mmol/l; p<0.0001) and fasting plasma glucose (least squares mean difference vs. placebo - 0.96 mmol/l; p=0.0126). Body weight was reduced with lixisenatide but with no significant difference vs. placebo. Gastrointestinal adverse events were more frequent with lixisenatide (61.1 vs. 11.5% for placebo) but were generally transient and mild-to-moderate in intensity. The incidence of symptomatic hypoglycemia was 39.0 vs. 13.5% in patients receiving sulfonylureas and 32.3 vs. 22.9% in those not receiving sulfonylureas, for lixisenatide and placebo, respectively. In Japanese patients with type 2 diabetes mellitus, once-daily lixisenatide was well tolerated and led to significant and clinically relevant improvement in glycemic control, with a pronounced effect on postprandial plasma glucose.
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Affiliation(s)
- Y Seino
- Diabetes, Clinical Nutrition and Endocrinology, Kansai Electric Power Hospital, Osaka, Japan
| | | | | | | | | | - D Yabe
- Diabetes, Clinical Nutrition and Endocrinology, Kansai Electric Power Hospital, Osaka, Japan
| | - N Inagaki
- Department of Diabetes and Clinical Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Araki E, Inagaki N, Tanizawa Y, Oura T, Takeuchi M, Imaoka T. Efficacy and safety of once-weekly dulaglutide in combination with sulphonylurea and/or biguanide compared with once-daily insulin glargine in Japanese patients with type 2 diabetes: a randomized, open-label, phase III, non-inferiority study. Diabetes Obes Metab 2015; 17:994-1002. [PMID: 26179754 PMCID: PMC5042081 DOI: 10.1111/dom.12540] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/23/2015] [Accepted: 07/02/2015] [Indexed: 01/18/2023]
Abstract
AIMS To evaluate 0.75 mg of dulaglutide, a once-weekly glucagon-like peptide-1 receptor agonist, compared with once-daily insulin glargine for glycaemic control in Japanese patients with type 2 diabetes (T2D). METHODS In this phase III, randomized, open-label, parallel-group, 26-week study, 361 patients with inadequately controlled T2D receiving sulphonylureas and/or biguanides, aged ≥20 years, with glycated haemoglobin (HbA1c) levels 7.0-10.0% (53-86 mmol/mol), inclusive, were randomized (1 : 1) to receive dulaglutide or glargine. Participants and investigators were not masked to treatment allocation. The primary measure was change from baseline in HbA1c at 26 weeks, analysed using a mixed-effects model for repeated measures, with a predefined non-inferiority margin of 0.4%. RESULTS At week 26, least-squares (LS) mean (standard error) reductions in HbA1c were -1.44 (0.05)% [-15.74 (0.55) mmol/mol] in the dulaglutide group and -0.90 (0.05)% [-9.84 (0.55) mmol/mol] in the glargine group. The mean between-group treatment difference in HbA1c was -0.54% (95% CI -0.67, -0.41) [-5.90 mmol/mol (95% CI -7.32, -4.48)]; p < 0.001. Dulaglutide significantly reduced body weight compared with glargine at week 26 (LS mean difference -1.42 kg, 95% CI -1.89, -0.94; p < 0.001). The most frequent adverse events with dulaglutide treatment were nasopharyngitis and gastrointestinal symptoms. The incidence of hypoglycaemia was significantly lower with dulaglutide [47/181 (26%)] compared with glargine [86/180 (48%)], p < 0.001. CONCLUSION In Japanese patients with T2D uncontrolled on sulphonylureas and/or biguanides, once-weekly dulaglutide was superior to once-daily glargine for reduction in HbA1c at 26 weeks. Although dulaglutide increased gastrointestinal symptoms, it was well tolerated, with an acceptable safety profile.
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Affiliation(s)
- E Araki
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - N Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Tanizawa
- Division of Endocrinology, Metabolism, Hematological Science and Therapeutics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - T Oura
- Eli Lilly Japan K.K., Kobe, Japan
| | | | - T Imaoka
- Eli Lilly Japan K.K., Kobe, Japan
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Kaido T, Tamai Y, Hamaguchi Y, Okumura S, Kobayashi A, Yagi S, Okajima H, Inagaki N, Uemoto S. MON-PP066: Impact of Pretransplant Sarcopenia and Sequential Changes in Sarcopenic Parameters after Living Donor Liver Transplantation: A Prospective Study. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30498-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Hamaguchi Y, Kaido T, Okumura S, Fujimoto Y, Ogawa K, Mori A, Hatano E, Tamai Y, Inagaki N, Uemoto S. OP025: The Impact of Preoperative Quality and Quantity of Skeletal Muscle on Survival in Patients Undergoing Living Donor Liver Transplantation. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50025-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Inagaki N, Kondo K, Yoshinari T, Maruyama N, Susuta Y, Kuki H. Efficacy and safety of canagliflozin in Japanese patients with type 2 diabetes: a randomized, double-blind, placebo-controlled, 12-week study. Diabetes Obes Metab 2013; 15:1136-45. [PMID: 23782594 PMCID: PMC3906835 DOI: 10.1111/dom.12149] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 02/04/2013] [Accepted: 06/11/2013] [Indexed: 12/15/2022]
Abstract
AIMS We examined the efficacy, safety and tolerability of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in Japanese patients with type 2 diabetes (T2DM) undergoing diet and exercise therapy. METHODS Patients aged 20-80 years with T2DM diagnosed ≥3 months previously, and HbA1c of 6.9-9.9% were randomized to 50, 100, 200 or 300 mg canagliflozin or placebo once daily for 12 weeks. The primary and secondary endpoints were changes in HbA1c, fasting plasma glucose (FPG), urinary glucose/creatinine and postprandial glycaemic parameters following a meal test. The safety assessments included adverse events (AEs) and clinical laboratory tests. RESULTS Overall, 383 patients were randomized to receive either placebo (n = 75), or 50 mg (n = 82), 100 mg (n = 74), 200 mg (n = 77) or 300 mg canagliflozin (n = 75). At week 12, significant reductions in HbA1c were observed in all canagliflozin groups relative to placebo (-0.61, -0.80, -0.79 and -0.88% for 50, 100, 200 and 300 mg, respectively, versus +0.11% for placebo; all, p < 0.01). FPG and postprandial glycaemic parameters improved significantly in the canagliflozin groups. Body weight was significantly decreased by canagliflozin. No deaths or drug-related serious AEs were reported. There was no dose-dependent increase in the incidence of AEs in the canagliflozin groups. The incidence of hypoglycaemia was low; episodes were not severe or dose dependent. Canagliflozin did not affect serum creatinine levels or the urinary albumin/creatinine ratio. CONCLUSIONS Treatment with canagliflozin for 12 weeks significantly improved glycaemic control and reduced body weight in Japanese patients with T2DM. Canagliflozin was well tolerated.
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Affiliation(s)
- N Inagaki
- Department of Diabetes and Clinical Nutrition, Kyoto University Graduate School of MedicineKyoto, Japan
| | - K Kondo
- Mitsubishi Tanabe Pharma CorporationTokyo, Japan
| | - T Yoshinari
- Mitsubishi Tanabe Pharma CorporationTokyo, Japan
- Correspondence to: Toru Yoshinari, Mitsubishi Tanabe Pharma Corporation, 17–10 Nihonbashi-Koamicho, Chuo-ku, Tokyo, Japan., E-mail:
| | - N Maruyama
- Mitsubishi Tanabe Pharma CorporationTokyo, Japan
| | - Y Susuta
- Mitsubishi Tanabe Pharma CorporationTokyo, Japan
| | - H Kuki
- Mitsubishi Tanabe Pharma CorporationTokyo, Japan
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17
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Tamai Y, Kaido T, Fujimoto Y, Shide K, Uemoto S, Inagaki N. PP055-MON IMPACT OF PREOPERATIVE NUTRITIONAL THERAPY IN PATIENTS UNDERGOING LIVING DONOR LIVER TRANSPLANTATION. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Kaido T, Ogawa K, Fujimoto Y, Ito T, Tomiyama K, Mori A, Tamai Y, Inagaki N, Uemoto S. OP002 IMPACT OF SARCOPENIA AND PERIOPERATIVE NUTRITIONAL THERAPY ON SURVIVAL IN PATIENTS UNDERGOING LIVING DONOR LIVER TRANSPLANTATION. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60004-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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19
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Inagaki N, Watada H, Murai M, Kagimura T, Gong Y, Patel S, Woerle HJ. Linagliptin provides effective, well-tolerated add-on therapy to pre-existing oral antidiabetic therapy over 1 year in Japanese patients with type 2 diabetes. Diabetes Obes Metab 2013; 15:833-43. [PMID: 23565760 DOI: 10.1111/dom.12110] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 02/26/2013] [Accepted: 03/24/2013] [Indexed: 01/26/2023]
Abstract
AIMS To evaluate the long-term safety and efficacy of linagliptin as add-on therapy to one approved oral antidiabetic drug (OAD) in Japanese patients with type 2 diabetes mellitus and insufficient glycaemic control. METHODS This 52-week, multicentre, open-label, parallel-group study evaluated once-daily linagliptin 5 mg as add-on therapy to one OAD [biguanide, glinide, glitazone, sulphonylurea (SU) or α-glucosidase inhibitors (A-GI)] in 618 patients. After a 2-week run-in, patients on SU or A-GI were randomized to either linagliptin (once daily, 5 mg) or metformin (twice or thrice daily, up to 2250 mg/day) as add-on therapy. Patients receiving the other OADs received linagliptin add-on therapy (non-randomized). RESULTS Adverse events were mostly mild or moderate, and rates were similar across all groups. Hypoglycaemic events were rare, except in the SU group. Overall, 26 (5.8%) hypoglycaemic events were reported in patients receiving linagliptin (non-randomized). Hypoglycaemic events were similar for linagliptin and metformin added to A-GI (1/61 vs. 2/61, respectively) or SU (17/124 vs. 10/63, respectively). Significant reductions in glycated haemoglobin (HbA1c) levels (between -0.7 and -0.9%) occurred throughout the study period for the background therapy groups that received linagliptin (baseline HbA1c 7.9-8.1%). The decline in HbA1c levels was indistinguishable between linagliptin and metformin groups when administered as add-on therapy to A-GI or SU. CONCLUSIONS Once-daily linagliptin showed safety and tolerability over 1 year and provided effective add-on therapy leading to significant HbA1c reductions, similar to metformin, over 52 weeks in Japanese patients.
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Affiliation(s)
- N Inagaki
- Department of Diabetes and Clinical Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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20
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Ooishi Y, Ishii T, Takahata T, Inagaki N, Akizuki N, Isakozawa Y, Takesawa S, Hirasawa H. Efficacy of Series Double Continuous Hemodiafiltration Using Two Polymethyl Methacrylate Membrane Hemofilters for Patients With Hypercytokinemia. Ther Apher Dial 2013; 18:132-9. [DOI: 10.1111/1744-9987.12075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yoshihide Ooishi
- Department of Medical Engineering; Faculty of Health Sciences; Junshin Gakuen University; Fukuoka Japan
| | - Takanori Ishii
- Department of Nephrology; Almeida Memorial Hospital of Oita city Medical Association; Oita Japan
| | - Tomohiro Takahata
- Department of Clinical Engineering; Almeida Memorial Hospital of Oita city Medical Association; Oita Japan
| | - Nobuhiro Inagaki
- Emergency and Critical Care Medicine; Almeida Memorial Hospital of Oita city Medical Association; Oita Japan
| | - Noboru Akizuki
- Emergency and Critical Care Medicine; Almeida Memorial Hospital of Oita city Medical Association; Oita Japan
| | - Yutaka Isakozawa
- Department of Clinical Engineering; School of Health Science; Kyushu University of Health and Welfare; Miyazaki Japan
| | - Shingo Takesawa
- Department of Clinical Engineering; School of Health Science; Kyushu University of Health and Welfare; Miyazaki Japan
| | - Hiroyuki Hirasawa
- Department of Emergency and Critical Care Medicine; Chiba University Graduate School of Medicine; Chiba Japan
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Abstract
Corticosteroids (CST) are the gold standard for asthma management and for several decades have been considered the cornerstone for asthma control. With the recent advent of genomic and structural analysis technologies, the molecular basis of the side effects, toxicity and resistance mechanisms of drug treatment are better understood. With respect to CST, there is consistent evidence that while CST therapy improves asthma symptoms, it does not alter the natural course of asthma or offer clear long-lasting improvement of respiratory performance. Therefore, the development of drugs capable of minimizing or avoiding CST side effects, toxicity and resistance could be the way forward for establishing new asthma therapies. This review summarizes the molecular basis of corticosteroid mechanisms of action and the related mechanisms influencing side effects and resistance. The future of CST adjunctive or replacement therapy is also briefly discussed.
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Affiliation(s)
- M Kandeel
- Department of Pharmacology, Kafrelshiekh University, Kafrelshiekh, Egypt.
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22
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Araki E, Kawamori R, Inagaki N, Watada H, Hayashi N, Horie Y, Sarashina A, Thiemann S, von Eynatten M, Dugi K, Woerle HJ. Long-term safety of linagliptin monotherapy in Japanese patients with type 2 diabetes. Diabetes Obes Metab 2013; 15:364-71. [PMID: 23163910 DOI: 10.1111/dom.12039] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 09/11/2012] [Accepted: 11/12/2012] [Indexed: 12/22/2022]
Abstract
AIMS In a phase III study conducted among Japanese patients with type 2 diabetes mellitus (T2DM), linagliptin 5 and 10 mg showed clinically meaningful improvements in glycaemic parameters after 12 and 26 weeks compared with placebo and voglibose, respectively. This extension study assessed long-term tolerability of linagliptin over 52 weeks. METHODS Japanese patients with T2DM who completed either phase of a 12-week/26-week study comparing linagliptin monotherapy with placebo or voglibose were eligible to enrol. In the extension study, the comparator groups switched to linagliptin 5 or 10 mg, while the linagliptin groups maintained dosage. RESULTS In all, 540 patients received at least one dose of linagliptin 5 or 10 mg and 494 completed the extension. Long-term treatment with linagliptin was well tolerated; adverse events (AEs) of special interest and serious AEs occurred in small percentages of patients. Drug-related AEs occurred in 10.2 and 10.6% of patients in the linagliptin 5- and 10-mg groups, respectively, and discontinuations due to drug-related AEs occurred in 1.1 and 0.7%, respectively. Only one (0.4%) patient in each dose group experienced investigator-defined hypoglycaemia during the treatment period (both events were non-severe). Body weight was not clinically altered in either group. The glycated haemoglobin A1c profiles over time were similar with linagliptin 5 and 10 mg. CONCLUSIONS These findings provide evidence for the safety and tolerability of oral linagliptin at either 5 or 10 mg for up to 52 weeks for the treatment of Japanese patients with T2DM, without clinically relevant increase in the risk of hypoglycaemia or weight gain.
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Affiliation(s)
- E Araki
- Department of Metabolic Medicine, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
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23
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Harashima SI, Tanaka D, Yamane S, Ogura M, Fujita Y, Murata Y, Seike M, Koizumi T, Aono M, Wang Y, Inagaki N. Efficacy and safety of switching from basal insulin to sitagliptin in Japanese type 2 diabetes patients. Horm Metab Res 2013; 45:231-8. [PMID: 22972180 DOI: 10.1055/s-0032-1323763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Basal-supported oral therapy (BOT) is often used to treat poorly controlled type 2 diabetes. However, patients sometimes experience nocturnal and early morning hypoglycemia. Thus, maintaining targeted glycemic control by BOT is limited in some patients. We assessed the efficacy and safety of replacing basal insulin by sitagliptin therapy in Japanese type 2 diabetes patients on BOT. Forty-nine subjects were sequentially recruited for the 52-week, prospective, single arm study. Patients on BOT therapy were switched from basal insulin to sitagliptin. The primary endpoint was change in HbA1c in 52 weeks. The secondary endpoints were dropout rate, changes in body weight, frequency of hypoglycemia, and relationship between change in HbA1c and insulin secretion capacity evaluated by glucagon loading test. The average dose of basal insulin was 15.0±8.4 units. Sixteen subjects (31.3%) were dropped because replacement by sitagliptin was less effective for glycemic control. In these subjects, diabetes duration was longer, FPG and HbA1c at baseline were higher, and insulin secretion capacity was lower. Change in HbA1c in 52 weeks was - 4 mmol/mol (95% CI - 5 to - 4 mmol/mol) (p<0.05). Change in body weight was - 0.71 kg (95% CI - 1.42 to - 0.004 kg) (p<0.05). Frequency of hypoglycemia was decreased from 1.21±1.05 to 0.06±0.24 times/month. HbA1c level was improved if C-peptide index (CPI) was over 1.19. In conclusion, basal insulin in BOT can be replaced by sitagliptin with a decrease in HbA1c level and frequency of hypoglycemia in cases where insulin secretion capacity was sufficiently preserved.
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Affiliation(s)
- S-I Harashima
- Department of Diabetes and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
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Toyama K, Yonezawa A, Masuda S, Osawa R, Hosokawa M, Fujimoto S, Inagaki N, Inui K, Katsura T. Loss of multidrug and toxin extrusion 1 (MATE1) is associated with metformin-induced lactic acidosis. Br J Pharmacol 2012; 166:1183-91. [PMID: 22242910 DOI: 10.1111/j.1476-5381.2012.01853.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUNDS AND PURPOSE Lactic acidosis is a fatal adverse effect of metformin, but the risk factor remains unclear. Multidrug and toxin extrusion 1 (MATE1) is expressed in the luminal membrane of the kidney and liver. MATE1 was revealed to be responsible for the tubular and biliary secretion of metformin. Therefore, some MATE polymorphisms, that cause it to function abnormally, are hypothesized to induce lactic acidosis. The purpose of this study is to clarify the association between MATE dysfunction and metformin-induced lactic acidosis. EXPERIMENTAL APPROACH Blood lactate, pH and bicarbonate ion (HCO(3) (-) ) levels were evaluated during continuous administration of 3 mg·mL(-1) metformin in drinking water using Mate1 knockout (-/-), heterozygous (+/-) and wild-type (+/+) mice. To determine the tissue accumulation of metformin, mice were given 400 mg·kg(-1) metformin orally. Furthermore, blood lactate data were obtained from diabetic patients given metformin. KEY RESULTS Seven days after metformin administration in drinking water, significantly higher blood lactate, lower pH and HCO(3) (-) levels were observed in Mate1(-/-) mice, but not in Mate1(+/-) mice. The blood lactate levels were not affected in patients with the heterozygous MATE variant (MATE1-L125F, MATE1-G64D, MATE2-K-G211V). Sixty minutes after metformin administration (400 mg·kg(-1) , p.o.) the hepatic concentration of metformin was markedly higher in Mate1(-/-) mice than in Mate1(+/+) mice. CONCLUSION AND IMPLICATIONS MATE1 dysfunction caused a marked elevation in the metformin concentration in the liver and led to lactic acidosis, suggesting that the homozygous MATE1 variant could be one of the risk factors for metformin-induced lactic acidosis.
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Affiliation(s)
- K Toyama
- Department of Pharmacy, Kyoto University Hospital, Faculty of Medicine, Kyoto University, Kyoto, Japan
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25
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Harashima SI, Ogura M, Tanaka D, Fukushima T, Wang Y, Koizumi T, Aono M, Murata Y, Seike M, Inagaki N. Sitagliptin add-on to low dosage sulphonylureas: efficacy and safety of combination therapy on glycaemic control and insulin secretion capacity in type 2 diabetes. Int J Clin Pract 2012; 66:465-76. [PMID: 22512606 DOI: 10.1111/j.1742-1241.2012.02903.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIMS To assess the efficacy and safety of combination therapy with sitagliptin and low dosage sulphonylureas on glycaemic control and insulin secretion capacity in Japanese type 2 diabetes. METHODS Eighty-two subjects were sequentially recruited for the 52-week, prospective, single arm study. Sitagliptin was added on to sulphonylureas (glimepride or gliclazide) with or without metformin. The primary endpoint was a change in A1C. The secondary endpoints were changes in BMI, insulin secretion capacity, blood pressure and urinary albumin excretion, unresponsive rate, and hypoglycaemia. Insulin secretion capacity was evaluated by glucagon loading test. RESULTS Change in A1C was -0.80% (95% CI -0.90 to -0.68) (p < 0.001). Change in BMI, systemic and diastolic blood pressure, and urinary albumin excretion were -0.38 kg/m(2) (95% CI -0.72 to -0.04) (p < 0.05), -6.7/-3.6 mmHg (95% CI -10.0 to -3.4/-4.8 to -2.4) (p < 0.001), and -43.2 mg/gCr (95% CI -65.7 to -20.8) (p < 0.001) respectively. Mild hypoglycaemia was observed in three cases. The unresponsive rate was 6.1%. Glucagon loading test showed that 0-min and 6-min CPR at baseline and 52-week were not significantly changed: 0-min CPR, 1.58 ± 0.58-1.71 ± 0.73 ng/ml; 6-min CPR, 3.48 ± 1.47-3.58 ± 1.21 ng/ml. Insulin secretion capacity, CPI and SUIT index at baseline did not predict the efficacy of the combination therapy. The final dosages of glimepiride and gliclazide were 1.44 ± 0.90 mg and 34.5 ± 15.3 mg respectively. The dosage of sitagliptin was increased from 50 mg to 69.0 ± 24.5 mg in 52-week. CONCLUSIONS The combination therapy with sitagliptin and low dosage sulphonylureas was safe and effective for glycaemic control. Glucagon loading test indicated that 1 year administration of sitagliptin and sulphonylureas preserved insulin secretion capacity.
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Affiliation(s)
- S-I Harashima
- Department of Diabetes and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Kawamori R, Inagaki N, Araki E, Watada H, Hayashi N, Horie Y, Sarashina A, Gong Y, von Eynatten M, Woerle HJ, Dugi KA. Linagliptin monotherapy provides superior glycaemic control versus placebo or voglibose with comparable safety in Japanese patients with type 2 diabetes: a randomized, placebo and active comparator-controlled, double-blind study. Diabetes Obes Metab 2012; 14:348-57. [PMID: 22145698 DOI: 10.1111/j.1463-1326.2011.01545.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIMS To evaluate the efficacy and safety of linagliptin 5 and 10 mg vs. placebo and voglibose in Japanese patients with type 2 diabetes mellitus (T2DM). METHODS This study enrolled patients with inadequately controlled T2DM who were previously treated with one or two oral antidiabetics or were drug naÏve. After a 2 to 4-week washout and placebo run-in, 561 patients were randomized (2 : 2 : 2 : 1) to double-blind treatment with linagliptin 5 or 10 mg qd, voglibose 0.2 mg tid or placebo. The primary endpoint was the change from baseline in haemoglobin A1c (HbA1c) with linagliptin vs. placebo after 12 weeks and vs. voglibose after 26 weeks. RESULTS Baseline characteristics were well balanced across treatment groups (overall mean HbA1c was 8.01%). The adjusted mean (95% confidence interval) treatment differences at week 12 were -0.87% (-1.04, -0.70; p < 0.0001) and -0.88% (-1.05, -0.71; p < 0.0001) for linagliptin 5 and 10 mg vs. placebo and at week 26 were -0.32% (-0.49, -0.15; p = 0.0003) and -0.39% (-0.56, -0.21; p < 0.0001) for linagliptin 5 and 10 mg vs. voglibose. At week 12, mean HbA1c was 7.58, 7.48 and 8.34% in patients receiving linagliptin 5 mg, linagliptin 10 mg and placebo, respectively. At week 26, mean HbA1c was 7.63% with linagliptin 5 mg, 7.50% with linagliptin 10 mg and 7.91% with voglibose. Drug-related adverse event rates were comparable across treatment groups over 12 weeks (9.4% linagliptin 5 mg, 8.8% linagliptin 10 mg and 10.0% placebo) and 26 weeks (11.3% linagliptin 5 mg, 10.6% linagliptin 10 mg and 18.5% voglibose). There were no documented cases of hypoglycaemia. CONCLUSIONS Linagliptin showed superior glucose-lowering efficacy and comparable safety and tolerability to both placebo and voglibose in Japanese patients with T2DM.
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Affiliation(s)
- R Kawamori
- Sportology Centre, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Abstract
BACKGROUND The number of food allergy patients is increasing. Some children outgrow their food allergies through tolerance, whereas others remain susceptible throughout their lives. We aimed to contribute to food allergy therapeutics by understanding induction of oral tolerance in a murine food allergy model. METHODS We modified an existing murine food allergy model by using ovalbumin (OVA) to induce oral tolerance, either by pretreating mice with OVA or by transferring mesenteric lymph node (MLN) cells or T cells derived from mice treated with OVA. RESULTS Pretreatment with OVA prevented food allergy, with complete suppression of OVA-specific immunoglobulin (Ig)E and IgA antibody production and interleukin (IL)-4, IL-10, and IL-9 mRNA expression. The proportion of regulatory T cells (Tregs) in MLN cells and expression of transforming growth factor-β mRNA increased. In the transfer model, anaphylaxis secondary to OVA intake was suppressed by transfer of whole MLN cells and Tregs from OVA-treated mice. However, OVA-specific IgE and IgA expressions were partially attenuated by transfer of antigen-specific and nonspecific Tregs, but not by whole MLN cells from OVA-treated mice. In the Treg transfer model, IL-4 and IL-10 mRNA expression decreased, but IL-9 mRNA expression increased. CONCLUSION We concluded that oral tolerance for food antigens is induced in two ways: (i) by initial exposure to antigen, or inherent tolerance, and (ii) by transfer of Tregs, or acquired tolerance. Because food allergies occur when inherent tolerance is absent, understanding of acquired tolerance is important for the development of therapies for food allergy.
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Affiliation(s)
- H Yamashita
- Laboratory of Pharmacology, Department of Bioactive Molecules, Gifu Pharmaceutical University, Daigakunishi, Japan.
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Hirano Y, Ito Y, Inagaki N, Yamasaki K, Yokota H, Kita K. Effect of Sesame Meal Supplemented in Sudangrass Silage on Fermentation Quality and Feed Intake in Goats. Journal of Applied Animal Research 2011. [DOI: 10.1080/09712119.2005.9706797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Y. Hirano
- a Laboratory of Animal Feeds and Production , University Farm Graduate School of Bioagricultural Sciences Nagoya University , Togo , Aichi , 470-0151 , Japan
| | - Y. Ito
- a Laboratory of Animal Feeds and Production , University Farm Graduate School of Bioagricultural Sciences Nagoya University , Togo , Aichi , 470-0151 , Japan
| | - N. Inagaki
- a Laboratory of Animal Feeds and Production , University Farm Graduate School of Bioagricultural Sciences Nagoya University , Togo , Aichi , 470-0151 , Japan
| | - K. Yamasaki
- a Laboratory of Animal Feeds and Production , University Farm Graduate School of Bioagricultural Sciences Nagoya University , Togo , Aichi , 470-0151 , Japan
| | - H. Yokota
- a Laboratory of Animal Feeds and Production , University Farm Graduate School of Bioagricultural Sciences Nagoya University , Togo , Aichi , 470-0151 , Japan
| | - K. Kita
- a Laboratory of Animal Feeds and Production , University Farm Graduate School of Bioagricultural Sciences Nagoya University , Togo , Aichi , 470-0151 , Japan
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Hirano Y, Hatano T, Takahashi A, Toriyama M, Inagaki N, Hakoshima T. Structural basis of cargo recognition by the myosin-X MyTH4-FERM domain. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311098485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Hyakkoku K, Hamanaka J, Tsuruma K, Shimazawa M, Tanaka H, Uematsu S, Akira S, Inagaki N, Nagai H, Hara H. Toll-like receptor 4 (TLR4), but not TLR3 or TLR9, knock-out mice have neuroprotective effects against focal cerebral ischemia. Neuroscience 2010; 171:258-67. [PMID: 20804821 DOI: 10.1016/j.neuroscience.2010.08.054] [Citation(s) in RCA: 169] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 08/21/2010] [Accepted: 08/24/2010] [Indexed: 10/19/2022]
Abstract
Toll-like receptors (TLRs) are signaling receptors in the innate immune system that is a specific immunologic response to systemic bacterial infection. We investigated whether cerebral ischemia induced by the middle cerebral artery occlusion (MCAO) for 2 h differed in mice that lack a functional TLR3, TLR4, or TLR9 signaling pathway. TLR4, but not TLR3 or TLR9, knock-out (KO) mice had significantly smaller infarct area and volume at 24 h after ischemia-reperfusion (I/R) compared with wild-type mice. In addition, TLR4 KO mice improved in neurological deficits after I/R compared with wild-type mice. Moreover, we investigated the expression of TLR4 in the ischemic brain with immunohistochemistry. The number of TLR4-positive cells gradually increased from 1 h after MCAO to 22 h after I/R. We also examined the localization of TLR4 in the ischemic area. TLR4 was localized with CD11b-positive microglial cells in the ischemic striatum and the number of CD11b-positive microglial cells was smaller in TLR4 KO mice than in wild-type mice. In addition, we investigated the translocation of NF-κB among TLR3, 4, and 9 KO mice after I/R injury using western blotting. NF-κB's p65 subunit was decreased in TLR4 KO mice compared to wild-type mice, but not TLR3 or 9 KO mice. These data suggest that TLR4 knockout, but not TLR3 or TLR9 knockout, may play a neuroprotective role in ischemic brain injury induced by MCAO in mice.
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Affiliation(s)
- K Hyakkoku
- Molecular Pharmacology, Department of Biofunctional Evaluation, Gifu Pharmaceutical University, Gifu 501-1196, Japan
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Fujita Y, Hosokawa M, Fujimoto S, Mukai E, Abudukadier A, Obara A, Ogura M, Nakamura Y, Toyoda K, Nagashima K, Seino Y, Inagaki N. Metformin suppresses hepatic gluconeogenesis and lowers fasting blood glucose levels through reactive nitrogen species in mice. Diabetologia 2010; 53:1472-81. [PMID: 20349346 DOI: 10.1007/s00125-010-1729-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 02/24/2010] [Indexed: 02/08/2023]
Abstract
AIMS/HYPOTHESIS Metformin, the major target of which is liver, is commonly used to treat type 2 diabetes. Although metformin activates AMP-activated protein kinase (AMPK) in hepatocytes, the mechanism of activation is still not well known. To investigate AMPK activation by metformin in liver, we examined the role of reactive nitrogen species (RNS) in suppression of hepatic gluconeogenesis. METHODS To determine RNS, we performed fluorescence examination and immunocytochemical staining in mouse hepatocytes. Since metformin is a mild mitochondrial complex I inhibitor, we compared its effects on suppression of gluconeogenesis, AMPK activation and generation of the RNS peroxynitrite (ONOO(-)) with those of rotenone, a representative complex I inhibitor. To determine whether endogenous nitric oxide production is required for ONOO(-) generation and metformin action, we used mice lacking endothelial nitric oxide synthase (eNOS). RESULTS Metformin and rotenone significantly decreased gluconeogenesis and increased phosphorylation of AMPK in wild-type mouse hepatocytes. However, unlike rotenone, metformin did not increase the AMP/ATP ratio. It did, however, increase ONOO(-) generation, whereas rotenone did not. Exposure of eNOS-deficient hepatocytes to metformin did not suppress gluconeogenesis, activate AMPK or increase ONOO(-) generation. Furthermore, metformin lowered fasting blood glucose levels in wild-type diabetic mice, but not in eNOS-deficient diabetic mice. CONCLUSIONS/INTERPRETATION Activation of AMPK by metformin is dependent on ONOO(-). For metformin action in liver, intra-hepatocellular eNOS is required.
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Affiliation(s)
- Y Fujita
- Department of Diabetes and Clinical Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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Kume N, Fujioka Y, Taniguchi A, Tanaka K, Kagimoto S, Hirata K, Nakamura Y, Yamamoto T, Fujimoto S, Hamamoto Y, Tsuda K, Inagaki N, Seino Y, Koshiyama H. MS41 PITAVASTATIN REDUCES HIGH-SENSITIVITY C-REACTIVE PROTEIN AND IMPROVES LIPID PROFILES IRRESPECTIVELY OF BODY MASS INDICES – SUBANALYSIS OF KISHIMEN MULTI-CENTER PROSPECTIVE STUDY. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70542-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kawasaki Y, Harashima S, Sasaki M, Mukai E, Nakamura Y, Harada N, Toyoda K, Hamasaki A, Yamane S, Yamada C, Yamada Y, Seino Y, Inagaki N. Exendin-4 protects pancreatic beta cells from the cytotoxic effect of rapamycin by inhibiting JNK and p38 phosphorylation. Horm Metab Res 2010; 42:311-7. [PMID: 20213584 DOI: 10.1055/s-0030-1249035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
It has been reported that the immunosuppressant rapamycin decreases the viability of pancreatic beta cells. In contrast, exendin-4, an analogue of glucagon-like peptide-1, has been found to inhibit beta cell death and to increase beta cell mass. We investigated the effects of exendin-4 on the cytotoxic effect of rapamycin in beta cells. Incubation with 10 nM rapamycin induced cell death in 12 h in murine beta cell line MIN6 cells and Wistar rat islets, but not when coincubated with 10 nM exendin-4. Rapamycin was found to increase phosphorylation of c-Jun amino-terminal kinase (JNK) and p38 in 30 minutes in MIN6 cells and Wistar rat islets while exendin-4 decreased their phosphorylation. Akt and extracellular signal-regulated kinase (ERK) were not involved in the cytoprotective effect of exendin-4. These results indicate that exendin-4 may exert its protective effect against rapamycin-induced cell death in pancreatic beta cells by inhibiting JNK and p38 signaling.
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Affiliation(s)
- Y Kawasaki
- Department of Diabetes and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Iwai A, Hamada Y, Takada K, Inagaki N, Nakatake R, Yanai H, Miki H, Araki Y, Sato M, Ono S, Iwai N, Kwon AH. Choledochal cyst associated with duodenal atresia: case report and review of the literature. Pediatr Surg Int 2009; 25:995-8. [PMID: 19693517 DOI: 10.1007/s00383-009-2462-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We report a rare case of choledochal cyst (CC) associated with congenital duodenal atresia (DA) and annular pancreas (AP). A girl was born at 37 weeks of gestation weighing 2,974 g with a prenatal diagnosis of DA. She underwent a duodenoduodenostomy for type III DA with an AP 1 day after birth. At 4 years of age, she was admitted for evaluation of cholangitis and pancreatitis. Radiological studies demonstrated a fusiform-type CC with pancreaticobiliary maljunction (PBMJ). Excision of the CC and hepaticojejunostomy were performed. The patient was discharged without complications. Despite the fact that CC, DA, and AP are embryologically closely related entities, to the best of our knowledge, only eight such cases have been documented. We must be aware of the possible combination of CC in the follow-up of the patients with DA associated with AP.
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Affiliation(s)
- A Iwai
- Division of Pediatric Surgery, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, Japan
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Kuwabara A, Tanaka K, Tsugawa N, Nakase H, Tsuji H, Shide K, Kamao M, Chiba T, Inagaki N, Okano T, Kido S. High prevalence of vitamin K and D deficiency and decreased BMD in inflammatory bowel disease. Osteoporos Int 2009; 20:935-42. [PMID: 18825300 DOI: 10.1007/s00198-008-0764-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2007] [Accepted: 09/03/2008] [Indexed: 12/19/2022]
Abstract
SUMMARY Vitamin K and D deficiency and decreased bone mineral density (BMD) were highly prevalent in patients with inflammatory bowel disease (IBD), especially Crohn's disease (CD). Dietary intakes of these vitamins, however, were above the Japanese adequate intakes in IBD patients, suggesting that malabsorption is the basis for hypovitaminosis K and D and decreased BMD. INTRODUCTION We have studied the possible involvement of vitamin K and D deficiency in the pathogenesis of decreased BMD in IBD. METHODS Seventy patients with IBD were evaluated for their BMD; plasma levels of vitamin K; phylloquinone (PK), menaquinone-7 (MK-7), and 25OH-D; serum PTH, protein induced by vitamin K absence (PIVKA-II), and undercarboxylated osteocalcin (ucOC) levels; and their food intake. RESULTS Compared with ulcerative colitis (UC) patients, CD patients had significantly lower plasma vitamin K and 25OH-D concentrations; significantly higher serum levels of PTH, PIVKA-II, and ucOC; and significantly lower BMD scores at almost all measurement sites. More IBD patients were vitamin K deficient in bone than in liver. Multiple regression analyses revealed that low plasma concentrations of vitamin K and 25OH-D were independent risk factors for low BMD and that they were associated with the patients' fat intake, but not with their intake of these vitamins. CONCLUSION IBD patients have high prevalence of decreased BMD and vitamin K and D deficiency probably caused by malabsorption of these vitamins.
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Affiliation(s)
- A Kuwabara
- Department of Food and Nutrition, Kyoto Women's University, 35, Imakumano-kitahiyoshicho, Higashiyama, Kyoto 605-8501, Japan
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Nishimura T, Ohyama K, Goto E, Inagaki N, Morota T. ULTRAVIOLET-B RADIATION SUPPRESSED THE GROWTH AND ANTHOCYANIN PRODUCTION OF PERILLA PLANTS GROWN UNDER CONTROLLED ENVIRONMENTS WITH ARTIFICIAL LIGHT. ACTA ACUST UNITED AC 2008. [DOI: 10.17660/actahortic.2008.797.61] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kominato R, Fujimoto S, Mukai E, Nakamura Y, Nabe K, Shimodahira M, Nishi Y, Funakoshi S, Seino Y, Inagaki N. Src activation generates reactive oxygen species and impairs metabolism-secretion coupling in diabetic Goto-Kakizaki and ouabain-treated rat pancreatic islets. Diabetologia 2008; 51:1226-35. [PMID: 18449527 DOI: 10.1007/s00125-008-1008-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Accepted: 03/16/2008] [Indexed: 11/29/2022]
Abstract
AIMS/HYPOTHESIS Na(+)/K(+)-ATPase inhibition by ouabain suppresses ATP production by generating reactive oxygen species (ROS) and impairs glucose-induced insulin secretion from pancreatic islets. To clarify the signal-transducing function of Na(+)/K(+)-ATPase in decreasing ATP production by the generation of ROS in pancreatic islets, the involvement of Src was examined. In addition, the significance of Src activation in diabetic islets was examined. METHODS Isolated islets from Wistar rats and diabetic Goto-Kakizaki (GK) rats (a model for diabetes) were used. ROS was measured by 5-(and 6)-chloromethyl-2',7'-dichlorofluorescein fluorescence using dispersed islet cells. After lysates were immunoprecipitated by anti-Src antibody, immunoblotting was performed. RESULTS Ouabain caused a rapid Tyr(418) phosphorylation, indicating activation of Src in the presence of high glucose. The specific Src inhibitor 4-amino-5-(4-chlorophenyl)-7-(t-butyl)pyrazolo[3,4-d]pyrimidine (PP2) restored the ouabain-induced decrease in ATP content and the increase in ROS production. Both PP2 and ROS scavenger restored the impaired insulin release and impaired ATP elevation in GK islets, but had no such effect in control islets. PP2 reduced the high glucose-induced increase in ROS generation in GK islet cells but had no effect on that in control islet cells. Moreover, ouabain had no effect on ATP content and ROS production in the presence of high glucose in GK islets. CONCLUSIONS/INTERPRETATION These results indicate that Src plays a role in the signal-transducing function of Na(+)/K(+)-ATPase, in which ROS generation decreases ATP production in control islets. Moreover, ROS generated by Src activation plays an important role in impaired glucose-induced insulin secretion in GK islets, in which Src is endogenously activated independently of ouabain.
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Affiliation(s)
- R Kominato
- Department of Diabetes and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, 606-8507, Japan
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Chapuy B, Koch R, Radunski U, Corsham S, Cheong N, Inagaki N, Ban N, Wenzel D, Reinhardt D, Zapf A, Schweyer S, Kosari F, Klapper W, Truemper L, Wulf GG. Intracellular ABC transporter A3 confers multidrug resistance in leukemia cells by lysosomal drug sequestration. Leukemia 2008; 22:1576-86. [PMID: 18463677 DOI: 10.1038/leu.2008.103] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Multidrug resistance (MDR) seriously limits the efficacy of chemotherapy in patients with cancer and leukemia. Active transport across membranes is essential for such cellular drug resistance, largely provided by ATP-binding cassette (ABC) transport proteins. Intracellular drug sequestration contributes to MDR; however, a genuine intracellular ABC transport protein with MDR function has not yet been identified. Analyzing the intrinsic drug efflux capacity of leukemic stem cells, we found the ABC transporter A3 (ABCA3) to be expressed consistently in acute myeloid leukemia (AML) samples. Greater expression of ABCA3 is associated with unfavorable treatment outcome, and in vitro, elevated expression induces resistance toward a broad spectrum of cytostatic agents. ABCA3 remains localized within the limiting membranes of lysosomes and multivesicular bodies, in which cytostatics are efficiently sequestered. In addition to AML, we also detected ABCA3 in a panel of lymphohematopoietic tissues and transformed cell lines. In conclusion, we identified subcellular drug sequestration mediated by the genuinely intracellular ABCA3 as being a clinically relevant mechanism of intrinsic MDR.
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Affiliation(s)
- B Chapuy
- Department of Hematology and Oncology, Georg-August-University Goettingen, Goettingen, Germany
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Kitatani N, Taniguchi A, Fukushima M, Nakai Y, Nagasaka S, Ohgushi M, Ohya M, Kuroe A, Inagaki N, Seino Y. Association of serum resistin with TNF system activity in Japanese type 2 diabetic patients. Diabetes Metab 2007; 33:156-7. [PMID: 17392006 DOI: 10.1016/j.diabet.2006.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Accepted: 10/30/2006] [Indexed: 11/25/2022]
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Affiliation(s)
- N. Inagaki
- a Laboratory of Polymer Chemistry Faculty of Engineering , Shizuoka University , 3-5-1 Johoku, Hamamatsu , 432 , Japan
| | - K. Katsuura
- a Laboratory of Polymer Chemistry Faculty of Engineering , Shizuoka University , 3-5-1 Johoku, Hamamatsu , 432 , Japan
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Nabeya D, Taniguchi A, Fukushima M, Nakai Y, Matsumoto K, Kuroe A, Ohgushi M, Ohya M, Nagasaka S, Inagaki N, Seino Y. Soluble vascular cell adhesion molecule-1 is independently associated with soluble tumor necrosis factor receptor 2 in Japanese type 2 diabetic patients. Diabetes Metab 2007; 33:81-2. [PMID: 17258924 DOI: 10.1016/j.diabet.2006.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Accepted: 10/26/2006] [Indexed: 11/30/2022]
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Inagaki N, Cech V, Narushima K, Takechi Y. Oxygen and water vapor gas barrier poly(ethylene naphthalate) films by deposition of SiOx plasma polymers from mixture of tetramethoxysilane and oxygen. J Appl Polym Sci 2007. [DOI: 10.1002/app.25802] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Yoneda K, Demitsu T, Kon A, Sadahira C, Moriue T, Katsuura J, Matsuoka Y, Takai I, Noda M, Inagaki N, Kubota Y. Ubiquitination of molluscum body and its implications for pathophysiology. Br J Dermatol 2006; 154:786-9. [PMID: 16536836 DOI: 10.1111/j.1365-2133.2006.07147.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Li CL, Tu CY, Inagaki N, Lee KR, Lai JY. Plasma-induced solid-state polymerization modified poly(tetrafluoroethylene) membrane for pervaporation separation of aqueous alcohol mixtures. J Appl Polym Sci 2006. [DOI: 10.1002/app.24384] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kawasaki Y, Taniguchi A, Fukushima M, Nakai Y, Kuroe A, Ohya M, Nagasaka S, Yamada Y, Inagaki N, Seino Y. Soluble TNF receptors and albuminuria in non-obese Japanese type 2 diabetic patients. Horm Metab Res 2005; 37:617-21. [PMID: 16278784 DOI: 10.1055/s-2005-870536] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this study was to investigate the relationships between albuminuria and tumor necrosis factor (TNF)-alpha or soluble TNF receptors (sTNF-R1, sTNF-R2) in eighty-eight non-obese Japanese type 2 diabetic patients stratified into two groups according to albuminuria status-microalbuminuria or normoalbuminuria. Patients with microalbuminuria were older and had significantly higher concentrations of sTNF-R1 and sTNF-R2 than those with normoalbuminuria. There was, however, no significant difference in sex, diabetes duration, smoking, BMI, systolic and diastolic blood pressure, HbA (1c), serum creatinine, and lipid profile between the two groups. Although serum TNF-alpha was positively correlated to serum sTNF-R1 and sTNF-R2, serum TNF-alpha level did not differ with respect to albuminuria. Univariate regression analysis showed that urinary albumin concentration was positively correlated to age (r=0.380, p<0.001), serum creatinine (r=0.214, p<0.05) and concentrations of sTNF-R1 (r=0.364, p<0.001) and sTNF-R2 (r=0.342, p<0.005). Other variables, including TNF-alpha, were not associated with albuminuria. Multiple regression analyses showed that urinary albumin concentration was independently predicted by the level of sTNF-R1 (F=32.1), which explained 26.3% of the variability of urinary albumin concentration. From these results, it can be concluded that serum soluble TNF receptor is an important independent factor associated with albuminuria in non-obese Japanese type 2 diabetic patients.
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Affiliation(s)
- Y Kawasaki
- Department of Metabolism and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, and Division of Diabetes and Clinical Nutrition, Kansai-Denryoku Hospital, Osaka, Japan
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Inagaki N, Ishikawa M, Takeda M, Abe M, Imai K, Kadoyama T, Kurokawa J, Soga Y, Nakagawa T, Suzuki T. Case with bromine exposure leading to respiratory insufficiency. Chudoku Kenkyu 2005; 18:141-7. [PMID: 16045175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A 21-year-old male had a chemical burn on the right forearm when he inadvertently spilled bromine during an experiment. Since he inhaled vaporized bromine and had dyspnea and pharyngalgia, he arrived at our hospital in an ambulance as an emergency patient. On arrival, he kept a clear consciousness with a pulse rate of 98, body temperature of 36.8 degrees C, blood pressure of 132/80 mmHg, respiratory rate of 25, and oxygen saturation of 100%. (10 L/min of oxygen were administered.) He had marked dry coughs. His clothes had a foreign odor with mucosal irritation. Arterial blood gas analysis and blood biochemistry were normal. Based on these findings, he was diagnosed with chemical airway damage and bulbar conjunctiva from the exposure to bromine and a chemical burn on the right forearm. His respiratory condition became worse after admission, resulting in pulmonary edema. He was endotracheally intubated and controlled with an artificial ventilator on Day 3 after his injury. He was continuously treated with steroids and sivelestat sodium hydrate, which gradually improved his respiration. He was released from the artificial ventilator and extubated on Day 7. Although dyspnea associated with body movement and hoarseness persisted after extubation, the symptoms decreased and he was discharged on Day 41. This rare case is worth attention because serious respiratory insufficiency requiring artificial ventilation due to pulmonary edema from bromine exposure has not been reported in Japan.
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Affiliation(s)
- Nobuhiro Inagaki
- Department of Emergency Medicine, Tokyo Women's Medical University
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Iwahashi K, Kuji N, Fujiwara T, Tanaka H, Takahashi J, Inagaki N, Komatsu S, Yamamoto A, Yoshimura Y, Akagawa K. Expression of the exocytotic protein syntaxin in mouse oocytes. Reproduction 2003; 126:73-81. [PMID: 12814349 DOI: 10.1530/rep.0.1260073] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Syntaxin is an integral membrane protein that is involved in membrane fusion. The exocytosis of the contents of cortical granules, secretory vesicles located in the cortex of an egg, modify the extracellular environment to block additional spermatozoa from penetrating the newly fertilized egg. The aim of this study was to characterize syntaxin expression in mouse oocytes, and to determine the specific isoform that is expressed. Syntaxin was demonstrated in the mouse ovary and in mouse oocytes by both western blot and reverse transcription-polymerase chain reaction analyses. Syntaxin 4 was specifically expressed in metaphase II oocytes. Syntaxin was also immunolocalized within metaphase II oocytes and one-cell embryos with pronuclei using laser scanning confocal microscopy. In metaphase II oocytes, syntaxin was located on the plasma membrane and in the cortex, where cortical granules are present, but was not seen at sites free of cortical granules. In one-cell embryos, no cytoplasmic region was free of syntaxin immunoreactivity. Immunoelectron microscopy detected syntaxin on both the plasma membrane and the vesicle membranes in mouse metaphase II oocytes. In conclusion the results indicate that syntaxin 4 co-localizes with cortical granules and participates in membrane fusion and exocytosis during the cortical reaction.
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Affiliation(s)
- K Iwahashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
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