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Howard JF, Vu T, Mantegazza R, Kushlaf H, Suzuki S, Wiendl H, Beasley KN, Liao S, Meisel A. Efficacy of ravulizumab in patients with generalized myasthenia gravis by time from diagnosis: A post hoc subgroup analysis of the CHAMPION MG study. Muscle Nerve 2024; 69:556-565. [PMID: 38380691 DOI: 10.1002/mus.28044] [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: 04/14/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION/AIMS The CHAMPION MG study demonstrated that ravulizumab significantly improved Myasthenia Gravis-Activities of Daily Living (MG-ADL) and Quantitative Myasthenia Gravis (QMG) total scores versus placebo in adults with acetylcholine receptor antibody-positive generalized myasthenia gravis (AChR+ gMG). This post hoc analysis aimed to assess these outcomes by time from MG diagnosis. METHODS Changes from baseline to week 26 in MG-ADL and QMG total scores were analyzed by time from MG diagnosis to study entry (≤2 vs. >2 years). Within each subgroup, least-squares (LS) mean changes for ravulizumab and placebo were compared using mixed models for repeated measures. RESULTS In ravulizumab-treated patients, differences in LS mean (standard error of the mean) changes from baseline to week 26 were not statistically significant in the ≤2-years subgroup versus the >2-years subgroup for MG-ADL (-4.3 [0.70] vs. -2.9 [0.37]; p = .0511) or QMG (-4.3 [0.94] vs. -2.5 [0.50]; p = .0822) scores. No clear trends were observed in the placebo group. LS mean changes from baseline were significantly greater for ravulizumab versus placebo in both the ≤2 and >2 years from diagnosis subgroups for MG-ADL and QMG scores (all p < .05). The difference in treatment effect between the ≤2-years and >2-years subgroups was not statistically significant. No clinically meaningful between-subgroup differences in treatment-emergent adverse events were observed in ravulizumab-treated patients. DISCUSSION Ravulizumab treatment improved clinical outcomes for patients with AChR+ gMG regardless of time from diagnosis. A numerical trend was observed favoring greater treatment effect with earlier versus later treatment after diagnosis. Further studies are required for confirmation.
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Affiliation(s)
- James F Howard
- The University of North Carolina, Chapel Hill, North Carolina, USA
| | - Tuan Vu
- University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | | | | | | | | | | | - Serena Liao
- Alexion, AstraZeneca Rare Disease, Boston, Massachusetts, USA
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Uzawa A, Suzuki S, Kuwabara S, Akamine H, Onishi Y, Yasuda M, Ozawa Y, Kawaguchi N, Kubota T, Takahashi MP, Suzuki Y, Watanabe G, Kimura T, Sugimoto T, Samukawa M, Minami N, Masuda M, Konno S, Nagane Y, Utsugisawa K. Taste disorders and alopecia in myasthenia gravis. BMC Neurol 2024; 24:139. [PMID: 38664714 PMCID: PMC11044552 DOI: 10.1186/s12883-024-03644-w] [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: 12/30/2023] [Accepted: 04/18/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Non-motor symptoms in myasthenia gravis (MG) are rarely confirmed. Although there are some small cohort studies, a large-systemic survey has not yet been performed. METHODS We investigated the incidence and clinical characteristics of patients with MG who had taste disorders and alopecia using data of 1710 patients with MG enrolled in the Japan MG Registry 2021. RESULTS Among them, 104 (6.1%) out of 1692 patients and 138 (8.2%) out of 1688 patients had histories of taste disorders and alopecia, respectively. Among the patients with MG, taste disorders were significantly more common in women, those with severe symptoms, refractory MG, or thymoma-associated MG, and were less common in those with ocular MG. The taste disorders often occurred after the onset of MG and often responded to MG treatments. Alopecia was more common in MG patients with a history of bulbar palsy and thymoma, and it often occurred before the onset of MG and sometimes responded to MG treatments. Multivariate logistic regression analysis revealed taste disturbance was associated with worst quantitative MG score and thymoma-associated MG; and alopecia was associated with thymoma-associated MG. CONCLUSION Clinicians should be aware of the non-motor symptoms in MG, especially in patients with severe myasthenic symptoms and thymoma-associated MG.
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Affiliation(s)
- Akiyuki Uzawa
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Hiroyuki Akamine
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Yosuke Onishi
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Manato Yasuda
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Yukiko Ozawa
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Naoki Kawaguchi
- Department of Neurology, Neurology Chiba Clinic, Chiba, Japan
| | - Tomoya Kubota
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masanori P Takahashi
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Suzuki
- Department of Neurology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Genya Watanabe
- Department of Neurology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Takashi Kimura
- Department of Neurology, Hyogo Medical University, Nishinomiya, Japan
| | - Takamichi Sugimoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
| | - Makoto Samukawa
- Department of Neurology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Naoya Minami
- Department of Neurology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Masayuki Masuda
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Shingo Konno
- Department of Neurology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Yuriko Nagane
- Department of Neurology, Hanamaki General Hospital, Hanamaki, Japan
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Oyama M, Holzer MT, Ohnuki Y, Saito Y, Nishimori Y, Suzuki S, Shiina T, Leonard-Louis S, Benveniste O, Schneider U, Stenzel W, Nishino I, Suzuki S, Uruha A. Pathologic Features of Anti-Ku Myositis. Neurology 2024; 102:e209268. [PMID: 38547417 DOI: 10.1212/wnl.0000000000209268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/16/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE Characteristics of myositis with anti-Ku antibodies are poorly understood. The purpose of this study was to elucidate the pathologic features of myositis associated with anti-Ku antibodies, compared with immune-mediated necrotizing myopathy (IMNM) with anti-signal recognition particle (SRP) and anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibodies, in muscle biopsy-oriented registration cohorts in Japan and Germany. METHODS We performed a retrospective pathology review of patients with anti-Ku myositis samples diagnosed in the Japanese and German cohorts. We evaluated histologic features and performed HLA phenotyping. RESULTS Fifty biopsied muscle samples in the Japanese cohort and 10 in the German cohort were obtained. After exclusion of myositis-specific autoantibodies or other autoimmune connective tissue diseases, 26 samples (43%) of anti-Ku antibody-positive myositis were analyzed. All the samples shared some common features with IMNM, whereas they showed expression of MHC class II and clusters of perivascular inflammatory cells more frequently than the anti-SRP/HMGCR IMNM samples (71% vs 7%/16%; p < 0.005/<0.005; 64% vs 0%/0%; p < 0.005/<0.005). Anti-Ku myositis biopsies could be divided into 2 subgroups based on the extent of necrosis and regeneration. The group with more abundant necrosis and regeneration showed a higher frequency of MHC class II expression and perivascular inflammatory cell clusters. HLA phenotyping in the 44 available patients showed possible associations of HLA-DRB1*03:01, HLA-DRB1*11:01, and HLA-DQB1*03:01 (p = 0.0045, 0.019, and 0.027; odds ratio [OR] 50.2, 4.6, and 2.8; 95% CI 2.6-2942.1, 1.1-14.5, and 1.0-7.0) in the group with less conspicuous necrosis and regeneration. On the contrary, in the group of more abundant necrosis and regeneration, the allele frequencies of HLA-A*24:02, HLA-B*52:01, HLA-C*12:02, and HLA-DRB1*15:02 were lower than those of healthy controls (p = 0.0036, 0.027, 0.016, and 0.026; OR = 0.27, 0, 0, and 0; 95% CI 0.1-0.7, 0-0.8, 0-0.8, and 0-0.8). However, these HLA associations did not remain significant after statistical correction for multiple testing. DISCUSSION While anti-Ku myositis shows necrotizing myopathy features, they can be distinguished from anti-SRP/HMGCR IMNM by their MHC class II expression and clusters of perivascular inflammatory cells. The HLA analyses suggest that anti-Ku myositis may have different subsets associated with myopathologic subgroups.
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Affiliation(s)
- Munenori Oyama
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Marie-Therese Holzer
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Yuko Ohnuki
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Yoshihiko Saito
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Yukako Nishimori
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Shingo Suzuki
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Takashi Shiina
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Sarah Leonard-Louis
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Olivier Benveniste
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Udo Schneider
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Werner Stenzel
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Ichizo Nishino
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Shigeaki Suzuki
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Akinori Uruha
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
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4
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Okuzono Y, Miyakawa S, Itou T, Sagara M, Iwata M, Ishizuchi K, Sekiguchi K, Motegi H, Oyama M, Warude D, Kikukawa Y, Suzuki S. B-cell immune dysregulation with low soluble CD22 levels in refractory seronegative myasthenia gravis. Front Immunol 2024; 15:1382320. [PMID: 38711503 PMCID: PMC11071663 DOI: 10.3389/fimmu.2024.1382320] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/01/2024] [Indexed: 05/08/2024] Open
Abstract
Myasthenia gravis (MG), primarily caused by acetylcholine receptor (AChR) autoantibodies, is a chronic autoimmune disorder causing severe muscle weakness and fatigability. In particular, seronegative MG constitutes 10%-15% of MG cases and presents diagnostic challenges especially in early-onset female patients who often show severe disease and resistance to immunosuppressive therapy. Furthermore, the immunopathology of seronegative MG remains unclear. Thus, in this study, we aimed to elucidate the pathogenic mechanism of seronegative MG using scRNA-seq analysis and plasma proteome analysis; in particular, we investigated the relationship between immune dysregulation status and disease severity in refractory seronegative MG. Employing single-cell RNA-sequencing and plasma proteome analyses, we analyzed peripheral blood samples from 30 women divided into three groups: 10 healthy controls, 10 early-onset AChR-positive MG, and 10 refractory early-onset seronegative MG patients, both before and after intravenous immunoglobulin treatment. The disease severity was evaluated using the MG-Activities of Daily Living (ADL), MG composite (MGC), and revised 15-item MG-Quality of Life (QOL) scales. We observed numerical abnormalities in multiple immune cells, particularly B cells, in patients with refractory seronegative MG, correlating with disease activity. Notably, severe MG cases had fewer regulatory T cells without functional abnormalities. Memory B cells were found to be enriched in peripheral blood cells compared with naïve B cells. Moreover, plasma proteome analysis indicated significantly lower plasma protein levels of soluble CD22, expressed in the lineage of B-cell maturation (including mature B cells and memory B cells), in refractory seronegative MG patients than in healthy donors or patients with AChR-positive MG. Soluble CD22 levels were correlated with disease severity, B-cell frequency, and RNA expression levels of CD22. In summary, this study elucidates the immunopathology of refractory seronegative MG, highlighting immune disorders centered on B cells and diminished soluble CD22 levels. These insights pave the way for novel MG treatment strategies focused on B-cell biology.
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Affiliation(s)
- Yuumi Okuzono
- Oncology Drug Discovery Unit Japan, Research, Takeda Pharmaceutical Company Limited, Kanagawa, Japan
| | - Shuuichi Miyakawa
- Oncology Drug Discovery Unit Japan, Research, Takeda Pharmaceutical Company Limited, Kanagawa, Japan
| | - Tatsuo Itou
- Oncology Drug Discovery Unit Japan, Research, Takeda Pharmaceutical Company Limited, Kanagawa, Japan
| | - Masaki Sagara
- Oncology Drug Discovery Unit Japan, Research, Takeda Pharmaceutical Company Limited, Kanagawa, Japan
| | - Masashi Iwata
- Oncology Drug Discovery Unit Japan, Research, Takeda Pharmaceutical Company Limited, Kanagawa, Japan
| | - Kei Ishizuchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Koji Sekiguchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Haruhiko Motegi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Munenori Oyama
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Dnyaneshwar Warude
- Oncology Drug Discovery Unit Japan, Research, Takeda Pharmaceutical Company Limited, Kanagawa, Japan
| | - Yusuke Kikukawa
- Oncology Drug Discovery Unit Japan, Research, Takeda Pharmaceutical Company Limited, Kanagawa, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
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5
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Okusa S, Takizawa T, Imai S, Oyama M, Ishizuchi K, Nakahara J, Hori S, Suzuki S. Serious Bacterial Infections Associated with Eculizumab: A Pharmacovigilance Study. Intern Med 2024; 63:1061-1066. [PMID: 37690847 DOI: 10.2169/internalmedicine.1893-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Objective Molecular-targeted agents, including eculizumab and rituximab, are considered treatment options for refractory myasthenia gravis (MG), but bacterial infections can occur as serious adverse events when using these agents. The present study elucidated the relative risks of bacterial infections associated with eculizumab and rituximab using a pharmacovigilance database. Methods We analyzed eculizumab- and rituximab-associated adverse events reported between 2007 and 2021 in the US Food and Drug Administration Adverse Event Reporting System (FAERS) and herein report a refractory MG patient who developed streptococcal toxic shock syndrome during eculizumab treatment. Patients We evaluated a 74-year-old Japanese woman with refractory MG who developed severe bacteremia after receiving eculizumab. Results A total of 44,215 and 108,485 adverse events were reported with eculizumab and rituximab, respectively, from among 13,742,321 individual case safety reports in the FAERS database after data cleaning. We found a strong association between eculizumab and Neisseria infections. In contrast, we found only one case of meningococcal meningitis treated with rituximab. Both eculizumab and rituximab were weakly associated with streptococcal infections. Two cases of streptococcal toxic shock syndrome were associated with rituximab. Conclusion Careful monitoring of serious bacterial infections associated with eculizumab treatment is warranted.
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Affiliation(s)
- Shohei Okusa
- Department of Neurology, Keio University School of Medicine, Japan
| | - Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Japan
| | - Shungo Imai
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Japan
| | - Munenori Oyama
- Department of Neurology, Keio University School of Medicine, Japan
| | - Kei Ishizuchi
- Department of Neurology, Keio University School of Medicine, Japan
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Japan
| | - Satoko Hori
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Japan
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6
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Tokuyasu D, Suzuki S, Uzawa A, Nagane Y, Masuda M, Konno S, Kubota T, Samukawa M, Sugimoto T, Ishizuchi K, Oyama M, Yasuda M, Akamine H, Onishi Y, Suzuki Y, Kawaguchi N, Minami N, Kimura T, Takahashi MP, Murai H, Utsugisawa K. Real-world experience with eculizumab and switching to ravulizumab for generalized myasthenia gravis. Ann Clin Transl Neurol 2024. [PMID: 38572524 DOI: 10.1002/acn3.52051] [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: 09/19/2023] [Revised: 03/01/2024] [Accepted: 03/10/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE Eculizumab and ravulizumab are complement protein C5 inhibitors, showing efficacy and tolerability for patients with anti-acetylcholine receptor-positive (AChR+) generalized myasthenia gravis (gMG) in phase 3 clinical trials and subsequent analyses. The purpose of the present study was to evaluate the clinical significance of eculizumab and switching to ravulizumab for refractory AChR+ gMG patients in the real-world experience. METHODS Among the database of Japan MG registry survey 2021, we studied AChR+ gMG patients who received eculizumab. We also evaluated these patients who switched from eculizumab to ravulizumab. Responder was defined as an improvement of at least 3 points in MG-ADL. We performed a questionnaire of preference between eculizumab and ravulizumab. RESULTS Among 1,106 patients with AChR+ gMG, 36 patients (3%) received eculizumab (female 78%, mean age 56.0 years). Eculizumab was preferentially used in severe and refractory MG patients. The duration of eculizumab treatment was 35 months on average. MG-ADL improved from 9.4 ± 4.9 to 5.9 ± 5.1, and 25 (70%) of the 36 gMG patients were responders. Postintervention status was markedly improved after the eculizumab treatment. Of 13 patients who did not continue eculizumab, 6 showed insufficiencies. Early onset MG was most effective. However, 15 patients switching from eculizumab to ravulizumab kept favorable response and tolerability. Questionnaire surveys showed preference for ravulizumab over eculizumab. INTERPRETATION Eculizumab and switching to ravulizumab showed to be effective for refractory AChR+ gMG patients in clinical settings.
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Affiliation(s)
- Daiki Tokuyasu
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Akiyuki Uzawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuriko Nagane
- Department of Neurology, Hanamaki General Hospital, Hanamaki, Japan
| | - Masayuki Masuda
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Shingo Konno
- Department of Neurology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Tomoya Kubota
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Makoto Samukawa
- Department of Neurology, Kindai University Faculty of Medicine, Sayama, Japan
| | - Takamichi Sugimoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
| | - Kei Ishizuchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Munenori Oyama
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Manato Yasuda
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroyuki Akamine
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yosuke Onishi
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasushi Suzuki
- Department of Neurology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Naoki Kawaguchi
- Department of Neurology, Neurology Chiba Clinic, Chiba, Japan
| | - Naoya Minami
- Department of Neurology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Takashi Kimura
- Department of Neurology, Hyogo Medical University, Nishinomiya, Japan
| | - Masanori P Takahashi
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroyuki Murai
- Department of Neurology, International University of Health and Welfare, Narita, Japan
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Suzuki T, Hishida T, Suzuki S, Okubo Y, Masai K, Kaseda K, Asakura K, Emoto K, Asamura H. Clinicopathological predictors of postoperative long-term myasthenic status in resected thymoma with myasthenia gravis. Surg Today 2024:10.1007/s00595-024-02806-0. [PMID: 38416144 DOI: 10.1007/s00595-024-02806-0] [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: 08/24/2023] [Accepted: 11/22/2023] [Indexed: 02/29/2024]
Abstract
PURPOSE Surgical patients with thymoma and myasthenia gravis (MG) must have their MG status and oncological outcomes critically monitored. We aimed to identify clinicopathological predictors of the postoperative MG status. METHODS We conducted a retrospective review of 40 consecutive surgical patients with MG-related thymomas between 2002 and 2020. The quantitative myasthenia gravis score (QMGS) and Myasthenia Gravis Foundation of America post-intervention status (MGFA-PIS) were used to evaluate postoperative MG status. RESULTS All patients underwent extended total thymectomy. The most common WHO type was type B2 (32%), while 65% of patients had type B1-B3 and 35% had type A-AB thymomas. Eleven patients (28%) achieved controlled MG status in MGFA-PIS 6 months after surgery. This controlled status was observed more frequently in type A-AB than in B1-B3 (57% vs. 12%, p = 0.007). In a multivariate analysis, WHO type (A-AB or B1-B3) was an independent predictor of worsening episodes of MG based on the QMGS (Type B1-B3, hazard ratio: 3.23, 95% confidence interval: 1.12-9.25). At the last follow-up, 23 patients (58%) achieved controlled MG status. The 5-year overall survival rate of all patients was 93.7%. CONCLUSION The WHO type of thymoma is an informative predictor of postoperative MG status in patients with MG-related thymoma.
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Affiliation(s)
- Takahiro Suzuki
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Tomoyuki Hishida
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Yu Okubo
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Kyohei Masai
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Kaoru Kaseda
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Keisuke Asakura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Katsura Emoto
- Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
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Suzuki S. [Clinical Features of Myasthenia Gravis as an Immune-related Adverse Event]. Brain Nerve 2024; 76:27-32. [PMID: 38191136 DOI: 10.11477/mf.1416202554] [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: 01/10/2024]
Abstract
Neurological and muscular immune-related adverse events (irAEs) associated with cancer treatment using immune checkpoint inhibitors (ICIs) may show a diverse clinical presentation. Myasthenia gravis (MG) represents a serious irAE associated with the aforementioned therapy. Recent studies have discussed the clinical features of MG that occurs as an irAE (irAE-MG). The incidence of irAE-MG is estimated to be 1%. This complication occurs during the early phase of ICI treatment and rapidly worsens, resulting in severe bulbar muscle involvement and myasthenic crisis and significantly elevated serum creatine kinase levels. MG and myositis, which may occur concomitantly as irAEs are often indistinguishable. Myocarditis is occasionally observed in patients with irAE-MG and can cause severe heart failure and lethal arrhythmias, with a fatal outcome. Kv1.4 antibodies serve as biomarkers of severe irAE-MG and myocarditis. Immunotherapy with corticosteroids is effective for management of irAE-MG and should be initiated promptly. Collaboration between consulting neurologists is necessary for safe management of cancer immunotherapy.
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Yasuda M, Uzawa A, Kuwabara S, Suzuki S, Akamine H, Onishi Y, Ozawa Y, Kawaguchi N, Kubota T, Takahashi MP, Suzuki Y, Watanabe G, Kimura T, Sugimoto T, Samukawa M, Minami N, Masuda M, Konno S, Nagane Y, Utsugisawa K. Clinical features and outcomes of patients with muscle-specific kinase antibody-positive myasthenia gravis in Japan. J Neuroimmunol 2023; 385:578241. [PMID: 37952282 DOI: 10.1016/j.jneuroim.2023.578241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/31/2023] [Accepted: 11/05/2023] [Indexed: 11/14/2023]
Abstract
This study included 51 patients with muscle-specific kinase antibody-positive myasthenia gravis (MuSK-MG) from a Japanese multicenter survey to examine clinical features and outcomes. Median onset age was 37 years and female predominance was observed. All patients developed generalized symptoms and almost all (50/51) patients had bulbar symptoms. About half of the patients met the criteria for refractory MG. The refractory group had a lower age of onset, higher severity scores, and higher maximum daily doses of oral prednisolone compared to the nonrefractory group. The outcomes for MuSK-MG patients in Japan are not favorable, indicating the need for more aggressive treatment.
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Affiliation(s)
- Manato Yasuda
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akiyuki Uzawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Akamine
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yosuke Onishi
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yukiko Ozawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Kawaguchi
- Department of Neurology, Neurology Chiba Clinic, Chiba, Japan
| | - Tomoya Kubota
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masanori P Takahashi
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Suzuki
- Department of Neurology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Genya Watanabe
- Department of Neurology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Takashi Kimura
- Department of Neurology, Hyogo Medical University, Nishinomiya, Japan
| | - Takamichi Sugimoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
| | - Makoto Samukawa
- Department of Neurology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Naoya Minami
- Department of Neurology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Masayuki Masuda
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Shingo Konno
- Department of Neurology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Yuriko Nagane
- Department of Neurology, Hanamaki General Hospital, Hanamaki, Japan
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Abe K, Hayato Y, Hiraide K, Ieki K, Ikeda M, Kameda J, Kanemura Y, Kaneshima R, Kashiwagi Y, Kataoka Y, Miki S, Mine S, Miura M, Moriyama S, Nakano Y, Nakahata M, Nakayama S, Noguchi Y, Okamoto K, Sato K, Sekiya H, Shiba H, Shimizu K, Shiozawa M, Sonoda Y, Suzuki Y, Takeda A, Takemoto Y, Takenaka A, Tanaka H, Watanabe S, Yano T, Han S, Kajita T, Okumura K, Tashiro T, Tomiya T, Wang X, Xia J, Yoshida S, Megias GD, Fernandez P, Labarga L, Ospina N, Zaldivar B, Pointon BW, Kearns E, Raaf JL, Wan L, Wester T, Bian J, Griskevich NJ, Kropp WR, Locke S, Smy MB, Sobel HW, Takhistov V, Yankelevich A, Hill J, Park RG, Bodur B, Scholberg K, Walter CW, Bernard L, Coffani A, Drapier O, El Hedri S, Giampaolo A, Mueller TA, Santos AD, Paganini P, Quilain B, Ishizuka T, Nakamura T, Jang JS, Learned JG, Choi K, Cao S, Anthony LHV, Martin D, Scott M, Sztuc AA, Uchida Y, Berardi V, Catanesi MG, Radicioni E, Calabria NF, Machado LN, De Rosa G, Collazuol G, Iacob F, Lamoureux M, Mattiazzi M, Ludovici L, Gonin M, Pronost G, Fujisawa C, Maekawa Y, Nishimura Y, Friend M, Hasegawa T, Ishida T, Kobayashi T, Jakkapu M, Matsubara T, Nakadaira T, Nakamura K, Oyama Y, Sakashita K, Sekiguchi T, Tsukamoto T, Boschi T, Di Lodovico F, Gao J, Goldsack A, Katori T, Migenda J, Taani M, Zsoldos S, Kotsar Y, Ozaki H, Suzuki AT, Takeuchi Y, Bronner C, Feng J, Kikawa T, Mori M, Nakaya T, Wendell RA, Yasutome K, Jenkins SJ, McCauley N, Mehta P, Tsui KM, Fukuda Y, Itow Y, Menjo H, Ninomiya K, Lagoda J, Lakshmi SM, Mandal M, Mijakowski P, Prabhu YS, Zalipska J, Jia M, Jiang J, Jung CK, Wilking MJ, Yanagisawa C, Harada M, Ishino H, Ito S, Kitagawa H, Koshio Y, Nakanishi F, Sakai S, Barr G, Barrow D, Cook L, Samani S, Wark D, Nova F, Yang JY, Malek M, McElwee JM, Stone O, Thiesse MD, Thompson LF, Okazawa H, Kim SB, Seo JW, Yu I, Ichikawa AK, Nakamura KD, Tairafune S, Nishijima K, Iwamoto K, Nakagiri K, Nakajima Y, Taniuchi N, Yokoyama M, Martens K, de Perio P, Vagins MR, Kuze M, Izumiyama S, Inomoto M, Ishitsuka M, Ito H, Kinoshita T, Matsumoto R, Ommura Y, Shigeta N, Shinoki M, Suganuma T, Yamauchi K, Martin JF, Tanaka HA, Towstego T, Akutsu R, Gousy-Leblanc V, Hartz M, Konaka A, Prouse NW, Chen S, Xu BD, Zhang B, Posiadala-Zezula M, Hadley D, Nicholson M, O'Flaherty M, Richards B, Ali A, Jamieson B, Marti L, Minamino A, Pintaudi G, Sano S, Suzuki S, Wada K. Erratum: Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande [Phys. Rev. Lett. 130, 031802 (2023)]. Phys Rev Lett 2023; 131:159903. [PMID: 37897794 DOI: 10.1103/physrevlett.131.159903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Indexed: 10/30/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.130.031802.
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11
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Scammell BH, Tchio C, Song Y, Nishiyama T, Louie TL, Dashti HS, Nakatochi M, Zee PC, Daghlas I, Momozawa Y, Cai J, Ollila HM, Redline S, Wakai K, Sofer T, Suzuki S, Lane JM, Saxena R. Multi-ancestry genome-wide analysis identifies shared genetic effects and common genetic variants for self-reported sleep duration. Hum Mol Genet 2023; 32:2797-2807. [PMID: 37384397 PMCID: PMC10656946 DOI: 10.1093/hmg/ddad101] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 07/01/2023] Open
Abstract
Both short (≤6 h per night) and long sleep duration (≥9 h per night) are associated with increased risk of chronic diseases. Despite evidence linking habitual sleep duration and risk of disease, the genetic determinants of sleep duration in the general population are poorly understood, especially outside of European (EUR) populations. Here, we report that a polygenic score of 78 European ancestry sleep duration single-nucleotide polymorphisms (SNPs) is associated with sleep duration in an African (n = 7288; P = 0.003), an East Asian (n = 13 618; P = 6 × 10-4) and a South Asian (n = 7485; P = 0.025) genetic ancestry cohort, but not in a Hispanic/Latino cohort (n = 8726; P = 0.71). Furthermore, in a pan-ancestry (N = 483 235) meta-analysis of genome-wide association studies (GWAS) for habitual sleep duration, 73 loci are associated with genome-wide statistical significance. Follow-up of five loci (near HACD2, COG5, PRR12, SH3RF1 and KCNQ5) identified expression-quantitative trait loci for PRR12 and COG5 in brain tissues and pleiotropic associations with cardiovascular and neuropsychiatric traits. Overall, our results suggest that the genetic basis of sleep duration is at least partially shared across diverse ancestry groups.
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Affiliation(s)
- B H Scammell
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02215, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - C Tchio
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02215, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Y Song
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02215, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - T Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medicine, Nagoya 467-8701, Japan
| | - T L Louie
- Department of Biostatistics, University of Washington, Seattle, WA 98105, USA
| | - H S Dashti
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02215, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - M Nakatochi
- Public Health Informatics Unit, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya 467-8701, Japan
| | - P C Zee
- Center for Circadian and Sleep Medicine, Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - I Daghlas
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02215, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
| | - Y Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan
| | - J Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - H M Ollila
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02215, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Institute for Molecular Medicine, HiLIFE, University of Helsinki, Helsinki 00014, Finland
| | - S Redline
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - K Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya 467-8701, Japan
| | - T Sofer
- Department of Biostatistics, University of Washington, Seattle, WA 98105, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - S Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medicine, Nagoya 467-8701, Japan
| | - J M Lane
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02215, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - R Saxena
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02215, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02141, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
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12
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Oyama M, Ohnuki Y, Uruha A, Saito Y, Nishimori Y, Suzuki S, Inoue M, Tanboon J, Okiyama N, Shiina T, Nishino I, Suzuki S. Association Between HLA Alleles and Autoantibodies in Dermatomyositis Defined by Sarcoplasmic Expression of Myxovirus Resistance Protein A. J Rheumatol 2023; 50:1159-1164. [PMID: 37321638 DOI: 10.3899/jrheum.2022-1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The diagnosis in the studies analyzing HLA of dermatomyositis (DM) was based on a combined clinical category of polymyositis/DM. This retrospective study investigated the associations of HLA with 5 DM-specific autoantibodies in Japanese patients diagnosed by muscle pathology. METHODS We diagnosed Japanese patients with DM based on sarcoplasmic expression of myxovirus resistance protein A. These patients underwent investigation for 5 DM-specific autoantibodies and HLA genotyping. RESULTS Of 175 patients (83 males and 92 females; range 1-86 yrs; mean 46 yrs), 173 (98.9%) had 1 of the 5 autoantibodies. Seven alleles-A*02:07, B*46:01, DRB1*04:07, DRB1*07:01, DRB1*08:03, DQB1*06:01, and DPB1*02:02-were more frequently detected in the patients with DM than healthy controls, but these associations were not significant after multiple testing correction. Stratifying by DM-specific autoantibodies, we found the associations of 6 already known and 7 new alleles-B*48:01, B*52:01, C*12:02, DRB1*04:05, DRB1*15:02, DPB1*05:01, and DPB1*09:01-with subsets of DM. Moreover, significant associations of 5 alleles with antinucleosome remodeling deacetylase complex (Mi-2) remained after multiple testing correction. In particular, the DRB1*04:07 (odds ratio [OR 28.9]; corrected P = 2.7 × 10-6) and DQB1*06:01 (OR 4.0; corrected P = 1.6 × 10-4) alleles were significantly more prevalent in patients with anti-Mi-2 antibody than in controls. CONCLUSION This study demonstrates DM-specific autoantibodies defined immunogenetic subsets of DM.
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Affiliation(s)
- Munenori Oyama
- M. Oyama, MD, PhD, Shigeaki Suzuki, MD, PhD, Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Ohnuki
- Y. Ohnuki, MD, PhD, Department of Medical Ethics, Tokai University School of Medicine, and Department of Clinical Genetics, Tokai University Hospital, Kanagawa, Japan
| | - Akinori Uruha
- A. Uruha, MD, PhD, Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Yoshihiko Saito
- Y. Saito, MD, M. Inoue, MD, PhD, I. Nishino, MD, PhD, Department of Neuromuscular Research, National Institute of Neuroscience, and Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Yukako Nishimori
- Y. Nishimori, MD, Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Shingo Suzuki
- Shingo. Suzuki, MD, PhD, T. Shiina, PhD, Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan;
| | - Michio Inoue
- Y. Saito, MD, M. Inoue, MD, PhD, I. Nishino, MD, PhD, Department of Neuromuscular Research, National Institute of Neuroscience, and Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Jantima Tanboon
- J. Tanboon, MD, Department of Neuromuscular Research, National Institute of Neuroscience, and Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan, and Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Naoko Okiyama
- N. Okiyama, MD, PhD, Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takashi Shiina
- Shingo. Suzuki, MD, PhD, T. Shiina, PhD, Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Ichizo Nishino
- Y. Saito, MD, M. Inoue, MD, PhD, I. Nishino, MD, PhD, Department of Neuromuscular Research, National Institute of Neuroscience, and Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Shigeaki Suzuki
- M. Oyama, MD, PhD, Shigeaki Suzuki, MD, PhD, Department of Neurology, Keio University School of Medicine, Tokyo, Japan
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13
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Tezuka T, Okuzumi S, Nakashima C, Ide T, Imai S, Mitsuboshi S, Kuwahara Y, Takizawa T, Seki M, Minematsu N, Aragane N, Nakahara J, Hori S, Nakane S, Suzuki S. Dysautonomia associated with immune checkpoint inhibitors. J Neurol 2023:10.1007/s00415-023-11667-5. [PMID: 36939931 DOI: 10.1007/s00415-023-11667-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/25/2023] [Revised: 02/15/2023] [Accepted: 03/14/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVE The purpose of this study is to report the clinical characteristics of dysautonomia associated with immune checkpoint inhibitors (ICIs). METHODS We reported two patients with autoimmune autonomic ganglionopathy (AAG) occurring as immune-related adverse events (irAEs). We also performed a review of previous case reports presenting dysautonomia during ICI therapy. Moreover, we conducted pharmacovigilance analyses using the US Food and Drug Administration Adverse Events Reporting System (FAERS) to investigate dysautonomia associated with ICI. RESULTS Two patients in our care developed both AAG and autoimmune encephalitis following ICI therapy for lung cancers. We comprehensively reviewed 13 published cases (M:F = 11:2, mean onset age of 53 years) with ICI-associated dysautonomia including AAG (n = 3) and autonomic neuropathy (n = 10). Of these, ICI monotherapy was performed in seven and combination ICI use in six. In 6 of 13 patients, dysautonomia appeared within one month after the start of ICIs. Orthostatic hypotension was observed in 7 and urinary incontinence or retention in five. All patients except three showed gastrointestinal symptoms. Anti-ganglionic acetylcholine receptor antibodies were undetectable. All but two patients received immune-modulating therapy. Immuno-modulating therapy was effective in three patients with AAG and two patients with autonomic neuropathy, but ineffective in the others. Five patients died, of either the neurological irAE (n = 3) or cancer (n = 2). The pharmacovigilance analyses using FAERS showed that ipilimumab monotherapy and the combination of nivolumab and ipilimumab constituted significant risks for developing dysautonomia, consistent with the review of literature. CONCLUSION ICIs can cause dysautonomia including AAG, and autonomic neuropathy is a neurological irAE.
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Affiliation(s)
- Toshiki Tezuka
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Shinichi Okuzumi
- Department of Internal Medicine, Hino Municipal Hospital, Tokyo, Japan
| | - Chiho Nakashima
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Toshihiro Ide
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Shungo Imai
- Division of Drug Informatics, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Satoru Mitsuboshi
- Division of Drug Informatics, Faculty of Pharmacy, Keio University, Tokyo, Japan.,Department of Pharmacy, Kaetsu Hospital, Niigata, Japan
| | - Yuki Kuwahara
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Morinobu Seki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Naoto Minematsu
- Department of Internal Medicine, Hino Municipal Hospital, Tokyo, Japan
| | - Naoko Aragane
- Division of Haematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Satoko Hori
- Division of Drug Informatics, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Shunya Nakane
- Department of Neurology, Nippon Medical University, Tokyo, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
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14
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Lin C, Ahn JK, Choi JM, Farrington MS, Gonzalez M, Grethen N, Hsiung YB, Inagaki T, Kamiji I, Kim EJ, Kim JL, Kim HM, Kawata K, Kitagawa A, Komatsubara TK, Kotera K, Lee SK, Lee JW, Lim GY, Luo Y, Matsumura T, Nakagiri K, Nanjo H, Nomura T, Ono K, Redeker JC, Sato T, Sasse V, Shibata T, Shimizu N, Shinkawa T, Shinohara S, Shiomi K, Shiraishi R, Suzuki S, Tajima Y, Tung YC, Wah YW, Watanabe H, Wu T, Yamanaka T, Yoshida HY. Search for the Pair Production of Dark Particles X with K_{L}^{0}→XX, X→γγ. Phys Rev Lett 2023; 130:111801. [PMID: 37001070 DOI: 10.1103/physrevlett.130.111801] [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: 09/23/2022] [Accepted: 02/08/2023] [Indexed: 06/19/2023]
Abstract
We present the first search for the pair production of dark particles X via K_{L}^{0}→XX with X decaying into two photons using the data collected by the KOTO experiment. No signal was observed in the mass range of 40-110 MeV/c^{2} and 210-240 MeV/c^{2}. This sets upper limits on the branching fractions as B(K_{L}^{0}→XX)<(1-4)×10^{-7} and B(K_{L}^{0}→XX)<(1-2)×10^{-6} at the 90% confidence level for the two mass regions, respectively.
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Affiliation(s)
- C Lin
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - J M Choi
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - M S Farrington
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - M Gonzalez
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - N Grethen
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - T Inagaki
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - I Kamiji
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - E J Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - J L Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - H M Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - K Kawata
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - A Kitagawa
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T K Komatsubara
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - K Kotera
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S K Lee
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - J W Lee
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - G Y Lim
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - Y Luo
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Matsumura
- Department of Applied Physics, National Defense Academy, Kanagawa 239-8686, Japan
| | - K Nakagiri
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Nanjo
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Nomura
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - K Ono
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - J C Redeker
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Sato
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - V Sasse
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Shibata
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - N Shimizu
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Shinkawa
- Department of Applied Physics, National Defense Academy, Kanagawa 239-8686, Japan
| | - S Shinohara
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - K Shiomi
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - R Shiraishi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S Suzuki
- Department of Physics, Saga University, Saga 840-8502, Japan
| | - Y Tajima
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
| | - Y-C Tung
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - Y W Wah
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - H Watanabe
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - T Wu
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - T Yamanaka
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - H Y Yoshida
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
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15
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Tanboon J, Inoue M, Hirakawa S, Tachimori H, Hayashi S, Noguchi S, Okiyama N, Fujimoto M, Suzuki S, Nishino I. Muscle pathology of antisynthetase syndrome according to antibody subtypes. Brain Pathol 2023:e13155. [PMID: 36882048 DOI: 10.1111/bpa.13155] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 08/21/2022] [Accepted: 02/15/2023] [Indexed: 03/09/2023] Open
Abstract
Identification of antisynthetase syndrome (ASS) could be challenging due to inaccessibility and technical difficulty of the serology test for the less common non-Jo-1 antibodies. This study aimed to describe ASS antibody-specific myopathology and evaluate the diagnostic utility of myofiber HLA-DR expression. We reviewed 212 ASS muscle biopsies and compared myopathologic features among subtypes. Additionally, we compared their HLA-DR staining pattern with 602 non-ASS myositis and 140 genetically confirmed myopathies known to have an inflammatory component. We used t-test and Fisher's exact for comparisons and used sensitivity, specificity, positive and negative predictive values to assess the utility of HLA-DR expression for ASS diagnosis. RNAseq performed from a subset of myositis cases and histologically normal muscle biopsies was used to evaluate interferon (IFN)-signaling pathway-related genes. Anti-OJ ASS showed prominent myopathology with higher scores in muscle fiber (4.6 ± 2.0 vs. 2.8 ± 1.8, p = 0.001) and inflammatory domains (6.8 ± 3.2 vs. 4.5 ± 2.9, p = 0.006) than non-OJ ASS. HLA-DR expression and IFN-γ-related genes upregulation were prominent in ASS and inclusion body myositis (IBM). When dermatomyositis and IBM were excluded, HLA-DR expression was 95.4% specific and 61.2% sensitive for ASS with a positive predictive value of 85.9% and a negative predictive value of 84.2%; perifascicular HLA-DR pattern is common in anti-Jo-1 ASS than non-Jo-1 ASS (63.1% vs. 5.1%, p < 0.0001). In the appropriate clinicopathological context, myofiber HLA-DR expression help support ASS diagnosis. The presence of HLA-DR expression suggests involvement of IFN-γ in the pathogenesis of ASS, though the detailed mechanisms have yet to be elucidated.
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Affiliation(s)
- Jantima Tanboon
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan.,Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Michio Inoue
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan.,Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Shinya Hirakawa
- Department of Clinical Data Science, Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Hisateru Tachimori
- Department of Clinical Data Science, Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Shinichiro Hayashi
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan.,Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Satoru Noguchi
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan.,Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | - Naoko Okiyama
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan.,Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan.,Department of Clinical Genome Analysis, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
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16
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Mori S, Suzuki S, Konishi T, Kawaguchi N, Kishi M, Kuwabara S, Ishizuchi K, Zhou H, Shibasaki F, Tsumoto H, Omura T, Miura Y, Mori S, Higashihara M, Murayama S, Shigemoto K. Proteolytic ectodomain shedding of muscle-specific tyrosine kinase in myasthenia gravis. Exp Neurol 2023; 361:114300. [PMID: 36525997 DOI: 10.1016/j.expneurol.2022.114300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/07/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
Autoantibodies to muscle-specific tyrosine kinase (MuSK) proteins at the neuromuscular junction (NMJ) cause refractory generalized myasthenia gravis (MG) with dyspnea more frequently than other MG subtypes. However, the mechanisms via which MuSK, a membrane protein locally expressed on the NMJ of skeletal muscle, is supplied to the immune system as an autoantigen remains unknown. Here, we identified MuSK in both mouse and human serum, with the amount of MuSK dramatically increasing in mice with motor nerve denervation and in MG model mice. Peptide analysis by liquid chromatography-tandem-mass spectrometry (LC-MS/MS) confirmed the presence of MuSK in both human and mouse serum. Furthermore, some patients with MG have significantly higher amounts of MuSK in serum than healthy controls. Our results indicated that the secretion of MuSK proteins from muscles into the bloodstream was induced by ectodomain shedding triggered by neuromuscular junction failure. The results may explain why MuSK-MG is refractory to treatments and causes rapid muscle atrophy in some patients due to the denervation associated with Ab-induced disruption of neuromuscular transmission at the NMJ. Such discoveries pave the way for new MG treatments, and MuSK may be used as a biomarker for other neuromuscular diseases in preclinical studies, clinical diagnostics, therapeutics, and drug discovery.
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Affiliation(s)
- Shuuichi Mori
- Research Team for Geriatric Medicine, Tokyo Metropolitan Institute of Gerontology (TMIG), Tokyo, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | | | - Naoki Kawaguchi
- Dowa Institute of Clinical Neuroscience, Neurology Clinic Chiba, Chiba, Japan
| | - Masahiko Kishi
- Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Chiba University School of Medicine, Chiba, Japan
| | - Kei Ishizuchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Heying Zhou
- Research Team for Geriatric Medicine, Tokyo Metropolitan Institute of Gerontology (TMIG), Tokyo, Japan
| | - Futoshi Shibasaki
- Department of Genome Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hiroki Tsumoto
- Research Team for Mechanism of Aging, TMIG, Tokyo, Japan
| | - Takuya Omura
- Research Team for Geriatric Medicine, Tokyo Metropolitan Institute of Gerontology (TMIG), Tokyo, Japan
| | - Yuri Miura
- Research Team for Mechanism of Aging, TMIG, Tokyo, Japan
| | - Seijiro Mori
- Research Team for Geriatric Medicine, Tokyo Metropolitan Institute of Gerontology (TMIG), Tokyo, Japan
| | - Mana Higashihara
- Department of Neurology, Tokyo Metropolitan Geriatric Hospital, Tokyo (TMGHIG), Japan
| | | | - Kazuhiro Shigemoto
- Research Team for Geriatric Medicine, Tokyo Metropolitan Institute of Gerontology (TMIG), Tokyo, Japan.
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17
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Motegi H, Kirino Y, Morishita R, Nishino I, Suzuki S. Overlap syndrome with antibodies against multiple transfer-RNA components presenting antisynthetase syndrome. Neuromuscul Disord 2023; 33:405-409. [PMID: 37037049 DOI: 10.1016/j.nmd.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/18/2023]
Abstract
Overlap syndrome is a clinical entity of myositis concomitant with one or more collagen diseases such as systemic lupus erythematosus, systemic sclerosis, and/or rheumatoid arthritis. It is not evident whether the myopathology of overlap syndrome is disease-specific or categorizes one of the four major subsets: inclusion body myositis, immune-mediated necrotizing myopathy, dermatomyositis, and antisynthetase syndrome. We report a patient with overlap syndrome who exhibited autoantibodies against multiple transfer-RNA components by RNA immunoprecipitation, suggesting antisynthetase syndrome. A 64-year-old woman developed systemic lupus erythematosus, systemic sclerosis, and myositis. Muscle biopsy showed perifascicular necrosis and perimysial alkaline phosphatase positivity, suggesting antisynthetase syndrome. Enzyme-linked immunosorbent assay was negative for autoantibodies to aminoacyl transfer-RNA synthetase, whereas RNA immunoprecipitation revealed a novel antibody to multiple transfer-RNA components. Although the myopathology of overlap syndrome may be diagnosed as any one of various subsets, this case suggests that the myopathological features of overlap syndrome may include antisynthetase syndrome.
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18
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Uzawa A, Suzuki S, Kuwabara S, Akamine H, Onishi Y, Yasuda M, Ozawa Y, Kawaguchi N, Kubota T, Takahashi MP, Suzuki Y, Watanabe G, Kimura T, Sugimoto T, Samukawa M, Minami N, Masuda M, Konno S, Nagane Y, Utsugisawa K. Impact of Early Treatment with Intravenous High-Dose Methylprednisolone for Ocular Myasthenia Gravis. Neurotherapeutics 2023; 20:518-523. [PMID: 36607596 PMCID: PMC10121971 DOI: 10.1007/s13311-022-01335-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Accepted: 12/07/2022] [Indexed: 01/07/2023] Open
Abstract
The efficacy of intravenous high-dose methylprednisolone (IVMP) in ocular myasthenia gravis (MG) has not been fully established. This study aimed to elucidate the effects of early intervention with IVMP for achieving the therapeutic targets (minimal manifestations [MM] or MM or better status with prednisolone ≤ 5 mg/day [MM5mg]) in ocular MG. In this observational study, we included a total of 1710 consecutive patients with MG enrolled in the Japan MG Registry in 2021. Of these, 204 patients with ocular MG who received immunotherapy were analyzed. The clinical course and time to first achieve MM or MM5mg after starting immunotherapy were compared between the early IVMP group (treated with IVMP within 3 months of treatment initiation) and the non-early IVMP group. Despite having greater clinical severity before immunotherapy and lower oral prednisolone doses throughout the course, the early IVMP group (n = 55) showed a higher rate of achievement of MM (P = 0.0040, log-rank test; hazard ratio 1.58, 95% confidence interval [CI] 1.13-2.20, P < 0.0001) and MM5mg (P = 0.0005, log-rank test; hazard ratio 1.78, 95% CI 1.27-2.51, P < 0.0001) compared with the non-early IVMP group (n = 149). In conclusion, an early intervention with IVMP is likely to increase the probability of achieving a better long-term outcome and reducing the total dose of corticosteroids in ocular MG.
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Affiliation(s)
- Akiyuki Uzawa
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan
| | - Hiroyuki Akamine
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan
| | - Yosuke Onishi
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan
| | - Manato Yasuda
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan
| | - Yukiko Ozawa
- Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan
| | - Naoki Kawaguchi
- Department of Neurology, Neurology Chiba Clinic, Chiba, Japan
| | - Tomoya Kubota
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masanori P Takahashi
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Suzuki
- Department of Neurology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Genya Watanabe
- Department of Neurology, National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - Takashi Kimura
- Department of Neurology, Hyogo Medical University, Nishinomiya, Japan
| | - Takamichi Sugimoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
| | - Makoto Samukawa
- Department of Neurology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Naoya Minami
- Department of Neurology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Masayuki Masuda
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Shingo Konno
- Department of Neurology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Yuriko Nagane
- Department of Neurology, Hanamaki General Hospital, Hanamaki, Japan
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19
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Yokote R, Kuwabara Y, Kasano S, Yonezawa M, Ouchi N, Ichikawa T, Suzuki S, Takeshita T. Risk factors for persistent positive anticardiolipin antibodies in women with recurrent pregnancy loss. J Reprod Immunol 2023; 156:103920. [PMID: 36863074 DOI: 10.1016/j.jri.2023.103920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/06/2023] [Accepted: 02/23/2023] [Indexed: 02/26/2023]
Abstract
Antiphospholipid syndrome (APS) is an established cause of recurrent pregnancy loss (RPL). It is necessary to detect persistently positive antiphospholipid antibodies to diagnose APS. This study aimed to explore risk factors for persistent anticardiolipin (aCL) positivity. Women with a history of RPL or with a history of one or more intrauterine fetal deaths after 10 weeks underwent examinations to determine the causes of RPL, including antiphospholipid antibodies. If aCL-IgG or aCL-IgM antibodies were positive, retests were performed at least 12 weeks apart. Risk factors for persistent aCL antibody positivity were retrospectively investigated. The number and percentage of cases above the 99th percentile were 74/2399 (3.1%) for aCL-IgG, and 81/2399 (3.5%) for aCL-IgM. Of the initially tested cases, 2.3% (56/2399) for aCL-IgG and 2.0% (46/2289) for aCL-IgM were ultimately positive above the 99th percentile in retests. Retest values after 12 weeks were significantly lower than the initial values for both IgG and IgM immunoglobulin classes. Initial aCL antibody titers were significantly higher in the persistent-positive group than in the transient-positive group for both IgG and IgM immunoglobulin classes. The cut-off values for predicting persistent positivity of aCL-IgG antibodies and aCL-IgM antibodies were 15 U/mL (99.1 percentile) and 11 U/mL (99.2 percentile), respectively. The only risk factor for persistently positive aCL antibodies is a high antibody titer during the initial test. When the aCL antibody titer in the initial test exceeds the cut-off value, therapeutic strategies can be defined in subsequent pregnancies without waiting for 12 weeks.
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Affiliation(s)
- R Yokote
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Y Kuwabara
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
| | - S Kasano
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - M Yonezawa
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - N Ouchi
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - T Ichikawa
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - S Suzuki
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - T Takeshita
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
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20
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Imai S, Mitsuboshi S, Hori S, Suzuki S. Increased risk of Lambert-Eaton myasthenic syndrome (LEMS) in small-cell lung cancer patients treated with immune checkpoint inhibitor. Eur J Cancer 2023; 180:1-3. [PMID: 36527972 DOI: 10.1016/j.ejca.2022.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/01/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Shungo Imai
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Satoru Mitsuboshi
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan; Department of Pharmacy, Kaetsu Hospital, Niigata, Japan
| | - Satoko Hori
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
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21
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Tanaka S, Suzuki S, Teshima T, Yamashita R, Hamamoto Y, Hara Y. Regression of venous thrombus after trans-sphenoidal hypophysectomy for pituitary-dependent hyperadrenocorticism in a dog. J Small Anim Pract 2023; 64:111-117. [PMID: 36335913 DOI: 10.1111/jsap.13560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 11/08/2022]
Abstract
An 8.0-kg 8-year-old male dachshund was presented for surgical treatment of suspected pituitary-dependent hyperadrenocorticism with portal vein thrombosis. Advanced diagnostic imaging revealed a thrombus in the splenic and portal veins. For the portal vein thrombus, CT angiography showed an enhanced timing delay in the lateral right and caudate liver lobes. Blood tests showed a marked increase in the liver panel, including total bile acid. Brain MRI revealed a pituitary mass, suggesting pituitary-dependent hyperadrenocorticism. The mass was completely resected. The preoperative antithrombotic therapy of rivaroxaban (0.66 mg/kg, PO, once per day) and clopidogrel sulphate (1.66 mg/kg, PO, once per day) was continued postoperatively. Six months after resection of the pituitary mass, the thrombus had disappeared. Further studies are required to prove a causal association between the disappearance of the thrombus and the treatments provided.
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Affiliation(s)
- S Tanaka
- Laboratory of Veterinary Surgery, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - S Suzuki
- Laboratory of Veterinary Surgery, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - T Teshima
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - R Yamashita
- Veterinary Medical Teaching Hospital, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - Y Hamamoto
- Veterinary Medical Teaching Hospital, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
| | - Y Hara
- Laboratory of Veterinary Surgery, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, 180-8602, Japan
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22
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Uzawa A, Suzuki S, Kuwabara S, Akamine H, Onishi Y, Yasuda M, Ozawa Y, Kawaguchi N, Kubota T, Takahashi MP, Suzuki Y, Watanabe G, Kimura T, Sugimoto T, Samukawa M, Minami N, Masuda M, Konno S, Nagane Y, Utsugisawa K. Effectiveness of early cycles of fast-acting treatment in generalised myasthenia gravis. J Neurol Neurosurg Psychiatry 2023; 94:467-473. [PMID: 36693723 DOI: 10.1136/jnnp-2022-330519] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Early fast-acting treatment (EFT) is the aggressive use of fast-acting therapies such as plasmapheresis, intravenous immunoglobulin and/or intravenous high-dose methylprednisolone (IVMP) from the early phases of treatment. EFT is reportedly beneficial for early achievement of minimal manifestations (MM) or better status with ≤5 mg/day prednisolone (MM5mg), a practical therapeutic target for myasthenia gravis (MG). OBJECTIVE The current study aimed to clarify which specific EFT regimen is efficacious and the patient characteristics that confer sensitivity to EFT. METHODS We recruited a total of 1710 consecutive patients with MG who enrolled in the Japan MG Registry for this large-cohort study. Among them, 1066 with generalised MG who had received immunotherapy were analysed. Prognostic background factors were matched in a 1:1 ratio using propensity score matching analysis between patients treated with EFT (n=350) and those treated without EFT (n=350). The clinical course and time to first achieve MM5mg after starting immunotherapy was analysed in relation to treatment combinations and patient characteristics. RESULTS Kaplan-Meier analyses showed that EFT had a significant effect on the achievement of MM5mg (p<0.0001, log-rank test; HR 1.82, p<0.0001). Notably, EFT was efficacious for any type of MG, and the inclusion of IVMP resulted in earlier and more frequent achievement of MM5mg (p=0.0352, log-rank test; HR 1.46, p=0.0380). In addition, early administration of calcineurin inhibitors also promoted MM5mg achievement. CONCLUSION Early cycles of intervention with EFT and early use of calcineurin inhibitors provides long-term benefits in terms of achieving therapeutic targets for generalised MG, regardless of clinical subtype.
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Affiliation(s)
- Akiyuki Uzawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroyuki Akamine
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yosuke Onishi
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Manato Yasuda
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yukiko Ozawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Kawaguchi
- Department of Neurology, Neurology Chiba Clinic, Chiba, Japan
| | - Tomoya Kubota
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Masanori P Takahashi
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yasushi Suzuki
- Department of Neurology, National Hospital Organisation Sendai Medical Center, Sendai, Miyagi, Japan
| | - Genya Watanabe
- Department of Neurology, National Hospital Organisation Sendai Medical Center, Sendai, Miyagi, Japan
| | - Takashi Kimura
- Department of Neurology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Takamichi Sugimoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
| | - Makoto Samukawa
- Department of Neurology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Naoya Minami
- Department of Neurology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Masayuki Masuda
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Shingo Konno
- Department of Neurology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Yuriko Nagane
- Department of Neurology, Hanamaki General Hospital, Hanamaki, Japan
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23
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Abe K, Hayato Y, Hiraide K, Ieki K, Ikeda M, Kameda J, Kanemura Y, Kaneshima R, Kashiwagi Y, Kataoka Y, Miki S, Mine S, Miura M, Moriyama S, Nakano Y, Nakahata M, Nakayama S, Noguchi Y, Okamoto K, Sato K, Sekiya H, Shiba H, Shimizu K, Shiozawa M, Sonoda Y, Suzuki Y, Takeda A, Takemoto Y, Takenaka A, Tanaka H, Watanabe S, Yano T, Han S, Kajita T, Okumura K, Tashiro T, Tomiya T, Wang X, Xia J, Yoshida S, Megias GD, Fernandez P, Labarga L, Ospina N, Zaldivar B, Pointon BW, Kearns E, Raaf JL, Wan L, Wester T, Bian J, Griskevich NJ, Kropp WR, Locke S, Smy MB, Sobel HW, Takhistov V, Yankelevich A, Hill J, Park RG, Bodur B, Scholberg K, Walter CW, Bernard L, Coffani A, Drapier O, El Hedri S, Giampaolo A, Mueller TA, Santos AD, Paganini P, Quilain B, Ishizuka T, Nakamura T, Jang JS, Learned JG, Choi K, Cao S, Anthony LHV, Martin D, Scott M, Sztuc AA, Uchida Y, Berardi V, Catanesi MG, Radicioni E, Calabria NF, Machado LN, De Rosa G, Collazuol G, Iacob F, Lamoureux M, Mattiazzi M, Ludovici L, Gonin M, Pronost G, Fujisawa C, Maekawa Y, Nishimura Y, Friend M, Hasegawa T, Ishida T, Kobayashi T, Jakkapu M, Matsubara T, Nakadaira T, Nakamura K, Oyama Y, Sakashita K, Sekiguchi T, Tsukamoto T, Boschi T, Di Lodovico F, Gao J, Goldsack A, Katori T, Migenda J, Taani M, Zsoldos S, Kotsar Y, Ozaki H, Suzuki AT, Takeuchi Y, Bronner C, Feng J, Kikawa T, Mori M, Nakaya T, Wendell RA, Yasutome K, Jenkins SJ, McCauley N, Mehta P, Tsui KM, Fukuda Y, Itow Y, Menjo H, Ninomiya K, Lagoda J, Lakshmi SM, Mandal M, Mijakowski P, Prabhu YS, Zalipska J, Jia M, Jiang J, Jung CK, Wilking MJ, Yanagisawa C, Harada M, Ishino H, Ito S, Kitagawa H, Koshio Y, Nakanishi F, Sakai S, Barr G, Barrow D, Cook L, Samani S, Wark D, Nova F, Yang JY, Malek M, McElwee JM, Stone O, Thiesse MD, Thompson LF, Okazawa H, Kim SB, Seo JW, Yu I, Ichikawa AK, Nakamura KD, Tairafune S, Nishijima K, Iwamoto K, Nakagiri K, Nakajima Y, Taniuchi N, Yokoyama M, Martens K, de Perio P, Vagins MR, Kuze M, Izumiyama S, Inomoto M, Ishitsuka M, Ito H, Kinoshita T, Matsumoto R, Ommura Y, Shigeta N, Shinoki M, Suganuma T, Yamauchi K, Martin JF, Tanaka HA, Towstego T, Akutsu R, Gousy-Leblanc V, Hartz M, Konaka A, Prouse NW, Chen S, Xu BD, Zhang B, Posiadala-Zezula M, Hadley D, Nicholson M, O'Flaherty M, Richards B, Ali A, Jamieson B, Marti L, Minamino A, Pintaudi G, Sano S, Suzuki S, Wada K. Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande. Phys Rev Lett 2023; 130:031802. [PMID: 36763398 DOI: 10.1103/physrevlett.130.031802] [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] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/30/2022] [Indexed: 06/18/2023]
Abstract
We report a search for cosmic-ray boosted dark matter with protons using the 0.37 megaton×years data collected at Super-Kamiokande experiment during the 1996-2018 period (SKI-IV phase). We searched for an excess of proton recoils above the atmospheric neutrino background from the vicinity of the Galactic Center. No such excess is observed, and limits are calculated for two reference models of dark matter with either a constant interaction cross section or through a scalar mediator. This is the first experimental search for boosted dark matter with hadrons using directional information. The results present the most stringent limits on cosmic-ray boosted dark matter and exclude the dark matter-nucleon elastic scattering cross section between 10^{-33}cm^{2} and 10^{-27}cm^{2} for dark matter mass from 1 MeV/c^{2} to 300 MeV/c^{2}.
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Affiliation(s)
- K Abe
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Hayato
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Hiraide
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Ieki
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Ikeda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - J Kameda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Kanemura
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - R Kaneshima
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - Y Kashiwagi
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - Y Kataoka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Miki
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - S Mine
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - M Miura
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Moriyama
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Nakano
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - M Nakahata
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Nakayama
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Noguchi
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - K Okamoto
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - K Sato
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - H Sekiya
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - H Shiba
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - K Shimizu
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - M Shiozawa
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Sonoda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - Y Suzuki
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - A Takeda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Takemoto
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - A Takenaka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - H Tanaka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Watanabe
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - T Yano
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - S Han
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - T Kajita
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Okumura
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - T Tashiro
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - T Tomiya
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - X Wang
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - J Xia
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - S Yoshida
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - G D Megias
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - P Fernandez
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - L Labarga
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - N Ospina
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - B Zaldivar
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - B W Pointon
- Department of Physics, British Columbia Institute of Technology, Burnaby, British Columbia V5G 3H2, Canada
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - E Kearns
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - J L Raaf
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - L Wan
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - T Wester
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - J Bian
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - N J Griskevich
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - W R Kropp
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - S Locke
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - M B Smy
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - H W Sobel
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - V Takhistov
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - A Yankelevich
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - J Hill
- Department of Physics, California State University, Dominguez Hills, Carson, California 90747, USA
| | - R G Park
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - B Bodur
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - K Scholberg
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - C W Walter
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - L Bernard
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - A Coffani
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - O Drapier
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - S El Hedri
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - A Giampaolo
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - Th A Mueller
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - A D Santos
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - P Paganini
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - B Quilain
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - T Ishizuka
- Junior College, Fukuoka Institute of Technology, Fukuoka, Fukuoka 811-0295, Japan
| | - T Nakamura
- Department of Physics, Gifu University, Gifu, Gifu 501-1193, Japan
| | - J S Jang
- GIST College, Gwangju Institute of Science and Technology, Gwangju 500-712, Korea
| | - J G Learned
- Department of Physics and Astronomy, University of Hawaii, Honolulu, Hawaii 96822, USA
| | - K Choi
- Institute for Basic Science (IBS), Daejeon 34126, Korea
| | - S Cao
- Institute For Interdisciplinary Research in Science and Education, ICISE, Quy Nhon 55121, Vietnam
| | - L H V Anthony
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - D Martin
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - M Scott
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - A A Sztuc
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - Y Uchida
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - V Berardi
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, I-70125 Bari, Italy
| | - M G Catanesi
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, I-70125 Bari, Italy
| | - E Radicioni
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, I-70125 Bari, Italy
| | - N F Calabria
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, I-80126 Napoli, Italy
| | - L N Machado
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, I-80126 Napoli, Italy
| | - G De Rosa
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, I-80126 Napoli, Italy
| | - G Collazuol
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - F Iacob
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - M Lamoureux
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - M Mattiazzi
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - L Ludovici
- INFN Sezione di Roma and Università di Roma "La Sapienza," I-00185, Roma, Italy
| | - M Gonin
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582, Japan
| | - G Pronost
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582, Japan
| | - C Fujisawa
- Department of Physics, Keio University, Yokohama, Kanagawa 223-8522, Japan
| | - Y Maekawa
- Department of Physics, Keio University, Yokohama, Kanagawa 223-8522, Japan
| | - Y Nishimura
- Department of Physics, Keio University, Yokohama, Kanagawa 223-8522, Japan
| | - M Friend
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Hasegawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Ishida
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Kobayashi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Jakkapu
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Matsubara
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Nakadaira
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - K Nakamura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Oyama
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - K Sakashita
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Sekiguchi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Tsukamoto
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Boschi
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - F Di Lodovico
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - J Gao
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - A Goldsack
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - T Katori
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - J Migenda
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - M Taani
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - S Zsoldos
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Kotsar
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - H Ozaki
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - A T Suzuki
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - Y Takeuchi
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - C Bronner
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - J Feng
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - T Kikawa
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - M Mori
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - T Nakaya
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - R A Wendell
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Yasutome
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - S J Jenkins
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - N McCauley
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - P Mehta
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - K M Tsui
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - Y Fukuda
- Department of Physics, Miyagi University of Education, Sendai, Miyagi 980-0845, Japan
| | - Y Itow
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Aichi 464-8602, Japan
- Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - H Menjo
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - K Ninomiya
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - J Lagoda
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - S M Lakshmi
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - M Mandal
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - P Mijakowski
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - Y S Prabhu
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - J Zalipska
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - M Jia
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - J Jiang
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - C K Jung
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - M J Wilking
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - C Yanagisawa
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - M Harada
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - H Ishino
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - S Ito
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - H Kitagawa
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - Y Koshio
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - F Nakanishi
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - S Sakai
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - G Barr
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
| | - D Barrow
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
| | - L Cook
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Samani
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
| | - D Wark
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington OX11 0QX, United Kingdom
| | - F Nova
- Rutherford Appleton Laboratory, Harwell, Oxford OX11 0QX, United Kingdom
| | - J Y Yang
- Department of Physics, Seoul National University, Seoul 151-742, Korea
| | - M Malek
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - J M McElwee
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - O Stone
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - M D Thiesse
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - L F Thompson
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - H Okazawa
- Department of Informatics in Social Welfare, Shizuoka University of Welfare, Yaizu, Shizuoka 425-8611, Japan
| | - S B Kim
- Department of Physics, Sungkyunkwan University, Suwon 440-746, Korea
| | - J W Seo
- Department of Physics, Sungkyunkwan University, Suwon 440-746, Korea
| | - I Yu
- Department of Physics, Sungkyunkwan University, Suwon 440-746, Korea
| | - A K Ichikawa
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - K D Nakamura
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - S Tairafune
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - K Nishijima
- Department of Physics, Tokai University, Hiratsuka, Kanagawa 259-1292, Japan
| | - K Iwamoto
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - K Nakagiri
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Nakajima
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - N Taniuchi
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - M Yokoyama
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Martens
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - P de Perio
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M R Vagins
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Kuze
- Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551, Japan
| | - S Izumiyama
- Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551, Japan
| | - M Inomoto
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - M Ishitsuka
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - H Ito
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - T Kinoshita
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - R Matsumoto
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - Y Ommura
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - N Shigeta
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - M Shinoki
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - T Suganuma
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - K Yamauchi
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - J F Martin
- Department of Physics, University of Toronto, Ontario M5S 1A7, Canada
| | - H A Tanaka
- Department of Physics, University of Toronto, Ontario M5S 1A7, Canada
| | - T Towstego
- Department of Physics, University of Toronto, Ontario M5S 1A7, Canada
| | - R Akutsu
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - V Gousy-Leblanc
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - M Hartz
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - A Konaka
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - N W Prouse
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - S Chen
- Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | - B D Xu
- Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | - B Zhang
- Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | | | - D Hadley
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - M Nicholson
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - M O'Flaherty
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - B Richards
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - A Ali
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
- Department of Physics, University of Winnipeg, Manitoba R3J 3L8, Canada
| | - B Jamieson
- Department of Physics, University of Winnipeg, Manitoba R3J 3L8, Canada
| | - Ll Marti
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - A Minamino
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - G Pintaudi
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - S Sano
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - S Suzuki
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - K Wada
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
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24
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Ohnuki Y, Suzuki S, Uruha A, Oyama M, Suzuki S, Kulski JK, Nishino I, Shiina T. Association of immune-mediated necrotizing myopathy with HLA polymorphisms. HLA 2022; 101:449-457. [PMID: 36565042 DOI: 10.1111/tan.14950] [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: 07/21/2022] [Revised: 11/08/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
Immune-mediated necrotizing myopathy (IMNM) is a type of autoimmune myositis typically characterized clinically by proximal muscle weakness with elevated creatine kinase levels, pathologically by myofiber necrosis and regeneration with paucity of lymphocytic cell infiltration, and serologically by the presence of either of two myositis-specific autoantibodies, anti-SRP, and anti-HMGCR antibodies. However, the HLA loci and alleles associated with IMNM are still not fully understood at least partly because IMNM was a relatively recently established condition. In this study, we genotyped the six HLA loci (HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1) in 250 patients (237 patients over age 18 years and 13 juvenile patients) diagnosed with IMNM based on clinicopathological features and autoantibody information and performed a case control study with Japanese healthy subjects. In the adult patients, specific HLA alleles associated with IMNM were identified at all HLA loci, with DRB1*08:03 showing the strongest association (OR = 2.5; p = 0.00000017). Furthermore, subgroup analysis with various clinical information showed that C*03:04 (OR = 3.7; p = 0.00012) was a higher risk allele for collagen disease in adult patients, and B*13:01 (OR = 23.2; p = 0.021) and C*03:04 (OR = 5.8; p = 0.0074) were higher risk for juvenile patients with anti-HMGCR antibody-positive IMNM. These findings will help to better understand the HLA genetic background and features of IMNM in designing future studies.
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Affiliation(s)
- Yuko Ohnuki
- Department of Medical Ethics, Tokai University School of Medicine, Kanagawa, Japan.,Department of Clinical Genetics, Tokai University Hospital, Kanagawa, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Akinori Uruha
- Department of Neuromuscular Research, National Institute of Neuroscience, and Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Munenori Oyama
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Shingo Suzuki
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Jerzy K Kulski
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, and Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takashi Shiina
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
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25
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Suzuki S, Uzawa A, Murai H. Efgartigimod for generalized myasthenia gravis with or without anti-acetylcholine receptor antibodies: a worldwide and Japanese perspective. Expert Rev Clin Immunol 2022; 18:1207-1215. [PMID: 36227228 DOI: 10.1080/1744666x.2022.2136167] [Citation(s) in RCA: 2] [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] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The management of myasthenia gravis (MG) has been improved due to immunotherapy advances, but 20% of individuals with MG are refractory to the conventional therapy, and the need for novel biological drugs remains. AREA COVERED The Japanese clinical guidelines for MG published in May 2022 include the concept that treatment is often lifelong and should aim to maintain a sufficient quality of life and mental health. We provide an overview of the therapeutic strategy for generalized MG in Japan, in comparison with the international consensus. We summarize the clinical efficacy, safety, and tolerability of efgartigimod, the first approved anti-neonatal Fc receptor inhibitor for MG. A phase III study showed that efgartigimod was well-tolerated and efficacious in patients with generalized MG. EXPERT OPINION Efgartigimod is a promising biological drug for patients with moderate to severe generalized MG with or without anti-acetylcholine receptor antibodies in Japan.
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Affiliation(s)
- Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Akiyuki Uzawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroyuki Murai
- Department of Neurology, International University of Health and Welfare, Narita, Japan
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26
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Yonemori K, Fujiwara K, Hasegawa K, Yunokawa M, Ushijima K, Suzuki S, Shikama A, Minobe S, Usami T, Kim JW, Kim BG, Wang PH, Chang TC, Yamamoto K, Han S, McKenzie J, Barresi G, Miura T, Makker V, Kim Y. 177O Lenvatinib plus pembrolizumab versus treatment of physician’s choice in patients with previously treated advanced endometrial cancer: Study 309/KEYNOTE-775 Asian subgroup. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.213] [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: 12/05/2022] Open
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27
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Minami T, Tokiyasu AO, Kohri H, Abe Y, Iwasaki K, Taguchi T, Oda K, Suzuki S, Asai T, Tanaka SJ, Isayama S, Kanasaki M, Kodaira S, Fukuda Y, Kuramitsu Y. Mass-resolved ion measurement by particle counting analysis for characterizing relativistic ion beams driven by lasers. Rev Sci Instrum 2022; 93:113530. [PMID: 36461420 DOI: 10.1063/5.0101872] [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: 06/03/2022] [Accepted: 09/09/2022] [Indexed: 06/17/2023]
Abstract
Particle counting analysis is a possible way to characterize GeV-scale, multi-species ions produced in laser-driven experiments. We present a multi-layered scintillation detector to differentiate multi-species ions of different masses and energies. The proposed detector concept offers potential advantages over conventional diagnostics in terms of (1) high sensitivity to GeV ions, (2) realtime analysis, and (3) the ability to differentiate ions with the same charge-to-mass ratio. A novel choice of multiple scintillators with different ion stopping powers results in a significant difference in energy deposition between the scintillators, allowing accurate particle identification in the GeV range. Here, we report a successful demonstration of particle identification for heavy ions, performed at the Heavy Ion Medical Accelerator in Chiba. In the experiment, the proposed detector setup showed the ability to differentiate particles with similar atomic numbers, such as C6+ and O8+ ions, and provided an excellent energy resolution of 0.41%-1.2% (including relativistic effect, 0.51%--1.6%).
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Affiliation(s)
- T Minami
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - A O Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Miyagi 982-0826, Japan
| | - H Kohri
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047, Japan
| | - Y Abe
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Iwasaki
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Taguchi
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Oda
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - S Suzuki
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Asai
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum Science and Technology (QST), Kyoto 619-0215, Japan
| | - S J Tanaka
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - S Isayama
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - M Kanasaki
- Graduate School of Maritime Sciences, Kobe University, Hyogo 658-0022, Japan
| | - S Kodaira
- National Institute of Radiological Sciences (NIRS), National Institutes for Quantum Science and Technology (QST), Chiba 263-8555, Japan
| | - Y Fukuda
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum Science and Technology (QST), Kyoto 619-0215, Japan
| | - Y Kuramitsu
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
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28
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Tezuka Y, Akao M, Suzuki S, Yamashita T, Kodani E, Tsuda T, Hayashi K, Furusho H, Sawano M, Fukuda K, Nakai M, Sasahara Y, Miyamoto Y, Tomita H, Okumura K. Usefulness of echocardiographic parameters in predicting the incidence of ischemic stroke in Japanese patients with non-valvular atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.548] [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
Atrial fibrillation (AF) is a risk factor for ischemic stroke (IS). We developed a novel risk score of IS (HELT-E2S2 score) in non-valvular atrial fibrillation (NVAF) patients from the combined database of 5 major AF registries in Japan. However, this score does not include echocardiographic (Echo) parameters that have been reported to be risk factors of IS, such as left atrial diameter (LAD) enlargement or increased relative wall thickness (RWT) of left ventricle (LV).
Purpose
To investigate the predictive value of Echo parameters in Japanese patients with NVAF.
Methods
After excluding patients without the Echo data, 6,032 NVAF patients were analyzed in the present study. LAD was measured in the parasternal long axis view at the end-ventricular systole. RWT was calculated as (2x posterior wall thickness)/ LV end-diastolic dimension. We compared clinical characteristics and the incidence of IS between NVAF patients divided by LAD level (High/Low LAD group) and RWT level (High/Low RWT group). To balance the follow-up period among the registries, event data from individuals whose follow-up period exceeded 730 days were excluded from the analysis.
Results
The optimal cut-off value of LAD and RWT to predict the incidence of IS with the receiver operating characteristic analysis was 43.3 mm and 0.4167, respectively. Between the High/Low LAD groups (High LAD: n=2,640 vs. Low LAD: n=3,392), age (70.3±12.1 vs. 68.3±12.5 years; p<0.001), CHA2DS2-VASc score (3.02±1.84 vs. 2.57±1.78; p<0.001), HELT-E2S2 score (2.20±1.31 vs. 1.55±1.33; p<0.001), the prescription of oral anticoagulants (OACs) (69.5 vs. 51.5%; p<0.001), LV ejection fraction (60.4±13.4 vs. 64.4±10.7%; p<0.001) and RWT (0.401±0.091 vs. 0.396±0.082; p=0.02) were significantly different. Between the High/Low RWT groups (High RWT: n=2,293 vs. Low RWT: n=3,739), percentage of female (35.6 vs. 27.8%; p<0.001), age (71.2±12.1 vs. 68.0±12.4 years; p<0.001), CHA2DS2-VASc score (3.08±1.82 vs. 2.58±1.79; p<0.001), HELT-E2S2 score (2.10±1.39 vs. 1.67±1.31; p<0.001), the prescription of OACs (62.6 vs. 57.4%; p<0.001), LV ejection fraction (65.5±9.9 vs. 60.9±13.0%; p<0.001) and LAD (43.0±8.1 vs. 42.4±8.3; p=0.004) were significantly different. In Kaplan-Meier analysis, the incidence of IS was different between the groups during the median follow-up period of 730 days (High LAD vs. Low LAD; 1.82 vs. 1.00 per 100 person-years; p<0.001, by log-rank test, High RWT vs. Low RWT; 1.86 vs. 1.06; p<0.001) (Figure). Both High LAD (hazard ratio: 1.65, 95% CI: 1.12–2.46; p=0.01) and High RWT (hazard ratio: 1.43, 95% CI: 1.01–2.04; p=0.045) were independent predictors of the incidence of IS after adjustment by the components of the HELT-E2S2 score and other clinically relevant variables including co-existing diseases, gender, and the prescription of OACs (Table).
Conclusion
Echo parameters, LAD and RWT, were independently associated with the incidence of IS among Japanese patients with NVAF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Japan Agency for Medical Research and Development
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Affiliation(s)
- Y Tezuka
- Mitsubishi Kyoto Hospital , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, Department of Cardiology , Kyoto , Japan
| | - S Suzuki
- Cardiovascular Institute, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Yamashita
- Cardiovascular Institute, Department of Cardiovascular Medicine , Tokyo , Japan
| | - E Kodani
- Nippon Medical School Hospital, Department of Internal Medicine and Cardiology , Tokyo , Japan
| | - T Tsuda
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine , Kanazawa , Japan
| | - K Hayashi
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine , Kanazawa , Japan
| | - H Furusho
- Kanazawa University, Department of Cardiovascular Medicine , Kanazawa , Japan
| | - M Sawano
- Keio University School of Medicine, Department of Cardiovascular Medicine , Tokyo , Japan
| | - K Fukuda
- Keio University School of Medicine, Department of Cardiovascular Medicine , Tokyo , Japan
| | - M Nakai
- National Cerebral & Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information , Suita , Japan
| | - Y Sasahara
- National Cerebral & Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information , Suita , Japan
| | - Y Miyamoto
- National Cerebral & Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information , Suita , Japan
| | - H Tomita
- Hirosaki University Graduate School of Medicine, Department of Cardiology , Hirosaki , Japan
| | - K Okumura
- Hirosaki University Graduate School of Medicine, Department of Cardiology , Hirosaki , Japan
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29
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Hirota N, Suzuki S, Arita T, Yagi N, Otsuka T, Yamashita T. Prediction of recurrence after catheter ablation for atrial fibrillation using left atrial morphology on preprocedural computed tomography: application of radiomics. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.597] [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
Radiomics is a comprehensive analysis methodology of medical image and involves the extraction of numerous features from standard imaging. Its usefulness has been reported mainly in the field of cancer for diagnosis and prediction of prognosis. In the territory of cardiac imaging, several reports have investigated the utility of radiomics for classifying the risk of prognosis in coronary artery disease, and few practical applications have been reported for patients with atrial fibrillation (AF) who underwent pulmonary vein isolation (PVI). Although the left atrial morphology can affect the clinical course after the PVI procedure, it is unclear whether the radiomics feature values of the left atrial morphology on cardiac computed tomography (CT) is useful for predicting the AF recurrence after PVI.
Purpose
To predict the recurrence of AF after PVI using the radiomics feature values of the left atrial morphology on cardiac computed tomography (CT).
Methods
We analyzed 525 consecutive three-dimensional cardiac CT in patients with atrial fibrillation who underwent PVI from 2018 to 2019 in our institute. After marking the region of interest on left atrium (including the root of pulmonary veins) semiautomatically, 107 radiomics feature values were obtained by Python program. After excluding the parameters having collinearity or with low predictive capability for the recurrence of AF after PVI, 42 parameters were applied to the final prediction model. Two prediction models were constructed by multivariate Cox regression analysis and machine learning model by support vector machine algorithm.
Results
The area under the curve (AUC) for predicting the recurrence of AF was 0.815 for the multivariate Cox regression model and 0.826 for the machine learning model by support vector machine.
Conclusion
The radiomics feature values on preprocedural cardiac CT could be helpful for predicting the recurrence of AF after PVI. Since radiomics feature analysis yields a huge number of numerical values representing the left atrial morphology in a reproducible manner, it would provide a new direction to construct a good prediction model using machine learning including artificial intelligence out of a routine cardiac CT scan.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Hirota
- Cardiovascular Institute Hospital , Tokyo , Japan
| | - S Suzuki
- Cardiovascular Institute Hospital , Tokyo , Japan
| | - T Arita
- Cardiovascular Institute Hospital , Tokyo , Japan
| | - N Yagi
- Cardiovascular Institute Hospital , Tokyo , Japan
| | - T Otsuka
- Cardiovascular Institute Hospital , Tokyo , Japan
| | - T Yamashita
- Cardiovascular Institute Hospital , Tokyo , Japan
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30
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Misumi K, Matsue Y, Nogi K, Kitai T, Oishi S, Suzuki S, Yamamoto M, Kida T, Okumura T, Nogi M, Ishihara S, Ueda T, Kawakami R, Saito Y, Minamino T. Derivation and validation of a machine learning-based risk prediction model for in-hospital mortality in patients with acute heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1083] [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
Although risk stratification is important in patients with acute heart failure (AHF) to predict patient prognosis, pre-existing risk models have not often been used due to its complexity. Recently, machine learning methods have been presented as an alternative approach to analyzing the predictive probability of large clinical datasets.
Purpose
The aim of this study is to develop a user-friendly risk score developed by one of machine learning methods and compare the performance of the new risk score to the existing conventional risk models.
Methods
A machine-learning-based risk model was developed using least absolute shrinkage and selection operator (LASSO) regression by identifying predictors of in-hospital mortality in the derivation cohort (REALITY-AHF) and externally validating and comparing its performance with two pre-existing risk models: the Get With The Guidelines risk score incorporating brain natriuretic peptide and hypochloremia (GWTG-BNP-Cl-RS) and the acute decompensated heart failure national registry (ADHERE) risk model.
Results
In-hospital deaths in the derivation and validation (NARA-HF) cohorts were 76 (5.1%) and 61 (4.9%), respectively. The risk score comprised four variables (systolic blood pressure, blood urea nitrogen, serum chloride, and C-reactive protein) and was developed according to the results of the LASSO regression weighting the coefficient for selected variables using a logistic regression model (4V-RS). Even though 4V-RS comprised fewer variables, In the validation cohort, it showed a higher area under the receiver operating characteristic curve (AUC) than the ADHERE risk model (AUC, 0.783 vs. 0.740; P=0.059) and a significant improvement in net reclassification (0.359; 95% CI, 0.10–0.67; p=0.006). 4V-RS performed similarly to GWTG-BNP-Cl-RS in terms of discrimination (AUC, 0.783 vs. 0.759; p=0.426) and net reclassification (0.176; 95% CI, −0.08–0.43; p=0.178).
Conclusions
The 4V-RS model comprising only four readily available data points at the time of admission performed similarly to the more complex pre-existing risk model in patients with AHF.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Cardiovascular Research Fund
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Affiliation(s)
- K Misumi
- Saiseikai Utsunomiya Hospital, Department of Cardiology , Tochigi , Japan
| | - Y Matsue
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - K Nogi
- Nara Medical University, Department of Cardiovascular Medicine , Kashihara , Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - S Oishi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiology , Osaka , Japan
| | - S Suzuki
- Fukushima Medical University, Department of Cardiovascular Medicine , Fukushima , Japan
| | - M Yamamoto
- Tsukuba University, Cardiovascular Division, Faculty of Medicine , Tsukuba , Japan
| | - T Kida
- St. Marianna University School of Medicine, Department of Pharmacology , Kawasaki , Japan
| | - T Okumura
- Nagoya University Graduate School of Medicine, Department of Cardiology , Nagoya , Japan
| | - M Nogi
- Nara Medical University, Department of Cardiovascular Medicine , Kashihara , Japan
| | - S Ishihara
- Nara Medical University, Department of Cardiovascular Medicine , Kashihara , Japan
| | - T Ueda
- Nara Medical University, Department of Cardiovascular Medicine , Kashihara , Japan
| | - R Kawakami
- Nara Medical University, Department of Cardiovascular Medicine , Kashihara , Japan
| | - Y Saito
- Nara Medical University, Department of Cardiovascular Medicine , Kashihara , Japan
| | - T Minamino
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
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31
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Suzuki S, Yamashita T. Clinical phenotypes of older adults with non-valvular atrial fibrillation not treated with oral anticoagulants by hierarchical cluster analysis in the ANAFIE registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.621] [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 and purpose
The All Nippon AF In the Elderly (ANAFIE) registry evaluated the current status of anticoagulant therapy in older adult patients (aged ≥75 years) with non-valvular atrial fibrillation (NVAF) in Japan. Although older adult NVAF patients requires anticoagulation therapy, some of them do not receive it and the reasons would be diverse. Therefore, we aimed to identify the phenotypes of older adult NVAF patients not treated with oral anticoagulants using data from the ANAFIE registry.
Methods
In this sub-analysis of the ANAFIE registry, the phenotypes of patients who were not receiving anticoagulants at baseline were evaluated by cluster analysis using Ward's linkage hierarchical algorithm. We used 20 categorical variables and 6 continuous variables for the cluster analysis which were used as the risk factors in the main analysis of the ANAFIE registry [1].
Results
Of 33,275 enrolled patients, 2445 (7.3%) were not receiving anticoagulants. Two clusters were identified: (1) elderly paroxysmal AF (PAF) patients with a low prevalence of comorbidities (58%) and (2) very elderly patients with a high previous major bleeding prevalence (42%). For each cluster, mean ages were 79.9 and 85.7 years, mean CHADS2 scores were 2.3 and 3.1, PAF prevalences were 83% and 54%, heart failure prevalences were 18% and 48%, the proportions of patients with a history of major bleeding were 0% and 25%, the proportions of patients with a history of catheter ablation were 21% and 8%, respectively. Annual incidence rates of each cluster were 2.62% and 9.08% for all-cause death, 1.72% and 5.83% for major adverse cardiovascular or neurological events, 1.22% and 3.14% for stroke or systemic embolism, and 0.53% and 1.43% for major bleeding.
Conclusions
In this cohort of elderly NVAF patients not receiving anticoagulants, more than half (∼60%) were PAF patients and had a low incidence of adverse outcomes. The remaining ∼40% were characterized as very elderly patients with a high prevalence of previous major bleeding and a high incidence of adverse outcomes.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Daiichi Sankyo Co., Ltd.
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Affiliation(s)
- S Suzuki
- Cardiovascular Institute, Department of cardiovascular medicine , Tokyo , Japan
| | - T Yamashita
- Cardiovascular Institute, Department of cardiovascular medicine , Tokyo , Japan
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32
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Yagi N, Suzuki S, Hirota N, Arita T, Otuka T, Yamashita T. Prediction of persistent form of atrial fibrillation using left atrial morphology on preprocedural computed tomography: application of radiomics. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.327] [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
Radiomics is a comprehensive analysis methodology of medical image and involves the extraction of numerous features from standard imaging. Its usefulness has been reported mainly in the field of cancer for diagnosis and prediction of prognosis. In the territory of cardiac imaging, several reports have investigated the utility of radiomics for classifying the risk of prognosis in coronary artery disease, and few practical applications have been reported for patients with atrial fibrillation (AF) who underwent catheter ablation (CA).
Purpose
The objective of this study was to evaluate the utility of radiomics analysis applying to the preprocedural cardiac computerized tomography (CT) in AF patients.
Methods
We analyzed 525 consecutive three-dimensional CT in patients with AF who underwent CA. After marking the region of interest on left atrium (LA) (including the root of pulmonary veins) semiautomatically, 107 radiomics feature values were obtained by Python program. We calculated the amount of representative statistics for each radiomics feature for prediction of persistent AF (PeAF) (Wald statistic in logistic regression analysis) and LA diameter (LAD) (coefficient correlation), respectively. To compare the distribution of the two statistics, the relative importance (calculated as the ratio of statistic to the maximum statistics among 107 radiomics features [%]) was calculated for each statistic. Further, we compared the area under the curve (AUC) in receiver operation characteristic (ROC) curve analysis for predicting PeAF between radiomics features (multivariate model) and LAD (single parameter).
Results
In 525 study patients (age 63±10 years old and male 80%), 253 (48%) were PeAF and remaining were paroxysmal AF (PAF). LAD was 43±6 mm and 38±6 mm in patients with PeAF and PAF, respectively. The relative importance of the two statistics (Wald statistic for PeAF and coefficient correlation for LAD) of 107 radiomics features are displayed in Figure 1, which shows similar distribution of two statistics. It means the close relationship between LA morphology and the form of PeAF in AF patients and the radiomics features possibly well explain the relationship. In Figure 2, the predictive capability for PeAF was compared between radiomics feature values and LAD, where the AUC was 0.85 (95% confidence interval [CI], 0.82–0.88) and 0.73 (95% CI, 0.69–0.78) for radiomics feature values and LAD, respectively (Delong test, P<0.001).
Conclusion
We applied the radiomics features for the evaluation of LA morphology. The predictive capability for PeAF in the prediction model with the radiomics feature values was much better than that with LAD alone. Since radiomics feature analysis yields a huge number of numerical values representing the LA morphology in a reproducible manner, it would provide a new direction to construct a good prediction model using machine learning including artificial intelligence out of a routine cardiac CT scan.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Yagi
- Cardiovascular Institute , Tokyo , Japan
| | - S Suzuki
- Cardiovascular Institute , Tokyo , Japan
| | - N Hirota
- Cardiovascular Institute , Tokyo , Japan
| | - T Arita
- Cardiovascular Institute , Tokyo , Japan
| | - T Otuka
- Cardiovascular Institute , Tokyo , Japan
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Solomon G, Suzuki S, Hathorne H, Barilla C, Wang B, Rab A, Manfredi C, Joshi D, Brewington J, Stecenko A, Driggers W, Bai S, Hunter E, Streby A, Hong J, Odem-Davis K, Davis B, Sorscher E, Linnemann R. 606 Focused clinical trials of modulator response for rare cystic fibrosis genotypes. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01296-6] [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: 11/07/2022]
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Barilla C, Suzuki S, Rab A, Sorscher E, Davis B. 632 Evaluation of gene insertion strategies for restoration of cystic fibrosis transmembrane conductance regulator expression in airway epithelium. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01322-4] [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: 11/06/2022]
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35
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Suzuki S, Barilla C, Doddipalli S, Acosta Sandoval N, Hassan D, Rab A, Sorscher E, Chen J, Davis B, Huang S. 599 iPSC-derived airway basal cells that exhibit increased competence for multipotent differentiation. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01289-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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36
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Sekiguchi K, Ishizuchi K, Takizawa T, Motegi H, Oyama M, Nakahara J, Suzuki S. Anemia in female patients with myasthenia gravis. PLoS One 2022; 17:e0273720. [PMID: 36067203 PMCID: PMC9447896 DOI: 10.1371/journal.pone.0273720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Myasthenia gravis (MG) is the most common autoimmune neuromuscular disorder, and is more common in women than in men. Anemia is also more common in women. The purpose of this study was to investigate factors associated with anemia and the negative impact of anemia in female MG patients. We investigated factors related to MG and anemia in 215 female patients with MG, who were attending the MG clinic of Keio Hospital between January and December 2021. We statistically evaluated clinical factors related to anemia in patients with and without anemia. Eighty-five patients (40%) had anemia in the past, and 130 patients did not have anemia in the past. There were no significant differences in age at study, age at MG onset, body mass index, or frequency of autoantibodies between the anemia and non-anemia groups. MG severity evaluated by the MG Foundation of America classification was greater in the anemia group than in the non-anemia group. History of anemia was associated with immunosuppressive treatment, such as prednisolone and calcineurin inhibitor treatment. There was a correlation between hemoglobin levels and the MG-quality of life score. Long term immunosuppressive therapy can cause anemia in female MG patients. Anemia may negatively affect the quality of life of female MG patients.
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Affiliation(s)
- Koji Sekiguchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Kei Ishizuchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Haruhiko Motegi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Munenori Oyama
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
- * E-mail:
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37
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Tamura M, Suzuki S, Yamaguchi Y. Effects of tourism promotion on COVID-19 spread: The case of the "Go To Travel" campaign in Japan. J Transp Health 2022; 26:101407. [PMID: 35664887 PMCID: PMC9151657 DOI: 10.1016/j.jth.2022.101407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 05/11/2023]
Abstract
Introduction On July 22, 2020, the Japanese government launched the "Go to Travel" campaign that subsidizes 50% of personal travel expenditure to support the tourism industry under the COVID-19 pandemic. This policy was controversial from the viewpoint of infection spread and was temporarily cancelled in December 2020, though there was no statistical evidence. Methods This is the first study that measures the extent to which this campaign increased COVID-19 cases. This study regards the campaign as a natural experiment: although Tokyo and its commuting areas experienced the same time-series trends of COVID-19 cases before the "Go To Travel" campaign, this campaign was implemented in areas outside Tokyo, but not in Tokyo. Then, the comparison (difference-in-differences) yields the campaign's effect. Results The estimation shows that the "Go To Travel" campaign significantly raised the increment rate of cases by 23.7%-34.4% during July 30-August 4. There is no significant effect after August 5. In addition, our simulation identified the number of campaign-related cases in each city. Conclusions Although the campaign significantly spread COVID-19, the effect was not continuous to permanently change the time-series trend.
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Affiliation(s)
- M Tamura
- Wakayama University, Faculty of Economics, Sakaedani 930, Wakayama-city, Japan
- NUCB Business School, Graduate School of Management, 1-3-1 Nishiki Naka-ku, Nagoya, Japan
| | - S Suzuki
- Nagoya University of Commerce and Business, 4-4 Sagamine, Komenoki, Nisshin, Japan
| | - Y Yamaguchi
- Nagoya University of Commerce and Business, 4-4 Sagamine, Komenoki, Nisshin, Japan
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Ishizuchi K, Takizawa T, Ohnuki Y, Sekiguchi K, Motegi H, Oyama M, Nakahara J, Shiina T, Suzuki S. Immunodeficiency in patients with thymoma-associated myasthenia gravis. J Neuroimmunol 2022; 371:577950. [PMID: 35994947 DOI: 10.1016/j.jneuroim.2022.577950] [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: 06/07/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 11/25/2022]
Abstract
Thymoma with immunodeficiency is sometimes accompanied by myasthenia gravis (MG), but the clinical characteristics have not been elucidated. This study aimed to characterize its clinical and immunological features. Of the 132 thymoma-associated MG patients, 9 patients presented with immunodeficiency. All suffered from severe pneumonia, and most had invasive thymoma and autoimmune disorders. DRB1*08:03 and DQB1*06:01 alleles were frequently detected. Compared to group without immunodeficiency, they showed no significant differences in the severity of MG, significantly lower IgG concentrations and higher mortality rate. Thymoma-associated MG with immunodeficiency is a distinct subset requiring special attention to prevent infection during the follow-up period.
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Affiliation(s)
- Kei Ishizuchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Yuko Ohnuki
- Department of Medical Ethics, Tokai University School of Medicine, Kanagawa, Japan; Department of Clinical Genetics, Tokai University School of Medicine, Kanagawa, Japan.
| | - Koji Sekiguchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Haruhiko Motegi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan; Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Munenori Oyama
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Takashi Shiina
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan.
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
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Matsubara S, Suzuki S, Komori T. Immunohistochemical Phenotype of T Cells Invading Muscle in Inclusion Body Myositis. J Neuropathol Exp Neurol 2022; 81:825-835. [PMID: 35920309 DOI: 10.1093/jnen/nlac067] [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] [Indexed: 11/13/2022] Open
Abstract
Inclusion body myositis (IBM) is an inflammatory myopathy of aged people with poor response to therapy. To characterize muscle-invading inflammatory cells, we performed immunohistochemical and ultrastructural studies on muscle biopsies from 10 patients with IBM with durations of illness from 3 to 84 months. At the surface of muscle fibers, 79% and 48% of CD8+ cells were positive for killer cell lectin-like receptor subfamily G, member 1 (KLRG1) and CD57, respectively. CD8+KLRG1+ cells are highly differentiated cytotoxic cells. On an average, 27% of CD8-CD57+KLRG1+ cells at the surface were CD4+. Proportions of CD28+ cells among KLRG1+ cells showed a negative correlation with duration of illness (r = -0.68). These changes indicated progressive differentiation of CD8+ T cells. Moreover, PD-1 expression on CD57+ and CD8+ cells increased early, then fluctuated, and reincreased in later stages. PD ligand-1 (PD-L1) and PD-L2 were expressed on adjacent cells including muscle fibers. T cell large granular lymphocytes (LGLs) are potent effector cells and cells with ultrastructure indistinguishable from LGLs were seen in the sarcoplasm along with lymphocytes undergoing degeneration. Together, along the course of IBM, some inflammatory cells retained the potential for cytotoxicity whereas others indicated suppression by exhaustion, senescence, or through the PD-1 pathway.
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Affiliation(s)
- Shiro Matsubara
- From the Department of Neurology, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Takashi Komori
- Laboratory Medicine, Pathology, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
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Watanabe S, Yoshikai K, Tomida M, Suzuki S, Matsuda Y, Miyai S, Nakano E, Kurahashi H, Sawada T. P-131 The fate of irregularly divided blastomeres: why does “Direct cleavage” reduce blastocyst development rate but not blastocyst euploid rate? Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
How do the blastomeres formed by direct cleavage (dynamics of one cell dividing into three or more cells) subsequently develop?
Summary answer
About half of the blastomeres by direct cleavage did not form blastocysts.
What is known already
There are many reports that embryos with direct cleavage in the early development have a lower blastocyst development rate because direct cleavage produces chromosomal abnormal cells. However, when such embryos develop into blastocysts, there have been some reports that the transfer pregnancy rate and euploid rate did not decrease, but the reasons for this have not been clarified.
Study design, size, duration
This is a retrospective study of 89 blastocysts obtained during 2013-18. These embryos were those that patients requested to be discarded and consented to be used in this study. All target embryos were time-lapse monitored by EmbryoScope (Vitrolife, Sweden), and several trophectoderms were biopsied and examined for euploidy.
Participants/materials, setting, methods
The target embryos were classified into three groups: embryos with normal first and second cleavage (NC group), embryos with irregular division (one cell dividing into three or more cells) called direct cleavage at the first cleavage (DC1 group), and embryos with direct cleavage of one blastomere at the second cleavage (DC2 group). It was recorded whether the blastomeres of the embryos subsequently developed into blastocysts or not. NGS analysis was performed on the embryos.
Main results and the role of chance
The target embryos were classified as 48 in the NC group, 32 in the DC1 group, and 9 in the DC2 group. Whether the blastomeres in the target embryos subsequently formed blastocysts or not was recorded one by one by time-lapse images, resulting in the blastomeres’ blastocyst formation rate was 95.1% in the NC group and 55.9% in the DC1 group, which was significantly lower in the DC1 group (P < 0.01). In the DC2 group, blastomeres formed by normal division and those by direct cleavage at the second cleavage were recorded separately, and the blastocyst formation rate was 90.8% for normal cleavage blastomeres and 46.0% for direct cleavage blastomeres, with significantly lower rates for direct cleavage blastomeres (P < 0.01). Therefore, about half of the blastomeres generated by direct cleavage at the first or second cleavage did not form blastocysts. The results of NGS analysis were as follows: NC group: 35.4% euploid, 45.8% aneuploid, and 18.8% mosaic; DC1 group: 37.5%, 53.1%, and 9.4%, respectively; and DC2 group: 55.6%, 33.3%, and 11.1%, respectively. There was no significant difference in any of the items, suggesting that direct cleavage does not affect the euploidy of blastocysts.
Limitations, reasons for caution
For the purpose of NGS analysis, all the target embryos in this study were blastocysts, but if all the cultured embryos were included, arrested embryos would be included, which would probably result in more blastomeres formed by direct cleavage not developing into blastocysts.
Wider implications of the findings
The blastomeres generated by direct cleavage were often excluded from blastocyst formation. This may be an exclusion of chromosomally abnormal cells and may be one of the reasons why direct cleavage decreases blastocyst development rate but does not decrease blastocyst euploid rate.
Trial registration number
not applicable
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Affiliation(s)
- S Watanabe
- Sawada Women's Clinic, ART Lab. , Nagoya, Japan
| | - K Yoshikai
- Sawada Women's Clinic, ART Lab. , Nagoya, Japan
| | - M Tomida
- Sawada Women's Clinic, ART Lab. , Nagoya, Japan
| | - S Suzuki
- Sawada Women's Clinic, ART Lab. , Nagoya, Japan
| | - Y Matsuda
- Sawada Women's Clinic, ART Lab. , Nagoya, Japan
| | - S Miyai
- Fujita Health University, Institute for Comprehensive Medical Science , Toyoake, Japan
| | - E Nakano
- Sawada Women's Clinic, ART Lab. , Nagoya, Japan
| | - H Kurahashi
- Fujita Health University, Institute for Comprehensive Medical Science , Toyoake, Japan
| | - T Sawada
- Sawada Women's Clinic, ART Lab. , Nagoya, Japan
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41
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Ishizuchi K, Takizawa T, Sekiguchi K, Motegi H, Oyama M, Nakahara J, Suzuki S. Flare of myasthenia gravis induced by COVID-19 vaccines. J Neurol Sci 2022; 436:120225. [PMID: 35290838 PMCID: PMC8906005 DOI: 10.1016/j.jns.2022.120225] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/11/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Kei Ishizuchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Koji Sekiguchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Haruhiko Motegi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan; Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Munenori Oyama
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
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Li HF, Naimi S, Sprouse TM, Mumpower MR, Abe Y, Yamaguchi Y, Nagae D, Suzaki F, Wakasugi M, Arakawa H, Dou WB, Hamakawa D, Hosoi S, Inada Y, Kajiki D, Kobayashi T, Sakaue M, Yokoda Y, Yamaguchi T, Kagesawa R, Kamioka D, Moriguchi T, Mukai M, Ozawa A, Ota S, Kitamura N, Masuoka S, Michimasa S, Baba H, Fukuda N, Shimizu Y, Suzuki H, Takeda H, Ahn DS, Wang M, Fu CY, Wang Q, Suzuki S, Ge Z, Litvinov YA, Lorusso G, Walker PM, Podolyak Z, Uesaka T. First Application of Mass Measurements with the Rare-RI Ring Reveals the Solar r-Process Abundance Trend at A=122 and A=123. Phys Rev Lett 2022; 128:152701. [PMID: 35499908 DOI: 10.1103/physrevlett.128.152701] [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: 12/09/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 06/14/2023]
Abstract
The Rare-RI Ring (R3) is a recently commissioned cyclotronlike storage ring mass spectrometer dedicated to mass measurements of exotic nuclei far from stability at Radioactive Isotope Beam Factory (RIBF) in RIKEN. The first application of mass measurement using the R3 mass spectrometer at RIBF is reported. Rare isotopes produced at RIBF-^{127}Sn, ^{126}In, ^{125}Cd, ^{124}Ag, ^{123}Pd-were injected in R3. Masses of ^{126}In, ^{125}Cd, and ^{123}Pd were measured whereby the mass uncertainty of ^{123}Pd was improved. This is the first reported measurement with a new storage ring mass spectrometry technique realized at a heavy-ion cyclotron and employing individual injection of the preidentified rare nuclei. The latter is essential for the future mass measurements of the rarest isotopes produced at RIBF. The impact of the new ^{123}Pd result on the solar r-process abundances in a neutron star merger event is investigated by performing reaction network calculations of 20 trajectories with varying electron fraction Y_{e}. It is found that the neutron capture cross section on ^{123}Pd increases by a factor of 2.2 and β-delayed neutron emission probability, P_{1 n}, of ^{123}Rh increases by 14%. The neutron capture cross section on ^{122}Pd decreases by a factor of 2.6 leading to pileup of material at A=122, thus reproducing the trend of the solar r-process abundances. The trend of the two-neutron separation energies (S_{2n}) was investigated for the Pd isotopic chain. The new mass measurement with improved uncertainty excludes large changes of the S_{2n} value at N=77. Such large increase of the S_{2n} values before N=82 was proposed as an alternative to the quenching of the N=82 shell gap to reproduce r-process abundances in the mass region of A=112-124.
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Affiliation(s)
- H F Li
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
- Lanzhou University, Lanzhou 730000, People's Republic of China
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - S Naimi
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T M Sprouse
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M R Mumpower
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Y Abe
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - Y Yamaguchi
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - D Nagae
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - F Suzaki
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - M Wakasugi
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Arakawa
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - W B Dou
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - D Hamakawa
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - S Hosoi
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - Y Inada
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - D Kajiki
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - T Kobayashi
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - M Sakaue
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - Y Yokoda
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - T Yamaguchi
- Department of Physics, Saitama University, Saitama 338-8570, Japan
| | - R Kagesawa
- Institute of Physics, University of Tsukuba, Ibaraki 305-8571, Japan
| | - D Kamioka
- Institute of Physics, University of Tsukuba, Ibaraki 305-8571, Japan
| | - T Moriguchi
- Institute of Physics, University of Tsukuba, Ibaraki 305-8571, Japan
| | - M Mukai
- Institute of Physics, University of Tsukuba, Ibaraki 305-8571, Japan
| | - A Ozawa
- Institute of Physics, University of Tsukuba, Ibaraki 305-8571, Japan
| | - S Ota
- Center for Nuclear Study, University of Tokyo, Wako, Saitama 351-0198, Japan
| | - N Kitamura
- Center for Nuclear Study, University of Tokyo, Wako, Saitama 351-0198, Japan
| | - S Masuoka
- Center for Nuclear Study, University of Tokyo, Wako, Saitama 351-0198, Japan
| | - S Michimasa
- Center for Nuclear Study, University of Tokyo, Wako, Saitama 351-0198, Japan
| | - H Baba
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - N Fukuda
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - Y Shimizu
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Takeda
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - D S Ahn
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Center for Exotic Nuclear Studies, Institute for Basic Science (IBS), Daejeon 34126, Republic of Korea
| | - M Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
| | - C Y Fu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
| | - Q Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
| | - S Suzuki
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
| | - Z Ge
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China
| | - Yu A Litvinov
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - G Lorusso
- National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - P M Walker
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - Zs Podolyak
- Department of Physics, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - T Uesaka
- Riken Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
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Nakamura S, Mitomo H, Suzuki S, Torii Y, Sekizawa Y, Yonamine Y, Ijiro K. Self-Assembly of Gold Nanorods into a Highly Ordered Sheet via Electrostatic Interactions with Double-Stranded DNA. CHEM LETT 2022. [DOI: 10.1246/cl.220069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Satoshi Nakamura
- Graduate School of Chemical Sciences and Engineering, Hokkaido University, Kita 13, Nishi 8, Kita-Ku, Sapporo 060-8628, Japan
| | - Hideyuki Mitomo
- Research Institute for Electronic Science, Hokkaido University, Kita 21, Nishi 10, Kita-Ku, Sapporo 001-0021, Japan
| | - Shigeaki Suzuki
- Graduate School of Chemical Sciences and Engineering, Hokkaido University, Kita 13, Nishi 8, Kita-Ku, Sapporo 060-8628, Japan
| | - Yu Torii
- Graduate School of Chemical Sciences and Engineering, Hokkaido University, Kita 13, Nishi 8, Kita-Ku, Sapporo 060-8628, Japan
| | - Yu Sekizawa
- Graduate School of Life Science, Hokkaido University, Kita 10, Nishi 8, Kita-Ku, Sapporo 060-0810, Japan
| | - Yusuke Yonamine
- Research Institute for Electronic Science, Hokkaido University, Kita 21, Nishi 10, Kita-Ku, Sapporo 001-0021, Japan
| | - Kuniharu Ijiro
- Research Institute for Electronic Science, Hokkaido University, Kita 21, Nishi 10, Kita-Ku, Sapporo 001-0021, Japan
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Yuan H, Suzuki S, Terui H, Hirata-Tsuchiya S, Nemoto E, Yamasaki K, Saito M, Shiba H, Aiba S, Yamada S. Loss of IκBζ Drives Dentin Formation via Altered H3K4me3 Status. J Dent Res 2022; 101:951-961. [PMID: 35193410 DOI: 10.1177/00220345221075968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Enforced enrichment of the active promoter marks trimethylation of histone H3 lysine 4 (H3K4me3) and acetylation of histone H3 lysine 27 (H3K27ac) by inhibiting histone demethylases and deacetylases is positively associated with hard tissue formation through the induction of osteo/odontogenic differentiation. However, the key endogenous epigenetic modulator of odontoblasts to regulate the expression of genes coding dentin extracellular matrix (ECM) proteins has not been identified. We focused on nuclear factor (NF)-κB inhibitor ζ (IκBζ), which was originally identified as the transcriptional regulator of NF-κB and recently regarded as the NF-κB-independent epigenetic modulator, and found that IκBζ null mice exhibit a thicker dentin width and narrower pulp chamber, with aged mice having more marked phenotypes. At 6 mo of age, dentin fluorescent labeling revealed significantly accelerated dentin synthesis in the incisors of IκBζ null mice. In the molars of IκBζ null mice, marked tertiary dentin formation adjacent to the pulp horn was observed. Mechanistically, the expression of COL1A2 and COL1A1 collagen genes increased more in the odontoblast-rich fraction of IκBζ null mice than in wild type in vivo, similar to human odontoblast-like cells transfected with small interfering RNA for IκBζ compared with cells transfected with control siRNA in vitro. Furthermore, the direct binding of IκBζ to the COL1A2 promoter suppressed COL1A2 expression and the local active chromatin status marked by H3K4me3. Based on whole-genome identification of H3K4me3 enrichment, ECM and ECM organization-related gene loci were selectively activated by the knockdown of IκBζ, which consistently resulted in the upregulation of these genes. Collectively, this study suggested that IκBζ is the key negative regulator of dentin formation in odontoblasts by inhibiting dentin ECM- and ECM organization-related gene expression through an altered local chromatin status marked by H3K4me3. Therefore, IκBζ is a potential target for epigenetically improving the clinical outcomes of dentin regeneration therapies such as pulp capping.
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Affiliation(s)
- H Yuan
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - S Suzuki
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Terui
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Hirata-Tsuchiya
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - E Nemoto
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - K Yamasaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Saito
- Department of Restorative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Yamada
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Miwa K, Ahn JK, Akazawa Y, Aramaki T, Ashikaga S, Callier S, Chiga N, Choi SW, Ekawa H, Evtoukhovitch P, Fujioka N, Fujita M, Gogami T, Harada T, Hasegawa S, Hayakawa SH, Honda R, Hoshino S, Hosomi K, Ichikawa M, Ichikawa Y, Ieiri M, Ikeda M, Imai K, Ishikawa Y, Ishimoto S, Jung WS, Kajikawa S, Kanauchi H, Kanda H, Kitaoka T, Kang BM, Kawai H, Kim SH, Kobayashi K, Koike T, Matsuda K, Matsumoto Y, Nagao S, Nagatomi R, Nakada Y, Nakagawa M, Nakamura I, Nanamura T, Naruki M, Ozawa S, Raux L, Rogers TG, Sakaguchi A, Sakao T, Sako H, Sato S, Shiozaki T, Shirotori K, Suzuki KN, Suzuki S, Tabata M, Taille CDL, Takahashi H, Takahashi T, Takahashi TN, Tamura H, Tanaka M, Tanida K, Tsamalaidze Z, Ukai M, Umetsu H, Wada S, Yamamoto TO, Yoshida J, Yoshimura K. Precise Measurement of Differential Cross Sections of the Σ^{-}p→Λn Reaction in Momentum Range 470-650 MeV/c. Phys Rev Lett 2022; 128:072501. [PMID: 35244436 DOI: 10.1103/physrevlett.128.072501] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/13/2022] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
The differential cross sections of the Σ^{-}p→Λn reaction were measured accurately for the Σ^{-} momentum (p_{Σ}) ranging from 470 to 650 MeV/c at the J-PARC Hadron Experimental Facility. Precise angular information about the Σ^{-}p→Λn reaction was obtained for the first time by detecting approximately 100 reaction events at each angular step of Δcosθ=0.1. The obtained differential cross sections show a slightly forward-peaking structure in the measured momentum regions. The cross sections integrated for -0.7≤cosθ≤1.0 were obtained as 22.5±0.68 [statistical error(stat.)] ±0.65 [systematic error(syst.)] mb and 15.8±0.83(stat)±0.52(syst) mb for 470<p_{Σ}(MeV/c)<550 and 550<p_{Σ}(MeV/c)<650, respectively. These results show a drastic improvement compared with past measurements of the hyperon-proton scattering experiments. They will play essential roles in updating the theoretical models of the baryon-baryon interactions.
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Affiliation(s)
- K Miwa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Korea
| | - Y Akazawa
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T Aramaki
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S Ashikaga
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - S Callier
- OMEGA Ecole Polytechnique-CNRS/IN2P3, 3 rue Michel-Ange, 75794 Paris 16, France
| | - N Chiga
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S W Choi
- Department of Physics, Korea University, Seoul 02841, Korea
| | - H Ekawa
- High Energy Nuclear Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - P Evtoukhovitch
- Joint Institute for Nuclear Research (JINR), Dubna, Moscow Region 141980, Russia
| | - N Fujioka
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - M Fujita
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - T Gogami
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - T Harada
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - S Hasegawa
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - S H Hayakawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - R Honda
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - S Hoshino
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - K Hosomi
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - M Ichikawa
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
- Meson Science Laboratory, Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - Y Ichikawa
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - M Ieiri
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - M Ikeda
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - K Imai
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - Y Ishikawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S Ishimoto
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - W S Jung
- Department of Physics, Korea University, Seoul 02841, Korea
| | - S Kajikawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - H Kanauchi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - H Kanda
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - T Kitaoka
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - B M Kang
- Department of Physics, Korea University, Seoul 02841, Korea
| | - H Kawai
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - S H Kim
- Department of Physics, Korea University, Seoul 02841, Korea
| | - K Kobayashi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - T Koike
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - K Matsuda
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - Y Matsumoto
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S Nagao
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - R Nagatomi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - Y Nakada
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - M Nakagawa
- High Energy Nuclear Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - I Nakamura
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T Nanamura
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - M Naruki
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - S Ozawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - L Raux
- OMEGA Ecole Polytechnique-CNRS/IN2P3, 3 rue Michel-Ange, 75794 Paris 16, France
| | - T G Rogers
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - A Sakaguchi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - T Sakao
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - H Sako
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - S Sato
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - T Shiozaki
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - K Shirotori
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - K N Suzuki
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - S Suzuki
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - M Tabata
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - C D L Taille
- OMEGA Ecole Polytechnique-CNRS/IN2P3, 3 rue Michel-Ange, 75794 Paris 16, France
| | - H Takahashi
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T Takahashi
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T N Takahashi
- Nishina Center for Accelerator-based Science, RIKEN, Wako 351-0198, Japan
| | - H Tamura
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - M Tanaka
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - K Tanida
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - Z Tsamalaidze
- Joint Institute for Nuclear Research (JINR), Dubna, Moscow Region 141980, Russia
- Georgian Technical University (GTU), Tbilisi 0175, Georgia
| | - M Ukai
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - H Umetsu
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S Wada
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - T O Yamamoto
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - J Yoshida
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - K Yoshimura
- Department of Physics, Okayama University, Okayama 700-8530, Japan
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Shinoda K, Okumura M, Yamaguchi S, Matsui A, Tsuda R, Hounoki H, Suzuki S, Tobe K. A Comparison of Line Blots, Enzyme-linked Immunosorbent, and RNA-immunoprecipitation Assays of Antisynthetase Antibodies in Serum Samples from 44 Patients. Intern Med 2022; 61:313-322. [PMID: 35110513 PMCID: PMC8866784 DOI: 10.2169/internalmedicine.7824-21] [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: 11/23/2022] Open
Abstract
Objective To determine the differences between anti-aminoacyl tRNA synthetase (ARS) antibodies among line blots, enzyme-linked immunosorbent assay (ELISA) anti-ARS tests, and RNA-immunoprecipitation (IP) assays. Methods Sera from patients with confirmed or suspected antisynthetase syndrome (ASS) that were positive for either the anti-ARS test or the line-blot assay were used to perform an RNA-IP assay and ELISA to detect individual anti-ARS antibodies. Results Among the 44 patients, 10 were positive only in line-blot assays, 6 were positive only in the anti-ARS test, and 28 were positive in both assays. We compared the accuracy of these assays against the gold standard RNA-IP assay. The κ coefficient was 0.23 in the line-blot assay, but this increased to 0.75 when the cut-off was increased from 1+ to 2+. The κ coefficient was 0.73 in the anti-ARS test. The κ coefficient was 0.85 for positivity in both assays. Patients with ASS that was positive in an RNA-IP assay more frequently had mechanic's hand (62.1% vs. 20%: p=0.031), myositis (51.7 vs. 10%: p=0.028) and more ASS symptoms than those who were positive only in line-blot assays (3.48 vs. 2.2: p=0.019). Conclusions Clinicians need to understand the features of each assay and determine diagnoses by also considering clinical presentations. Diagnoses should not be judged based only on the results of line-blot assays due to the risk of a misdiagnosis from false positives.
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Affiliation(s)
- Koichiro Shinoda
- First Department of Internal Medicine, University of Toyama, Japan
| | - Maiko Okumura
- First Department of Internal Medicine, University of Toyama, Japan
| | | | - Atsushi Matsui
- First Department of Internal Medicine, University of Toyama, Japan
| | - Reina Tsuda
- First Department of Internal Medicine, University of Toyama, Japan
| | - Hiroyuki Hounoki
- First Department of Internal Medicine, University of Toyama, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Japan
| | - Kazuyuki Tobe
- First Department of Internal Medicine, University of Toyama, Japan
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Miwa K, Nanamura T, Sakao T, Ahn JK, Akazawa Y, Aramaki T, Ashikaga S, Callier S, Chiga N, Chiga N, Choi SW, Ekawa H, Evtoukhovitch P, Fujioka N, Fujita M, Gogami T, Harada T, Hasegawa S, Hayakawa SH, Honda R, Hoshino S, Hosomi K, Ichikawa M, Ichikawa Y, Ieiri M, Ikedai M, Imai K, Ishikawa Y, Ishimoto S, Jung WS, Kajikawa S, Kanauchi H, Kanda H, Kitaoka T, Kang BM, Kawai H, Kim SH, Kobayashi K, Koike T, Matsuda K, Matsumoto Y, Nagao S, Nagatomi R, Nakada Y, Nakagawa M, Nakamura I, Naruki M, Ozawa S, Raux L, Rogers TG, Sakaguchi A, Sako H, Sato S, Shiozaki T, Shirotori K, Suzuki KN, Suzuki S, Tabata M, Taille CDL, Takahashi H, Takahashi T, Takahashi TN, Tamura H, Tanaka M, Tanida K, Tsamalaidze Z, Ukai M, Umetsu H, Wada S, Yamamoto TO, Yoshida J, Yoshimura K. Recent progress and future prospects of hyperon nucleon scattering experiment. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202227104001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A new hyperon-proton scattering experiment, dubbed J-PARC E40, was performed to measure differential cross sections of the Σ+p, Σ−p elastic scatterings and the Σ−p → Λn scattering by identifying a lot of Σ particles in the momentum ranging from 0.4 to 0.8 GeV/c produced by the π±p → K+Σ± reactions. We successfully measured the differential cross sections of these three channels with a drastically improved accuracy with a fine angular step. These new data will become important experimental constraints to improve the theories of the two-body baryon-baryon interactions. Following this success, we proposed a new experiment to measure the differential cross sections and spin observables by using a highly polarized Λ beam for providing quantitative information on the ΛN interaction. The results of three Σp channels and future prospects of the Λp scattering experiment are described.
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Barillà C, Suzuki S, Rab A, Wang B, Hong J, Driggers W, Streby A, Feldman R, Linnemann R, Solomon G, Stecenko A, Sorscher E, Davis B. 667: Development of an iPSC-based airway epithelial platform for evaluating patient-specific responses to modulators. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02090-7] [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: 10/20/2022]
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49
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Linnemann R, Solomon G, Streby A, Rab A, Driggers W, Slaten K, Hathorne H, Hong J, Suzuki S, Wang B, Barillà C, Stecenko A, Davis B, Sorscher E. 572: Clinical and iPSC-derived airway epithelial responses to elexacaftor/tezacaftor/ivacaftor in CF patients without an approved modulator. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01995-0] [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: 10/20/2022]
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50
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Kanai M, Kimura K, Motoki H, Suzuki S, Okano T, Minamisawa M, Yoshie K, Kato T, Saigusa T, Ebisawa S, Okada A, Kuwahara K. Cardio-renal protective effects of SGLT2 inhibitors in patients with type 2 diabetes mellitus and severely impaired renal function. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2958] [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
Prognostic impact of Sodium-Glucose Cotransporter 2 (SGLT2) inhibitors on cardiovascular and renal outcome was unknown in patients with type-2 diabetes mellitus (DM) and severely impaired renal function.
Methods
From July 2015 to December 2020, patients with type-2 DM who were taken SGLT2 inhibitors for more than six months were retrospectively screened. Patients with estimated glomerular filtration rate (eGFR) over 60ml/min/1.73m2 were excluded. We divided those patients into two groups by eGFR; less than 45ml/min/1,73m2 were group A and 46–60ml/min/m2 were group B. Randomly selected patients with DM not taking SGLT2 inhibitors and having severe renal dysfunction: eGFR less than 45ml/min/m2 (Group C) were set as controls. The primary outcome was a composite of cardiovascular/renal death, initiation of dialysis, doubling of the serum creatine level, decline in the eGFR more than 30%, nonfatal myocardial infraction, nonfatal stroke, and hospitalization for heart failure.
Results
Totally 418 patients were enrolled. Median age was 71 years (group A, n=106), 64 years (group B, n=115), and 77 years (group C, n=201) (p<0.001). After median 24 months follow-up, primary endpoints were observed 24.5% in group A, 4.3% in group B, 36.8% in group C (p<0.001). In Kaplan-Meier analysis, significantly lower incidence of primary endpoints were observed in SGLT2 groups (group A and B) than controls (p<0.001, Figure 1). In patients with severe renal dysfunction, taking SGLT2 inhibitors tended to decrease future renal event (Figure 2). The incidence of SGLT2 related adverse events was not different between 2 groups (A and B).
Conclusions
Even in patients with severe renal dysfunction, SGLT2 inhibitors would have cardio-renal protective effects without drug-related adverse effects.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Kanai
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kimura
- Shinshu University Hospital, Matsumoto, Japan
| | - H Motoki
- Shinshu University Hospital, Matsumoto, Japan
| | - S Suzuki
- Shinshu University Hospital, Matsumoto, Japan
| | - T Okano
- Shinshu University Hospital, Matsumoto, Japan
| | | | - K Yoshie
- Shinshu University Hospital, Matsumoto, Japan
| | - T Kato
- Shinshu University Hospital, Matsumoto, Japan
| | - T Saigusa
- Shinshu University Hospital, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University Hospital, Matsumoto, Japan
| | - A Okada
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
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