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Sugawara Y, Yabe Y, Hagiwara Y, Tsuji I. Association between cognitive social capital and all-cause mortality in Great East Japan Earthquake survivors: a prospective cohort study. Public Health 2022; 207:108-112. [PMID: 35617772 DOI: 10.1016/j.puhe.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Cognitive social capital (SC), such as attitude, trust, or norms, may help improve resilience among survivors, thus improving their health. However, the association between cognitive SC and the risk of all-cause mortality among survivors after the natural disaster has never been investigated. The purpose of the present study is to investigate the association between cognitive SC and the risk of all-cause mortality among survivors of the Great East Japan Earthquake (GEJE). STUDY DESIGN Prospective cohort study. METHODS We conducted a health survey on 1654 residents aged ≥18 years who lived in two areas affected by the GEJE. One year after the GEJE, between June and August 2012, cognitive SC (helping each other, trust, greeting, and solving problems together) was assessed using a self-administrated questionnaire. We divided the subjects into two groups based on response to questionnaire: "high" or "low." We obtained information on death and emigration from the Residential Registration Record and followed up on the participants from June 2012 to November 2020. The Cox proportional hazards regression analysis was used for estimating the multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of all-cause mortality according to each cognitive SC indicator. RESULTS During the 8.5 years of follow-up, 213 subjects died (12.9%). For greeting, compared with subjects who were "high," subjects who were "low" were significantly associated with the risk of all-cause mortality (HR: 2.92, 95% CI: 1.19-7.17). No statistically significant association was observed for helping each other, trust, and solving problems together. CONCLUSION Our findings suggest that perception of greeting may be associated with the risk of all-cause mortality in survivors after natural disasters.
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Affiliation(s)
- Y Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan.
| | - Y Yabe
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Y Hagiwara
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - I Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
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IMAIZUMI T, Toda T, Sakurai D, Hagiwara Y, Ando M, Yoshida Y, Maruyama S. POS-325 AN “IMPROVED” eGFR SLOPE IS ASSOCIATED WITH HOSPITALIZATION EVENTS. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.341] [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: 11/17/2022] Open
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El Hafi L, Isobe S, Tabuchi Y, Katsumata Y, Nakamura H, Fukui T, Matsuo T, Garcia Ricardez GA, Yamamoto M, Taniguchi A, Hagiwara Y, Taniguchi T. System for augmented human–robot interaction through mixed reality and robot training by non-experts in customer service environments. Adv Robot 2019. [DOI: 10.1080/01691864.2019.1694068] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- L. El Hafi
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - S. Isobe
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Y. Tabuchi
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Y. Katsumata
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - H. Nakamura
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - T. Fukui
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - T. Matsuo
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - G. A. Garcia Ricardez
- Division of Information Science, Nara Institute of Science and Technology, Ikoma, Japan
| | - M. Yamamoto
- Business Innovation Division, Panasonic Corporation, Osaka, Japan
| | - A. Taniguchi
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Y. Hagiwara
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - T. Taniguchi
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
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Takahashi J, Goto T, Ishimaru T, Okamoto H, Hagiwara Y, Watase H, Hasegawa K. 73 Association of Advanced Age With a Higher Risk of Endobronchial Intubation in the Emergency Department. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.077] [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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Taniguchi T, Mochihashi D, Nagai T, Uchida S, Inoue N, Kobayashi I, Nakamura T, Hagiwara Y, Iwahashi N, Inamura T. Survey on frontiers of language and robotics. Adv Robot 2019. [DOI: 10.1080/01691864.2019.1632223] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- T. Taniguchi
- Department of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - D. Mochihashi
- The Institute of Statistical Mathematics, Tachikawa, Japan
- SOKENDAI (The Graduate University for Advanced Studies), Tokyo, Japan
| | - T. Nagai
- Graduate School of Engineering Science, Osaka University, Toyonaka, Osaka, Japan
| | - S. Uchida
- Faculty of Languages and Cultures, Kyushu University, Fukuoka, Japan
| | - N. Inoue
- Graduate School of Information Sciences, Tohoku University, Sendai, Japan
- RIKEN Center for Advanced Intelligence Project, Chuo-ku, Japan
| | - I. Kobayashi
- Advanced Sciences, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - T. Nakamura
- Department of Mechanical Engineering and Intelligent Systems, The University of Electro-Communications, Chofu, Japan
| | - Y. Hagiwara
- Department of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - N. Iwahashi
- Department of Information and Communication Engineering, Okayama Prefectural University, Okayama, Japan
| | - T. Inamura
- SOKENDAI (The Graduate University for Advanced Studies), Tokyo, Japan
- National Institute of Informatics, Tokyo, Japan
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Kobayashi K, Taira N, Sawaki M, Sagawa N, Baba S, Saito T, Kawahara T, Hagiwara Y, Uemura Y, Shimozuma K, Ohashi Y, Mukai H. Abstract P2-13-02: Patient-reported outcomes with trastuzumab monotherapy versus trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients (RESPECT): A randomized, open-label, phase 3 clinical trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-13-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
OBJECTIVE: The RESPECT trial compared 1-year trastuzumab monotherapy with trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients. Primary objective of this study was to verify the noninferiority of 1-year trastuzumab monotherapy to trastuzumab plus chemotherapy in terms of disease free survival, and the planned analysis showed that the difference of restricted mean survival time between two groups at 3 years was 0.45 months (reported by Sawaki at ASCO2018). This report assesses the patients-reported outcomes and health-related quality of life (HRQoL).
PATIENTS AND METHODS: The study was done at 99 hospitals in Japan. Elderly women (70 to 80 years old) with HER2-positive, stageI-IIIA invasive breast cancer treated by surgery with clear resection margins were randomly assigned to receive either 1-year trastuzumab or 1-year trastuzumab plus standard chemotherapy, stratified by age, hormone-receptor status, pathological lymph node metastasis and institution. Patients completed questionnaires at baseline, 2 months, 1year, and 3 years after protocol treatment started. The primary outcome was global HRQoL assessed using Functional Assessment of Cancer Therapy-General (FACT-G) total score, and secondary outcomes were chemotherapy-induced peripheral neuropathy (CIPN), instrumental activities of daily living (IADL), anxiety, depression, and subjective happiness. We did the analyses by intention to treat, including patients who completed questionnaires at baseline before start of protocol treatment, and 5point or more change is meaningful in FACT-G total score. This study is registered with ClinicalTrials.gov, NCT01104935.
RESULTS: Between Oct 2009 and Oct 2014, 275 patients were enrolled in the study, of whom 9 patients were excluded: 135 assigned to trastuzumab monotherapy and 131 assigned to trastuzumab plus chemotherapy. We detected significant difference between treatment groups for: clinically meaningful HRQoL deterioration rate at 2 months (31% for trastuzumab monotherapy vs 48% for trastuzumab plus chemotherapy; p=0.016) and at 1year (19% vs 38%; p=0.009), clinically meaningful HRQoL improvement rate at 2 months (38% for trastuzumab monotherapy vs 15% for trastuzumab plus chemotherapy; p<0.01) and at 1year (43% vs 25%; p=0.021), severe sensory CIPN rate at 2months (1.9% for trastuzumab monotherapy vs 14.4% for trastuzumab plus chemotherapy; p=0.001), IADL score at 1year (11.97 for trastuzumab monotherapy vs 11.54 for trastuzumab plus chemotherapy; p<0.042), Hospital Anxiety and Depression Scale score at 2months (8.92 for trastuzumab monotherapy vs 10.79 for trastuzumab plus chemotherapy; p<0.003), and subjective happiness score at 1year (12.8 for trastuzumab monotherapy vs 11.8 for trastuzumab plus chemotherapy; p<0.024).
CONCLUSION: Given the small advantage of adjuvant trastuzumab plus chemotherapy compared to trastuzumab monotherapy for elderly HER-2 positive breast cancer women, decisions about treatment should be informed by the risk for adverse health effects associated with chemotherapy.
Citation Format: Kobayashi K, Taira N, Sawaki M, Sagawa N, Baba S, Saito T, Kawahara T, Hagiwara Y, Uemura Y, Shimozuma K, Ohashi Y, Mukai H. Patient-reported outcomes with trastuzumab monotherapy versus trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients (RESPECT): A randomized, open-label, phase 3 clinical trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-13-02.
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Affiliation(s)
- K Kobayashi
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Taira
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - M Sawaki
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Sagawa
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - S Baba
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Saito
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Kawahara
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Hagiwara
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Uemura
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - K Shimozuma
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Ohashi
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - H Mukai
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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Takahashi M, Sawaki M, Hagiwara Y, Uemura Y, Kawahara T, Shimozuma K, Ohashi Y, Saito T, Baba S, Kobayashi K, Mukai H, Taira N. Abstract P1-11-21: Analysis of cognitive function in elderly HER2-positive breast cancer patients receiving either trastuzumab monotherapy or trastuzumab plus chemotherapy as a postoperative adjuvant treatment: A cognitive function sub-study of a randomized, open-label, phase 3 clinical trial (RESPECT trial). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-11-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
OBJECTIVE: The effect of trastuzumab(Tmab) or chemotherapy on cognitive function has not been fully understood, especially in elderly breast cancer patients. The RESPECT trial compared 1-year(yr) Tmab monotherapy with Tmab plus standard chemotherapy as adjuvant therapy in elderly patients with HER2-positive breast cancer. The primary objective was to verify the noninferiority of 1-yr Tmab monotherapy compared to Tmab plus chemotherapy in terms of disease-free survival, and the planned analysis showed that the difference of restricted mean survival time between two groups at 3 yrs was 0.45 months (Sawaki at ASCO2018). The goal of this report was to assess the impact of the treatment groups on longitudinal cognitive function.
PATIENTS AND METHODS: The study was performed with patients from 99 hospitals in Japan. Elderly women with HER2-positive, stage I-IIIA invasive breast cancer surgery treated with clear resection margins were randomly assigned to either receive 1-yr Tmab or 1-yr Tmab plus standard chemotherapy. 15 institutions participated in the cognitive sub-study. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) at baseline and at 1 and 3 yrs after treatment. The primary outcome was the amount of change in the MMSE score from the baseline. A linear mixed-effects model was used for comparisons of change in the MMSE score between groups, controlling for time and baseline score. Secondary outcomes were the proportion of both suspected mild dementia (MMSE≤27) and dementia (MMSE≤23) at each time point.
RESULTS: Between October 2009 and October 2014, 275 patients were enrolled in the RESPECT trial, and 57 patients were enrolled in the cognitive function sub-study with 2 patients subsequently excluded. The 55-patient sub-study comprised 29 patients assigned to the Tmab monotherapy group and 26 patients assigned to the Tmab plus chemotherapy group. Primary analysis revealed that change in the MMSE score was not significantly different between the two groups (difference −0.6 at 1 yr and −0.9 at 3 yrs; p=0.136), whereas the baseline score was the only significant factor that had an effect on the amount of change in the MMSE score (p<0.001). The proportions of suspected mild dementia at baseline, and at 1 yr and 3 yrs were 15.4, 32.0, and 41.7% in the Tmab monotherapy group, and 45.8, 17.6, and 28.6% in the Tmab plus chemotherapy group. The proportions of suspected mild dementia at baseline were significantly higher in the Tmab plus chemotherapy group (p=0.04). The proportions of suspected dementia at baseline, and at 1 yr and 3 yrs were 0%, 0%, and 4.2% in the Tmab monotherapy group, and 4.2%, 0%, and 4.8% in the Tmab plus chemotherapy group. There were no significant differences in the proportions of suspected dementia between the treatment groups at each time point.
CONCLUSION: Postoperative chemotherapy for elderly breast cancer patients was considered to have little effect on the onset of dementia during the follow-up period of 3 yrs. Further long-term observation is necessary to obtain a significant conclusion.
Citation Format: Takahashi M, Sawaki M, Hagiwara Y, Uemura Y, Kawahara T, Shimozuma K, Ohashi Y, Saito T, Baba S, Kobayashi K, Mukai H, Taira N. Analysis of cognitive function in elderly HER2-positive breast cancer patients receiving either trastuzumab monotherapy or trastuzumab plus chemotherapy as a postoperative adjuvant treatment: A cognitive function sub-study of a randomized, open-label, phase 3 clinical trial (RESPECT trial) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-21.
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Affiliation(s)
- M Takahashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - M Sawaki
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Hagiwara
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Uemura
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - T Kawahara
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - K Shimozuma
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Ohashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - T Saito
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - S Baba
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - K Kobayashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - H Mukai
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - N Taira
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
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Shitara K, Yamanaka T, Denda T, Tsuji Y, Shinozaki K, Komatsu Y, Kobayashi Y, Furuse J, Okuda H, Asayama M, Akiyoshi K, Kagawa Y, Kato T, Oki E, Ando T, Hagiwara Y, Ohashi Y, Yoshino T. REVERCE: a randomized phase II study of regorafenib followed by cetuximab versus the reverse sequence for previously treated metastatic colorectal cancer patients. Ann Oncol 2019; 30:259-265. [PMID: 30508156 DOI: 10.1093/annonc/mdy526] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [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] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The objective of this randomized phase II trial was to evaluate efficacy and safety of the therapeutic sequence of regorafenib followed by cetuximab, compared with cetuximab followed by regorafenib, as the current standard sequence for metastatic colorectal cancer patients. PATIENTS AND METHODS Patients with KRAS exon 2 wild-type metastatic colorectal cancer after failure of fluoropyrimidine, oxaliplatin, and irinotecan were randomized to receive sequential treatment with regorafenib followed by cetuximab ± irinotecan (R-C arm), or the reverse sequence [cetuximab ± irinotecan followed by regorafenib (C-R arm)]. The primary end point was overall survival (OS). Key secondary end points included progression-free survival (PFS) with initial treatment (PFS1), PFS with second treatment (PFS2), safety, and quality of life. Exploratory end points included serial biomarker analyses, including oncogenic alterations from circulating tumor DNA or multiple serum or plasma proteins. RESULTS One-hundred one patients were randomized and eligible for efficacy analysis. Sequential treatment was successful in 86% patients in both arms. Median OS for R-C and C-R was 17.4 and 11.6 months, respectively (P = 0.0293), with a hazard ratio (HR) of 0.61 for OS [95% confidence interval (CI) 0.39-0.96]. The HR for PFS1 (regorafenib in R-C versus cetuximab in C-R) was 0.97 (95% CI 0.61-1.54), and PFS2 (C in R-C versus R in C-R) was 0.29 (95% CI 0.17-0.50). No unexpected safety signals were observed. The quality of life scores during the entire treatment period was not significantly different between the two arms. Circulating biomarker analyses showed emerging oncogenic alterations in RAS, BRAF, EGFR, HER2, and MET, which were more commonly detected after cetuximab than after regorafenib. CONCLUSIONS The therapeutic sequence of regorafenib followed by cetuximab suggests a longer OS than the current standard sequence.
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Affiliation(s)
- K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - T Yamanaka
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - T Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Y Tsuji
- Department of Medical Oncology, Tonan Hospital, Sapporo, Japan
| | - K Shinozaki
- Division of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Y Komatsu
- Division of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Japan
| | - Y Kobayashi
- Department of Medical Oncology, Kushiro Rosai Hospital, Kushiro, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - H Okuda
- Department of Medical Oncology, Keiyukai Sapporo Hospital, Sapporo, Japan
| | - M Asayama
- Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - K Akiyoshi
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Y Kagawa
- Department of Surgery, Kansai Rosa Hospital, Amagasaki, Japan
| | - T Kato
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ando
- School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Y Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
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Kunitani Y, Goto T, Funakoshi H, Okamoto H, Hagiwara Y, Watase H, Hasegawa K. 97 The Association Between Multiple Intubation Attempts and Adverse Events in Pediatric Intubations in the Emergency Department. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.102] [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: 10/28/2022]
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Ishimaru M, Matsui H, Ono S, Hagiwara Y, Morita K, Yasunaga H. Preoperative oral care and effect on postoperative complications after major cancer surgery. Br J Surg 2018; 105:1688-1696. [DOI: 10.1002/bjs.10915] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/26/2018] [Accepted: 05/17/2018] [Indexed: 01/30/2023]
Abstract
Abstract
Background
Improving patients' oral hygiene is an option for preventing postoperative pneumonia that may be caused by aspiration of oral and pharyngeal secretions. Whether preoperative oral care by a dentist can decrease postoperative complications remains controversial. A retrospective cohort study was undertaken to assess the association between preoperative oral care and postoperative complications among patients who underwent major cancer surgery.
Methods
The nationwide administrative claims database in Japan was analysed. Patients were identified who underwent resection of head and neck, oesophageal, gastric, colorectal, lung or liver cancer between May 2012 and December 2015. The primary outcomes were postoperative pneumonia and all-cause mortality within 30 days of surgery. Patient background was adjusted for with inverse probability of treatment weighting using propensity scoring.
Results
Of 509 179 patients studied, 81 632 (16·0 per cent) received preoperative oral care from a dentist. A total of 15 724 patients (3·09 per cent) had postoperative pneumonia and 1734 (0·34 per cent) died within 30 days of surgery. After adjustment for potential confounding factors, preoperative oral care by a dentist was significantly associated with a decrease in postoperative pneumonia (3·28 versus 3·76 per cent; risk difference − 0·48 (95 per cent c.i. −0·64 to−0·32) per cent) and all-cause mortality within 30 days of surgery (0·30 versus 0·42 per cent; risk difference − 0·12 (−0·17 to −0·07) per cent).
Conclusion
Preoperative oral care by a dentist significantly reduced postoperative complications in patients who underwent cancer surgery.
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Affiliation(s)
- M Ishimaru
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - H Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - S Ono
- Department of Biostatistics and Bioinformatics, University of Tokyo, Tokyo, Japan
| | - Y Hagiwara
- Department of Biostatistics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - K Morita
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - H Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
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Yoshino T, Yamanaka T, Denda T, Tsuji Y, Shinozaki K, Komatsu Y, Kobayashi Y, Furuse J, Okuda H, Asayama M, Akiyoshi K, Kagawa Y, Kato T, Oki E, Ando T, Hagiwara Y, Ohashi Y, Shitara K. REVERCE: Randomized phase II study of regorafenib followed by cetuximab versus the reverse sequence for metastatic colorectal cancer patients previously treated with fluoropyrimidine, oxaliplatin, and irinotecan: Quality of life analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.009] [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: 11/13/2022] Open
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Shiroiwa T, Fukuda T, Shimozuma K, Mouri M, Hagiwara Y, Doihara H, Akabane H, Kashiwaba M, Watanabe T, Ohashi Y, Mukai H. Long-term health status as measured by EQ-5D among patients with metastatic breast cancer: comparison of first-line oral S-1 and taxane therapies in the randomized phase III SELECT BC trial. Qual Life Res 2016; 26:445-453. [PMID: 27517267 PMCID: PMC5288429 DOI: 10.1007/s11136-016-1388-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 12/29/2022]
Abstract
Purpose The goal of chemotherapy for metastatic breast cancer (MBC) is to prolong survival and maintain health-related quality of life. This study aimed to evaluate long-term health status of patients with MBC who participated in the phase III randomized SELECT BC trial. Methods In the SELECT BC trial, patients were randomly allocated to the S-1 or taxane (paclitaxel or docetaxel) arm. Health status was assessed by EQ-5D at pre-treatment, 3 and 6 months after randomization, and every 6 months thereafter to the extent possible. Least square mean scores were assessed to compare EQ-5D index values between groups. Time to deterioration analysis was also performed by defining the minimally important difference of EQ-5D as 0.05 or 0.1. Results The number of patients for EQ-5D analysis was 175 and 208 in the taxane and S-1 arms, respectively. Least square mean EQ-5D index values up to 60 months were 0.741 (95 % CI [0.713–0.769]) in the taxane arm and 0.748 [0.722–0.775] in the S-1 arm. The EQ-5D index value during PFS up to 12 months in the S-1 was superior to the corresponding index value in the taxane (0.812 [0.789–0.834] vs. 0.772 [0.751–0.792], P = 0.009). Time to deterioration analysis also revealed that S-1 significantly delayed the deterioration of EQ-5D index value during the period before progression (P = 0.002 and 0.003). Conclusions Our findings suggest that the EQ-5D index value was higher in patients treated with S-1 during first-line chemotherapy. Considering non-inferiority of S-1 in terms of OS, obtained quality-adjusted life years may be greater in the S-1 arm.
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Affiliation(s)
- T Shiroiwa
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - T Fukuda
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - K Shimozuma
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - M Mouri
- Kanagawa Academy of Science and Technology (KAST), 3-2-1 Sakado, Takatsu-ku, Kawasaki, Kanagawa, 213-0012, Japan
| | - Y Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - H Doihara
- Breast and Endocrine Surgery Department, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - H Akabane
- Department of Surgery, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, 24-111 Ichijo dori, Asahikawa, Hokkaido, 078 8211, Japan
| | - M Kashiwaba
- Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - T Watanabe
- Department of Breast Surgery, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo, 112-8551, Japan
| | - H Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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Goto T, Gibo K, Hagiwara Y, Okubo M, Brown D, Brown C, Hasegawa K. 18 Factors Associated With First-Pass Success in Pediatric Intubation in the Emergency Department: An Analysis of Multicenter Prospective Observational Study. Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.047] [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: 11/16/2022]
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Hagiwara Y, Dyment N, Jiang X, Huang J, Ackert-Bicknell C, Adams D, Rowe D. Fixation stability dictates the differentiation pathway of periosteal progenitor cells in fracture repair. J Orthop Res 2015; 33:948-56. [PMID: 25639792 PMCID: PMC4891973 DOI: 10.1002/jor.22816] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 12/02/2014] [Accepted: 12/19/2014] [Indexed: 02/04/2023]
Abstract
This study compared fracture repair stabilized by intramedullary pin (IMP) or external fixation (EF) in GFP reporter mice. A modified IMP was used as control while EF utilized six needles inserted transversely through the tibia and into a segment of a syringe barrel. X-rays taken at days 0, 14, and 35 showed that IMP resulted in significant three-dimensional deformity with a large callus while EF showed minimal deformity and callus formation. Cryohistological analysis of IMP at day 14 confirmed a large ColX-RFPchry+ callus surrounded by woven bone (Col3.6-GFPcyan) and TRAP+ osteoclasts with mature bone (hOC-GFPtpz) at the base. By day 35, cartilaginous components had been resorbed and an outer cortical shell (OCS) showed evidence of inward modeling. In contrast, the EF at day 14 showed no evidence of cartilage formation. Instead, periosteal-derived osteoblasts (Col3.6-GFPcyan) entered the fracture cleft and formed woven bone that spanned the marrow space. By day 35, mature bone had formed that was contiguous with the opposing cortical bone. Fracture site stability greatly affects the cellular response during repair and must be considered in the preclinical models that test therapies for improving fracture healing.
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Affiliation(s)
- Y. Hagiwara
- Department of Orthopedic Surgery, Nippon Medical School Hospital, Tokyo 113, JAPAN
| | | | | | | | - C. Ackert-Bicknell
- Dept. Orthopaedics and Rehabilitation, Center for Musculoskeletal Research, University of Rochester School of Medicine, Rochester, NY 14642
| | - D.J. Adams
- Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06030
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Dyment N, Hagiwara Y, Jiang X, Huang J, Adams D, Rowe D. Response of knee fibrocartilage to joint destabilization. Osteoarthritis Cartilage 2015; 23:996-1006. [PMID: 25680653 PMCID: PMC4757847 DOI: 10.1016/j.joca.2015.01.017] [Citation(s) in RCA: 18] [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: 07/03/2014] [Revised: 01/16/2015] [Accepted: 01/28/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE A major challenge to understanding osteoarthritis (OA) pathology is identifying the cellular events that precede the onset of cartilage damage. The objective of this study is to determine the effect of joint destabilization on early changes to fibrocartilage in the joint. DESIGN/METHODS The anterior cruciate ligament was transected in collagen reporter mice (Col1CFP and ColXRFP). Mineralization labels were given every 2 weeks to measure new mineralized cartilage apposition. Novel fluorescent histology of mineralized tissue was used to characterize the changes in fibrocartilage at 2 and 4 weeks post-injury. RESULTS Changes in fibrocartilaginous structures of the joint occur as early as 2 weeks after injury and are well developed by 4 weeks. The alterations are seen in multiple entheses and in the medial surface of the femoral and tibial condyles. In the responding entheses, mineral apposition towards the ligament midsubstance results in thickening of the mineralize fibrocartilage. These changes are associated with increases in ColX-RFP, Col1-CFP reporter activity and alkaline phosphatase enzyme activity. Mineral apposition also occurs in the fibrocartilage of the non-articular regions of the medial condyles by 2 weeks and develops into osteophytes by 4 weeks post-injury. An unexpected observation is punctate expression of tartrate resistant acid phosphatase activity in unmineralized fibrochondrocytes adjacent to active appositional mineralization. DISCUSSION These observations suggest that fibrocartilage activates prior to degradation of the articular cartilage. Thus clinical and histological imaging of fibrocartilage may be an earlier indicator of disease initiation and may indicate a more appropriate time to start preventative treatment.
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Affiliation(s)
- N.A Dyment
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
| | - Y. Hagiwara
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032,Department of Orthopedic Surgery, Nippon Medical School Hospital, Tokyo 113, JAPAN
| | - X. Jiang
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
| | - J. Huang
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
| | - D.J. Adams
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
| | - D.W. Rowe
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
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Hagiwara Y, Kamisaka K, Sakui D, Adachi T, Nakane E, Inoko M, Yamada S. Physical performance is a related factor in cognitive impairment in elderly patients with heart failure. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3302] [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: 11/15/2022]
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Ide K, Yamada H, Umegaki K, Mizuno K, Kawakami N, Hagiwara Y, Matsumoto M, Yoshida H, Kim K, Shiosaki E, Yokochi T, Harada K. PP273-MON: Outstanding abstract: Lymphocyte and Plasma Vitamin Levels as Potential Biomarkers for Parkinson’s Disease Progression. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50607-3] [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: 10/24/2022]
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Morino T, Ookawa K, Haruta N, Hagiwara Y, Seki M. Effects of professional oral health care on elderly: randomized trial. Int J Dent Hyg 2014; 12:291-7. [PMID: 24502652 DOI: 10.1111/idh.12068] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To better understand the role of the professional oral health care for elderly in improving geriatric oral health, the effects of short-term professional oral health care (once per week for 1 month) on oral microbiological parameters were assessed. METHODS Parallel, open-labelled, randomize-controlled trial was undertaken in a nursing home for elderly in Shizuoka, Japan. Thirty-four dentate elderly over 74 years were randomly assigned from ID number to the intervention (17/34) and control (17/34) groups. The outcomes were changes in oral microbiological parameters (number of bacteria in unstimulated saliva; whole bacteria, Streptococcus, Fusobacterium and Prevotella: opportunistic pathogens detection: and index of oral hygiene evaluation [Dental Plaque Index, DPI]) within the intervention period. Each parameter was evaluated at before and after intervention period. Four elderly were lost from mortality (1), bone fracture (1), refused to participate (1) and multi-antibiotics usage (1). Finally, 30 elderly were analysed (14/intervention and 16/control). RESULTS At baseline, no difference was found between the control and intervention groups. After the intervention period, the percentage of Streptococcus species increased significantly in the intervention group (Intervention, 86% [12/14]; Control, 50% [8/16]: Fisher's, right-tailed, P < 0.05). Moreover, DPI significantly improved in the intervention group (Intervention, 57% [8/14]; Control, 13% [2/16]: Fisher's, two-tailed, P < 0.05). The improvement in DPI extended for 3 months after intervention. None of side effects were reported. CONCLUSION The short-term professional oral health care can improve oral conditions in the elderly.
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Affiliation(s)
- T Morino
- University of Shizuoka, Junior College, Shizuoka, Japan
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Aghi M, Vogelbaum MA, Jolly DJ, Robbins JM, Ostertag D, Ibanez CE, Gruber HE, Kasahara N, Bankiewicz K, Cloughesy TF, Chang SM, Butowski N, Kesari S, Chen C, Mikkelsen T, Landolfi J, Chiocca EA, Elder JB, Foltz G, Pertschuk D, Anaizi A, Taylor C, Kosty J, Zimmer L, Theodosopoulos P, Anaizi A, Gantwerker E, Pensak M, Theodosopoulos P, Anaizi A, Grewal S, Theodosopoulos P, Zimmer L, Anaizi A, Pensak M, Theodosopoulos P, Arakawa Y, Kang Y, Murata D, Fujimoto KI, Miyamoto S, Blagia M, Paulis M, Orunesu G, Serra S, Akers J, Ramakrishnan V, Kim R, Skog J, Nakano I, Pingle S, Kalinina J, Kesari S, Breakfield X, Hochberg F, Van Meir E, Carter B, Chen C, Czech T, Nicholson J, Frappaz D, Kortmann RD, Alapetite C, Garre ML, Ricardi U, Saran F, Calaminus G, Hamer PDW, Hendriks E, Mandonnet E, Barkhof F, Zwinderman K, Duffau H, Esquenazi Y, Johnson J, Tandon N, Esquenazi Y, Friedman E, Lin Y, Zhu JJ, Tandon N, Fujimaki T, Kobayashi M, Wakiya K, Ohta M, Adachi J, Fukuoka K, Suzuki T, Yanagisawa T, Matsutani M, Mishima K, Sasaki J, Nishikawa R, Hoffermann M, Bruckmann L, Ali KM, Asslaber M, Payer F, von Campe G, Jungk C, Beigel B, Abb V, Herold-Mende C, Unterberg A, Kim JH, Cho YH, Kim CJ, Mardor Y, Nissim O, Grober Y, Guez D, Last D, Daniels D, Hoffmann C, Nass D, Talianski A, Spiegelmann R, Cohen Z, Zach L, Marupudi N, Mittal S, Michaud K, Cantin L, Cottin S, Dandurand C, Mohammadi A, Hawasli A, Rodriguez A, Schroeder J, Laxton A, Elson P, Tatter S, Barnett G, Leuthardt E, Moriuchi S, Dehara M, Fukunaga T, Hagiwara Y, Soda H, Imakita M, Nitta M, Maruyama T, Iseki H, Ikuta S, Tamura M, Chernov M, Okamoto S, Okada Y, Muragaki Y, Ohue S, Kohno S, Inoue A, Yamashita D, Kumon Y, Ohnishi T, Oppido P, Villani V, Vidiri A, Pace A, Pompili A, Carapella C, Orringer D, Lau D, Niknafs Y, Piquer J, Llacer JL, Rovira V, Riesgo P, Cremades A, Rotta R, Levine N, Prabhu S, Sawaya R, Weinberg J, Rao G, Tummala S, Tilley C, Rovin R, Kassam A, Schwartz C, Romagna A, Thon N, Tonn JC, Schwarz SB, Kreth FW, Sonoda Y, Shibahara I, Saito R, Kanamori M, Kumabe T, Tominaga T, Steele C, Lawrence J, Rovin R, Winn R, Rachinger W, Simon M, Dutzmann S, Feigl G, Kremenevskaya N, Thon N, Tonn JC, Whelan H, Kelly M, Jogel S, Kaufmann B, Foy A, Lew S, Quirk B, Yong RL, Wu T, Mihatov N, Shen MJ, Brown MA, Zaghloul KA, Park GE, Park JK. SURGICAL THERAPIES. Neuro Oncol 2013; 15:iii217-iii225. [PMCID: PMC3823906 DOI: 10.1093/neuonc/not191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
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Hagiwara Y, Yanagisawa T, Atsumi C, Maki F, Shimizu T, Hasegawa Y. Cyclophosphamide-responsive cerebral amyloid angiopathy-related inflammation. A case report and review of the literature. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kawashiro S, Nomiya T, Hagiwara Y, Ota I, Ichikawa M, Kuroda Y, Murakami M, Nemoto K. Verification of Respiratory Position Reproducibility With a Respiration Self-Monitoring Device: Results for 12 Patients With Lung Tumors. Pract Radiat Oncol 2013; 3:S16. [DOI: 10.1016/j.prro.2013.01.058] [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: 10/27/2022]
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Nakajima M, Miyajima M, Ogino I, Watanabe M, Hagiwara Y, Segawa T, Kobayashi K, Arai H. Brain localization of leucine-rich α2-glycoprotein and its role. Acta Neurochir Suppl 2012; 113:97-101. [PMID: 22116432 DOI: 10.1007/978-3-7091-0923-6_20] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES We have previously reported that the level of leucine-rich alpha-2-glycoprotein (LRG) expression is specifically increased in cerebrospinal fluid (CSF) of idiopathic normal pressure hydrocephalus (INPH). The objective of this study is to examine the localization of LRG - the cerebral areas where it is expressed. METHOD The histological sections of autopsied brain specimens from ten subjects, five adult cases (mean age 43.6 years; range 34-50 years) and five senile cases (mean age 76.0 years; range 67-88 years) were prepared, multistained with antibodies against human LRG, glial fibrillary acidic protein (GFAP), CD31, and aquaporin-4 (AQP4), and reviewed for the expression sites of LRG. RESULTS Immunostains of GFAP and LRG were compared in standard brain specimens from elderly patients. The results indicated that LRG is distributed throughout the entire brain, with especially high expression in the deep cerebral cortex. In addition, the cells that express LRG showed similar morphology to astrocytes. Double staining of CD31 and LRG revealed a significant expression of LRG in the pericapillary regions. The expression was observed in resident astrocytes, as well as in the capillary vessel to which astrocytic processes grow and adhere. When age-related comparisons were made between senile and adult specimens, LRG expression increased with age. CONCLUSION LRG expression in resident astrocytes increased with age.
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Affiliation(s)
- Madoka Nakajima
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan.
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Hasegawa K, Hagiwara Y, Chiba T, Watase H, Brown C, Walls R, Brown D. 380 Emergency Airway Management in Japan: Interim Analysis of a Multi-Center Prospective Observational Study. Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.412] [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: 11/29/2022]
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25
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Wada K, Hagiwara Y, Fukuyama K. One residue substitution in PcyA leads to unexpected changes in tetrapyrrole substrate binding. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311079876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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26
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Yoshino N, Kanekiyo M, Hagiwara Y, Okamura T, Someya K, Matsuo K, Ami Y, Sato S, Yamamoto N, Honda M. Intradermal delivery of recombinant vaccinia virus vector DIs induces gut-mucosal immunity. Scand J Immunol 2010; 72:98-105. [PMID: 20618768 DOI: 10.1111/j.1365-3083.2010.02416.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Antigen-specific mucosal immunity is generally induced by the stimulation of inductive mucosal sites. In this study, we found that the replication-deficient vaccinia virus vector, DIs, generates antigen-specific mucosal immunity and systemic responses. Following intradermal injection of recombinant DIs expressing simian immunodeficiency virus gag (rDIsSIVgag), we observed increased levels of SIV p27-specific IgA and IgG antibodies in faecal extracts and plasma samples, and antibody-forming cells in the intestinal mucosa and spleen of C57BL/6 mice. Antibodies against p27 were not detected in nasal washes, saliva, and vaginal washes. The enhanced mucosal and systemic immunity persisted for 1 year of observation. Induction of Gag-specific IFN-gamma spot-forming CD8(+) T cells in the spleen, small intestinal intraepithelial lymphocytes, and submandibular lymph nodes was observed in the intradermally injected mice. Heat-inactivated rDIsSIVgag rarely induced antigen-specific humoral and T-helper immunity. Moreover, rDIsSIVgag was detected in MHC class II IA antigen-positive (IA(+)) cells at the injection site. Consequently, intradermal delivery of rDIs effectively induces antigen-specific humoral and cellular immunity in gut-mucosal tissues of mice. Our data suggest that intradermal injection of an rDIs vaccine may be useful against mucosally transmitted pathogens.
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Affiliation(s)
- N Yoshino
- Department of Microbiology, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan.
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Wada T, Hagiwara A, Sasaki R, Sato T, Kobayashi K, Inaka A, Sakamoto T, Hagiwara Y, Inagaki T, Katsuno K, Takegawa R, Kimura A. Can follow-up procalcitonin measurements shorten the periods of antibiotic administrations for septic patients? Crit Care 2010. [PMCID: PMC2934230 DOI: 10.1186/cc8276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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28
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Yuki Y, Tokuhara D, Nochi T, Yasuda H, Mejima M, Kurokawa S, Takahashi Y, Kataoka N, Nakanishi U, Hagiwara Y, Fujihashi K, Takaiwa F, Kiyono H. Oral MucoRice expressing double-mutant cholera toxin A and B subunits induces toxin-specific neutralising immunity. Vaccine 2009; 27:5982-8. [DOI: 10.1016/j.vaccine.2009.07.071] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 07/10/2009] [Accepted: 07/22/2009] [Indexed: 10/20/2022]
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29
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Yoshino N, Fujihashi K, Hagiwara Y, Kanno H, Takahashi K, Kobayashi R, Inaba N, Noda M, Sato S. Co-administration of cholera toxin and apple polyphenol extract as a novel and safe mucosal adjuvant strategy. Vaccine 2009; 27:4808-17. [DOI: 10.1016/j.vaccine.2009.05.081] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Accepted: 05/28/2009] [Indexed: 01/24/2023]
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30
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Yoshino N, Kanekiyo M, Hagiwara Y, Okamura T, Someya K, Matsuo K, Ami Y, Sato S, Yamamoto N, Honda M. Mucosal Administration of Completely Non-Replicative Vaccinia Virus Recombinant Dairen I strain Elicits Effective Mucosal and Systemic Immunity. Scand J Immunol 2008; 68:476-83. [DOI: 10.1111/j.1365-3083.2008.02168.x] [Citation(s) in RCA: 2] [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: 11/28/2022]
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31
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Hagiwara Y, Sugishima M, Khawn H, Kinoshita H, Inomata K, Shang L, Lagarias J, Takahashi Y, Fukuyama K. Snapshots in the reaction pathway of bilin reductase PcyA. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308092143] [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: 11/11/2022] Open
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32
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Takagi Y, Kobayashi T, Shiono M, Wang L, Piao X, Sun G, Zhang D, Abe M, Hagiwara Y, Takahashi K, Hino O. Interaction of folliculin (Birt-Hogg-Dubé gene product) with a novel Fnip1-like (FnipL/Fnip2) protein. Oncogene 2008; 27:5339-47. [PMID: 18663353 DOI: 10.1038/onc.2008.261] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Birt-Hogg-Dubé (BHD) syndrome is characterized by the development of pneumothorax, hair folliculomas and renal tumors and the responsible BHD gene is thought to be a tumor suppressor. The function of folliculin (Flcn), encoded by BHD, is totally unknown, although its interaction with Fnip1 has been reported. In this study, we identified a novel protein binding to Flcn, which is highly homologous to Fnip1, and which we named FnipL (recently reported in an independent study as Fnip2). The interaction between FnipL/Fnip2 and Flcn may be mediated mainly by the C-terminal domains of each protein as is the case for the Flcn-Fnip1 interaction. FnipL/Fnip2 and Flcn were located together in the cytoplasm in a reticular pattern, although solely expressed Flcn was found mainly in the nucleus. Cytoplasmic retention of Flcn was canceled with C-terminal truncation of FnipL/Fnip2, suggesting that FnipL/Fnip2 regulates Flcn distribution through their complex formation. By the employment of siRNA, we observed a decrease in S6K1 phosphorylation in the BHD-suppressed cell. We also observed a decrease in S6K1 phosphorylation in FNIP1- and, to a lesser extent, in FNIPL/FNIP2-suppressed cells. These results suggest that Flcn-FnipL/Fnip2 and Flcn-Fnip1 complexes positively regulate S6K1 phosphorylation and that FnipL/Fnip2 provides an important clue to elucidating the function of Flcn and the pathogenesis of BHD.
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Affiliation(s)
- Y Takagi
- Department of Pathology and Oncology, Juntendo University School of Medicine, Bunkyo-Ku, Tokyo, Japan
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Yonemoto T, Ishii T, Takeuchi Y, Kimura K, Hagiwara Y, Tatezaki S. Education and Employment in Long-Term Survivors of High-Grade Osteosarcoma: A Japanese Single-Center Experience. Oncology 2008; 72:274-8. [DOI: 10.1159/000113038] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2007] [Accepted: 07/20/2007] [Indexed: 12/18/2022]
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Abstract
We report a case of endometriosis in the right inguinal region, attached to the right round ligament in a 28-year-old woman. At the age of 20, laparoscopic left ovarian cystectomy and pelvic adhesiolysis for endometriosis was carried out. She noticed a right tender groin mass 7 months previously, and the tumour size fluctuated with the menstrual cycle. A poorly circumscribed elastic hard mass, measuring 3 cm in diameter, was palpated in her right inguinal region. Magnetic resonance imaging showed a 2.5 cm x 2.5 cm mass in the right inguinal canal and a 5.4 cm x 6.8 cm mass was seen in the left ovary. The mass enlarged during menstruation. The groin mass was removed, in addition to carrying out laparoscopic ovarian cystectomy. At operation, the groin mass was found to be in continuity with the round ligament of extraperitoneal portion. Histological diagnosis of endometriosis was made in both ovarian and inguinal tumours. After surgery, the pain disappeared completely. Worth mentioning is that MRI clearly showed the change of tumour size depending on the menstrual cycle, which aided in arriving at the correct diagnosis of endometriosis in an unusual location.
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Affiliation(s)
- Y Hagiwara
- Departments of Orthopedic Surgery, Tohoku University School of Medicine, Sendai, Japan
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Hagiwara Y, Kawamura YI, Kataoka K, Rahima B, Jackson RJ, Komase K, Dohi T, Boyaka PN, Takeda Y, Kiyono H, McGhee JR, Fujihashi K. A second generation of double mutant cholera toxin adjuvants: enhanced immunity without intracellular trafficking. J Immunol 2006; 177:3045-54. [PMID: 16920941 PMCID: PMC4469177 DOI: 10.4049/jimmunol.177.5.3045] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Nasal application of native cholera toxin (nCT) as a mucosal adjuvant has potential toxicity for the CNS through binding to GM1 gangliosides in the olfactory nerves. Although mutants of cholera toxin (mCTs) have been developed that show mucosal adjuvant activity without toxicity, it still remains unclear whether these mCTs will induce CNS damage. To help overcome these concerns, in this study we created new double mutant CTs (dmCTs) that have two amino acid substitutions in the ADP-ribosyltransferase active center (E112K) and COOH-terminal KDEL (E112K/KDEV or E112K/KDGL). Confocal microscopic analysis showed that intracellular localization of dmCTs differed from that of mCTs and nCTs in intestinal epithelial T84 cells. Furthermore, both dmCTs exhibited very low toxicity in the Y1 cell assay and mouse ileal loop tests. When mucosal adjuvanticity was examined, both dmCTs induced enhanced OVA-specific immune responses in both mucosal and systemic lymphoid tissues. Interestingly, although both dmCT E112K/KDEV and dmCT E112K/KDGL showed high Th2-type and significant Th1-type cytokine responses by OVA-specific CD4+ T cells, dmCT E112K/KDEV exhibited significantly lower Th1-type cytokine responses than did nCT and dmCT E112K/KDGL. These results show that newly developed dmCTs retain strong biological adjuvant activity without CNS toxicity.
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Affiliation(s)
- Yukari Hagiwara
- Department of Pediatric Dentistry and Microbiology, Immunobiology Vaccine Center, University of Alabama at Birmingham, Birmingham, AL 35294
- Department of Research Center for Biologicals, Kitasato Institute, Saitama, Japan
| | - Yuki I. Kawamura
- Department of Gastroenterology, Research Institute, International Medical Center of Japan, Tokyo, Japan
| | - Kosuke Kataoka
- Department of Pediatric Dentistry and Microbiology, Immunobiology Vaccine Center, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Bibi Rahima
- Department of Pediatric Dentistry and Microbiology, Immunobiology Vaccine Center, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Raymond J. Jackson
- Department of Pediatric Dentistry and Microbiology, Immunobiology Vaccine Center, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Katsuhiro Komase
- Department of Research Center for Biologicals, Kitasato Institute, Saitama, Japan
| | - Taeko Dohi
- Department of Gastroenterology, Research Institute, International Medical Center of Japan, Tokyo, Japan
| | - Prosper N. Boyaka
- Department of Pediatric Dentistry and Microbiology, Immunobiology Vaccine Center, University of Alabama at Birmingham, Birmingham, AL 35294
| | | | - Hiroshi Kiyono
- Department of Pediatric Dentistry and Microbiology, Immunobiology Vaccine Center, University of Alabama at Birmingham, Birmingham, AL 35294
- Division of Mucosal Immunology, Department of Microbiology and Immunology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Jerry R. McGhee
- Department of Pediatric Dentistry and Microbiology, Immunobiology Vaccine Center, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Kohtaro Fujihashi
- Department of Pediatric Dentistry and Microbiology, Immunobiology Vaccine Center, University of Alabama at Birmingham, Birmingham, AL 35294
- Address correspondence and reprint requests to Dr. Kohtaro Fujihashi, Department of Pediatric Dentistry, Immunobiology Vaccine Center, University of Alabama at Birmingham, 761 Bevill Biomedical Research Building, 845 19th Street South, Birmingham, AL 35294-2170.
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36
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Hagiwara Y, Fujita M, Imamura M, Noguchi S, Sasaoka T. Caveolin-3 deficiency decreases the gene expression level of osteopontin in mdx mouse skeletal muscle. Acta Myol 2006; 25:53-61. [PMID: 18593005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Caveolin-3 is a muscle-specific membrane protein that serves as a scaffold of various molecules. As previously reported, caveolin-3 deficiency causes muscle degeneration in mice. In the present study, gene expression profiles, analyzed in the skeletal muscles of caveolin-3 deficient mice using the DNA microarray technique, showed that the gene of osteopontin, a versatile regulator of inflammation and tissue repair, was significantly down-regulated. This is in contrast to mdx mice showing a markedly up-regulated osteopontin gene in their skeletal muscles. Recently, osteopontin has been reported to be important in the pathogenesis of muscular dystrophy. We examined whether up-regulated osteopontin gene expression in mdx muscles is altered by the deficiency of caveolin-3. To this end, we developed caveolin-3 and dystrophin double-deficient mice and used them for the analysis. Levels of osteopontin mRNA and protein in the double-deficient mice clearly decreased compared with those in mdx mice.
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Affiliation(s)
- Y Hagiwara
- National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
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37
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Hino O, Shiomo K, Hagiwara Y, Segawa T, Maeda M. 158 Serum tumor marker of human asbestos-related mesothelioma: Translational research from a hereditary rat cancer model. Lung Cancer 2006. [DOI: 10.1016/s0169-5002(07)70234-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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38
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Shiomi K, Hagiwara Y, Segawa T, Maeda M, Miyamoto H, Takahasi K, Sakao Y, Sakuraba M, Hino O. 159 Re-evaluation of plasma osteopontin as a tumor marker for mesothelioma. Lung Cancer 2006. [DOI: 10.1016/s0169-5002(07)70235-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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39
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Aoyama H, Hagiwara Y, Misumi O, Kuroiwa T, Nakamura S. Complete elimination of maternal mitochondrial DNA during meiosis resulting in the paternal inheritance of the mitochondrial genome in Chlamydomonas species. Protoplasma 2006; 228:231-42. [PMID: 16838082 DOI: 10.1007/s00709-006-0155-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2005] [Accepted: 07/27/2005] [Indexed: 05/10/2023]
Abstract
The non-Mendelian inheritance of organellar DNA is common in most plants and animals. In the isogamous green alga Chlamydomonas species, progeny inherit chloroplast genes from the maternal parent, as paternal chloroplast genes are selectively eliminated in young zygotes. Mitochondrial genes are inherited from the paternal parent. Analogically, maternal mitochondrial DNA (mtDNA) is thought to be selectively eliminated. Nevertheless, it is unclear when this selective elimination occurs. Here, we examined the behaviors of maternal and paternal mtDNAs by various methods during the period between the beginning of zygote formation and zoospore formation. First, we observed the behavior of the organelle nucleoids of living cells by specifically staining DNA with the fluorochrome SYBR Green I and staining mitochondria with 3,3'-dihexyloxacarbocyanine iodide. We also examined the fate of mtDNA of male and female parental origin by real-time PCR, nested PCR with single zygotes, and fluorescence in situ hybridization analysis. The mtDNA of maternal origin was completely eliminated before the first cell nuclear division, probably just before mtDNA synthesis, during meiosis. Therefore, the progeny inherit the remaining paternal mtDNA. We suggest that the complete elimination of maternal mtDNA during meiosis is the primary cause of paternal mitochondrial inheritance.
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Affiliation(s)
- H Aoyama
- Laboratory of Cell and Functional Biology, Faculty of Science, University of the Ryukyus, Nishihara, Okinawa, Japan.
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40
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van Ginkel FW, Jackson RJ, Yoshino N, Hagiwara Y, Metzger DJ, Connell TD, Vu HL, Martin M, Fujihashi K, McGhee JR. Enterotoxin-based mucosal adjuvants alter antigen trafficking and induce inflammatory responses in the nasal tract. Infect Immun 2005; 73:6892-902. [PMID: 16177369 PMCID: PMC1230900 DOI: 10.1128/iai.73.10.6892-6902.2005] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The safety of nasal vaccines containing enterotoxin-based mucosal adjuvants has not been studied in detail. Previous studies have indicated that native cholera toxin (nCT) can alter antigen trafficking when applied nasally. In this study, we determined the enterotoxin-based variables that alter antigen trafficking. To measure the influence of enterotoxin-based mucosal adjuvants on antigen trafficking in the nasal tract, native and mutant enterotoxins were coadministered with radiolabeled tetanus toxoid (TT). The nCT and heat-labile enterotoxin type 1 (LTh-1) redirected TT into the olfactory neuroepithelium (ON/E). Antigen redirection occurred mainly across the nasal epithelium without subsequent transport along olfactory neurons into the olfactory bulbs (OB). Thus, no significant accumulation of the vaccine antigen TT was observed in the OB when coadministered with nCT. In contrast, neither mutant CT nor mutant LTh-1, which lack ADP-ribosyltransferase activity, redirected TT antigen into the ON/E. Thus, ADP-ribosyltransferase activity was essential for antigen trafficking across the olfactory epithelium. Accumulation of TT in the ON/E was also due to B-subunit binding to GM1 gangliosides, as was demonstrated (i) by redirection of TT by LTh-1 in a dose-dependent manner, (ii) by ganglioside inhibition of the antigen redirection by LTh-1 and nCT, and (iii) by the use of LT-IIb, a toxin that binds to gangliosides other than GM1. Redirection of TT into the ON/E coincided with elevated production of interleukin 6 (IL-6) but not IL-1beta or tumor necrosis factor alpha in the nasal mucosa. Thus, redirection of TT is dependent on ADP-ribosyltransferase activity and GM1 binding and is associated with production of the inflammatory cytokine IL-6.
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Affiliation(s)
- Frederik W van Ginkel
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL 36849, USA.
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41
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Hagiwara Y, Sugishima M, Takahashi Y, Fukuyama K. Crystal structure of PcyA-biliverdin IXα complex. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305091737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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42
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Sugishima M, Hagiwara Y, Migita CT, Zhang X, Yoshida T, Fukuyama K. Crystal structures of cyanobacterial heme oxygenases. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305090926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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43
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Kondo T, Mori K, Hagiwara Y, Kodama T. P-256 Results of low-dose multi-detector CT screening for lung cancerover a period of 4 years. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80750-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Yoshino N, Lü FXS, Fujihashi K, Hagiwara Y, Kataoka K, Lu D, Hirst L, Honda M, van Ginkel FW, Takeda Y, Miller CJ, Kiyono H, McGhee JR. A novel adjuvant for mucosal immunity to HIV-1 gp120 in nonhuman primates. J Immunol 2005; 173:6850-7. [PMID: 15557179 DOI: 10.4049/jimmunol.173.11.6850] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The development of a safe and effective mucosal adjuvant is a crucial step toward a mucosal HIV/AIDS vaccine. This study seeks to determine the promise of a nontoxic mutant of cholera toxin (mCT; E112K) as a mucosal adjuvant in nonhuman primates. HIV-1 gp120 was nasally administered together with mCT E112K or native CT (nCT) as adjuvant on five to six occasions over a 6- to 8-wk period to groups of four rhesus macaques and alone to two monkeys that acted as controls. Macaques given nasal gp120 with either mCT E112K or nCT showed elevated gp120-specific IgG and IgA Ab responses with virus-neutralizing activity in both their plasma and mucosal external secretions, as well as higher numbers of gp120-specific IgA Ab-forming cells in their mucosal and peripheral lymphoid tissues and of IL-4-producing Th2-type CD4-positive (CD4(+)) T cells than did controls. Even though significant mucosal adjuvanticity was seen with both mCT E112K and nCT, neuronal damage was observed only in the nCT-treated, but not in the control or mCT E112K-treated groups. These results clearly show that mCT E112K is an effective and safe mucosal adjuvant for the development of a nasal HIV/AIDS vaccine.
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Affiliation(s)
- Naoto Yoshino
- Department of Oral Biology and Microbiology, Immunobiology Vaccine Center, University of Alabama, Birmingham, AL 35294, USA
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46
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Watanabe I, Hagiwara Y, Kadowaki SE, Yoshikawa T, Komase K, Aizawa C, Kiyono H, Takeda Y, McGhee JR, Chiba J, Sata T, Kurata T, Tamura SI. Characterization of protective immune responses induced by nasal influenza vaccine containing mutant cholera toxin as a safe adjuvant (CT112K). Vaccine 2003; 20:3443-55. [PMID: 12297389 DOI: 10.1016/s0264-410x(02)00351-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Immune responses induced by a nasal influenza vaccine with a mutant cholera toxin (CT112K), known to be a safe adjuvant, were characterized in BALB/c mice to confirm the most suitable regimen of this vaccine for humans. Mice received a primary intranasal administration of the adjuvant (0.1 micro g)-combined PR8 vaccine (0.1 micro g) and a secondary administration of the PR8 vaccine alone (0.1 micro g) 4 weeks later. Two weeks after the secondary immunization, the mice were infected with a nonlethal or a lethal dose of PR8 viruses. Nasal and lung wash virus titers 1 or 3 days after infection indicated that complete protection could be provided by secondary immune responses, which had an immediate effect of preventing infection 2 weeks after the secondary immunization. In this two-dose regimen, high levels of secondary IgA, IgG and IgM antibody-forming cell (AFC) responses were induced in the nasal-associated lymphoid tissue and the spleen. In parallel with the AFC responses, high levels of nasal wash anti-PR8 HA IgA, and lung and serum IgG antibody (Ab) responses were induced 2 weeks after the secondary immunization. The two-dose regimen also induced accelerated delayed-type hypersensitivity responses, which exhibited almost the same peak height as that in the case of the primary response. In addition, the two-dose regimen induced a low memory cell activity of cytotoxic T lymphocytes, detected by in vitro culture of spleen cells. Thus, the immediate effect of preventing infection was mainly provided by the secondary Ab responses. Moreover, the levels of nasal wash IgA Abs correlated well with cross-protection against infection with variant viruses in the upper respiratory tract (RT). These results suggest that the major protective factors among Ab and T cell-mediated immune responses, which are induced by the two-dose regimen using CT112K-combined vaccines, are the cross-reactive IgA Abs in the upper RT and the less cross-reactive IgG Abs in the lower RT, and that the two-dose regimen is a suitable vaccination condition for humans.
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Affiliation(s)
- Izumi Watanabe
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
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Hagiwara Y, McGhee JR, Fujihashi K, Kobayashi R, Yoshino N, Kataoka K, Etani Y, Kweon MN, Tamura S, Kurata T, Takeda Y, Kiyono H, Fujihashi K. Protective mucosal immunity in aging is associated with functional CD4+ T cells in nasopharyngeal-associated lymphoreticular tissue. J Immunol 2003; 170:1754-62. [PMID: 12574339 DOI: 10.4049/jimmunol.170.4.1754] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Our previous studies showed that mucosal immunity was impaired in 1-year-old mice that had been orally immunized with OVA and native cholera toxin (nCT) as mucosal adjuvant. In this study, we queried whether similar immune dysregulation was also present in mucosal compartments of mice immunized by the nasal route. Both 1-year-old and young adult mice were immunized weekly with three nasal doses of OVA and nCT or with a nontoxic chimeric enterotoxin (mutant cholera toxin-A E112K/B subunit of native labile toxin) from Brevibacillus choshinensis. Elevated levels of OVA-specific IgG Abs in plasma and secretory IgA Abs in mucosal secretions (nasal washes, saliva, and fecal extracts) were noted in both young adult and 1-year-old mice given nCT or chimeric enterotoxin as mucosal adjuvants. Significant levels of OVA-specific CD4(+) T cell proliferative and OVA-induced Th1- and Th2-type cytokine responses were noted in cervical lymph nodes and spleen of 1-year-old mice. In this regard, CD4(+), CD45RB(+) T cells were detected in greater numbers in the nasopharyngeal-associated lymphoreticular tissues of 1-year-old mice than of young adult mice, but the same did not hold true for Peyer's patches or spleen. One-year-old mice given nasal tetanus toxoid plus the chimeric toxin as adjuvant were protected from lethal challenge with tetanus toxin. This result reinforced our findings that age-associated immune alterations occur first in gut-associated lymphoreticular tissues, and thus nasal delivery of vaccines for nasopharyngeal-associated lymphoreticular tissue-based mucosal immunity offers an attractive possibility to protect the elderly.
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Affiliation(s)
- Yukari Hagiwara
- Department of Oral Biology, Immunobiology Vaccine Center, University of Alabama, 845 19th Street South, Birmingham, AL 35294, USA
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Kato H, Fujihashi K, Kato R, Dohi T, Fujihashi K, Hagiwara Y, Kataoka K, Kobayashi R, McGhee JR. Lack of oral tolerance in aging is due to sequential loss of Peyer's patch cell interactions. Int Immunol 2003; 15:145-58. [PMID: 12578844 DOI: 10.1093/intimm/dxg011] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Our past studies showed that Peyer's patches were required for the induction of oral tolerance to the protein antigen ovalbumin (OVA), but not to the hapten 2,4,6-trinitrobenzene sulfonic acid (TNBS). In the present study, the effects of immunosenescence on oral tolerance induction were assessed with these two toleragens. Significant reductions in OVA-specific serum IgG antibody and CD4(+) T cell responses to subsequent challenge were observed in OVA-fed, young adult mice. Importantly, these reduced anti-OVA antibody responses were associated with delayed-type hypersensitivity, and antigen-induced CD4(+) T(h)1- and T(h)2-type cytokine responses. On the other hand, aged mice fed OVA failed to develop oral tolerance. Thus, CD4(+) T cells from Peyer's patches produced selected T(h)2- but no T(h)1-type cytokines. The TNP-specific serum IgG antibody and T cell responses were significantly diminished by prior TNBS feeding in young adult, 6- to 8-month-old and 12- to 14-month-old, but not in senescent, 2-year-old mice. Finally, we have directly assessed dendritic cell subsets and T cell responses in Peyer's patches, and their function in tolerance induction was impaired at an earlier stage of life. These results suggest that lack of oral tolerance to the protein OVA during aging is the result of dysfunctional Peyer's patches.
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Affiliation(s)
- Hirotomo Kato
- Department of Microbiology, Immunobiology Vaccine Center, University of Alabama at Birmingham, 761 BBRB, 845 19th Street South, Birmingham, AL 35294-2170, USA
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Abstract
In the development of mucosal vaccines, cholera toxin (CT) has been shown to be an effective adjuvant and to induce both mucosal and systemic immune responses via a Th2 cell-dependent pathway. However, a major concern for use of mucosal adjuvants such as CT is that this molecule is not suitable for use in humans because of its innate toxicity. Recent vaccine development efforts have emphasized nasal application of antigen and CT for the induction of mucosal IgA responses. When we examined potential toxicity of CT for the central nervous system (CNS), both CT and CT-B accumulated in the olfactory nerves/epithelium and olfactory bulbs of mice when given by the nasal route. The development of effective mucosal vaccines for the elderly is also an important issue; however, only limited information is available. When mucosal adjuvanticity of CT was evaluated in aged mice, an early immune dysregulation was evident in the mucosal immune system. The present review discusses these potential problems for effective mucosal vaccine development.
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Affiliation(s)
- Kohtaro Fujihashi
- Department of Microbiology, BBRB Room 716, Immunobiology Vaccine Center, University of Alabama at Birmingham, Medical Center, 35294-2170, USA.
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