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Ota E, Hiyoshi Y, Matsuura N, Ishikawa K, Fujinami F, Mukai T, Yamaguchi T, Nagasaki T, Akiyoshi T, Fukunaga Y. Standardization of preoperative stoma site marking and its utility for preventing stoma leakage: a retrospective study of 519 patients who underwent laparoscopic/robotic rectal cancer surgery. Tech Coloproctol 2023; 27:1387-1392. [PMID: 37358669 DOI: 10.1007/s10151-023-02839-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/17/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE Stoma site marking is an important preoperative intervention for preventing various stoma-associated complications. In our institution, standardized stoma site marking is routinely performed before rectal cancer surgery with stoma creation, and various stoma-associated factors are recorded in the ostomy-record template. The present study investigated risk factors for stoma leakage. METHODS Our stoma site marking is standardized so that it can be performed by non-stoma specialists. To identify risk factors of stoma leakage at 3 months after surgery, various preoperative factors associated with stoma site marking in our ostomy-record template were retrospectively analyzed in 519 patients who underwent rectal cancer surgery with stoma creation from 2015 to 2020. RESULTS Stoma leakage was seen in 35 of the 519 patients (6.7%). The distance between the stoma site marking and the umbilicus was less than 60 mm in 27 of the 35 patients (77%) who experienced stoma leakage, so a distance of less than 60 mm was identified as an independent risk factor for stoma leakage. Aside from preoperative factors, stoma leakage was also caused by postoperative skin wrinkles or surgical scars near the stoma site in 8 of 35 patients (23%). CONCLUSION Preoperative standardized stoma site marking is necessary to achieve reliable marking that is easy to perform. To reduce the risk of stoma leakage, a distance of 60 mm or more between the stoma site marking and the umbilicus is ideal, and surgeons need to contrive ways to keep surgical scars away from the stoma site.
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Affiliation(s)
- E Ota
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Y Hiyoshi
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - N Matsuura
- Gastroenterological Center, Department of Wound, Ostomy and Continence (WOC) Nursing, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - K Ishikawa
- Gastroenterological Center, Department of Wound, Ostomy and Continence (WOC) Nursing, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - F Fujinami
- Gastroenterological Center, Department of Wound, Ostomy and Continence (WOC) Nursing, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - T Mukai
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - T Yamaguchi
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - T Nagasaki
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - T Akiyoshi
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Y Fukunaga
- Gastroenterological Center, Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Morizane S, Mukai T, Sunagawa K, Tachibana K, Kawakami Y, Ouchida M. "Input/output cytokines" in epidermal keratinocytes and the involvement in inflammatory skin diseases. Front Immunol 2023; 14:1239598. [PMID: 37881433 PMCID: PMC10597658 DOI: 10.3389/fimmu.2023.1239598] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 06/13/2023] [Accepted: 09/20/2023] [Indexed: 10/27/2023] Open
Abstract
Considering the role of epidermal keratinocytes, they occupy more than 90% of the epidermis, form a physical barrier, and also function as innate immune barrier. For example, epidermal keratinocytes are capable of recognizing various cytokines and pathogen-associated molecular pattern, and producing a wide variety of inflammatory cytokines, chemokines, and antimicrobial peptides. Previous basic studies have shown that the immune response of epidermal keratinocytes has a significant impact on inflammatory skin diseases. The purpose of this review is to provide foundation of knowledge on the cytokines which are recognized or produced by epidermal keratinocytes. Since a number of biologics for skin diseases have appeared, it is necessary to fully understand the relationship between epidermal keratinocytes and the cytokines. In this review, the cytokines recognized by epidermal keratinocytes are specifically introduced as "input cytokines", and the produced cytokines as "output cytokines". Furthermore, we also refer to the existence of biologics against those input and output cytokines, and the target skin diseases. These use results demonstrate how important targeted cytokines are in real skin diseases, and enhance our understanding of the cytokines.
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Affiliation(s)
- Shin Morizane
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomoyuki Mukai
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Japan
| | - Ko Sunagawa
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kota Tachibana
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshio Kawakami
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mamoru Ouchida
- Department of Molecular Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Yamauchi R, Fujisawa M, Koyanagi S, Muramatsu A, Kobayashi T, Wada Y, Akama K, Tanaka M, Kurashige H, Sato A, Horiuchi H, Mukai T, Yamamoto Y, Sasaki Y. Formate-producing capacity provided by reducing ability of Streptococcus thermophilus nicotinamide adenine dinucleotide oxidase determines yogurt acidification rate. J Dairy Sci 2023; 106:6710-6722. [PMID: 37211485 DOI: 10.3168/jds.2023-23245] [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: 01/09/2023] [Accepted: 04/19/2023] [Indexed: 05/23/2023]
Abstract
Yogurt is made by fermenting milk with 2 lactic acid bacteria, Lactobacillus delbrueckii ssp. bulgaricus and Streptococcus thermophilus. To comprehensively understand the protocooperation mechanism between S. thermophilus and L. bulgaricus in yogurt fermentation, we examined 24 combinations of cocultures comprising 7 fast- or slow-acidifying S. thermophilus strains with 6 fast- or slow-acidifying L. bulgaricus strains. Furthermore, 3 NADH oxidase (Nox)-deficient mutants (Δnox) and one pyruvate formate-lyase deficient mutant (ΔpflB) of S. thermophilus were used to evaluate the factor that determines the acidification rate of S. thermophilus. The results revealed that the acidification rate of S. thermophilus monoculture determined the yogurt fermentation rates, despite the coexistence of L. bulgaricus, whose acidification rate was either fast or slow. Significant correlation was found between the acidification rate of S. thermophilus monoculture and the amount of formate production. Result using ΔpflB showed that the formate was indispensable for the acidification of S. thermophilus. Moreover, results of the Δnox experiments revealed that formate production required Nox activity, which not only regulated dissolved oxygen, but also the redox potential. The Nox provided the large decrease in redox potential required by pyruvate formate-lyase to produce formate. A highly significant correlation was found between formate accumulation and Nox activity in S. thermophilus. In conclusion, the formate production ability provided by the action of Nox activity determines the acidification rate of S. thermophilus, and consequently, regulates yogurt coculture fermentation.
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Affiliation(s)
- R Yamauchi
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - M Fujisawa
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - S Koyanagi
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - A Muramatsu
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - T Kobayashi
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - Y Wada
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - K Akama
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - M Tanaka
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - H Kurashige
- Department of Animal Science, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23, Towada, Aomori 034-8628, Japan
| | - A Sato
- Department of Animal Science, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23, Towada, Aomori 034-8628, Japan
| | - H Horiuchi
- Food Science and Technology Research Laboratories, R&D Division, Meiji Co. Ltd., 1-29-1 Nanakuni, Hachioji, Tokyo 192-0919, Japan
| | - T Mukai
- Department of Animal Science, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23, Towada, Aomori 034-8628, Japan
| | - Y Yamamoto
- Department of Animal Science, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23, Towada, Aomori 034-8628, Japan
| | - Y Sasaki
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan.
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Takezaki D, Morizane S, Ikeda K, Iseki M, Sakamoto Y, Kawakami Y, Hashiguchi T, Shirakata Y, Nishina S, Mukai T. Co-occurrence of non-alcoholic steatohepatitis exacerbates psoriasis associated with decreased adiponectin expression in a murine model. Front Immunol 2023; 14:1214623. [PMID: 37646025 PMCID: PMC10461570 DOI: 10.3389/fimmu.2023.1214623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/24/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Clinical studies have suggested a bidirectional association between non-alcoholic steatohepatitis (NASH) and psoriasis, affecting each other's development and severity. Here, we explored bidirectional causal linkages between NASH and psoriasis using a murine model. Methods NASH was induced in mice by streptozotocin injection at 2 days of age and by high-fat diet feeding (STAM™ model). Psoriasis was induced by topical application of imiquimod (IMQ) on the ear. The severities of liver damage and psoriatic skin changes were determined using histological analysis. Gene expression in the skin tissues was evaluated using quantitative PCR analysis. Serum cytokine levels were determined using enzyme-linked immunosorbent assay. To examine the innate immune responses of normal human epidermal keratinocytes (NHEKs), the cells were treated with interleukin (IL)-17A, tumor necrosis factor (TNF)-α, and AdipoRon, an adiponectin receptor agonist. Results and Discussion There were no differences in the degree of liver tissue damage (fat deposition, inflammation, and fibrosis) between NASH mice with and those without psoriasis. Conversely, the co-occurrence of NASH significantly augmented psoriatic skin changes, represented by epidermal hyperplasia, in psoriatic mice. Pro-inflammatory cytokines were expressed in the inflamed skin of psoriatic mice, and the expression of genes, especially Il23a, Il1b, Il36g, and Mip2, was significantly upregulated by the co-occurrence of NASH. The expression of keratinocyte activation marker genes Defb4b and Krt16 was also upregulated by the co-occurrence of NASH. The serum TNF-α and IL-17 levels were increased by the co-occurrence of NASH and psoriasis. The serum adiponectin levels decreased in NASH mice compared with that in non-NASH mice. In NHEK culture, TNF-α and IL-17A synergistically upregulated CXCL1, CXCL8, and IL1B expression. The upregulated pro-inflammatory gene expression was suppressed by AdipoRon treatment, reflecting the anti-inflammatory capacity of adiponectin. Conclusion The co-occurrence of NASH exacerbated psoriatic skin changes associated with increased serum inflammatory cytokine levels and decreased serum adiponectin levels. Combined with in vitro findings, increased inflammatory cytokine levels and decreased adiponectin levels likely promote innate immune responses in epidermal keratinocytes in psoriatic skin lesions. Overall, therapeutic intervention for co-occurring NASH is essential to achieve a favorable prognosis of psoriasis in clinical practice.
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Affiliation(s)
- Daiki Takezaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Okayama, Japan
| | - Shin Morizane
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kenta Ikeda
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Dermatology, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
| | - Masanori Iseki
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Okayama, Japan
| | - Yuma Sakamoto
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Okayama, Japan
| | - Yoshio Kawakami
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | | | - Sohji Nishina
- Department of Gastroenterology and Hepatology, Kawasaki Medical School, Okayama, Japan
| | - Tomoyuki Mukai
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Okayama, Japan
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Mukai T, Akagi T, Asano SH, Tosa I, Ono M, Kittaka M, Ueki Y, Yahagi A, Iseki M, Oohashi T, Ishihara K, Morita Y. Imatinib has minimal effects on inflammatory and osteopenic phenotypes in a murine cherubism model. Oral Dis 2023; 29:1089-1101. [PMID: 34743383 PMCID: PMC9076755 DOI: 10.1111/odi.14073] [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] [Received: 08/22/2021] [Revised: 10/14/2021] [Accepted: 11/01/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Cherubism is a genetic disorder characterised by bilateral jawbone deformation. The associated jawbone lesions regress after puberty, whereas severe cases require surgical treatment. Although several drugs have been tested, fundamental treatment strategies for cherubism have not been established. The effectiveness of imatinib has recently been reported; however, its pharmaceutical mechanism remains unclear. In this study, we tested the effects of imatinib using a cherubism mouse model. METHODS We used Sh3bp2 P416R cherubism mutant mice, which exhibit systemic organ inflammation and osteopenia. The effects of imatinib were determined using primary bone marrow-derived macrophages. Imatinib was administered intraperitoneally to the mice, and serum tumour necrosis factor-α (TNFα), organ inflammation and bone properties were examined. RESULTS The cherubism mutant macrophages produced higher levels of TNFα in response to lipopolysaccharide compared to wild-type macrophages, and imatinib did not significantly suppress TNFα production. Although imatinib suppressed osteoclast formation in vitro, administering it in vivo did not suppress organ inflammation and osteopenia. CONCLUSION The in vivo administration of imatinib had a minimal therapeutic impact in cherubism mutant mice. To establish better pharmaceutical interventions, it is necessary to integrate new findings from murine models with clinical data from patients with a definitive diagnosis of cherubism.
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Affiliation(s)
- Tomoyuki Mukai
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
- Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Sumie Hiramatsu Asano
- Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Ikue Tosa
- Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama 700-8558, Japan
| | - Mitsuaki Ono
- Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama 700-8558, Japan
| | - Mizuho Kittaka
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, 635 Barnhill Dr, Indianapolis, IN 46202, USA
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, 635 Barnhill Dr, Indianapolis, IN 46202, USA
| | - Yasuyoshi Ueki
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, 635 Barnhill Dr, Indianapolis, IN 46202, USA
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, 635 Barnhill Dr, Indianapolis, IN 46202, USA
| | - Ayano Yahagi
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Masanori Iseki
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Toshitaka Oohashi
- Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama 700-8558, Japan
| | - Katsuhiko Ishihara
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
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Mukai T, Ida H, Ueki Y, Nishikomori R. Editorial: A new frontier in translational research on autoinflammatory diseases - various aspects of innate immunity on human diseases. Front Immunol 2023; 14:1147202. [PMID: 36798122 PMCID: PMC9927384 DOI: 10.3389/fimmu.2023.1147202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 02/04/2023] Open
Affiliation(s)
- Tomoyuki Mukai
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Japan,*Correspondence: Tomoyuki Mukai,
| | - Hiroaki Ida
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yasuyoshi Ueki
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN, United States,Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ryuta Nishikomori
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
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Takimoto-Ito R, Kambe N, Kogame T, Nomura T, Izawa K, Jo T, Kazuma Y, Yoshifuji H, Tabuchi Y, Abe H, Yamamoto M, Nakajima K, Tomita O, Yagi Y, Katagiri K, Matsuzaka Y, Takeuchi Y, Hatanaka M, Kanekura T, Takeuchi S, Kadono T, Fujita Y, Migita K, Fujino T, Akagi T, Mukai T, Nagano T, Kawano M, Kimura H, Okubo Y, Morita A, Hide M, Satoh T, Asahina A, Kanazawa N, Kabashima K. Summary of the current status of clinically diagnosed cases of Schnitzler syndrome in Japan. Allergol Int 2022; 72:297-305. [PMID: 36470790 DOI: 10.1016/j.alit.2022.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/16/2022] [Accepted: 10/31/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Schnitzler syndrome is a rare disorder with chronic urticaria, and there is no report summarizing the current status in Japan. METHODS A nationwide survey of major dermatology departments in Japan was conducted in 2019. We further performed a systematic search of PubMed and Ichushi-Web, using the keywords "Schnitzler syndrome" and "Japan" then contacted the corresponding authors or physicians for further information. RESULTS Excluding duplicates, a total of 36 clinically diagnosed cases were identified from 1994 through the spring of 2022, with a male to female ratio of 1:1. The median age of onset was 56.5 years. It took 3.3 years from the first symptom, mostly urticaria, to reach the final diagnosis. The current status of 30 cases was ascertained; two patients developed B-cell lymphoma. SchS treatment was generally effective with high doses of corticosteroids, but symptoms sometimes recurred after tapering. Colchicine was administered in 17 cases and was effective in 8, but showed no effect in the others. Tocilizumab, used in six cases, improved laboratory abnormalities and symptoms, but lost its efficacy after several years. Rituximab, used in five cases, was effective in reducing serum IgM levels or lymphoma mass, but not in inflammatory symptoms. Four cases were treated with IL-1 targeting therapy, either anakinra or canakinumab, and achieved complete remission, except one case with diffuse large B-cell lymphoma. CONCLUSIONS Since Schnitzler syndrome is a rare disease, the continuous collection and long-term follow-up of clinical information is essential for its appropriate treatment and further understanding of its pathophysiology.
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Akagi T, Hiramatsu-Asano S, Ikeda K, Hirano H, Tsuji S, Yahagi A, Iseki M, Matsuyama M, Mak TW, Nakano K, Ishihara K, Morita Y, Mukai T. TRAPS mutations in Tnfrsf1a decrease the responsiveness to TNFα via reduced cell surface expression of TNFR1. Front Immunol 2022; 13:926175. [PMID: 35936010 PMCID: PMC9355097 DOI: 10.3389/fimmu.2022.926175] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Tumor necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS) is an autoinflammatory periodic fever syndrome associated with heterozygous mutations in TNFRSF1A, which encodes TNF receptor type I (TNFR1). Although possible proinflammatory mechanisms have been proposed, most previous studies were performed using in vitro overexpression models, which could lead to undesirable inflammatory responses due to artificial overexpression. It is crucial to reproduce heterozygous mutations at physiological expression levels; however, such studies remain limited. In this study, we generated TRAPS mutant mice and analyzed their phenotypes. Three Tnfrsf1a mutant strains were generated by introducing T79M, G87V, or T90I mutation. T79M is a known mutation responsible for TRAPS, whereas G87V is a TRAPS mutation that we have reported, and T90I is a variant of unknown significance. Using these murine models, we investigated whether TRAPS mutations could affect the inflammatory responses in vivo and in vitro. We found that none of the mutant mice exhibited detectable inflammatory phenotypes under standard housing conditions for 1 year. Interestingly, TRAPS mutant (T79M and G87V) mice had reduced mortality rates after the administration of lipopolysaccharide (LPS) and D-galactosamine, which induce TNFα-dependent lethal hepatitis. Moreover, TRAPS mutations strongly suppressed the development of TNFα-mediated arthritis when crossed with human TNFα transgenic mice. In in vitro primary bone marrow-derived macrophage cultures, the T79M and G87V mutations attenuated the inflammatory responses to TNFα compared with the wild-type, whereas these mutations did not alter the responsiveness of these cells to LPS. The T90I mutant macrophages behaved similarly to wild type in response to LPS and TNFα. The TNFR1 levels were increased in whole-cell lysates of TRAPS mutant macrophages, whereas the cell surface expression of TNFR1 was significantly decreased in TRAPS mutant macrophages. Taken together, TRAPS mutations did not augment the inflammatory responses to TNFα and LPS; instead, they suppressed the response to TNFα via decreased cell surface expression of TNFR1. The stimulation of lymphotoxin-α, adenosine triphosphate, and norepinephrine in primary macrophages or various stimuli in murine splenocytes did not induce detectable inflammatory responses. In conclusion, TRAPS mutations suppressed responsiveness to TNFα, and TRAPS-associated inflammation is likely induced by unconfirmed disease-specific proinflammatory factors.
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Affiliation(s)
- Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | | | - Kenta Ikeda
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Japan
| | - Hiroyasu Hirano
- Department of General Internal Medicine 1, Kawasaki Medical School, Okayama, Japan
| | - Shoko Tsuji
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Ayano Yahagi
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Japan
| | - Masanori Iseki
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Japan
| | - Makoto Matsuyama
- Division of Molecular Genetics, Shigei Medical Research Institute, Okayama, Japan
| | - Tak W. Mak
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Kazuhisa Nakano
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Katsuhiko Ishihara
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Japan
- *Correspondence: Tomoyuki Mukai, ;
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Yamamoto S, Mukai T, Fujita S, Koide Y, Ono Y, Inubushi M, Nishimura H, Munekane A, Morita Y. The "Ant-farm"-like Appearance of Restricted Lower Limb Vasculitis on Fluorodeoxyglucose-positron Emission Tomography. Intern Med 2022; 61:897-902. [PMID: 34471030 PMCID: PMC8987253 DOI: 10.2169/internalmedicine.8016-21] [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: 11/09/2022] Open
Abstract
Restricted lower limb vasculitis is a type of localized muscle vasculitis limited to the lower limbs. The usefulness of fluorodeoxyglucose-positron emission tomography (FDG-PET) for the diagnosis of this entity has not yet been reported. We herein report three patients with a fever and persistent lower limb pain. FDG-PET revealed linear and patchy FDG uptakes in their lower limbs. Combined with magnetic resonance imaging and histological findings, they were diagnosed with lower limb vasculitis. Linear and patchy FDG uptakes are considered to reflect the presence of muscle vasculitis. The characteristic "ant-farm"-like FDG-PET images can be a diagnostic clue for the currently overlooked vasculitis.
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Affiliation(s)
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Japan
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Japan
| | | | - Yuka Koide
- Department of Rheumatology, Kawasaki Medical School, Japan
| | - Yumika Ono
- Department of Nuclear Medicine, Kawasaki Medical School, Japan
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10
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Hiramatsu-Asano S, Mukai T, Akagi T, Uchida HA, Fujita S, Nakano K, Morita Y. IL-17A promotes vascular calcification in an ex vivo murine aorta culture. Biochem Biophys Res Commun 2022; 604:83-87. [PMID: 35303683 DOI: 10.1016/j.bbrc.2022.03.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 01/11/2022] [Accepted: 03/09/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Vascular calcification is characterized by mineral deposition in the vasculature, which is triggered by chronic systemic inflammation, including psoriasis. Psoriasis is an IL-17A-mediated inflammatory skin disease that is associated with exacerbated vascular calcification and high cardiovascular mortality. Although previous studies have shown that IL-17A induces vascular dysfunction in murine psoriasis models, it has not been clarified whether IL-17A induces vascular calcification. In this study, we investigated the potential vascular calcification-inducing effect of IL-17A in an ex vivo culture system. METHODS Thoracic and abdominal aortas from mice were cultured in a medium supplemented with inorganic phosphate and were treated with inflammatory cytokines (IL-1β, TNF-α, IL-6, and IL-17A). Vascular calcification was determined using micro-computed tomography (CT) and histological analyses. RESULTS IL-1β, TNF-α, and IL-6 did not significantly promote vascular calcification, whereas IL-17A significantly accelerated vascular calcification of the aorta, as indicated by the increased mineralized volume based on micro-CT analysis. Micro-CT and histological analyses also revealed that the promoting effect of IL-17A on vascular calcification was concentration dependent. CONCLUSIONS IL-17A significantly promoted vascular calcification in ex vivo cultured aortas, which suggests that this mechanism is involved in the increased risk of cardiovascular events in IL-17A-mediated inflammatory diseases.
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Affiliation(s)
- Sumie Hiramatsu-Asano
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, 701-0192, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, 701-0192, Japan; Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Okayama, 701-0192, Japan.
| | - Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, 701-0192, Japan
| | - Haruhito A Uchida
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, 700-8558, Japan; Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, 700-8558, Japan
| | - Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, 701-0192, Japan
| | - Kazuhisa Nakano
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, 701-0192, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, 701-0192, Japan
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11
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Affiliation(s)
- Tomoyuki Mukai
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Japan
- Department of Rheumatology, Kawasaki Medical School, Japan
- Department of Internal Medicine (Rheumatology), Fukuyama City Hospital, Japan
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12
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Yamamoto S, Mukai T, Fujita S, Morita Y. Iliopectineal bursitis. Rheumatology (Oxford) 2021; 61:e242-e243. [PMID: 34849625 DOI: 10.1093/rheumatology/keab864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/06/2021] [Accepted: 11/11/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Shintaro Yamamoto
- Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.,Department of Immunology and Molecular Genetics, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
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13
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Yamamoto S, Mukai T, Fujita S, Morita Y. Barium-induced pneumatosis intestinalis in a patient with anti-synthetase syndrome. Clin Case Rep 2021; 9:e04775. [PMID: 34504699 PMCID: PMC8418673 DOI: 10.1002/ccr3.4775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/05/2021] [Accepted: 08/19/2021] [Indexed: 12/03/2022] Open
Abstract
Pneumatosis intestinalis is defined as the presence of gas in the bowel wall. The combination of the two risks, pre-existing connective tissue diseases and barium contrast examination, may trigger pneumatosis intestinalis, albeit at a low incidence. Clinicians should be aware of the condition for proper differential diagnosis.
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Affiliation(s)
| | - Tomoyuki Mukai
- Department of RheumatologyKawasaki Medical SchoolKurashikiJapan
- Department of Immunology and Molecular GeneticsKawasaki Medical SchoolKurashikiJapan
| | - Shunichi Fujita
- Department of RheumatologyKawasaki Medical SchoolKurashikiJapan
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14
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Affiliation(s)
- Shintaro Yamamoto
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Hirotake Nishimura
- Department of Pathology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
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15
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Yamamoto S, Mukai T. Purple urine bags reflecting an aging society. Clin Case Rep 2021; 9:e04295. [PMID: 34194797 PMCID: PMC8222760 DOI: 10.1002/ccr3.4295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/27/2021] [Accepted: 04/28/2021] [Indexed: 11/17/2022] Open
Abstract
The purple urine bag syndrome is an underrecognized but quite common condition, resulting in marked discoloration of the urine bag system due to bacterial metabolism. This syndrome is associated with advanced age and bedridden persons.
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Affiliation(s)
- Shintaro Yamamoto
- Department of RheumatologyKawasaki Medical SchoolOkayamaJapan
- Department of Internal MedicineSayo Central HospitalHyogoJapan
| | - Tomoyuki Mukai
- Department of RheumatologyKawasaki Medical SchoolOkayamaJapan
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16
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Mukai T, Morita Y. Osteopoikilosis. Rheumatology (Oxford) 2021; 61:879-880. [PMID: 33989397 DOI: 10.1093/rheumatology/keab436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tomoyuki Mukai
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.,Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.,Department of Internal Medicine (Rheumatology), Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, Hiroshima, 721-8511, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
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17
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Hiramatsu-Asano S, Sunahori-Watanabe K, Zeggar S, Katsuyama E, Mukai T, Morita Y, Wada J. Deletion of Mir223 Exacerbates Lupus Nephritis by Targeting S1pr1 in Faslpr/lpr Mice. Front Immunol 2021; 11:616141. [PMID: 33574820 PMCID: PMC7871001 DOI: 10.3389/fimmu.2020.616141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/09/2020] [Indexed: 12/29/2022] Open
Abstract
Objective The micro RNAs (miRNAs) and their target mRNAs are differentially expressed in various immune-mediated cells. Here, we investigated the role of Mir223 and sphingosine-1-phosphate receptor 1 (S1pr1) in the pathogenesis of systemic lupus erythematosus. Methods We analyzed miRNA and mRNA profiling data of CD4+ splenic T cells derived from MRL/MpJ-Faslpr /J mice. We performed 3' untranslated region (UTR) luciferase reporter gene assay using human umbilical vein endothelial cells (HUVECs). We generated the B6-Mir223-/-Faslpr/lpr mice and the lupus phenotypes were analyzed. Results In CD4+ splenic T cells, we identified upregulation of miR-223-3p and downregulation of the possible target, S1pr1 by RNA sequencing of MRL/MpJ-Faslpr /J mice. The transfection with miR-223-3p mimic significantly suppressed a luciferase activity in HUVEC treated with a Lentivirus vector containing 3' UTR of S1pr1. The mRNA levels of S1pr1 were significantly decreased after miR-223-3p overexpression. In B6-Mir223-/-Faslpr/lpr mice, the proportion of CD3+ T cells, CD3+CD4-CD8- cells, B cells, plasma cells, and S1PR1+CD4+ T cells in the spleen was significantly increased compared with that in B6-Mir223+/+Faslpr/lpr mice by flow cytometry. B6-Mir223-/-Faslpr/lpr mice demonstrated the elevation of glomerular and renal vascular scores associated with enhanced intraglomerular infiltration of S1PR1+CD4+ T cells. Conclusion Unexpectedly, the deletion of Mir223 exacerbated the lupus phenotypes associated with increased population of S1PR1+CD4+ T in spleen and the enhanced infiltration of S1PR1+CD4+ T cells in inflamed kidney tissues, suggesting compensatory role of Mir223 in the pathogenesis of lupus nephritis.
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Affiliation(s)
- Sumie Hiramatsu-Asano
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Katsue Sunahori-Watanabe
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Sonia Zeggar
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Eri Katsuyama
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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18
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Wang T, Ikeo N, Okumura K, Akasaka H, Yada R, Yoshida K, Miyawaki D, Ishihara T, Mukumoto N, Shimizu Y, Mukai T, Nakaoka A, Sasaki R. PO-1587: Novel biocompatible artifact-robust and highly visible fiducial marker for image-guided radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01605-4] [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: 10/22/2022]
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19
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Abstract
Drug-induced aortitis is rare; thus, the diagnosis of drug-induced aortitis could be delayed unless clinicians are aware of the disease entity. Herein, we describe the case of a 66-year-old woman who developed aortitis after administration of granulocyte-colony stimulating factor (G-CSF) during chemotherapy for her breast cancer. Thickening of the aortic wall was clearly detected by computed tomography (CT) and magnetic resonance imaging. After excluding the other possible aetiologies, an association between G-CSF and the development of aortitis was highly suspected. Corticosteroid treatment rapidly regressed the aortitis, as confirmed by follow-up CT examination. G-CSF analog is generally well tolerated; however, there are limited case reports of G-CSF-associated aortitis, suggesting the causative effect of G-CSF in the development of aortitis. Currently, G-CSF-associated aortitis has received little attention among rheumatologists. As the delayed diagnosis results in irreversible changes in the aorta, not only oncologists but also rheumatologists should be aware of this unrecognized disease entity, G-CSF-associated aortitis.
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Affiliation(s)
- Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan.,Department of Internal Medicine (Rheumatology), Fukuyama City Hospital, Fukuyama, Japan
| | - Shinichiro Kubo
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Mari Yamamoto
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - Masahiko Ikeda
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, Fukuyama, Japan
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20
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Mukai T, Fujiwara D, Miyake T, Fujita S, Morizane S, Morita Y. Tattoo skin reaction as a skin manifestation of systemic sarcoidosis. Mod Rheumatol Case Rep 2020; 5:167-171. [PMID: 32967569 DOI: 10.1080/24725625.2020.1816645] [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: 10/23/2022]
Abstract
A 41-year-old man presented with itching of the skin surrounding his tattoos, blurred vision, fever, general fatigue, and arthralgia. Physical examination revealed skin bulges confined to the tattoo ink lines. Histological analyses of the skin revealed non-caseating granulomas surrounding the tattoo inks. Together with other clinical manifestations including uveitis, lymph nodes swelling, and elevated serum angiotensin-converting enzyme and lysozyme, he was diagnosed with systemic sarcoidosis. The administration of prednisolone alleviated the sarcoidosis-related symptoms, including skin changes. This case illustrates that skin changes on tattoos can be a presenting manifestation of systemic sarcoidosis and that skin biopsy is useful in early diagnosis.
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Affiliation(s)
- Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Okayama, Japan.,Department of Internal Medicine, Fukuyama City Hospital, Hiroshima, Japan
| | - Dan Fujiwara
- Department of Dermatology, Fukuyama City Hospital, Hiroshima, Japan
| | - Tomoko Miyake
- Department of Ophthalmology, Fukuyama City Hospital, Hiroshima, Japan
| | - Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Okayama, Japan
| | - Shin Morizane
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Okayama, Japan
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21
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Akagi T, Mukai T, Fujita S, Yamamoto T, Fukuda M, Morita Y. Severe oral stomatitis due to reactivation of herpes simplex virus type 1 in a methotrexate-treated patient with dermatomyositis. Immunol Med 2020; 44:56-60. [PMID: 32649847 DOI: 10.1080/25785826.2020.1787585] [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: 10/23/2022] Open
Abstract
We herein report a case of a 79-year-old Japanese woman who developed severe oral stomatitis during methotrexate (MTX) treatment for dermatomyositis. She had been treated with MTX (12 mg/week) and prednisolone (5 mg/day) for dermatomyositis for 4 years. She developed painful stomatitis, fever, and pancytopenia. Initially, her symptoms were suspected to be caused by mucosal toxicity of MTX. Therefore, the drug was discontinued, and leucovorin was administered. However, oral stomatitis worsened in a few days, resulting in intolerance of oral ingestion due to severe pain. Polymerase chain reaction revealed the presence of herpes simplex virus type 1 (HSV-1) in oral erosive lesions, and blood examination was positive and negative for anti-HSV IgG and anti-HSV IgM, respectively. Therefore, HSV-1 reactivation-induced oral stomatitis was diagnosed, and acyclovir treatment was started, which promptly improved oral stomatitis. HSV-1 reactivation is usually asymptomatic or results in localized vesicular lesions at the mucocutaneous junction of the lips in immunocompetent individuals. Our case illustrates that HSV-1 reactivation induces severe stomatitis in patients treated with low-dose MTX for autoimmune diseases, not just in those with severe immunosuppressive conditions. Of note, HSV-1 reactivation-induced stomatitis is a diagnostic challenge, especially during MTX treatment.
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Affiliation(s)
- Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Takenobu Yamamoto
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Mikiko Fukuda
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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22
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Ochi K, Mukai T, Ota S, Hiraiwa C, Ikeda M, Ikeda A, Oda T, Yamamoto Y, Ueki T. Tsukamurella pulmonis central venous catheter infection mimicking proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA)-associated vasculitis. Immunol Med 2020; 44:211-215. [PMID: 32649848 DOI: 10.1080/25785826.2020.1791403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
A 40-year-old Japanese woman, who underwent total thyroidectomy, had suffered from repeated episodes of fever and microscopic hematuria for 3 years, which had started 3 months after central venous port catheter insertion. On admission, she had malaise and low-grade fever, and was found to have microscopic hematuria, urinary red blood cell casts, multiple pulmonary nodules, and positivity of proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA), which were suggestive to the presence of ANCA-associated small vessel vasculitis. However, her blood culture and subsequent gene analysis revealed the positivity of Tsukamurella pulmonis, and she was diagnosed with Tsukamurella pulmonis bacteremia accompanying PR3-ANCA positivity. Her condition improved after the removal of the catheter and antibiotic treatment. Tsukamurella species are categorized to the order Actinomycetales and can be misidentified as other Actinomycetales without genetic analyses. This case illustrates that chronic Tsukamurella pulmonis infection can cause ANCA production and nephritis, which mimics ANCA-associated vasculitis. Thus, it is critical to diagnose these cases correctly to avoid misdiagnosis and inappropriate treatment, such as immunosuppressive treatment.
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Affiliation(s)
- Kiyoaki Ochi
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan
| | - Tomoyuki Mukai
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan.,Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Shigeru Ota
- Department of Internal Medicine, Fujii Hospital, Fukuyama, Hiroshima, Japan
| | - Chihiro Hiraiwa
- Department of Internal Medicine, Fujii Hospital, Fukuyama, Hiroshima, Japan
| | - Masahiko Ikeda
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan
| | - Airi Ikeda
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan
| | - Takashi Oda
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan
| | - Youichiro Yamamoto
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan
| | - Toru Ueki
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan
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23
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Akagi T, Mukai T, Mito T, Kawahara K, Tsuji S, Fujita S, Uchida HA, Morita Y. Effect of Angiotensin II on Bone Erosion and Systemic Bone Loss in Mice with Tumor Necrosis Factor-Mediated Arthritis. Int J Mol Sci 2020; 21:ijms21114145. [PMID: 32532031 PMCID: PMC7312645 DOI: 10.3390/ijms21114145] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/25/2020] [Accepted: 06/07/2020] [Indexed: 12/14/2022] Open
Abstract
Angiotensin II (Ang II) is the main effector peptide of the renin-angiotensin system (RAS), which regulates the cardiovascular system. The RAS is reportedly also involved in bone metabolism. The upregulation of RAS components has been shown in arthritic synovial tissues, suggesting the potential involvement of Ang II in arthritis. Accordingly, in the present study, we investigated the role of Ang II in bone erosion and systemic bone loss in arthritis. Ang II was infused by osmotic pumps in tumor necrosis factor-transgenic (TNFtg) mice. Ang II infusion did not significantly affect the severity of clinical and histological inflammation, whereas bone erosion in the inflamed joints was significantly augmented. Ang II administration did not affect the bone mass of the tibia or vertebra. To suppress endogenous Ang II, Ang II type 1 receptor (AT1R)-deficient mice were crossed with TNFtg mice. Genetic deletion of AT1R did not significantly affect inflammation, bone erosion, or systemic bone loss. These results suggest that excessive systemic activation of the RAS can be a risk factor for progressive joint destruction. Our findings indicate an important implication for the pathogenesis of inflammatory bone destruction and for the clinical use of RAS inhibitors in patients with rheumatoid arthritis.
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Affiliation(s)
- Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan; (T.A.); (T.M.); (K.K.); (S.T.); (S.F.); (Y.M.)
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan; (T.A.); (T.M.); (K.K.); (S.T.); (S.F.); (Y.M.)
- Correspondence: ; Tel.: +81-86-462-1111
| | - Takafumi Mito
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan; (T.A.); (T.M.); (K.K.); (S.T.); (S.F.); (Y.M.)
| | - Kyoko Kawahara
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan; (T.A.); (T.M.); (K.K.); (S.T.); (S.F.); (Y.M.)
| | - Shoko Tsuji
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan; (T.A.); (T.M.); (K.K.); (S.T.); (S.F.); (Y.M.)
| | - Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan; (T.A.); (T.M.); (K.K.); (S.T.); (S.F.); (Y.M.)
| | - Haruhito A. Uchida
- Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-0914, Japan;
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan; (T.A.); (T.M.); (K.K.); (S.T.); (S.F.); (Y.M.)
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24
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Yamaguchi T, Akiyoshi T, Fukunaga Y, Nagayama S, Nagasaki T, Mukai T, Nakanishi R, Konishi T. Robotic extralevator abdominoperineal resection with en bloc multivisceral resection and lateral lymph node dissection for rectal cancer. Tech Coloproctol 2020; 24:1093-1094. [PMID: 32472358 DOI: 10.1007/s10151-020-02256-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/25/2020] [Indexed: 01/31/2023]
Affiliation(s)
- T Yamaguchi
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - T Akiyoshi
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Y Fukunaga
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - S Nagayama
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - T Nagasaki
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - T Mukai
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - R Nakanishi
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - T Konishi
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
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25
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Abstract
OBJECTIVES Rheumatoid arthritis (RA) is characterized by inflammation in multiple joints. In addition to causing joint destruction, the persistent systemic inflammation with RA increases the risk of cardiovascular disease. Although there are in vitro studies showing the prothrombotic effect of inflammatory cytokines, especially TNF, in vivo experimental evidence is lacking due to the complexity of in vivo modeling and observation. In this study, we aimed to model in vivo thrombus formation in arthritic mice and to determine whether the arthritic condition would further promote thrombotic formation. METHODS Human TNF-transgenic mice were used as the arthritis model. Thrombus formation was observed on the testicular arterioles. Thrombus formation was induced by reactive oxygen species generated from hematoporphyrin under laser irradiation. RESULTS Platelet thrombus formation was observed in real-time using a laser confocal microscopy in both wild-type and arthritic mice. Quantitative analyses revealed that no significant differences were observed in thrombus formation, represented by platelet attachment time and vascular obstruction time, in our experimental setting. CONCLUSION Although we confirmed the usefulness of this novel technique for in vivo studies, further investigation is required to conclude the possible mechanism of prothrombotic phenotypes under inflammatory conditions.
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Affiliation(s)
- Shoko Tsuji
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Hiroyasu Hirano
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
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Yamamoto S, Fujita S, Mukai T, Sawachika H, Morita Y. Paraneoplastic Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome Should Be Treated with Low-dose Prednisolone During Pembrolizumab Therapy. Intern Med 2020; 59:597-598. [PMID: 31666471 PMCID: PMC7056381 DOI: 10.2169/internalmedicine.3902-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Japan
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27
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Yamamoto S, Fujita S, Mukai T, Sawachika H, Morita Y. Paraneoplastic Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome Should Be Treated with Low-dose Prednisolone During Pembrolizumab Therapy. Intern Med 2020; 59:599. [PMID: 31666472 PMCID: PMC7056386 DOI: 10.2169/internalmedicine.3938-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Japan
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28
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Sakuta K, Mukai T, Hasegawa I, Okuno K, Tanaka T, Yaguchi H. External validation of the nag scale for predicting hematoma expansion in patients with acute intracerebral hemorrhage. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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29
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Tsuji S, Matsuzaki H, Iseki M, Nagasu A, Hirano H, Ishihara K, Ueda N, Honda Y, Horiuchi T, Nishikomori R, Morita Y, Mukai T. Functional analysis of a novel G87V TNFRSF1A mutation in patients with TNF receptor-associated periodic syndrome. Clin Exp Immunol 2019; 198:416-429. [PMID: 31429073 DOI: 10.1111/cei.13365] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2019] [Indexed: 12/17/2022] Open
Abstract
Tumor necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS) is an autoinflammatory disease that is caused by heterozygous mutations in the TNFRSF1A gene. Although more than 150 TNFRSF1A mutations have been reported to be associated with TRAPS phenotypes only a few, such as p.Thr79Met (T79M) and cysteine mutations, have been functionally analyzed. We identified two TRAPS patients in one family harboring a novel p.Gly87Val (G87V) mutation in addition to a p.Thr90Ile (T90I) mutation in TNFRSF1A. In this study, we examined the functional features of this novel G87V mutation. In-vitro analyses using mutant TNF receptor 1 (TNF-R1)-over-expressing cells demonstrated that this mutation alters the expression and function of TNF-R1 similar to that with the previously identified pathogenic T79M mutation. Specifically, cell surface expression of the mutant TNF-R1 in transfected cells was inhibited with both G87V and T79M mutations, whereas the T90I mutation did not affect this. Moreover, peripheral blood mononuclear cells (PBMCs) from TRAPS patients harboring the G87V and T90I mutations showed increased mitochondrial reactive oxygen species (ROS). Furthermore, the effect of various Toll-like receptor (TLR) ligands on inflammatory responses was explored, revealing that PBMCs from TRAPS patients are hyper-responsive to TLR-2 and TLR-4 ligands and that interleukin (IL)-8 and granulocyte-macrophage colony-stimulating factor (GM-CSF) are likely to be involved in the pathogenesis of TRAPS. These findings suggest that the newly identified G87V mutation is one of the causative mutations of TRAPS. Our findings based on unique TRAPS-associated mutations provide novel insight for clearer understanding of inflammatory responses, which would be basic findings of developing a new therapeutic and prophylactic approach to TRAPS.
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Affiliation(s)
- S Tsuji
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - H Matsuzaki
- Department of Life Sciences, Faculty of Life and Environmental Sciences, Prefectural University of Hiroshima, Shobara, Hiroshima, Japan
| | - M Iseki
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - A Nagasu
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - H Hirano
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - K Ishihara
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - N Ueda
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Y Honda
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Oita, Japan
| | - R Nishikomori
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Y Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - T Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
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30
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Fujita S, Hayashi H, Kodama S, Mukai T, Morita Y. Infection of Helicobacter cinaedi Should Be Treated for an Adequate Duration with Combined Antibiotic Therapy: Author's Reply. Intern Med 2019; 58:2591. [PMID: 31118407 PMCID: PMC6761331 DOI: 10.2169/internalmedicine.2926-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - Shoko Kodama
- Department of Rheumatology, Kawasaki Medical School, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Japan
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31
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Akagi T, Fujita S, Mukai T, Morita Y. Complete resolution of giant cell arteritis after tocilizumab monotherapy determined by positron emission tomography-CT. BMJ Case Rep 2019; 12:12/1/bcr-2018-228697. [PMID: 30635325 DOI: 10.1136/bcr-2018-228697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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32
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Fujita S, Hayashi H, Kodama S, Mukai T, Morita Y. Bacteremia Possibly Caused by Helicobacter cinaedi and Associated with Painful Erythema in Rheumatoid Arthritis with Malignant Lymphoma. Intern Med 2018; 57:3663-3666. [PMID: 30146580 PMCID: PMC6355406 DOI: 10.2169/internalmedicine.1196-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 12/03/2022] Open
Abstract
We herein report the case of a 69-year-old woman with rheumatoid arthritis (RA) and malignant lymphoma who developed Helicobacter cinaedi bacteremia after starting rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. She had a recurrent fever and painful erythema for 13 months before the diagnosis was made. This delayed diagnosis was attributable to the underlying RA, which typically presents with various cutaneous manifestations and elevated C-reactive protein levels. The erythema on the thighs, abdomen, and left forearm improved following treatment with intravenous aminobenzyl penicillin; she received antibiotics for six weeks. This case emphasizes the importance of recognizing this opportunistic infection in immunocompromised patients.
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Affiliation(s)
| | | | - Shoko Kodama
- Department of Rheumatology, Kawasaki Medical School, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Japan
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33
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Aiba T, Uehara K, Mukai T, Hattori N, Nakayama G, Nagino M. Transanal extended rectal surgery with lateral pelvic lymph node dissection. Tech Coloproctol 2018; 22:893-894. [PMID: 30483903 DOI: 10.1007/s10151-018-1891-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Affiliation(s)
- T Aiba
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Aichi, Japan
| | - K Uehara
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Aichi, Japan.
| | - T Mukai
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Aichi, Japan
| | - N Hattori
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - G Nakayama
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Aichi, Japan
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34
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Akagi T, Mukai T, Tsuji S, Morita Y. Scrub typhus (Tsutsugamushi disease) in a patient presenting with hemophagocytic syndrome. Immunol Med 2018; 41:82-84. [PMID: 30938265 DOI: 10.1080/13497413.2018.1481581] [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: 10/28/2022] Open
Abstract
Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which is found mainly in East and Southeast Asia and in Australia. The disease presents with a variety of non-specific symptoms, including fever, headache, cough, myalgia, and rash. Delay in starting appropriate antimicrobial therapy may lead to serious complications and even death. We report the case of an 84-year-old Japanese patient with scrub typhus who developed hemophagocytic syndrome (HPS) and was successfully treated with minocycline in addition to corticosteroids. A pathognomonic skin ulcer on her right buttock, which was initially covered with black eschar, prompted us to consider the possibility of scrub typhus. Blood polymerase chain reaction and antibody assays confirmed the diagnosis. Scrub typhus must be considered as one of the underlying diseases that may cause HPS in patients living in the Asia-Pacific region and in those who have recently returned from endemic areas.
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Affiliation(s)
- Takahiko Akagi
- a Department of Rheumatology , Kawasaki Medical School , Kurashiki , Japan
| | - Tomoyuki Mukai
- a Department of Rheumatology , Kawasaki Medical School , Kurashiki , Japan
| | - Shoko Tsuji
- a Department of Rheumatology , Kawasaki Medical School , Kurashiki , Japan
| | - Yoshitaka Morita
- a Department of Rheumatology , Kawasaki Medical School , Kurashiki , Japan
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35
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Abstract
Rheumatoid pleural effusion is generally responsive to corticosteroids, but refractory cases require consideration of second-line therapy. Here we report the case of a 61-year-old man with rheumatoid arthritis (RA) who developed a large right-sided pleural effusion and was successfully treated with abatacept. Thoracocentesis showed a sterile exudate and an elevated adenosine deaminase level. The methotrexate and etanercept used to treat the RA were withheld initially while he underwent a trial of prednisolone 40 mg/day for the pleural effusion. However, the effusion did not respond to this therapy. Thoracoscopic biopsy of the right pleura revealed fibrotic changes with lymphocyte infiltration mainly composed of CD4+ T cells and B cells but no evidence of malignancy or infection. The patient was started on abatacept and resumed methotrexate. The treatment was effective in our case. Abatacept should be considered as a treatment option in patients with refractory rheumatoid pleural effusion.
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Affiliation(s)
- Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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36
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Sawachika H, Fujita S, Mukai T, Morita Y. IgG4-related autoimmune pancreatitis complicated by splenic artery pseudoaneurysm. BMJ Case Rep 2018; 2018:bcr-2018-224589. [PMID: 29507039 DOI: 10.1136/bcr-2018-224589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Hiroshi Sawachika
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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37
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Affiliation(s)
- Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | | | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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38
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Kawahara K, Mukai T, Miyaji Y, Morita Y. Chronic reactive arthritis associated with prostatitis caused by Neisseria meningitidis. BMJ Case Rep 2018; 2018:bcr-2017-223537. [PMID: 29374652 DOI: 10.1136/bcr-2017-223537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kyoko Kawahara
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshiyuk Miyaji
- Department of Urology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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39
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Sawachika H, Kodama S, Mukai T, Morita Y. Mycophenolate mofetil treatment in a patient with recurrent lymphocytic hypophysitis. BMJ Case Rep 2018; 2018:bcr-2017-222678. [PMID: 29306856 DOI: 10.1136/bcr-2017-222678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Lymphocytic hypophysitis (LHP) is a relatively rare disease characterised by lymphocytic infiltration of the pituitary gland, resulting in pituitary dysfunction. LHP is generally responsive to corticosteroid therapy, but cases with recurrence require clinicians to select second-line therapy. We report here the case of a 58-year-old patient with LHP who developed panhypopituitarism and bitemporal hemianopia. He responded to prednisolone 40 mg/day but relapsed during tapering. The prednisolone dose was increased again and mycophenolate mofetil (MMF) was added. Thereafter, over the course of 1 year, prednisolone was tapered to 8 mg/day without relapse. Because of the rarity of LHP, there are no standard treatment protocols that support the choice of a specific immunosuppressive drug. MMF was effective for recurrent LHP in our case. Further accumulation of cases is needed to establish the standard treatment for this disease.
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Affiliation(s)
- Hiroshi Sawachika
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Shoko Kodama
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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40
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Fujita S, Mukai T, Mito T, Kodama S, Nagasu A, Kittaka M, Sone T, Ueki Y, Morita Y. Pharmacological inhibition of tankyrase induces bone loss in mice by increasing osteoclastogenesis. Bone 2018; 106:156-166. [PMID: 29055830 PMCID: PMC6912859 DOI: 10.1016/j.bone.2017.10.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/05/2017] [Accepted: 10/18/2017] [Indexed: 12/20/2022]
Abstract
Tankyrase is a poly (ADP-ribose) polymerase that leads to ubiquitination and degradation of target proteins. Since tankyrase inhibitors suppress the degradation of AXIN protein, a negative regulator of the canonical Wnt pathway, they effectively act as Wnt inhibitors. Small molecule tankyrase inhibitors are being investigated as drug candidates for cancer and fibrotic diseases, in which the Wnt pathways are aberrantly activated. Tankyrase is also reported to degrade the adaptor protein SH3BP2 (SH3 domain-binding protein 2). We have previously shown that SH3BP2 gain-of-function mutation enhances receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclastogenesis in murine bone marrow-derived macrophages (BMMs). Although the interaction between tankyrase and SH3BP2 has been reported, it is not clear whether and how the inhibition of tankyrase affects bone cells and bone mass. Here, we have demonstrated that tankyrase inhibitors (IWR-1, XAV939, and G007-LK) enhanced RANKL-induced osteoclast formation and function in murine BMMs and human peripheral blood mononuclear cells through the accumulation of SH3BP2, subsequent phosphorylation of SYK, and nuclear translocation of NFATc1. Tankyrase inhibitors also enhanced osteoblast differentiation and maturation, represented by increased expression of osteoblast-associated genes accompanied by the accumulation of SH3BP2 protein and enhanced nuclear translocation of ABL, TAZ, and Runx2 in primary osteoblasts. Most importantly, pharmacological inhibition of tankyrase in mice significantly decreased tibia and lumbar vertebrae bone volumes in association with increased numbers of osteoclasts. Our findings uncover the role of tankyrase inhibition in bone cells and highlight the potential adverse effects of the inhibitor on bone.
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Affiliation(s)
- Shunichi Fujita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan.
| | - Takafumi Mito
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Shoko Kodama
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Akiko Nagasu
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Mizuho Kittaka
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, MO, USA
| | - Teruki Sone
- Department of Nuclear Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Yasuyoshi Ueki
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, MO, USA
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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41
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Kittaka M, Mayahara K, Mukai T, Yoshimoto T, Yoshitaka T, Gorski JP, Ueki Y. Cherubism Mice Also Deficient in c-Fos Exhibit Inflammatory Bone Destruction Executed by Macrophages That Express MMP14 Despite the Absence of TRAP+ Osteoclasts. J Bone Miner Res 2018; 33:167-181. [PMID: 28914985 PMCID: PMC5771992 DOI: 10.1002/jbmr.3295] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 08/28/2017] [Accepted: 09/07/2017] [Indexed: 11/10/2022]
Abstract
Currently, it is believed that osteoclasts positive for tartrate-resistant acid phosphatase (TRAP+) are the exclusive bone-resorbing cells responsible for focal bone destruction in inflammatory arthritis. Recently, a mouse model of cherubism (Sh3bp2KI/KI ) with a homozygous gain-of-function mutation in the SH3-domain binding protein 2 (SH3BP2) was shown to develop auto-inflammatory joint destruction. Here, we demonstrate that Sh3bp2KI/KI mice also deficient in the FBJ osteosarcoma oncogene (c-Fos) still exhibit noticeable bone erosion at the distal tibia even in the absence of osteoclasts at 12 weeks old. Levels of serum collagen I C-terminal telopeptide (ICTP), a marker of bone resorption generated by matrix metalloproteinases (MMPs), were elevated, whereas levels of serum cross-linked C-telopeptide (CTX), another resorption marker produced by cathepsin K, were not increased. Collagenolytic MMP levels were increased in the inflamed joints of the Sh3bp2KI/KI mice deficient in c-Fos. Resorption pits contained a large number of F4/80+ macrophages and genetic depletion of macrophages rescued these erosive changes. Importantly, administration of NSC405020, an MMP14 inhibitor targeted to the hemopexin (PEX) domain, suppressed bone erosion in c-Fos-deficient Sh3bp2KI/KI mice. After activation of the NF-κB pathway, macrophage colony-stimulating factor (M-CSF)-dependent macrophages from c-Fos-deficient Sh3bp2KI/KI mice expressed increased amounts of MMP14 compared with wild-type macrophages. Interestingly, receptor activator of NF-κB ligand (RANKL)-deficient Sh3bp2KI/KI mice failed to show notable bone erosion, whereas c-Fos deletion did restore bone erosion to the RANKL-deficient Sh3bp2KI/KI mice, suggesting that osteolytic transformation of macrophages requires both loss-of-function of c-Fos and gain-of-function of SH3BP2 in this model. These data provide the first genetic evidence that cells other than osteoclasts can cause focal bone destruction in inflammatory bone disease and suggest that MMP14 is a key mediator conferring pathological bone-resorbing capacity on c-Fos-deficient Sh3bp2KI/KI macrophages. In summary, the paradigm that osteoclasts are the exclusive cells executing inflammatory bone destruction may need to be reevaluated based on our findings with c-Fos-deficient cherubism mice lacking osteoclasts. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Mizuho Kittaka
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Kotoe Mayahara
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA.,Department of Orthodontics, Nihon University, School of Dentistry, Tokyo, Japan
| | - Tomoyuki Mukai
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Tetsuya Yoshimoto
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Teruhito Yoshitaka
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Jeffrey P Gorski
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA.,University of Missouri-Kansas City (UMKC) Center of Excellence in the Study of Dental and Musculoskeletal Tissues (CEMT), Kansas City, MO, USA
| | - Yasuyoshi Ueki
- Department of Oral and Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA.,University of Missouri-Kansas City (UMKC) Center of Excellence in the Study of Dental and Musculoskeletal Tissues (CEMT), Kansas City, MO, USA
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42
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Affiliation(s)
- Shoko Kodama
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Koji Kurose
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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43
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Mukai T, Okamoto T, Taminato T, Lin Y, Araki M, Sato W, Yamamura T, Takahashi Y. Neurological adverse events after fingolimod administration in patients with multiple sclerosis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mukai Y, Miyazaki M, Mukai T, Tasaki A, Yuji T, Murata M. The pharmacokinetics of patients with Parkinson’s disease receiving levodopa-carbidopa intestinal gel infusion therapy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kinboshi M, Mukai T, Nagao Y, Shimizu S, Ito H, Ikeda A, Ohno Y. Dysfunction of astrocytic Kir4.1 channels induces BDNF expression. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3746] [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: 10/18/2022]
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Innami K, Mukai T, Kodama S, Morita Y. Successful treatment using rituximab in a patient with refractory polymyositis complicated by scleroderma renal crisis. BMJ Case Rep 2017; 2017:bcr-2017-221205. [PMID: 28942404 DOI: 10.1136/bcr-2017-221205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Corticosteroids are the first-line treatment for patients with inflammatory myopathies. Myositis can be a clinical feature of scleroderma (polymyositis-scleroderma overlap syndrome), and treatment of this syndrome is a challenge for clinicians because moderate to high doses of corticosteroids are considered a risk factor for development of acute kidney injury in affected patients. We report here the case of a 56-year-old woman with scleroderma who developed polymyositis and was successfully treated with rituximab. Initial treatment of the polymyositis with prednisolone 40 mg/day was rapidly tapered to 2.5 mg/day due to development of scleroderma renal crisis, for which four weekly infusions of rituximab (500 mg; off-label) were given. She responded well to rituximab in addition to prednisolone 2.5 mg/day. Rituximab may improve inflammatory myopathies, even in cases where high-dose corticosteroids should be avoided due to complications. Rituximab should be considered as a treatment option in cases of refractory polymyositis.
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Affiliation(s)
- Kyoko Innami
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Shoko Kodama
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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Abstract
Multiple myeloma has been reported to be associated with rheumatoid arthritis (RA). POEMS syndrome is a rare variant of multiple myeloma and is characterised by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes. We report the case of a 67-year-old patient with RA who developed numbness and tingling in both legs due to polyneuropathy. CT showed a massive right pleural effusion and a sclerotic lesion in the right ninth rib. Histopathological examination of the rib revealed IgA lambda-type plasmacytoma. Serum vascular endothelial growth factor was extremely high at 5530 pg/mL. We made a diagnosis of POEMS syndrome. A literature search of the PubMed database identified only two documented cases of POEMS syndrome in patients with RA. Neuropathies are reportedly more frequent in patients with RA than in the general population. Rheumatologists should consider POEMS syndrome in patients with RA and neurological symptoms.
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Affiliation(s)
- Takahiko Akagi
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Shoko Kodama
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshitaka Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Japan
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Mukai T, Nagamura-Inoue T. Neurotropism and neuroprotective effect in umbilical cord derived-mesenchymal stromal cells. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.058] [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: 11/28/2022]
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Ihara K, Fukano C, Ayabe T, Fukami M, Ogata T, Kawamura T, Urakami T, Kikuchi N, Yokota I, Takemoto K, Mukai T, Nishii A, Kikuchi T, Mori T, Shimura N, Sasaki G, Kizu R, Takubo N, Soneda S, Fujisawa T, Takaya R, Kizaki Z, Kanzaki S, Hanaki K, Matsuura N, Kasahara Y, Kosaka K, Takahashi T, Minamitani K, Matsuo S, Mochizuki H, Kobayashi K, Koike A, Horikawa R, Teno S, Tsubouchi K, Mochizuki T, Igarashi Y, Amemiya S, Sugihara S. FUT2 non-secretor status is associated with Type 1 diabetes susceptibility in Japanese children. Diabet Med 2017; 34:586-589. [PMID: 27859559 DOI: 10.1111/dme.13288] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 01/04/2023]
Abstract
AIM To examine the contribution of the FUT2 gene and ABO blood type to the development of Type 1 diabetes in Japanese children. METHODS We analysed FUT2 variants and ABO genotypes in a total of 531 Japanese children diagnosed with Type 1 diabetes and 448 control subjects. The possible association of FUT2 variants and ABO genotypes with the onset of Type 1 diabetes was statistically examined. RESULTS The se2 genotype (c.385A>T) of the FUT2 gene was found to confer susceptibility to Type 1A diabetes in a recessive effects model [odds ratio for se2/se2, 1.68 (95% CI 1.20-2.35); corrected P value = 0.0075]. CONCLUSIONS The FUT2 gene contributed to the development of Type 1 diabetes in the present cohort of Japanese children.
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Affiliation(s)
- K Ihara
- Department of Paediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Paediatrics, Oita University School of Medicine, Yufu, Japan
| | - C Fukano
- Department of Paediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ayabe
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - M Fukami
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - T Ogata
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Paediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Kawamura
- Department of Paediatrics, Osaka City University Hospital, Osaka, Japan
| | - T Urakami
- Department of Paediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - N Kikuchi
- Department of Paediatrics, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - I Yokota
- Department of Clinical Laboratory, Shikoku Medical Center for Children and Adults, Zentsuji, Japan
- Department of Paediatrics, Graduate School of Medical Sciences Tokushima University, Tokushima, Japan
| | - K Takemoto
- Department of Paediatrics, Ehime University Hospital, Toon, Japan
- Department of Paediatrics, Sumitomo Besshi Hospital, Niihama, Japan
| | - T Mukai
- Department of Paediatrics, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Paediatrics, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - A Nishii
- Department of Paediatrics, JR Sendai Hospital, Sendai, Japan
| | - T Kikuchi
- Department of Paediatrics, Saitama Medical University Hospital, Saitama, Japan
- Department of Paediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - T Mori
- Department of Paediatrics, Nagano Red Cross Hospital, Nagano, Japan
- Department of Paediatrics, Shinshu Ueda Medical Centre, Ueda, Japan
| | - N Shimura
- Department of Paediatrics, Dokkyo Medical University Hospital, Shimotsuga, Japan
| | - G Sasaki
- Department of Paediatrics, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - R Kizu
- Department of Paediatrics, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - N Takubo
- Department of Pediatrics, Kitasato University Hospital, Sagamihara, Japan
- Department of Paediatrics and Adolescent Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - S Soneda
- Department of Paediatrics, St Marianna University School of Medicine, Kawasaki, Japan
| | - T Fujisawa
- Department of Paediatrics, National Mie Hospital, Tsu, Japan
| | - R Takaya
- Department of Paediatrics, Osaka Medical College, Takatsuki, Japan
| | - Z Kizaki
- Department of Paediatrics, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - S Kanzaki
- Department of Paediatrics, Tottori University Faculty of Medicine, Yonago, Japan
| | - K Hanaki
- Department of Paediatrics, Tottori Prefectural Kousei Hospital, Kurayoshi, Japan
| | - N Matsuura
- Department of Paediatrics, Teine Keijinkai Hospital, Sapporo, Japan
- Department of Early Childhood Care and Education, Seitoku University Junior College, Matsudo, Japan
| | - Y Kasahara
- Department of Paediatrics, Kanazawa University, Kanazawa, Japan
| | - K Kosaka
- Department of Paediatrics, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - K Minamitani
- Department of Paediatrics, Teikyo University Chiba Medical Center, Ichihara, Japan
| | - S Matsuo
- Matsuo Kodomo Clinic, Kyoto, Japan
| | - H Mochizuki
- Department of Metabolism and Endocrinology, Saitama Children's Medical Centre, Saitama, Japan
| | - K Kobayashi
- Department of Paediatrics, University of Yamanashi Hospital, Chuo, Japan
| | - A Koike
- Miyanosawa Koike Child Clinic, Sapporo, Japan
| | - R Horikawa
- Division of Endocrinology and Metabolism, Department of Medical Subspecialties, National Medical Centre for Children and Mothers, Tokyo, Japan
| | - S Teno
- Teno Clinic, Izumo, Japan
| | - K Tsubouchi
- Department of Paediatrics, Chuno Kosei Hospital, Seki, Japan
| | - T Mochizuki
- Department of Paediatrics, Osaka City General Hospital, Osaka, Japan
- Department of Paediatrics, Osaka Police Hospital, Osaka, Japan
| | - Y Igarashi
- Igarashi Children's Clinic, Sendai, Japan
| | - S Amemiya
- Department of Paediatrics, Saitama Medical University Hospital, Saitama, Japan
| | - S Sugihara
- Department of Paediatrics, Tokyo Women's Medical University Medical Centre East, Tokyo, Japan
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Ayabe T, Fukami M, Ogata T, Kawamura T, Urakami T, Kikuchi N, Yokota I, Ihara K, Takemoto K, Mukai T, Nishii A, Kikuchi T, Mori T, Shimura N, Sasaki G, Kizu R, Takubo N, Soneda S, Fujisawa T, Takaya R, Kizaki Z, Kanzaki S, Hanaki K, Matsuura N, Kasahara Y, Kosaka K, Takahashi T, Minamitani K, Matsuo S, Mochizuki H, Kobayashi K, Koike A, Horikawa R, Teno S, Tsubouchi K, Mochizuki T, Igarashi Y, Amemiya S, Sugihara S. Variants associated with autoimmune Type 1 diabetes in Japanese children: implications for age-specific effects of cis-regulatory haplotypes at 17q12-q21. Diabet Med 2016; 33:1717-1722. [PMID: 27352912 DOI: 10.1111/dme.13175] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 05/08/2016] [Accepted: 06/27/2016] [Indexed: 12/11/2022]
Abstract
AIMS The aim of this study was to clarify the significance of previously reported susceptibility variants in the development of autoimmune Type 1 diabetes in non-white children. Tested variants included rs2290400, which has been linked to Type 1 diabetes only in one study on white people. Haplotypes at 17q12-q21 encompassing rs2290400 are known to determine the susceptibility of early-onset asthma by affecting the expression of flanking genes. METHODS We genotyped 63 variants in 428 Japanese people with childhood-onset autoimmune Type 1 diabetes and 457 individuals without diabetes. Possible association between variants and age at diabetes onset was examined using age-specific quantitative trait locus analysis and ordered-subset regression analysis. RESULTS Ten variants, including rs2290400 in GSDMB, were more frequent among the people with Type 1 diabetes than those without diabetes. Of these, rs689 in INS and rs231775 in CTLA4 yielded particularly high odds ratios of 5.58 (corrected P value 0.001; 95% CI 2.15-14.47) and 1.64 (corrected P value 5.3 × 10-5 ; 95% CI 1.34-2.01), respectively. Age-specific effects on diabetes susceptibility were suggested for rs2290400; heterozygosity of the risk alleles was associated with relatively early onset of diabetes, and the allele was linked to the phenotype exclusively in the subgroup of age at onset ≤ 5.0 years. CONCLUSIONS The results indicate that rs2290400 in GSDMB and polymorphisms in INS and CTLA4 are associated with the risk of Type 1 diabetes in Japanese children. Importantly, cis-regulatory haplotypes at 17q12-q21 encompassing rs2290400 probably determine the risk of autoimmune Type 1 diabetes predominantly in early childhood.
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Affiliation(s)
- T Ayabe
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - M Fukami
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - T Ogata
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Kawamura
- Department of Pediatrics, Osaka City University Hospital, Osaka, Japan
| | - T Urakami
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - N Kikuchi
- Department of Pediatrics, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - I Yokota
- Department of Clinical Laboratory, Shikoku Medical Center for Children and Adults, Zentsuji, Japan
- Department of Pediatrics, Graduate School of Medical Sciences Tokushima University, Tokushima, Japan
| | - K Ihara
- Department of Pediatrics, Kyushu University Hospital, Fukuoka, Japan
- Department of Pediatrics, Oita University Hospital, Yufu, Japan
| | - K Takemoto
- Department of Pediatrics, Ehime University Hospital, Toon, Japan
- Department of Pediatrics, Sumitomo Besshi Hospital, Niihama, Japan
| | - T Mukai
- Department of Pediatrics, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - A Nishii
- Department of Pediatrics, JR Sendai Hospital, Sendai, Japan
| | - T Kikuchi
- Department of Pediatrics, Saitama Medical University Hospital, Saitama, Japan
- Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - T Mori
- Department of Pediatrics, Nagano Red Cross Hospital, Nagano, Japan
- Department of Pediatrics, Shinshu Ueda Medical Center, Ueda, Japan
| | - N Shimura
- Department of Pediatrics, Dokkyo Medical University Hospital, Shimotsuga, Japan
| | - G Sasaki
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - R Kizu
- Department of Pediatrics, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - N Takubo
- Department of Pediatrics, Kitasato University Hospital, Sagamihara, Japan
- Department of Pediatrics and Adolescent Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - S Soneda
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - T Fujisawa
- Department of Pediatrics, National Mie Hospital, Tsu, Japan
| | - R Takaya
- Department of Pediatrics, Osaka Medical College, Takatsuki, Japan
| | - Z Kizaki
- Department of Pediatrics, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - S Kanzaki
- Department of Pediatrics, Tottori University Faculty of Medicine, Yonago, Japan
| | - K Hanaki
- Department of Pediatrics, Tottori Prefectural Kousei Hospital, Kurayoshi, Japan
| | - N Matsuura
- Department of Pediatrics, Teine Keijinkai Hospital, Sapporo, Japan
- Department of Early Childhood Care and Education, Seitoku University Junior College, Matsudo, Japan
| | - Y Kasahara
- Department of Pediatrics, Kanazawa University, Kanazawa, Japan
| | - K Kosaka
- Department of Pediatrics, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - K Minamitani
- Department of Pediatrics, Teikyo University Chiba Medical Center, Ichihara, Japan
| | - S Matsuo
- Matsuo Kodomo Clinic, Kyoto, Japan
| | - H Mochizuki
- Department of Metabolism and Endocrinology, Saitama Children's Medical Center, Saitama, Japan
| | - K Kobayashi
- Department of Pediatrics, University of Yamanashi Hospital, Chuo, Japan
| | - A Koike
- Miyanosawa Koike Child Clinic, Sapporo, Japan
| | - R Horikawa
- Division of Endocrinology and Metabolism, Department of Medical Subspecialties, National Medical Center for Children and Mothers, Tokyo, Japan
| | - S Teno
- Teno Clinic, Izumo, Japan
| | - K Tsubouchi
- Department of Pediatrics, Chuno Kosei Hospital, Seki, Japan
| | - T Mochizuki
- Department of Pediatrics, Osaka City General Hospital, Osaka, Japan
- Department of Pediatrics, Osaka Police Hospital, Osaka, Japan
| | - Y Igarashi
- Igarashi Children's Clinic, Sendai, Japan
| | - S Amemiya
- Department of Pediatrics, Saitama Medical University Hospital, Saitama, Japan
| | - S Sugihara
- Department of Pediatrics, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
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